Alcohol-related death is the third-highest cause of preventable deaths in the United States, and less than 10 percent typically attend a substance abuse treatment program annually.
Although there are different types of alcohol and drug abuse treatment options, many individuals actually don’t see their substance use as an issue until they are already addicted.
Being able to recognize the stages of alcoholism and recovery can help a person identify the problem they have with alcohol abuse and work toward recovery.
Identifying A Potential Alcohol Addiction
We currently live in a society that tells us that consuming alcohol is acceptable, and wants us to believe that alcohol is nearly a prerequisite for a good time.
For many, having a drink or two may not cause an issue. However, casual drinking can easily become a problem for someone who struggles to know when to stop.
Recognizing problematic drinking behaviors can be difficult for those who are regularly consuming more than recommended amounts of alcohol.
The following are some warning signs associated with alcohol abuse:
- drinking alone
- unable to remember due to alcohol consumption (blackout)
- drinking to decrease social anxiety or increase confidence
- feeling bad or depressed about drinking
- money trouble due to drinking
- hangovers that result in missing school or work
- relationship problems due to drinking
- stopping previously enjoyed activities or hobbies to drink
- continued drinking despite negative effects
- withdrawal in the absence of alcohol
If a person is experiencing three or more of these warning signs, their alcohol use is likely a problem.
The more symptoms a person experiences, the more severe the alcohol abuse issue. Tolerance indicates that an alcohol addiction has started to form.
A person may have been able to feel the effects of two beers, but some time later, they may need to drink four or more to have those same effects. Or, a person may switch from beer to hard liquor to feel the effects of the booze and not on their checkbook.
Stages Of Alcohol Abuse
In 1960, Elvin Jellinek published a book titled, “The Disease Concept of Alcoholism”. Within the text, Jellinek provided support for the model that alcoholism is a disease, similar to other chronic conditions that progress over time and require treatment.
Jellinek clearly outlines the progression of alcohol abuse, using four stages.
The Pre-Alcoholic Stage/Symptomatic Drinking Stage
This early stage of alcohol abuse is easily masked by social drinking. However, a person who drinks to ease into a social situation, or to “take the edge off”, is already using alcohol to manage feelings of discomfort.
While it is true that some people will stay in this stage, others may quickly develop a tolerance to alcohol that indicates that they have progressed to the next stage. Tolerance is the need to drink more alcohol to have the same effects as before.
The Early Stage/Prodromal Stage
This stage of the recovery process is earmarked by the beginning of the cycle of abuse. A pattern of drinking emerges, and the person’s alcohol consumption starts causing issues in their life.
The cycle continues when the person starts feeling the strain alcohol is causing, and to cope with or forget about those issues they consume more alcohol, which in turn causes more problems. And the cycle of alcohol abuse continues.
During this stage is when a person starts experiencing blackouts. When a person consumes excessive amounts of alcohol, they become unable to form memories.
The result is empty hours of time that the person was still awake, but has no recollection of what they said or did, which can cause extreme guilt.
The Middle Stage/Crucial Stage
This stage is characterized by intense feelings of shame and guilt over alcohol consumption. The person is aware that their drinking is a problem and make attempts to control their alcohol abuse.
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These attempts to control drinking may work at first, like drinking beer again instead of wine. They may also attempt to drink less often or abstain for periods of time. However, these changes don’t often stick, and the person eventually starts abusing alcohol again.
With every failed attempt to regulate their drinking, the cycle of abuse gets deeper and deeper. Alcohol habits become more noticeably problematic, and it is common for a person at this stage to start attempting to hide their alcohol abuse from loved ones.
Late Stage/Chronic Stage
The late stage, also called the final stage, is where the person loses their ability to control their drinking. Alcohol consumption becomes a compulsion, and the person will retreat from nearly every activity that does not involve drinking.
Damage and disease due to alcohol abuse become apparent during this stage as well.
Chronic or late-stage alcoholism is dangerous for many reasons, and without substance abuse treatment, the possibility of severe side effects or even death is a real concern.
Addiction Recovery Stages
Committing to alcohol abstinence and recovery is a process, and it requires dedication. Psychologists C. DiClemente and J. Prochaska identified the Stages of Change using six steps.
During this step, the person is able to see the negative way that their life is being impacted by drinking alcohol.
It becomes clear that their alcohol addiction is causing health issues, financial strain, issues in relationships, weight change, skin problems, or a number of other health issues.
They may not do anything about these realizations, and in fact, may blatantly ignore them. The pre-contemplation stage is not marked for action, it is about self-awareness.
To move on to the next step, it may take a catastrophic event for them to come to terms with the need to change and take action.
