Treating end-stage alcoholism is complicated and difficult. There are many different symptoms and changes that occur across all four stages of alcoholism, including liver failure. Dying as a result of alcoholism is painful and agonizing.
According to data from 2018, nearly half of the 83,517 deaths due to liver disease involved alcohol. About 48 percent of cirrhosis deaths were alcohol-related in 2013. One in three liver transplants was the result of liver disease due to alcohol.
Addiction treatment and the medications available to those struggling with addiction have been improving exponentially. It is important to seek treatment as soon as addiction is acknowledged by the person struggling with addiction, alcoholism included.
The Four Stages of Alcoholism
The stages of alcoholism are broken down into experimental, social, instrumental and compulsive stages. They have specific markers and each stage progresses into the next.
Stage One: Experimental Phase
Initially, people are simply experimenting with different types of alcohol and exploring their limitations. Most often, young adults are in this phase as they are experimenting with multiple facets of adulthood.
A person in this stage may drink occasionally, but it is not a daily occurrence. It is not on a regular basis, and they are not drinking in every situation that it may seem appropriate to drink.
Binge drinking is likely to occur in this stage. Binge drinking involves drinking several alcoholic beverages in a short amount of time. For women, four drinks in two hours, and men drinking five alcoholic beverages in two hours.
What many young people do not understand is that binge drinking can significantly harm organs in the body, more than drinking the same amount over a longer period of time.
Stage Two: Social Drinking
When a person starts drinking more frequently, they have moved into the second stage, Social Drinking.
Someone in this phase may choose to drink every weekend. They also may use drinking to reduce stress, something to do, push out negative feelings, or an excuse to hang out with friends.
Using alcohol regularly puts a person at risk for developing an alcohol use disorder. A regular drinker is not the same as a moderate drinker. A person who uses alcohol regularly uses alcohol to increase positive feelings and to avoid feeling negative.
Stage Three: Instrumental Stage
Problem drinking occurs when a person drinks alcohol frequently and uncontrollably. Up to this point, the person may not have experienced consequences of their alcohol consumption habits.
However, at this stage, the person starts feeling the negative effects of their drinking, such as:
- increased depression
- more anxiety than normal
- problems sleeping
- having hangovers more frequently
- legal issues
- erratic behaviors
- relationship problems
- different friends (ones who drink more often than the old ones)
- less social activity (due to behaviors while drinking)
It is also during this stage that tolerance and dependence are noticeable. The person will need to drink more to achieve the desired results.
A person will typically only willingly engage in situations that involve alcohol consumption. They also drink to manage day to day stressors or to stop feeling emotions they would like to avoid.
Stage 4: The Compulsive Stage
This stage is when a person is completely addicted to alcohol. The person thinks about and uses alcohol obsessively. The person may hide their drinking because they are ashamed of it, but are unable to stop. Alcohol consumption becomes a compulsion and is no longer a choice.
The person also starts losing people and things that were previously valued, such as relationships, jobs, freedom, belongings, or even their home.
It is at this point that the health of the person becomes noticeably degraded. In addition, a person in this stage of alcoholism is either hungover, drunk, or in withdrawal.
For a person in end-stage alcoholism, going into alcohol withdrawal can be fatal. Some people experience seizures in the first few days of detox, which is why it is important to seek professional help when attempting to detox from alcohol.
Many treatment facilities offer a medically supervised detox program, and these programs are designed to make the person as comfortable as possible while detoxing, while medical staff is nearby.
Alcoholic Liver Disease
There are three types of alcoholic liver disease, alcoholic fatty liver disease (or steatosis), alcoholic hepatitis, and cirrhosis. These diseases are indicative of a person who heavily abuses alcohol.
Alcoholic Fatty Liver Disease This is an early form of liver disease where fat begins to accumulate inside the liver cells, which make it difficult for the liver to function. There are not many symptoms of this disease, although if the liver becomes enlarged, pain will radiate from the right side of the abdomen. Alcoholic fatty liver disease will correct if the person stops drinking.
Alcoholic Hepatitis Symptoms of alcoholic hepatitis include inflammation, swelling and cell death in the liver. The cell death causes scarring (fibrosis). Alcoholic Hepatitis can develop over time, but binge drinking can result in immediate symptoms. These symptoms include abdominal pain and tenderness, jaundice, vomiting, nausea, and fever.
Over 30 percent of “heavy” drinkers develop alcoholic hepatitis, ranging from mild to severe. The mild cases are reversible if alcohol consumption stops.
Cirrhosis is the most serious form of alcoholic liver disease, cirrhosis occurs when the whole liver is completely scarred. The result is a shrunken, hardened liver that cannot function properly. Eventually it leads to liver failure and is irreversible in most cases. A person who drinks heavily is at nearly a 20 percent chance of developing cirrhosis after about ten years.
Additional Risk Factors for Alcoholic Liver Disease
When a person is a long term heavy or binge drinker, there are other contributing factors that put them at risk for developing alcoholic liver disease, such as:
- being overweight
- previously diagnosed with hepatitis
It is important to know these additional risk factors, as they can increase the possibility of developing alcoholic liver disease.
Painful Symptoms Of Alcoholic Liver Disease
There are many symptoms of alcoholic liver disease, and as the disease progresses it becomes painful.
These symptoms progress and include:
- blood in the digestive tract
- high blood pressure
- swelling in lower extremities
- fluid accumulating in the abdomen (ascites)
- severe abdominal pain
- variceal hemorrhage
- hepatic encephalopathy
- enlarged spleen
- kidney failure
- liver failure
As alcoholic liver disease progresses, the liver becomes unable to function properly and blood flow is compromised. Ascites may occur at this stage. The accumulation of fluid makes it difficult to breath, is incredibly painful and uncomfortable. Kidney failure occurs and eventually death due to system organ failure.
Liver failure due to alcoholism is extremely painful, as the body shuts down slowly, and the complications from alcohol liver disease take over.
Treatment For Long-Term Alcoholism
It is important that a person struggling with long term alcoholism understands that seeking substance abuse treatment can help them to stop drinking. While some of the effects of long term alcohol abuse are irreversible, there is a chance that becoming sober may help heal some of the damage.
If you or a loved one has been struggling with alcohol abuse, please reach out and get help today. We are available for you, the possibility of enjoying an alcohol-free life is very real, and we can help you on that path.
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.
- Environmental Research and Public Health - Sudden Unexpected Death in Alcohol Misuse-An Unrecognized Public Health Issue?
- Mayo Clinic - Alcoholic Hepatitis
- National Institute on Alcohol Abuse and Alcoholism - Alcohol Facts and Statistics
- UCSF Department of Surgery - End-Stage Liver Disease
- University of Michigan - Alcoholic Liver Disease