Stages of Alcoholism

Alcoholism, prevalent since the Prohibition era, does not happen overnight. It develops over time and is often characterized by alcohol dependence, both physical and psychological, and preoccupation.


The length of time for each stage may vary but the symptoms remain the same. The stages of alcoholism are usually defined as early, middle, and late. The lines between the stages are not clearly defined. Nor do these stages have any particular time frame of when one leads to another. What marks the passage from one to the other are the characteristics of each stage.


The early stage of alcoholism develops without any outward physical indicators. Starting with experimentation, a tolerance to alcohol allows the drinker to consume more and more. This can lead to binge drinking. Binge drinking is the consumption of large amounts of alcohol in a very short period of time.


For men, this means drinking 5 or more alcoholic beverages in under 2 hours. For women, it means drinking 4 or more in under 2 hours. Binge drinking is very dangerous and can lead to alcohol poisoning, coma, and even death. One important symptom is drinking to get drunk. Most drinkers will drink a glass of wine with dinner, for social occasions, or to unwind.


The alcoholic drinks to get drunk or “buzzed”. From outward appearances, the alcoholic shows no signs of the illness and can function as they normally would in their day-to-day life.


The middle stage involves drinking more often as a way to cope with stress, anxiety, or depression. The physical dependence on alcohol now takes place. The body has become more tolerant of higher levels of alcohol in the early stage and now requires more to achieve the state of well-being the drinker is wanting to find.


Another characteristic is the craving for alcohol. The craving from the physical and psychological dependence increases beyond the person’s control as their tolerance increases. Withdrawal symptoms start to surface, causing loss of control over alcohol consumption. Symptoms can include tremors in the hands, irritability, and sweating profusely. Blackouts may start, allowing the drinker to still function but have no memory of what happened.

Problems from drinking may start to become apparent such as missing work, friction within the family, isolation, etc.
The late stage is characterized by the effect of constant drinking, now clear to see by all. The need to drink has caused alienation from concerned family and friends.


It has caused problems at work, if not the loss of employment. The world now revolves around alcohol. Although the alcoholic may notice the downward spiral, denial takes root. The need to drink more and more alcohol becomes stronger than any other need in their daily lives.


The stages of alcoholism cannot be measured in any particular length of time. But each stage has characteristics defining each. Over 18 million Americans suffer from alcohol disorders.


This has led to over 18,000 deaths from excessive alcohol use, making alcohol abuse the third largest killer in the United States.


How Relapse Happens

For the alcoholic, the recovery process is a lifelong fight to stay sober. It usually involves complete changes to daily activities, lifestyles, and friends. Even with the help of support groups and family members, the risk of relapse is high. Although relapse can happen from a slip, most relapses begin long before the actual act of taking that first drink.


Slips and relapses are different. A slip is a temporary break from sobriety. It is defined as a spontaneous moment back into the addiction but the addict returns to the road to recovery.


Relapse comes from the Latin term meaning to slip back. Slips can be the start of a relapse but usually it starts before the actual act. It is not the first drink that separates slips from relapses but the action after that makes the difference.


The downward spiral to relapse can be broken down into several steps or markers. Knowing the signs of an impending relapse can help the recovering alcoholic to prevent it.


Relapse can happen quickly, and unconsciously. A close friend of mine relapsed and was treated through Abbeycare's rehab progam in Scotland, an excellent clinic.


Steps to Relapse
• Attitude changes. Attending Alcoholics Anonymous meetings during recovery begins to seem less and less important. Negative, unhealthy thinking begins to set in as the withdrawal symptoms continue.

• Stress levels rise. Without the encouragement and support of AA meetings, managing stress becomes harder and harder. Mood swings begin and go from one extreme to the other.

• Denial reappears. The alcoholic does not deny the addiction. The denial is about the rising amount of stress experienced by the recovering addict. The person insists that everything is fine, more to convince themselves than others.

• Withdrawal symptoms continue. The alcoholic’s withdrawal symptoms will continue long after abstaining from alcohol. The problem arises when the recovering addict becomes tempted to self-medicate to reduce the severity. Taking that drink seems much easier than dealing with the discomfort and pain.

