The Four Stages of Alcoholism

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Alcoholism Stages: The Emotional, Social, and Physical Consequences

Problems With Alcohol. Alcoholism is a progressive degenerative disease that includes the following four symptoms: craving, physical dependence, tolerance, and the loss of control.

Alcoholism is a complex topic that can be better understood when it is studied and assessed via the four alcoholism stages. As one reviews these four stages, it will become clear that one's problems with alcohol become increasingly worse as he or she continues to drink in a hazardous, abusive manner. And keep in mind that when the term "alcoholism" is used, this also means "alcohol addiction," "alcohol dependency," or "alcohol dependence."

Alcoholism Stages: The First Stage

In the first stage of alcoholism, drinking is no longer social but becomes a means of emotional escape from inhibitions, problems, inhibitions.  Stated differently, during the first stage of alcoholism, drinking is, in many instances, a psychological attempt to escape from reality. For instance, early in the disease an individual starts to depend on the mood-altering effects of alcohol.

Another observable characteristic of the first stage of alcoholism is that a slow and gradual increase in tolerance develops, meaning that more and more amounts of alcohol are needed for the individual to "get high" or to "feel the buzz."   For example, it is common for problem drinkers in the first stage of alcoholism to start gulping one or two drinks before attending a social function and then to increase social drinking to 3 to 5 drinks per day.

Stages of Alcoholism: The Second Stage

In the second stage of alcoholism, the need to drink becomes more powerful. For example, it is common during this stage for the problem drinker to start to drink earlier in the day.

As tolerance increases, furthermore, the individual with the drinking problem drinks not because of psychological tension or stress relief, but because of his or her dependence on alcohol.  During this stage of the disease, even though the "loss of control" does not occur on a regular basis, it is, nevertheless, starting to become more noticeable by others such as relatives, family members, neighbors, friends, and co-workers. In other words, as the disease continues, the person's problems with alcohol become worse and more noticeable to others.

Also during this stage of the disease, the problem drinker may begin to feel more concerned and embarrassed about his or her drinking.  Often during this stage, problem drinkers are unsuccessful in their attempts to stop drinking. 

In this stage, physical symptoms such as hangovers, blackouts, hand tremors, and stomach problems increase.  Interestingly, instead of seeing their drinking as the root of the many problems and issues they experience, however, drinkers with a drinking problem in this stage frequently start to blame others and things external to themselves for their difficulties.

Alcoholism Stages: The Third Stage

In the third stage of alcoholism, the loss of control becomes more severe and more observable. This means that problem drinkers are unable to drink in accordance with their intentions.  For example, once the individual takes the first drink, he or she commonly can no longer control further drinking behavior, in spite of the fact that the intent might have been to have just "one or two drinks."  It should be stressed that an important aspect of this stage of the illness is the following: the drinker often starts to experience more serious drinking problems as well as alcohol-related employment, relationship, financial, and legal problems.  

In the third stage of alcoholism, it is common for the problem drinker to start avoiding friends and family and to show a lack of interest in activities and events that once were fun or important.  Also typical during this stage are "eye-openers," that is, drinks that are taken whenever the problem drinker awakens.  Eye-openers are taken mainly to "calm the nerves," lessen a hangover, or to quiet the feelings of remorse the individual occasionally experiences after a period of time without consuming a drink.

As the drinking increases the individual with the drinking problem starts to neglect most things of importance, even necessities such as food, water, personal hygiene, shelter, and personal interaction.  And finally, during this stage, the drinker often makes half-hearted attempts at getting professional medical assistance. 

Stages of Alcoholism: The Fourth Stage

The fourth and last stage of alcoholism is characterized by a chronic loss of control.  In the earlier stages of the illness, the problem drinker may have been successful in maintaining a job.  Due to the fact that drinking during this stage frequently starts earlier in the day and commonly continues throughout the day, however, few, if any, full-time jobs can be maintained under these conditions.

