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The 5 Stages of Alcoholism: Symptoms & Treatment

Alcoholism isn’t something that a person just wakes up with one day. To devolve so deeply into alcohol addiction that you develop alcoholism, you need to be misusing substances for quite some time and have extremely negative consequences as a result.

What may start as drinking alcohol most weekends to have some fun and lighten the mood, can end in having a few drinks throughout the day just to get by. A person suffering from alcoholism may be unlikely to admit to their problems, but the signs are there and might be easy to see. It may take months or even years to recognize that someone is struggling with it.

Everyone who experiences substance abuse, including alcohol and drug abuse, deals with it in their own unique way, which can make identifying someone with alcoholism or addiction difficult. Not everyone who drinks develops alcoholism, and there are people out there that may be more at risk of developing it than others.

Alcoholism happens in several stages: pre-alcoholic, early-stage alcoholism, middle phase, end-stage alcoholism, and addiction recovery. People that may only feel that they are in the first two stages may not be too concerned with their use, but alcoholism is a progressive disease, and things tend to get worse before they get better.

To learn more about what alcoholism is, the symptoms associated with the disease, and how best to treat it, keep reading.

What Is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is one of the most common addictions Americans suffer from, with over 17 million people over 18 being diagnosed with it. And even with that number being so high, many people never seek proper treatment and are never actually diagnosed with the disease, so the number may be much higher.

AUD is a medical condition characterized by loss of control over a person’s alcohol use, even though there are negative consequences and health problems when they drink. These negative outcomes may affect relationships, cause failure to meet responsibilities, inability to take proper care of themselves, and a decline in mental and physical health conditions.

Alcoholism affects everyone differently, so no two people will have the same journey or experience the same things. It’s important to know that no matter what stage of alcoholism you are in, you can always get help and stop the disease from progressing.

The DSM-5 Criteria

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has 11 different criteria to consider when diagnosing alcohol use disorder. A person that experiences two or more of the following in a 12-month period can be diagnosed with AUD, but the severity can change depending on how many a person relates to. People that relate to over six or more of the symptoms are considered to have severe alcohol use disorder.

The 11 criteria that are used are:

  • Using more alcohol or over a longer period than necessary

  • Spending a significant amount of time trying to obtain or gain access to alcohol

  • Having a strong desire to use alcohol

  • Trying to cut back or stop using alcohol but failing each time

  • Heavy drinking, despite social or interpersonal problems occurring when you use

  • Failing to fulfill obligations and responsibilities, whether at home, at work, or at school

  • Giving up hobbies and activities that you love so that you can fit in more time and money for alcohol use

  • Using alcohol in dangerous scenarios

  • Using alcohol despite experiencing negative consequences related to physical and psychological health

  • Having a tolerance build up to the point where you need more alcohol to feel anything

  • Going through alcohol withdrawal symptoms whenever you are unable to consume alcohol

Symptoms of Alcohol Abuse

Alcohol abuse may look different for every person you come across, so it can be hard to distinguish if there is a problem. It’s also not something most people are willing to admit or seek help for, making it even more difficult to recognize. In many cases, a person will do anything to hide the fact that they are struggling with their alcohol use.

However, no matter how hard a person may try to hide their alcoholism from you, there are several signs that you can be on the lookout for that might cue you in.


Everyone reacts to alcohol differently, so how they appear when drinking can vary. You may not be able to tell someone is under the influence even though they have consumed more than a normal amount, simply because they have become tolerant to the effects of alcohol.

Looking for signs of intoxication is a good indicator, but not everyone that is intoxicated is experiencing alcoholism. If you recognize that you or a loved one are struggling with frequent intoxication, there might be an addiction underneath the actions.

  • Lack of coordination

  • Impaired attention span

  • Lack of memory

  • Losing time / blacking out

  • Sweating

  • An unsteady gait

  • Slurred speech

  • Rapid eye movement

  • Excessive sleepiness

  • Nausea

  • Diarrhea

  • Rapid heart rate

  • Erectile dysfunction

  • Suppressed breathing

  • Lowered body temperature

  • Coma / passing out


When a person is struggling with alcoholism, there are often other underlying issues and conditions that feed into their behaviors. Many people with addiction have co-occurring mental health disorders that further impair them and impact their alcohol use. Alcohol may be used to cope with the other stressors in their life, but that doesn’t result in anything positive.

Alcohol alters how the brain functions, so after a while, you may notice changes in a person dealing with alcoholism. A person may become more distant and behave erratically as their use worsens, becoming more unpredictable and hard to control. How much a person’s behavior changes can vary based on how much they are using and their mental state.

Some behavioral signs that a person is dealing with alcoholism can be:

  • Mood instability

  • Aggressiveness

  • Depression and anxiety

  • Inability to function socially

  • Inappropriate sexual behaviors

  • Increase in dangerous behaviors

  • Neglecting personal care

  • Falling off from responsibilities

  • Pulling away from family and friends

  • Hanging out with a new group of people

  • Recurring absences from work or school

  • Impaired judgment

  • Suicidal behaviors or ideation

What Can Cause Alcoholism?

