The Stages of Alcoholism: Early Chronic and End Stage Alcoholism

Alcoholism, also known as an alcohol use disorder, is a disorder that can affect any individual, no matter their social, cultural, or demographic background.

If an individual begins to struggle with an alcohol use disorder, then many areas of their lives may become affected e.g., their job or school performance, relationship difficulties, and financial struggles.

However, depending on how much alcohol an individual consumes and how regularly this occurs can affect how severely these areas are affected.

In general, individuals with a shorter history of an alcohol addiction may see less damage across these areas, perhaps highlighting the need to seek further care before the situation worsens.

In addition, individuals with a longer history of alcohol may have a higher alcohol dependence – the body’s needs and cravings relating to alcohol and its effects.

This can cause greater issues later in the rehabilitation process – something that all individuals struggling with the different stages of alcohol abuse should consider and research as soon as possible.

Pre-Alcoholic Stage

Before it becomes clear that an individual may be struggling with alcoholism, there are some factors that can be spotted.

This pre-alcoholic stage is not something that is generally included with professional diagnoses, but even the early-stage alcoholism stage does not take into account any factors previous to the individual’s alcohol consumption.

Though these symptoms are often harder to spot (as they may not include any directly ‘alcoholic’ behaviours e.g., heavy drinking from the start) they are vitally important in getting help for an individual before their disorder worsens.

Aside from direct alcoholism behaviours, this stage refers generally to the thoughts, feelings, and opinions that the individual may have around alcohol and its consumption.

This may include individuals who view alcohol as a recreational beverage and do not consider it to be as dangerous a substance as other well-known drugs such as heroin.

Especially in the UK, this is a common belief, as many individuals are not educated about the dangers of alcohol and its physically addictive nature – similar to that of heroin and other opioids.

How to Spot Someone in the Pre-Alcoholic Stage

Individuals in the pre-alcoholic stage, as mentioned above, are likely to have positive and lax opinions about the consumption and use of alcohol.

This individual may be comfortable consuming alcohol and view it as a way to relax or escape from lifestyle difficulties.

This may include stresses at work, career performance, family troubles, and many other social and societal factors.

Because of this, these individuals may not see the issues with consuming large quantities of alcohol (even if this is a behaviour that they are not explicitly displaying themselves, yet) and begin to engage in this behaviour on a more and more regular basis.

When approaching an individual who you feel may be in this position, it is important not to be accusatorial, overly direct, or judgemental about their situation.

This is the extreme in early detection of alcoholism, so the individual may not always be struggling. Instead, it is important to raise concerns in a respectful way, ensuring not to pry too much into the individual’s private life.

Early-Stage Alcoholism

Early-stage alcoholism is where the individual will first start to engage in alcoholic behaviours. The official first stage of the stages of alcoholism is generally when close friends and family may pick up on changes to their loved ones‘ drinking behaviours.

Drinking large quantities of alcohol, unless in a bar or restaurant, often leaves a large number of paraphernalia and other evidence behind.

By noticing multiple empty bottles or containers in bins or in places where the individual has attempted to conceal them, close friends and family members may notice that something is different or has changed.

In addition, if the friends and family of the individual struggling with early-stage alcoholism keep alcohol within their homes and this begins to disappear, this may be another hinting factor that this is something their loved one may be struggling with.

Early-stage alcoholism is possibly the best stage in which an intervention may be effective as this is the stage in which the least harm has been done to the individual and those around them.

By waiting longer or delaying the need to seek care, individuals are placing themselves at a greater risk of harm from alcoholic behaviours and the effects of alcohol on both their physical and mental health.

Looking for Signs of Early-Stage Alcoholism

On a biological level, the early stages of alcoholism show the least changes in the brain and body, making it extremely difficult to detect these micro and neurological changes (1).

However, the most ‘telling’ factors come from the individual and their behaviours directly.

During early-stage alcoholism, the main behaviour that will change in relation to alcoholic behaviours is the sudden or steady increase in the quantity of alcohol the individual will be consuming at social events, on nights out with friends, or during other group gatherings.

Although this may not be regular or frequent at the very early stages, it is likely that individuals struggling with the early stages of alcoholism may begin to binge drink more frequently, beginning to need more and more alcohol in order to achieve the same level of ‘drunkenness’ or inebriation.

If you recognise any of these signs or symptoms in someone you know or love, ensure that the utmost care and respect are taken when addressing the issue.

Again, it is important to be completely non-judgemental and listen to everything the individual has to say about their experience.

This will help build a trusting and supportive relationship, increasing the chances that this individual will confide in their loved one more often about what they are experiencing and how they may be able to support them.

Middle Alcoholic Stage

The middle alcoholic stage is also known as the chronic alcoholism stage and occurs when the individual has not received suitable or appropriate care up until this point.

This may be due to the individual attempting to hide or conceal their behaviours, leading to a lack of knowledge on their loved ones’ behalf, as well as a sudden or exponential worsening in their condition.

When it comes to alcoholism, is a disorder that has the potential to worsen over a very short time period when not identified and treated as soon as possible.

This stage can also be incredibly risky, as the individual may have developed a dependence on alcohol depending on how long they have been addicted, meaning that their body will undergo severe alcohol withdrawal symptoms if they attempt to cut down.