In the earlier stages of the illness, the problem drinker had a choice whether he or she would take the first drink.  After taking the first drink, the drinker typically lost all control and would then continue drinking.  In the last stage of alcoholism, however, alcoholics no longer have a choice:  they need to drink in order to function on a daily basis.

During the fourth stage of alcoholism, benders are typical.  More to the point, in the fourth stage of alcoholism the alcoholic frequently gets helplessly drunk and may remain in this predicament for a number of days or weeks.  The unattainable goal for the drinker while engaging in his or her bender is to experience the "high" they he or she once experienced.

In the second or third stages of alcoholism the drinker's hands may have trembled slightly on mornings after getting drunk the previous night.  In the fourth and last stage of alcoholism, conversely, alcoholics get "the shakes" whenever they attempt or are forced to refrain from drinking. 

These tremors are an indication of a serious nervous disorder that now affects the drinker's entire body.  When "the shakes" are combined with hallucinations, furthermore, the result is known as "the DTs" or delirium tremens. The DTs are a potentially deadly kind of alcoholism withdrawal that almost always takes place unless the alcoholic receives immediate alcoholism treatment.  It may come as no surprise that after an attack of the DTs, more than a few alcoholics promise to never drink again.  Sadly, most of them do not and cannot fulfill their promise.  Consequently, they more often than not return to drinking and the alcoholic drinking patterns and drinking problem start all over again.

The Four Stages of Alcoholism:  Conclusion

From the information discussed above, it can be concluded that the four stages of alcoholism paint a bleak picture for individuals who are alcohol addicted.  Perhaps learning about the destructive and damaging outcomes and the unhealthy nature of alcoholism may not make a much of an impact on most individuals who are already chronically alcohol dependent. 

It is hoped, however, that by exposing the facts about alcohol dependency and about the stages of alcoholism to our youth BEFORE they start consuming alcohol in an abuse and irresponsible manner will prevent many of our teenagers from experiencing the drinking problems and the unhealthy and devastating realities suffered by most alcoholics.

One more thing, it is important to point out that when the term "alcoholism" is used, this also means "alcohol dependence," "alcohol addiction," or "alcohol dependency."

Extra Information

Finding a quality treatment program can be a difficult process.  This is why we are including the following information.

The following toll-free phone number is a number to a call center/treatment center that we are proudly affiliated with. This treatment facility provides top-quality and professional "holistic" drug and alcohol rehab and counseling that addresses virtually every aspect of the person's life.

There is someone at this phone number 24 hours per day, 7 days per week. Please call this number if you have questions about a drug or alcohol problem or if you want some information about quality drug or alcohol treatment. (888) 565-2282

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Help For Alcohol and Drug Abuse

The following toll-free phone number is a number to a call center/treatment center that we are proudly affiliated with. This treatment facility provides top-quality and professional "holistic" drug and alcohol rehab and counseling that addresses virtually every aspect of the person's life.

There is someone at this phone number 24 hours per day, 7 days per week. Please call this number if you have questions about a drug or alcohol problem or if you want some information about quality drug or alcohol treatment. (888) 565-2282

Alcoholism and other Alcohol-Related Quick Facts

Did you know...

Doctor Lost in Thought About an Alcoholism Patient

  • Factors that affect your blood alcohol level include the following: how many drinks you consume, how quickly you consume the alcoholic drink, how much food is in your stomach at the time you drink, how strong the alcoholic drink is, and how quickly your body metabolizes alcohol.

  • Many chronic conditions such as diabetes, depression, hypertension, and asthma require continual care in order for treatment benefits to be sustained. Alcoholism is similar to other chronic diseases in this regard. Additionally, alcohol addiction requires monitoring of patient status on a regular basis, early intervention regarding possible problems, and proper referrals in order to maintain positive treatment effects.

  • According to the 2000 Monitoring the Future study conducted each year for the National Institute on Drug Abuse, 22 percent of U.S. 8th graders say they have consumed alcohol, and 8 percent say they have been drunk within the past year.