Alcohol abuse can be influenced by several different factors. After prolonged use of alcohol, your brain adapts to its effects on the body and can develop a physical dependence on it. The brain relies on alcohol to produce certain chemicals in the body, and without it in the system, horrible alcohol withdrawal effects can be felt.

The common causes of developing alcohol stem from biological, environmental, psychological, and social factors. Some families have multiple members with substance abuse problems, and it’s shown that certain genes can be passed down that heighten your likelihood of having addiction tendencies.

When children are raised in an environment riddled with substance abuse issues, it’s more likely that they pick up those behaviors as they grow up.

Alcoholism can impact anyone, no matter what they are going through. Enduring stress and trying to fit in and survive can all lead to excessive drinking. Alcoholism doesn’t spare anyone, so it’s important that you get help whenever you can.

Stages of Alcoholism

Everyone goes through the stages of alcohol in their own way. Whether the progression is slow and hard to see or a rapid decline, they all lead to two choices: a life of never-ending pain and obstacles or a life that leads to recovery.

Symptoms of a person’s alcoholism will continue to grow worse as they progress into the illness. Without early intervention, a person can end up developing a severe addiction to alcohol and need serious alcohol treatment.

At any stage of alcoholism, you can reach out for help. No problem is too small when it comes to alcoholism. If you feel that you are beginning to lose control of your relationship with drinking, it’s time to seek help. Getting into treatment early can save you a world of pain and suffering.

No matter what stage you decide you need help, you should be proud of yourself for seeking it out!

1. Pre-Alcoholic

You can never truly predict if social drinking will lead to alcoholism. Someone who has an occasional drink or only has 1-2 drinks per outing may not seem like a problem, but the devolvement into alcoholism doesn’t have a time limit.

Binge drinking is something that many younger adults and teens end up partaking in. This is when you consume multiple drinks in a short amount of time and maintain a BAC level of at least .08%. This can happen without much thought when out partying or at a bar, and many young people are unaware that it’s happening to them as it happens.

During these times, a person might begin associating alcohol with being relaxed, carefree, and having a good time. There are hardly any consequences to their behavior which reinforces the behavior. It makes going out and drinking seem like a really good time without thinking too much into it.

2. Early Stage Alcoholism

As people move out of the pre-alcoholic stage, you may notice an uptick in their usage. They may be binge drinking more regularly and experiencing blackouts more frequently. However, these behaviors may not become worrisome to someone at this stage. They may believe it’s normal behavior, especially because it’s been widely discussed as an occasional side effect of drinking.

People in the early stage of alcoholism may not be using every day, but they usually use more than others in one period of time. They may become more drunk than others without thinking about any consequences that might occur from blacking out again.

They may begin to lie about their alcohol usage and hide it from their family. A person in this stage will begin to use alcohol to de-stress, cope with any issues that arise, or just have a good time, which is behavior that often leads to a progression in the addiction. They will often begin to experience cravings when they are not drinking.

3. Middle Alcoholic Phase

At this middle stage, your alcoholism will become apparent to those around you who know you well. Friends and family may notice that you are not taking care of your responsibilities, missing out on work or school, and going through behavioral and emotional changes. You’ve developed an alcohol dependence.

You may become more irritable during this stage, especially if you aren’t actively consuming alcohol. It’s a lot easier to lie to those around you and yourself about your problems, but no matter how hard you try, others will begin to notice the truth.

4. End-Stage Alcoholism

If you haven’t received treatment for your alcoholism by this late stage, the long-term effects of prolonged use will become apparent. At this point, you likely have no control over your alcohol consumption, and it has consumed your everyday life. It can be impossible to stop drinking at this stage if you don’t have a support system and the willingness to get better.

You may feel like there are no other options but to continue drinking to help the pain go away, even temporarily. However, it’s never too late to get help. People in the final stage of alcoholism have come away stronger than ever with the proper support system and treatment program.

5. Recovery

After all of the pain and trauma you’ve endured, addiction recovery is waiting for you on the other side. This stage of alcoholism is the only one you want to get to. Recovery is not easy, and it’s not linear. You may find that you enter into recovery multiple times throughout the process as you learn to take care of yourself.

Seeking Addiction Treatment for Alcoholism

Alcohol abuse is not easy to overcome. You likely will undergo detoxification before starting any kind of therapy program. You need to rid yourself of the toxins before you can feel like yourself again. The detox process is safe and under 24/7 surveillance to ensure you are assisted whenever you need it.

Patients then choose between several treatment options, including inpatient and outpatient services, depending on how severe their problem drinking is, what kind of time they can give to a program and other life circumstances. These programs create specialized plans that ensure all of your needs are being met and you’re moving into recovery smoothly.

You will need to undergo therapy to get to the bottom of your alcoholism and know how to treat it. We all have specific problems and needs, and treating alcoholism is about understanding and catering to them to get results.

Find Community With Sober Sidekick

Alcoholism is isolating; finding a community of people who understand what you’re going through can make recovery easier. With Sober Sidekick, you can connect with other sober-seeking individuals and addiction professionals who can offer you advice and support.

Sign-up today with your Android or iPhone and gain access to sober resources and Alcoholics Anonymous meetings from all over the world!


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