These vary in severity depending on how long the individual has been addicted to and consuming large amounts of alcohol (2) and also depend on many other personal factors such as metabolism, gender, and body size.

Identifying Someone with Middle-Stage Alcoholism

An individual within the middle stages of alcoholism is generally categorised by the daily and excessive consumption of alcohol over an extended period of time.

The amount of alcohol consumed will vary between individuals, especially depending on the factors mentioned above such as gender and body size, as well as any additional medication the individual may be consuming.

Another factor to consider is the fact that alcoholic beverages vary in strength and alcohol content, meaning that depending on the alcohol, an individual may be consuming more or less than another type of alcohol.

These individuals may begin to experience some of the more serious implications of a long-term alcohol addiction during middle-stage alcoholism.

This includes serious mental health issues, as well as neurobiological effects, some of which affect memory and other essential processing areas of the brain (3).

Another risk factor to consider is the increased risk to the individual’s physical health. High alcohol consumption is known to lead to an increase in liver disease, heart complications, and an increased risk of developing body tremors and/or alcoholic seizures.

End-Stage Alcoholism

End-stage alcoholism is potentially the most dangerous stage of the stages of alcoholism due to the implications of the amount of time and quantity of alcohol consumed for the individual to reach this stage.

In general, individuals who are considered to be within the end stage of alcoholism have been consuming alcohol over a long period of time, often in large quantities and regularly.

During this stage, individuals risk experiencing severe withdrawal symptoms if they attempt to stop consuming alcohol. This is because their body will have developed a strong dependence on alcohol, causing serious damage if this is suddenly to be removed.

An alcohol withdrawal can be life-threatening if not properly managed, meaning that all withdrawals should be supervised and monitored by a consenting and willing individual, if not (more preferably) within a specialised detox clinic or rehabilitation centre.

This will allow the safest transition from alcoholism to recovery, including future stages of rehabilitation that individuals may not have previously known about or considered.

What to Do When Someone Has End-Stage Alcoholism

As this is the most dangerous of the stages of alcoholism in terms of the individual’s health and wellbeing, it is especially important that the most care and support is provided at this stage.

Choosing to enter rehabilitation and begin recovery is no easy decision, meaning that individuals should be supported as best they can during this process.

As they are likely to experience serious withdrawal symptoms (especially in the cases of a long-term addiction), medical interventions should also be on-hand.

These are available within most rehab centres and almost all detox clinics and include drugs such as Librium – known for its ability to reduce the harmful physical effects that an individual may experience during the detoxification process and help ensure their safety over the remainder of the process.

Recovery

For individuals who choose recovery, rehabilitation is the best way for individuals to learn to cope with their addiction in the long term.

In general, rehabilitation is split into three stages, all of which require complete dedication and motivation from the individual to be effective in the treatment and recovery of the individual.

These stages are outlined below:

• Detoxification – the process in which the body removes harmful chemicals and toxins that have built up in the body as a result of long-term alcohol addiction.
• Rehabilitation/therapy – the process in which most of the addiction treatment programmes and therapies are carried out.
• Aftercare – refers to any additional support, treatment, or therapy that an individual engages in after leaving rehab (either a centre or outpatient treatment).

Most rehab centres and programmes will follow this approach and additional care should be taken to ensure that the individual’s chosen addiction rehab service provider abides by these stages.

Finding Detox and Treatment

Especially for individuals who may have never experienced or researched rehabilitation before, knowing where to start and which addiction treatment or detox programmes will be most effective is almost impossible.

However, there are some steps that individuals can take before entering rehab to gain a greater understanding of what they may benefit from during their time in rehab.

Interventions conducted before an individual enters rehabilitation are also beneficial, as these allow individuals around the individuals struggling with addiction to make useful and suitable suggestions for the future of their loved ones’ rehabilitation with the help of a counsellor or interventionist (4).

In addition, local councils and establishments generally allow individuals to take part in trial sessions or spend time in addiction treatment programmes as an example of the services available.

This will also help individuals figure out which forms of treatment will be most effective and efficient for them.

Ready to make a change?

Rehab 4 Alcoholism specialises in supporting individuals who may be struggling with addiction, no matter the stage of alcoholism or rehabilitation that they may be in.

Through our referral service, individuals will be able to enter rehab centres, gain expert advice and next steps on addiction, as well as have the opportunity just to have a chat about their current situation.

No matter how trivial or serious you feel your questions or queries may be, please do not hesitate to contact Rehab 4 Alcoholism on 0800 111 4108 today – our dedicated addiction support hotline.

References

[1] Hannuksela, M.L., Liisanantti, M.K., Nissinen, A.E. and Savolainen, M.J., 2007. Biochemical markers of alcoholism.

[2] Caetano, R., Clark, C.L. and Greenfield, T.K., 1998. Prevalence, trends, and incidence of alcohol withdrawal symptoms: analysis of general population and clinical samples. Alcohol health and research world, 22(1), p.73.

[3] Nelson, T.M., Sinha, B.K. and Olson, W.M., 1977. Short‐term memory for hue in chronic alcoholics. British Journal of Addiction to Alcohol & Other Drugs, 72(4), pp.301-307.

[4] Copello, A.G., Velleman, R.D. and Templeton, L.J., 2005. Family interventions in the treatment of alcohol and drug problems. Drug and alcohol review, 24(4), pp.369-385.

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