• Behavior changes. Healthy daily routines are replaced with impulsive behaviors and poor judgement. Exposing themselves to temptation can further increase stress and cause unnecessary problems.

• Isolation begins. Whether out of guilt or other negatives feelings, the recovering addict begins to miss more and more meetings, if not stopping their attendance completely. This isolation is extremely dangerous because meetings with other recovering alcoholics is a necessary support system at this time.

• Healthy daily routines are completely abandoned. Not continuing to follow this new routine can involve anything from sleeping later, neglecting personal hygiene, and skipping meals. Plans and goals are no longer made as often. If one is and it falls through, the recovering alcoholic will tend to overreact.

• Poor judgement takes over. With the increase of negative, unhealthy thinking, the alcoholic struggles to make good decisions. Emotions start to get out of control.

• Recovering alcoholic loses control. The last step before relapse. The world comes crashing down. Recovery seems impossible. The recovering addict will only see three options: insanity, suicide, or return to the life they know.

Faced with many challenges and triggers, 90% of recovering addicts will relapse. The key is positive thinking and continued support.


Alcoholism and the Brain...

Alcoholism can affect the brain in many different ways.


Although some may be temporary, others can have a lasting effect. Contrary to popular belief, alcoholism does not kill brain cells but can inhibit brain growth or cause permanent brain damage.


Alcoholism changes the way the brain functions. Outward symptoms of this damage can be shown in slurred speech, weak coordination, blurred vision, and blackouts. As the disease progresses, so does the amount of damage. It alters the brain’s ability to keep the body in balance.


Brain chemistry and its communicative patterns are also altered.

The human brain is the monitoring system for the entire body. Neurons and other transmitters convey millions of bits of information gathered from the five senses and act accordingly.


They are responsible for keeping all systems in the body balanced and running smoothly. Excessive consumption of alcohol causes these systems to misfire and malfunction, causing the brain to adapt to the changes and make alterations in order to restore balance. The physical effects of these changes result in compulsive and obsessive behavior and poor decision-making.


These effects make it easier to continue drinking rather than stopping. Because of the changes made caused by excessive drinking, the brain now craves it to stay balanced.
Alcoholism changes the brain’s chemistry. Known to be a depressant, alcohol depresses the neuron transmitters in the body and decreases inhibitions. Normally, alcohol can be consumed to reduce stress.


Taken in excessive amounts, other emotions such as anger, depression, and anxiety can rise to the surface. The brain’s reward system is also altered. The reward system is responsible for our desire to survive by rewarding us with good feelings when we ear, sleep, or drink. Because of the brain’s altered chemistry, it begins to do with same with alcohol.


Alcohol creates a sense of well-being. This makes the brain begin create withdrawal symptoms when the alcoholic tries to stop drinking. Withdrawal symptoms can vary from tremors to nausea.
The way the brain gives and receives communication changes.


The brain’s adaptation to changing neuron pathways and patterns from alcoholism begins to affect decision-making, emotions, and memory. Blackouts are one of the results. Blackout commonly occur from binging or excessive drinking. This type of drinking prevents the brain’s ability to form new memories. Blackouts are not the same as passing out.


When someone blacks out, they continue to function and act accordingly. However, once the level of alcohol decreases in the body, the person will have little to no memory of previous events.


All of these changes in the brain and how it functions make recovery very difficult. The brain has to learn to adapt to the absence of alcohol after it has already made the necessary adjustments with it.


Withdrawal symptoms begin to surface as the brain fights to maintain balance and can be one of the strongest reasons for relapse. Some damage can be irreparable such as alcoholic dementia and the shrinking of different parts of the brain. Some will return once sober.


Alcoholism and Teenagers

Alcohol abuse and alcoholism is occurring at an alarming rate among today’s younger generation.


Becoming the drug of choice, underage drinking has become a dangerous pastime, leading to a rise in alcohol-related deaths and other problems.


Causes can run the gamut from the accessibility of the drug in comparison to other drugs, family factors, thrill seeking behaviors, and emotional instability. The younger the drinker, the more likely they are to become alcoholics in adulthood, if not before.
Statistics show the impact alcohol has had on the next generation.


