Alcoholism is a chronic and relapsing disease marked by changes in brain structure and function that affect behavior and perception. Heavy alcohol abuse can lead to addiction, and once there, it will likely take a professional rehabilitation program to help ensure long-term recovery. In this article we will discuss the 3 stages of alcholism.
Denial is a common byproduct of addiction, a psychological defense mechanism that protects us from what we don’t want to acknowledge about ourselves, but refusing to acknowledge that you’ve developed alcoholism can lead to serious physical and mental health problems down the road.1
The Stages of Alcoholism
According to the U.S. Office of Personnel Management, the most widely accepted theory regarding alcoholism is the disease theory, which postulates that alcoholism is a disease with recognizable symptoms, and it can be treated with research-based methods.2
The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM-5) classifies alcoholism into three groups based on 11 criteria.3 The presence of two or three of the 11 symptoms indicates mild, or early-stage, alcoholism, while the presence of four or five symptoms indicates moderate, or middle-stage, alcoholism. The presence of six or more symptoms indicates severe, or late-stage, alcoholism.
The DSM-5 criteria include symptoms like drinking more alcohol or for a longer period of time than intended, wanting to stop but being unable to, experiencing intense cravings for alcohol, and continuing to drink even though it’s causing problems in your life.
Mild or Early-Stage Alcoholism
The early stage of alcoholism is characterized by an increasingly higher tolerance for alcohol, which is an indication that brain function is changing in order to compensate for the frequent presence of alcohol in the body. You may begin to have doubts about your ability to handle alcohol, and you may begin to feel guilty about drinking to excess.
You may experience blackouts regularly, which are memory lapses of the events that occur while you were drinking, and you may become increasingly preoccupied with drinking. Your loved ones may begin to voice concerns about your drinking habits, but you’re probably pretty sure you don’t have a problem. In the early stages, someone with alcoholism is generally indistinguishable from someone who simply abuses alcohol on occasion.
Moderate or Middle-Stage Alcoholism
In the middle stage of alcoholism, the consequences of your alcohol abuse begin to pile up. You may call in sick to work more often than you should, and you may find yourself less interested in the activities and hobbies you used to enjoy. You may begin drinking to stave off withdrawal symptoms, which indicate that you have become physically dependent on alcohol and your brain has adapted to having alcohol in the body. You may drink to alleviate your hangovers.
You have probably lost your ability to control your drinking even though you may want to, and you likely hide the extent of your drinking from others. Alcohol cravings are intense. The withdrawal symptoms can be excruciating, and the blackouts become more frequent in the middle stages of alcoholism. You may still be under the impression that you don’t really have a problem, you just drink too much sometimes.
Severe or Late-Stage Alcoholism
In the late stage of alcoholism, your life has likely become unmanageable. You may begin to exhibit signs of medical problems like high blood pressure, liver disease or acute pancreatitis, and you may be suffering from insomnia and depression. You’re likely obsessed with alcohol and may avoid the people and activities you used to enjoy so that you can drink to excess. You probably have alcohol hidden around the house, in the car and at work, and you may be mired in legal or financial problems stemming from your drinking.
If you try to stop drinking at this stage, you may experience tremors and hallucinations, and quitting on your own without medical supervision at this point can be dangerous or even fatal due to a condition known as delirium tremens, or DTs. Despite all of this, you may still be in denial that there’s a serious problem.
There is Always Hope
No matter what stage of alcoholism you find yourself in, there is hope for recovery, but it will likely take a professional alcohol treatment program to get you there. Treatment will start with medical detox, which is medically supervised and involves taking medications that will help alleviate the intensity of withdrawal symptoms like tremors, nausea and cravings.
Following detox, various therapies will be used to help you address the issues underlying the alcohol abuse. These therapies will include cognitive-behavioral therapy, which helps you identify self-destructive attitudes, beliefs and behaviors and learn how to replace them with healthier ways of behaving and thinking.
Once alcohol treatment is complete, an aftercare plan will include various components that will help prevent relapse, including engaging in ongoing therapy and making a commitment to regularly attend 12-step meetings.
The National Institute on Drug Abuse stresses that alcoholism is in no way a matter of moral failure, and it takes more than willpower and good intentions to stop drinking once an addiction has set in, even if you’re highly motivated to quit and dearly want to enjoy a life of sobriety.4 A high-quality treatment program that takes a holistic approach to alcoholism treatment can help you restore your future, improve your physical and mental health, and enjoy a life free of alcohol and the myriad problems it causes. Treatment works, and it can vastly improve your quality of life.
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