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The Stages of Alcoholism, and How To Know When You Have a Problem

By  Neha Kashyap
Learn about the signs and symptoms of alcoholism and how to get help.

Alcoholism, or alcohol use disorder (AUD), doesn’t develop overnight. Knowing the stages of AUD could be key to prevention and treatment.

“Early signs of problem drinking or alcohol misuse can be subtle. For example, starting to prioritize activities that involve alcohol steadily leads to a shift in daily routines and relationships,”  Dr. Harshal Kirane, Medical Director of Wellbridge treatment centers in New York, tells WebMD Connect to Care. “As drinking becomes more routine, changes in sleep patterns, mood, energy, and interests can signal the onset of early alcohol use disorder.”

What is alcoholism?

Alcoholism is a physical and psychological dependency on alcohol that also interferes with daily life. Symptoms of alcoholism include an intense urge to drink at all times and an inability to control oneself when drinking. Advanced alcoholism can include drinking to avoid withdrawal symptoms like the shakes and nausea. According to the National Institutes for Health, about 14 million American adults struggle with AUD.

The 5 stages of alcoholism

Alcoholism is a progressive disease that takes time to develop. Here are some indicators of each phase of the disorder.

Pre-Alcoholic: In the pre-alcoholic stage, a person begins to drink to relieve stress. During this stage tolerance can start increasing, meaning more alcohol is needed to get the same effect.

Early Alcoholic: During the early alcoholic phase, alcohol can begin to affect a person’s relationships, job and daily life. These disruptions can lead to guilt and shame, which can lead the alcoholic to drink even more. “For some, this is a critical tipping point, because alcohol intake increases in an attempt to alleviate the very challenges it is creating,” Dr. Kirane says.

Middle Alcoholic: During this phase, drinking becomes more frequent, and a person with alcoholism might try to hide or rationalize their drinking. They might also try to quit, only to start again.

Late Alcoholic: During this phase, an alcoholic can no longer control their drinking. They might also exhibit physical symptoms of prolonged alcohol abuse. Alcoholics in this phase might also suffer from withdrawal when trying to stop drinking. Withdrawal occurs when abstaining from alcohol leads to bodily reactions like shaking, nausea and in more extreme cases, seizures and tremors.

Recovery: The recovery phase is when an alcoholic decides to get help. This usually begins at a point of hitting rock bottom before deciding to change one’s life.

Getting help

To begin recovery, experts advise detoxing under medical supervision and finding support groups or therapy. Recovery can also include medications and addressing underlying mental health concerns, like depression.

“There are numerous ways to get help, but it starts by reaching out. Reach out to a friend or family you trust can support you non-judgmentally,”  Dr. Kirane says. “If that is hard to identify: 12-step groups, SMART recovery, or online forums can be less threatening outlets.”