  • In the United States during 2004, 16,694 deaths occurred as a result of alcohol-related motor-vehicle accidents. This amount was roughly 39% of all traffic fatalities. This amounts to one alcohol-related death every 31 minutes.

  • Drinkers who experience blackouts usually drink excessively and too quickly, a combination that results in relatively fast increases in a person's blood alcohol concentration. Due to the fact that an alarming number of college students engage in binge drinking, students who engage in this form of college alcohol abuse may be at increased risk for experiencing blackouts.

  • Research shows that alcoholism tends to run in families. If there has ever been a serious drinking problem in your family, you are at high risk of having a regular drinking pattern turn into an uncontrollable addiction before you realize it. If you do have a family history of excessive drinking, it's advisable to minimize your social drinking.

  • Recent U.S. alcohol abuse and drunk driving statistics reveal that alcohol-involved crashes accounted for 46 percent of fatal injury crash costs, 21 percent of nonfatal injury crashes, and 10 percent of property-damage-only crash costs during one calendar year.

  • Fortunately, research is helping to define the barriers that exist in accessing care and achieving recovery from alcohol abuse and alcoholism.

  • Physical alcohol dependence occurs in consistently heavy drinkers. Due to the fact that their bodies have adapted to the presence of alcohol, they suffer alcohol withdrawal symptoms if they abruptly quit drinking.

  • In one U.S. study, the intoxication rate (.08+ BAC) for male drivers involved in fatal crashes was 25%, compared to 12% for female drivers.

  • When it is looked at closely, it can be seen that alcohol abuse can destroy families in a number of different ways. For instance, according to alcoholism research, more than 75% of female victims of nonfatal, domestic violence stated that their assailant had been using drugs or had been drinking. Research also demonstrates that 40% of divorced or separated women lived with or were married to an individual who engaged in excessive, abusive drinking.

  • The most dangerous stage of alcohol withdrawal is called delirium tremens (DTs). About 5% of people withdrawing from alcohol experience DTs. This condition occurs about 48-72 hours after drinking stops.

  • Alcoholism and medical research have discovered that drinking alcohol can be hazardous in smaller amounts if it is consumed along with the following drugs: street drugs such as heroin and opium; sedatives such as tranquilizers and barbiturates; anti-seizure medications such as phenobarbital; and narcotic pain medications such as Codeine, Codeine derivatives, and Darvocet. Not only this, but mixing alcohol and drugs not only compounds the drug and alcohol problems that the abuser experiences, but doing so increases the person's need for professional alcohol and drug treatment.

  • Studies have shown that inpatient detoxification programs are more effective and longer lasting than outpatient detox programs. The important issue here, however, is the following: the more severe the alcohol-related withdrawal symptoms, the more likely that inpatient detox programs should be used.

  • According to the alcohol abuse and alcoholism research literature, approximately 500 million work days are lost each year to alcoholism in the United States.

  • Substance abuse research demonstrates the fact that a man who has more than four drinks per occasion or more than 14 drinks per week is drinking too much. Simply stated: a man who drinks this much is abusing alcohol.

  • Alcoholism statistics demonstrate that you might think you can quit drinking at any time. Many people who have alcohol problems do quit for periods of days, weeks, or even months before they start drinking again. But unless you can consistently keep your drinking under control and not fall back into unhealthy patterns, you need professional help.

  • Stress and anxiety can be temporarily relieved by drinking alcohol, but this may lead to repeated intake and dependence.

  • Alcohol is typically found in the offender, victim or both, in about half of all U.S. homicides and serious assaults, as well as in a high percentage of sex-related crimes, robberies, and incidents of domestic violence, and alcohol-related problems are disproportionately found among both juvenile and adult criminal offenders.

