What Are The Three Stages of Alcoholism?
Alcoholism can have three stages, but the goal should always be to prevent them. Ideally, it stops at the first stage before intervention keeps someone from becoming fully dependent on alcohol. If left unchecked, alcoholism can progress into something highly dangerous. In a perfect world, alcoholism that reaches all three stages should progress towards a fourth, fifth, and sixth stage of maintained recovery.
What Constitutes Alcoholism?
The guidelines for heavy drinking are different for men and women. For women, it’s recognized as more than three drinks in a day or 7 drinks in a week. For men, it’s more than four drinks in a day or 14 drinks in a week.
This isn’t necessarily the same guidelines addiction specialists would use to identify alcoholism, but they’re the perfect starting point for identifying problematic drinking behavior. It’s also worth noting that even if someone doesn’t precisely follow the three stages of alcoholism, they still may be an alcoholic.
Guidelines give us a framework for establishing and identifying problems, but every person is different. Every alcoholic is not the same person, and each alcoholic will have a different relationship with alcohol. Why they use, when they use, how often they use, and what they use will often differ. Just like their alcoholism will have unique components, so will their recovery. There is not such thing as an effective blanket approach.
The First Stage: Denial
Denial is not the stage of denying that you’re an alcoholic. It’s more or less being oblivious to the fact that you’re becoming an alcoholic. The people around you may not even notice the warning signs of alcoholism at this stage. Although the stage is called “Denial”, a better term might be “uninformed” or “unaware.”
The problem with alcohol use is that it’s easy and normal. If you were sitting outside of a restaurant mainlining heroin, everyone would stop and look. Someone would call the police. People would yell at you. If you were sitting outside of a restaurant drinking a beer, people might stop to join you. That’s why the first stage of alcoholism is so tricky. Nobody, including the impending alcoholic, has an adequate opportunity to realize that problems are afoot.
In the beginning, alcoholics don’t realize that they’re using alcohol irresponsibly. They figure that having a few drinks is their way of blowing off steam or having fun with their friends. They’ve not yet conceptualized that alcohol has become an unhealthy crutch and that their dependency will only grow with time.
When recognized at the first stage, outpatient treatment and therapy can provide promising outcomes for people. When the stages progress, significant intervention becomes significantly more necessary.
The Second Stage: Loss of Control
Loss of control is a longer stage. At this stage, you might notice that you have an increased tolerance for alcohol. It takes more to give you the euphoric, liberated feeling of being drunk. This amount of alcohol may be more than your body can actually handle, leading to blackouts or expanses of lost time where your brain was too inebriated to record long term memory.
At the loss of control phase, people usually wake up in strange places, forget where their car is, or find themselves surrounded by people they don’t remember. This is often utilized as a trope in films or on TV. Many people don’t take it seriously, simply equating it to a “wild night” or “going hard” and some people might recognize it as some kind of achievement.
The lack of negative social reinforcement that comes from infrequent or one-off blackout drinking might hinder you from thinking it’s a problem. It almost seems like everybody does that from time to time. It might be something that your friends laugh about. In reality, it’s a horrifying sign that your relationship with alcohol has become something you aren’t capable of managing.
If this behavior becomes a norm rather than an occasional occurrence, your friends and family might realize that your drinking is becoming a problem. Some people who are non-confrontational or otherwise fear upsetting you may not say anything. Your bolder and more confident friends and family members will likely come forward and ask you to evaluate your relationship with alcohol.
During the loss of control phase, you’ll realize that you feel different when you’re sober. You might feel anxious, or sweat. You might get mood swings or become very irritable. Your drive to drink will become stronger. You want to feel better and you want the urge to go away. You may begin drinking at inappropriate times, like during work hours, just to pacify yourself.
It’s also common for alcoholics in the second stage to begin hiding their drinking habits. This is partially because they don’t want to endure criticism from those around them, partially because they give into urges to drink at inappropriate times, and partially because they’re beginning to recognize that their relationship with alcohol may be abnormal.
The Third Stage: Deterioration
The third stage is where alcoholism reaches maximum severity, and you will continue to decline indefinitely. Alcohol is no longer a part of your life: it is your life. It’s what you spend most of your time and money doing. It’s alienating you from the people around you. You can’t bear the thought of going without a drink because just a few hours without one makes you sick.
Health problems will begin to develop. Illnesses of the liver, gout, jaundice, and muscle injuries from chronic dehydration make every day a little more painful.
Without intervention, this is the stage where most alcoholics will eventually die.
The First Stage of Recovery: Detoxing from Alcohol
At stages two or three, intervention with detox is necessary. Detoxing from alcohol is dangerous at either stage, but most dangerous at the third stage. Alcohol is one of the most dangerous drugs available. Alcohol Withdrawal Syndrome can be more painful and more complicated than withdrawal from any other drug due to the way alcohol impacts the brain.
When you use alcohol, you severely damage and impair your neurotransmitters. Alcohol causes motor skill and speech impairment because of what it does to your brain as you drink. When you never give your brain a break, this damage becomes chronic. When you withdraw from alcohol, your body begins to try to repair your neurotransmitters and replenish the chemicals that were throttled for such a long period of time.
Alcohol withdrawal can cause fevers, irritability, rapid heartbeat, nausea, diarrhea, and tremors. These things all come as a result of the body attempting to repair itself. In some cases, seizures are also normal. The brain replenishes chemicals, but it doesn’t replenish them in their ideal amounts at the right times. These temporary imbalances are the cause of alcohol related seizures.
Alcoholics who stayed in stage three for an extended period of time are also vulnerable to a condition called delirium tremens. Delirium tremens occurs when chemicals surge too quickly through the brain, causing disorientation, hallucinations, and delusions in conjunction with seizures.
Even in its mildest state, alcohol withdrawal requires the supervision of medical professionals to keep a patient stable. Withdrawing alone is extremely dangerous.
The Second Stage of Recovery: Participating in Treatment
Withdrawing from alcohol might free the body of its constraints, but it doesn’t resolve the pattern of behavior that led to alcoholism. Unless and until the cause of the addiction is identified and new coping mechanisms can be put in place, you’re likely to run back to the bottle the next time the patterns of your life re-emerge.
Inpatient treatment is the best solution for alcoholics seeking immediate help. You can undergo supervised detox and attend treatment in the same place, treating all aspects of your addiction in a straight line.
The Third Stage of Recovery: Maintaining Sobriety
Since the stage of maintaining sobriety is self managed, it’s important to keep yourself accountable. Making the most of your inpatient treatment and applying everything you learned there will give you the groundwork to independently establish a system for your sobriety that you can adhere to.
Maintaining sobriety is where tools like outpatient programs come in handy. You’ve detoxed, you’ve worked with your inpatient addiction therapist to discover the cause of your desire to drink and the origin of your abuse of alcohol, and created a roadmap to set yourself up for continued success.
Checking in on a weekly basis with an accountability group or an individual therapist can help you deal with new feelings as they arise. As your life changes, your outpatient treatment will continue to keep you on track.
There are stages of alcoholism, and three stages of recovery. You didn’t become an alcoholic overnight, and you won’t become a sober success overnight. Recovery takes patience and dedication. You need to be willing to give yourself the time and care you deserve to become the person you want to be. Like with any long and complicated journey, the sooner you embark, the sooner you’ll arrive.