• Between the ages of 12-20, over half have tried alcohol at least once.
• Out of those who begin drinking before the age of 15, 40% will become alcoholics in their lifetime.
• Suicide attempts in 8th grade girls are higher for those who drink than those that do not.
• Half of junior and senior high school students drink on a monthly basis, 14% admitted to being drunk at least once in a year’s time.
• Out of all violent deaths involving teens, half were alcohol-related.


With teenage alcoholics, their bodies are still growing and maturing. The brain continues to develop well into the age of 20. This makes the causes different from adult alcoholics. There are several underlying causes of underage drinking and alcoholism. Family dynamics, psychological makeup, and genetics are just some that can predispose a teenager to alcoholism.


Family dynamics may play a big part in a teenager’s road to alcoholism. It may be due to exposure to alcoholism through a family member or parent. Lack of structure or rules can allow for the opportunity to experiment. Ongoing conflicts within the home can also tempt the teen to use it as an escape mechanism. Sometimes a simple glass of wine at dinner can lead the person to believe that drinking alcohol is harmless.


The causes could be psychological and unique to the individual. The underdeveloped parts of the brain that control inhibitions, impulsive behavior, and emotions can be responsible. Lack of self-esteem can increase the desire to fit in with their peers. Depression can be another underlying factor and the need to self-medicate.


Genetics have also been suggested to play a part in alcoholism. Research points to alcoholic parents or grandparents passing the susceptibility onto their children and grandchildren. The choice to drink or not is still their own, but once that first drink is taken, it activates that gene.


Clearly, underage drinking is an ever-growing concern everywhere. Alcohol can have devastating effects on the younger generation, including becoming future alcoholics. Drinking lowers the ability to pay attention, which can be reflected in school. It affects judgement making skills and good decision making. This can lead to dangerous thrill-seeking activities or even getting behind the wheel of a car after a night of drinking.


Finding help is very important. Most medications used for alcoholism is meant for treating adults, not teenagers. Help can be found in the form of individual counseling and alcoholism treatment programs designed for teenagers. Help is out there.

Alcoholism Intervention

Before recovery can take place, the alcoholic has to realize their problem. Many are so obsessed with their addiction, the effect it has on themselves, their friends and families, and others around them will go unnoticed.


An intervention can help. But in order for it have any chance of success, careful preparation and consideration must be done prior to it.
An intervention is a non-threatening confrontation to meet with the alcoholic in a neutral environment and address the addiction, the effects of it, and what needs to be done for recovery.


Family and friends gather together, preferably with a trained intervention specialist, to talk to the alcoholic and try to convince them why help is needed and how that help can be found.


This intervention cannot be spur-of-the-moment. Family and friends can make matters worse if they do this and without the proper guidance. Education is key. Understanding the addiction and the effects it has on the alcoholic will help those involved better understand what is going on and how best to address the situation.


Enlisting the help of an intervention specialist can help to better organize the intervention, address any questions those involved might have, and can guide the group towards a successful intervention with the addict. Intervention specialist have advanced training in addictions. Some may specialize in certain addiction and others more generalized. A specialist can work with the addict in a group of friends and family or one-on-one. The main goal is to provide support and guidance to the client and those involved.


The location of the intervention is very important. It should be held somewhere private and neutral. Choose a place where everyone is comfortable discussing such a delicate matter. The intervention should take no more than an hour or an hour and half. Longer interventions tend to allow emotions to rise and the intervention can quickly get out of control. The location should also be safe for everyone, especially the addict.


The sole purpose of the intervention is to address the problem, not to confront the addict. Family members and friends can write down their thoughts and feelings about their loved one’s behavior but need to make sure they keep a loving, yet firm tone. Confrontation can have a negative bearing on the intervention if made into a personal attack.


Consequences should be presented. This requires the individual to start taking responsibilities for their actions. It could be in the form of the loss of a car or even moving out. It all depends on the situation.

It’s important to note that not every intervention will be successful on the first attempt. Sometimes the alcoholic is not ready to admit there is a problem. Denial is a strong motivator for the addict to continue using alcohol and not see the negative effects it has around them. Accepting responsibility for their actions is often very difficult, if not impossible to do.


Some may still feel they can stop drinking on their own without any outside help.