  • Ironically, harmful relationship patterns such as codependency are often continued even after the alcoholic or chemically addicted person becomes 'clean' or sober. Logically, when perceived from the outside, sobriety in the household would seem to lead to a less chaotic domestic living circumstance. When looked at from the inside, however, the co-dependents may be more depressed and unhappy than ever because the earlier balance, no matter how damaging or detrimental, has been upset.

  • The substance abuse research literature demonstrates that classical alcoholism takes about 15 years to develop, but it can happen much quicker in adolescents and young adults.

  • Several U.S. studies have shown that about half of alcoholics who have successfully undergone detoxification will relapse within 6-12 months.

  • Substance abuse research demonstrates the fact that a man who has more than four drinks per occasion or more than 14 drinks per week is drinking too much. Simply stated: a man who drinks this much is abusing alcohol.

  • Telling teens and pre-teens to 'Just Say No' is simply not enough to stop them from drinking. This message neglects the underlying pressures that youth face every day. In fact, this simplistic message not only tends to turn teens off, but it also can become a source of humor for them. Rather than just telling them not to drink, teach them about the harmful effects and about the consequences of underage drinking.

  • Fortunately, research is helping to define the barriers that exist in accessing care and achieving recovery from alcohol abuse and alcoholism.

  • Recent U.S. alcohol abuse and drunk driving statistics reveal that alcohol-involved crashes accounted for 46 percent of fatal injury crash costs, 21 percent of nonfatal injury crashes, and 10 percent of property-damage-only crash costs during one calendar year.

  • According to a 1999 Federal Trade Commission study, alcoholic beverage companies have created more than one hundred internet websites to advertise and promote their products. More than a few of these online advertising efforts have a strong appeal on our youth. For instance, some of these promotional efforts include interactive games and contests.

  • Drinkers who experience blackouts usually drink excessively and too quickly, a combination that results in relatively fast increases in a person's blood alcohol concentration. Due to the fact that an alarming number of college students engage in binge drinking, students who engage in this form of college alcohol abuse may be at increased risk for experiencing blackouts.

  • Alcoholism research scientists have found that blackouts are experienced among social drinkers much more frequently than previously thought. As a consequence, blackouts need to be perceived as a potential result of acute drunkenness or intoxication no matter what the drinker's age or whether he or she is alcohol dependent.

Dad, Please Stop Drinking

Young Girl Asking Her Dad to Please Stop DrinkingThis photo illustrates the hurt and pain that loved ones experience when there's a chronic problem drinker in the household. What is more, friends, co-workers, and neighbors can also feel this pain that in turn frustrates them because they feel helpless to do anything positive for their friend, coworker, or neighbor.

Some alcoholics seem to think that their addiction hurts only themselves. This is so incorrect. Sure, alcoholism hurts the alcoholic and adversely affects virtually every aspect of his life such as his physical and mental health, finances, employment, education, and his interactions with the police and legal system (such as receiving one or more DUIs).

But alcoholism also negatively affects the alcoholic's relationships. Indeed, alcoholism can devastate the lives of those who care most about the alcoholic.

This is what is going on in the life of this cute girl in the photo. Her Dad just failed a random alcohol test at work for the third time in the past year. As a result, he was fired. What is his family supposed to do without an income?

If this girl's father does not quit drinking, how likely is it that he will be able to pass an interview for another job? Even if he is hired, moreover, how can he honestly expect to pass a random alcohol test at his next place of employment?

The young girl in this photo sees what drinking is doing to her Dad and to everyone in her family. She is in pain for what she feels, for her Dad, and for all of her family members.

This young girl correctly sees her Dad's drinking as the main problem and consequently wants her Dad to stop drinking. No, she is not aware what alcohol treatment is, what it entails, how expensive it may be, or how long it might take before her Dad gets sober and starts on the road to recovery.

What does this young girl want? She wants her pain to go away. She wants her Dad's pain to stop. And she wants her Mother and her brothers and sisters to stop worrying about the drinking of her Dad. In a word, she wants her Dad to stop drinking.