At this stage, the person actually wants help for their drinking problem, however, no official decision has been made. Perhaps an unclear idea of recovery may come up, or thoughts about future sobriety, but nothing concrete.
A person in the contemplation stage is more open to hearing suggestions or recommendations for treatment, significantly more than when they were in the pre-contemplation phase.
People think about sobriety at this stage and are unsure if they can actually do it.
During this step, a change in thinking takes place. To the person struggling with alcohol addiction, it is no longer enough to consider treatment. The potential for attending a substance abuse treatment program is a true option.
Individuals who are in the preparation step begin to move away from bad habits while getting educated about what recovery looks like. Learning what treatment will be like is an important part of this phase.
Individuals in the preparation stage will find it beneficial to reconnect with loved ones and share their desire to seek treatment.
This part of the process can be emotionally overwhelming, and lead to feelings of grief and loss. This can include mourning the life the person will be leaving behind once they become sober, the relationship that they had with alcohol.
Support of loved ones can help them grieve properly and accept this loss. While they may still continue to drink, there is an action plan that includes stopping drinking and entering a recovery program.
The action stage is where the plan in the previous stage is put into place. The first part of alcohol addiction treatment generally consists of a medically supervised detoxification, usually at an alcoholism treatment facility.
Once the body has become free of alcohol, the person can move on to substance abuse treatment that consists of therapy, recovery counseling, developing appropriate coping strategies, and managing sobriety.
Once treatment is complete, the newly sober individual can begin enjoying the fruits of their labor. Taking the skills learned in treatment out into the world can be rewarding as they navigate making them habits and a way of life.
This step can also be overwhelming, as many who struggle with addiction are emotionally stunted by their substance abuse. Sobriety comes with a resurgence of emotions that had been hidden for many years.
Developing new patterns and managing triggers are all part of becoming a newly recovered alcoholic.
Of all the Stages of Change, this tends to be the one that causes the most conflict. According to some, this stage allows a person to claim they no longer struggle with their alcohol addiction. This means they no longer have cravings and the chance of relapse is low.
This stage is debated by many since alcoholism is defined as a chronic disease that needs to be managed throughout the lifespan.
Even though a person in the termination stage is considered stable, diligence to avoid relapse is key in any stage of change.
People in recovery may consider one of the following ways to combat relapse in the termination stage: become a sponsor, attend support meetings, or monthly therapist appointments.
Symptoms Of Alcohol Withdrawal
Even when a person decides to stop drinking, the fear of withdrawal can result in early relapse. Symptoms of withdrawal can begin to emerge within hours of that last drink.
The brain becomes overactive, resulting in withdrawal symptoms that range from unpleasant to fatal. This is why it is so important to seek assistance from a medically supervised detoxification center that is equipped to manage and ease alcohol withdrawal symptoms.
Some of the milder symptoms of alcohol withdrawal include:
- extreme tiredness
- mood swings
- clammy skin
For a person who meets criteria for a severe case of alcohol use disorder, they are likely to experience some of the more intense withdrawal symptoms, including:
- loss of appetite
- dilated pupils
- cold sweats
- muscle spasms
- increased heart rate
- temperature control issues
The most concerning of all withdrawal symptoms is delirium tremens. Often referred to as simply DT, delirium tremens is especially concerning because the onset of DT can be anywhere from two to seven days after the last drink.
The symptoms of DT are life-threatening. It causes breathing changes, severe temperature dysregulation, excessively high blood pressure, seizures, and extreme dehydration. Mentally, DT can result in irrational beliefs, hallucinations, seemingly unprovoked aggression, and delusions.
Attending a medically supervised detox program can help alleviate many of these symptoms. Under supervision, medications can be given to ease several withdrawal symptoms, lowering the risk of fatality due to alcohol withdrawal.
Ways To Maintain Sobriety
The point of an alcohol treatment program is to achieve long-term sobriety. In many cases, this means a person needs to put in work and make changes to their lifestyle.
Some recommendations for maintaining sobriety are:
- create strong, supportive relationships with friends and family members
- be mindful of yourself and your surroundings
- take care of both physical and mental health
- develop new hobbies or skills
- replace old patterns with better habits
Alcohol Addiction Treatment
Making the decision to get sober is complicated and can be incredibly overwhelming. However, some of that stress can be reduced by choosing a substance abuse treatment program that meets the individual needs of you or your loved one.
Reach out to our professional team of specialists today, we can help you find a program that meets your individual needs.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- American Psychological Association—Assessing drinkers’ motivation for change: The Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES)
- Journal of Studies on Alcohol and Drugs—Stages in the alcoholic process. Toward a cumulative, non sequential index
- Journal of Addictions Nursing—Stages of Change
- Research Advances in Alcohol and Drug Problems—The Disease Concept of Alcoholism