Stages of Alcoholism

The path to addiction: Stages of alcoholism

Moderate drinking isn’t a cause for concern in most adults. But when alcohol consumption gets out of control, you may find yourself on a dangerous path toward addiction.
The National Institute on Alcohol Abuse and Alcoholism estimates that 17 million American adults have alcohol use disorders. Another 855,000 Americans ages 12 to 17 years old have alcohol use
disorders. It’s important to remember that alcoholism isn’t created overnight. It emerges out of long-term alcohol abuse.
Knowing the signs and symptoms of each stage can aid you in seeking help before your problem turns into dependence and addiction.

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Experimentation and binge drinking

Stage #1: Occasional abuse and binge drinking

The first stage of alcoholism is a general experimentation with alcohol. These drinkers may be new to different forms of alcohol and likely to test their limits. This experimental stage is commonly seen in young adults.
These experimental drinkers also frequently engage in binge drinking. While they may not drink regularly, they consume exceptionally large amounts of alcohol at one time. Medline Plus characterizes binge drinking as:

• for men, five or more alcoholic beverages within two hours
• for women, four or more alcoholic beverages within two hours

Drinking responsibly

Experts in the United States recommend that men consume no more than 2 drinks a day (or 28 grams of pure alcohol). Men should not exceed 14 drinks per week.
Women should avoid having more than 7 drinks per week. One drink usually equals:

• 1.5 oz. of distilled spirits or liquor, including gin, rum, vodka, and whiskey
• 5 oz. of wine
• 8 oz. of malt liquor
• 12 oz. of beer

Many binge drinkers exceed this amount. This is especially true for teens who attend parties where drinking is the primary activity. You might think binge drinking is safe when you only do it occasionally, but that couldn’t be further from the truth.
Drinking large amounts of alcohol at one time is dangerous, and can even lead to coma or death. Furthermore, you may become dependent on the feeling you get from drinking and find that these episodes increase in frequency.

Increased drinking

Stage #2: Increased drinking

Drinkers leave the experimental stage when their alcohol consumption becomes more frequent. Instead of just drinking at parties once in a while, you may find yourself drinking every weekend.
Increased alcohol consumption can also lead to drinking for these reasons:

• as an excuse to get together with friends
• to alleviate stress
• out of boredom
• to combat sadness or loneliness

Regular alcohol use is different from moderate drinking. There is usually a higher emotional attachment to it. A moderate drinker might pair a glass of wine with a meal, while a regular drinker uses alcohol to feel good in general. As increased drinking continues, you become more dependent on alcohol and are at risk of developing alcoholism.
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Stage #3: Problem drinking

Frequent, uncontrolled alcohol abuse eventually leads to problem drinking. While any form of alcohol abuse is problematic, the term “problem drinker” refers to someone who starts experiencing the impacts of their habit.
You may become more depressed, more anxious, or start losing sleep. You may start to feel sick from heavy drinking, but enjoy its effects too much to care. Many drinkers at this stage are more likely to drink and drive or experience legal troubles as a result of their drinking.
There are also specific social changes related to problem drinking. These include:

• relationship issues
• decreased social activity because of erratic behavior
• sudden change in friends
• difficulty conversing with strangers

Dependence

Stage #4: Alcohol dependence

Alcoholism has two facets: dependence and addiction. It’s possible for a person to be dependent on alcohol, but not yet addicted.
Dependence forms after the problem drinking stage. At this point, you have an attachment to alcohol that has taken over your regular routine. You’re aware of the adverse effects, but no longer have control over your alcohol consumption.
Alcohol dependence also means that you have developed a tolerance to drinking. As a result, you may have to drink larger quantities to get “buzzed” or drunk. Increased drinking has more damaging effects on the body.
Another characteristic of dependence is withdrawal. As you sober up, you may feel undesirable symptoms such as:

• nausea that is unrelated to a hangover
• body tremors
• sweating
• severe irritability
• a racing heart
• trouble sleeping

Addiction

Stage #5: Addiction and alcoholism

The final stage of alcoholism is addiction. At this stage, you no longer want to drink just for pleasure. Alcohol addiction is characterized by a physical and psychological need to drink.
People with alcohol addiction physically crave the substance and are often inconsolable until they start drinking again. They may be addicted to other drugs as well.
Compulsive behaviors are prominent in addiction, and people with alcohol addiction often drink whenever and wherever they desire.
Learn more: Alcohol addiction »

What’s the outlook?

One of the biggest concerns with risky drinkers is when they don’t think they have a problem. Any stage of alcoholism is problematic. Moderate drinking is the only safe way to consume alcohol, but drinking in general isn’t safe for everyone.
Identifying problems with alcohol early can help prevent dependence and addiction. Medical treatment may be necessary to detoxify the body of alcohol and to obtain a fresh start. Since many people with alcoholism endure psychological problems, individual or group therapy may help in overcoming addiction.
The deeper into the stages of alcoholism you enter, the tougher it is to quit drinking. Long-term risks of heavy drinking include:

• liver damage
• heart disease
• brain damage
• malnutrition
• mental health disorders, including an increased risk of suicide

Talk to your doctor if you think you might have a drinking problem.
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From our medical expert

Unfortunately, most people who develop alcohol use disorders are unaware that they are developing a disorder. Their family members see it, their friends see it, but they do not. Many people believe that others are being inappropriately critical of their drinking behaviors or believe that others are trying to control them by objecting to their alcohol use. Some people use alcohol to address other problems such as the inability to sleep or to quell their anxiety. If someone is drinking for these reasons, they should contact their doctor right away, as these can be symptoms of other medical or mental health issues.