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Additional Alcoholism and other Alcohol-Related Quick Facts

Did you know...

young female needing alcoholism information

  • Approximately 9.7 million current drinkers in the United States are between the ages of 12-20. Of these young drinkers, 18.7% are binge drinking and 6% are heavy drinkers.

  • Since teenage alcohol abuse involves adolescents who are not normally on their own, it can be concluded that most of these youth live at home with at least one parent and that most of these teenagers attend school. Consequently, school teachers and parents need to learn how to identify the "red flags" for teenage alcohol abuse. One of these "red flags" as pointed out by medical researchers, concerns unexplained or repeated injuries and accidents. Examples include the following: multiple bike or vehicle accidents, knife wounds, black and blue marks, and a series of broken bones.

  • According to the substance abuse literature, prevention messages can make a positive difference. In a word, these messages can convey information to change people's attitudes about drug use and alcohol drinking behavior in a positive manner.

  • Many chronic conditions such as diabetes, depression, hypertension, and asthma require continual care in order for treatment benefits to be sustained. Alcoholism is similar to other chronic diseases in this regard. Additionally, alcohol addiction requires monitoring of patient status on a regular basis, early intervention regarding possible problems, and proper referrals in order to maintain positive treatment effects.

  • Drinkers who experience blackouts usually drink excessively and too quickly, a combination that results in relatively fast increases in a person's blood alcohol concentration. Due to the fact that an alarming number of college students engage in binge drinking, students who engage in this form of college alcohol abuse may be at increased risk for experiencing blackouts.

  • Since teenage alcohol abuse involves adolescents who are not normally on their own, it can be concluded that most of these youth live at home with at least one parent and that most of these teenagers attend school. Consequently, school teachers and parents need to learn how to identify the "red flags" for teenage alcohol abuse. One of these "red flags" as pointed out by medical researchers, concerns unexplained or repeated injuries and accidents. Examples include the following: multiple bike or vehicle accidents, knife wounds, black and blue marks, and a series of broken bones.

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If you cannot drink responsibly and in moderation, you have a drinking problem. Moreover, if you have a drinking problem and you want to solve this problem, professional alcohol treatment is usually a logical course of action.

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The following toll-free phone number is a number to a call center/treatment center that we are proudly affiliated with. This treatment facility provides top-quality and professional "holistic" drug and alcohol rehab and counseling that addresses virtually every aspect of the person's life.

There is someone at this phone number 24 hours per day, 7 days per week. Please call this number if you have questions about a drug or alcohol problem or if you want some information about quality drug or alcohol treatment. (888) 565-2282

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Let us admit the truth: most people drink because alcohol makes them feel good. The difficulty with this, however, is that the law of diminishing returns eventually rears its ugly head and takes over. What this means is that up to a certain point, the more alcohol a person drinks the better he or she feels. Once a certain point is reached, however, increased drinking begins to lead to negative feelings, drinking problems, Ill health, and sickness,

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The following toll-free phone number is a number to a call center/treatment center that we are proudly affiliated with. This treatment facility provides top-quality and professional "holistic" drug and alcohol rehab and counseling that addresses virtually every aspect of the person's life.

There is someone at this phone number 24 hours per day, 7 days per week. Please call this number if you have questions about a drug or alcohol problem or if you want some information about top-of-the-line drug or alcohol treatment. (888) 565-2282

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Feedback From Visitors and Friends

Thank you for visiting my "Alcoholism Stages" lens. Feel free to post a quick hello and share some of your thoughts and stories about alcoholism and alcohol abuse.

