According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 29.5 million people were classified as suffering from alcohol abuse. Alcoholism is a level of alcohol use disorder characterized by excessive drinking that affects your physical and mental health or causes some other type of problem in your life. For example, some people with alcoholism experience severe financial difficulties or get into legal trouble when they drink and drive or engage in other criminal behavior after binge drinking or combining alcohol with other substances. It’s important to understand that alcoholism isn’t a one-size-fits-all type of behavior. It occurs in three stages, with each stage causing increasingly more severe symptoms than the one before it. Keep reading to understand what are the three stages of alcoholism and their effects.

Crying woman with alcohol addicted husband in the kitchen concept image for the stages of alcoholism

The Three Stages of Alcoholism

First Stage of Alcoholism: The Early Stage

In the early stage of alcoholism, you’ve started to develop alcohol dependence. During this stage, you may engage in problem drinking because a few drinks aren’t enough to produce the pleasurable feelings you usually get when you drink. In other words, you’ve started to develop a drinking problem and start to regulary consume alcohol that can put your physical and/or mental health at risk. Many binge drinkers in this early stage of alcoholism may engage in risky behaviors, such as drinking and driving or neglecting responsibilities, due to impaired judgment and decision-making.

When you’re in the first stage of alcoholism, you may start using alcohol to relieve stress or avoid dealing with your problems. You drink heavily under the guise of “socializing” or “having a good time,” but in reality, you’re using alcohol as a coping mechanism. Even though you have a drinking problem, you can still function fairly normally. You may continue going to work or school, spending time with friends, attending social events and participating in family activities, all without anyone noticing that you have a problem with alcohol use.

One of the main symptoms of this stage is denial. You may find yourself saying things like “My alcohol use is under control” or “I could stop drinking at any time.” Even though you’re in denial, your problem with drinking starts to take a toll on your life. Instead of focusing on work or being mentally present when you spend time with family members, you start thinking about when you can have your next drink. Your drinking habits also adapt to your new level of alcohol tolerance, causing a gradual increase in your alcohol consumption.

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Second Stage of Alcoholism: The Middle Stage

When you enter middle stage alcoholism, you need to drink alcohol to prevent unpleasant withdrawal symptoms. If you try to stop drinking for a few days, you may experience the following:

  • Nausea and/or vomiting: Nausea and vomiting are some of the most common symptoms. They may be the most severe two to three days after your last alcoholic drink.
  • Insomnia: When you read about alcohol withdrawal symptoms, insomnia is inevitably near the top of the list. Alcohol use disorder can interfere with your sleep cycle, making it difficult to get a good night’s sleep after you stop drinking alcohol. If you had insomnia before you developed a problem with alcohol addiction, it may get worse when you enter alcohol withdrawal.
  • Irritability: Alcohol cravings combined with physical alcohol withdrawal symptoms can make you moody and irritable during the second stage of alcoholism.
  • Headaches: Headaches are also among the most common withdrawal symptoms when you stop drinking alcohol after drinking heavily for a long time.

During middle stage alcoholism, you’re also at risk for something called delirium tremens (d.t.’s), which occurs when someone with alcohol use disorder stops drinking. Your risk for this condition increases if your alcohol addiction caused you to engage in binge drinking over a period of several months. You also have a higher risk of severe alcohol withdrawal symptoms if you’ve ever experienced alcohol withdrawal in the past. Delirium tremens may cause the following signs and symptoms:

  • Severe confusion a few days after you quit drinking
  • Tremors
  • Irritability/agitation
  • Mood changes
  • Fatigue
  • Restlessness
  • Sensitivity to sound or light
  • Changes in your mental function

According to the National Institute on Alcohol Abuse and Alcoholism, d.t.’s occur because the brain changes that occur when you’re drinking get out of balance when you start to withdraw from alcohol. In some cases, d.t.’s can also cause seizures, usually within 12 to 48 hours after your last drink.


Group consoling a man suffering from severe alcohol use disorder

Third Stage of Alcoholism: End Stage Alcoholism

The final stage of alcoholism is known as end stage alcoholism, which can cause several physical and mental health problems. At this point, alcohol has taken over your life. If you don’t drink, you may feel depressed and irritable. During this stage of alcoholism, you may also feel lonely or isolated if you don’t drink alcohol, almost as if alcohol is a friend you’ve been counting on to help you with your problems.

End stage alcoholism increases your risk for several health problems:

  • Cancer: This stage of alcoholism increases your risk of liver cancer, esophageal cancer, colorectal cancer and cancer of the mouth and throat. The reason alcohol addiction increases your risk of cancer is because it breaks down into a substance that can damage your DNA, causing cells to turn cancerous.
  • Hepatitis: Alcohol use disorder can lead to hepatitis, chronic inflammation of the liver that damages the liver cells. Hepatitis caused by an alcohol addiction can lead to nausea, vomiting, reduced appetite, abdominal pain, weight loss, fever and fatigue.
  • Cirrhosis: Cirrhosis is one of the most common complications of alcohol addiction. It results in permanent scarring of the liver, which can reduce your liver function.

If you reach this stage of alcoholism, you’ll need a comprehensive addiction treatment program to start recovering which may include alcohol withdrawal and detox treatment. Working with a certified addiction professional can help you identify the factors that trigger your binge drinking and other harmful behaviors, learn how to develop healthy coping skills and withdraw from alcohol safely.

Changing Tides is an addiction treatment center in North Carolina and is staffed by recovery professionals who have experience working with people at all stages of alcoholism. If you need help recovering from an alcohol addiction, we’re ready to help. Contact our alcohol treatment center in Kitty Hawk, North Carolina, today at 252-715-3905.

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