Thanks,

denman4

  • andrewcrter May 3, 2012 @ 11:09 pm | delete
    Great information! Thank you for sharing your knowledge about the stages of alcoholism or alcohol addiction. Keep posting!
  • InspirationbyDmarie Apr 30, 2012 @ 3:33 pm | delete
    Well done! Thanks for sharing all you knowledge...I've learned most of it the hard way but am clean and sober 20 months now
  • denman4 Apr 30, 2012 @ 6:12 pm | delete
    You have obviously been doing something "right" to stay sober for 20 months. Way to go. And thank you for getting the word out about addiction. The more good information we can share on our lenses about overcoming addiction, the more people we can possibly help.
  • Recovery1st Apr 5, 2012 @ 6:11 am | delete
    Denman, thank you for posting all of this valuable information. And for those who have progressed through these four stages and finally achieved sobriety, there's only one more difficult stage to progress and grow through, and that is Post Acute Withdrawal Syndrome. In fact, it's widely thought to be the most significant cause of alcohol relapses. Our very first lens here on Squidoo provides comprehensive information and PAWS recognition and management. If you think it might help someone you care about, please share: http://www.squidoo.com/post-acute-withdrawal-syndrome

    Thanks for your great lens!

    -Deb Davis
  • themeanviolets Apr 4, 2012 @ 1:39 pm | delete
    Thanks for sharing your lens. Recovering myself at almost a year of sobriety, my life has changed dramatically for the better. The hardest part was becoming aware that I was in my own way of my recovery. Keep it up this is good stuff!
  • denman4 Apr 30, 2012 @ 5:57 pm | delete
    Thank you for the kind words. Way to go regarding your sobriety. I know it's difficult at times to avoid situations and friends from the past who were part of your addiction but the longer you stay sober the more you will find new friends who reaffirm you as a person and help you grow.
  • denman4 Apr 30, 2012 @ 6:13 pm | delete
    Congratulations for creating a professional lens with a such important and relevant information. Maybe, just maybe the information we provide via our drug and alcohol abuse and addiction lenses will help some people achieve sobriety.
  • JeremyBenson Jan 13, 2012 @ 3:30 pm | delete
    Alcoholism is an awful thing! I used to be heavy into drinking, and taking drugs. I hope that more people will see it for what it is. The worst part, the part that makes it the hardest, is liking it, enjoying it. Having fun...The thing is things are fun are more often than not actually NOT good things.
  • denman4 Mar 25, 2012 @ 2:02 pm | delete
    Hi Jeremy,
    You are one of the first persons to actually say that drinking is fun. Why do so many people avoid discussing this reality? In all honesty, I miss the days (many years ago) when some of the best times I ever had was when I was drinking with a group of friends. But as you stated, a lot of fun things (like abusing alcohol) are not healthy.
  • thetreatmentcenter Oct 4, 2011 @ 11:53 am | delete
    Good Luck with everything your doing. Addiction can destroy lives, we need more people like you who are trying to help others get released from its grips! Happy to be fighting the battle with you!
  • Mia-Mia Sep 11, 2011 @ 8:58 pm | delete
    Thank you for this great lens. I'm listing it in a text list module as a Related Lens on my lens on the new Alabama DUI law.
  • Treatment4Addiction Jun 14, 2011 @ 11:56 am | delete
    Great information! Our site helps thousands of people find treatment for alcoholism.. Visit www.treatment4addiction.com
  • carolyntarot May 18, 2011 @ 3:43 pm | delete
    Thank you for this very informative article. There are over 100,000 related alcohol deaths a year. This includes suicides, homicides and drunk driving accidents. Over 18 million Americans suffer from alcoholism!

    Best,
    Carolyn
    http://signsofalcoholism.org
  • denman4 Mar 25, 2012 @ 1:57 pm | delete
    I looked at your website. Lots of excellent info. Thank you for taking the time to spread the word about alcoholism signs and other aspects of alcoholism.
  • bikerministry Apr 26, 2011 @ 8:30 pm | delete
    Did a search on addiction and found you. Thank you. Me, a recovering alcoholic, I know I can never pretend that alcohol can be a social thing - I'd be right back - after nearly 33 years of sobriety. I do have a lens about Wm C Moyer's book Broken. THANK YOU!!
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denman4

Hi everyone.  My online name is denman and I work full-time developing informational and educational websites. 
I have numerous alcohol-related...
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