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What Are the Stages of Alcoholism?

Alcohol use disorder (AUD) is a medical condition where an individual is unable to stop or control their alcohol intake despite the negative effects on their personal, professional, and social lives. It is a progressive condition, meaning that it can worsen over time without appropriate intervention. 

By understanding the stages of alcoholism, individuals and their loved ones can better recognize early signs and seek necessary help before the situation escalates to a critical level. 

Understanding Alcoholism: How Common is Alcohol Use Disorder?

Alcohol use disorder (AUD) affects millions worldwide, cutting across demographics and social boundaries. 

Prevalence and Statistics

According to the 2022 National Survey on Drug Use and Health, AUD remains a significant public health issue. In the United States alone, an estimated 29.5 million people ages 12 and older have had AUD in the past year, highlighting the need for widespread awareness and accessible treatment options. These statistics underscore the importance of understanding AUD as more than an individual struggle; it’s a societal challenge requiring community-wide efforts. 

Impact on Individuals and Society

The consequences of AUD extend beyond the individual to affect families, workplaces, and communities. Economically, it burdens healthcare systems and reduces workplace productivity due to absenteeism and decreased performance. Socially, it can lead to strained relationships and social isolation, further complicating the lives of those affected and their loved ones. 

The Stages of Alcoholism

Stages of Alcoholism

Alcoholism is not a sudden onset but a gradual progression through various stages, each with distinct characteristics and challenges. 

Stage 1: Early-Stage Alcoholism: Experimentation and Occasional Binge Drinking

The first and beginning stage of alcoholism is called early-stage alcoholism. During this stage, a person begins to experiment with drinking alcohol, a common occurrence with young adults. Since most people who engage in this stage are just beginning to enjoy drinking, they tend to drink an excessive amount, or what is called binge drinking.  

Gradual increase in the frequency and quantity of alcohol consumption.

Experiencing mild withdrawal symptoms like irritability or headaches when not drinking. 

Understanding these early signs is crucial for timely intervention, which can significantly alter the course of the disorder.

Stage 2: Middle-Stage Alcoholism: Increased Drinking

In the second stage, also known as Middle-Stage Alcoholism, people have already left this element of experimentation, which occurs in the first stage. Drinking starts to increase and escalate. As a result of increasing the amount of being drunk, people quickly develop increased tolerance and dependence on alcohol.   

Since the body becomes used to large amounts of alcohol in such a short amount of time (binge drinking), the body becomes used to it (tolerance), which results in dependence. Since a person at this stage can no longer control their drinking, they are now at risk of developing alcoholism.  

The body starts to require alcohol to function normally. 

Withdrawal from social activities, family gatherings, and a noticeable decline in personal relationships.

Drinking continues despite clear evidence of mounting personal, health, and professional problems. 

This stage often triggers loved ones to urge the dependent to seek help, though resistance from the person with AUD is common. 

Stages 3: Problem Drinking

Stage three is when a person is considered a “problem-drinker.” This means that they have been misusing alcohol uncontrollably, and finally start to experience the physical and social consequences of their actions.

  • Depressed 
  • Anxious 
  • Develop insomnia, and start losing sleep 
  • Relationship issues and decreased social activity usually also occur because of their preoccupation with alcohol 

Stage 4: Dependence

Alcoholism has two main components, dependency, and addiction. While they are two different things, they are related to one another. When someone reaches the last stage in the alcoholism cycle, they are attached to alcohol, and it has taken control over various aspects of one’s life.   

As a result of drinking heavily, the body becomes dependent or used to how much of a substance has entered the bloodstream. In other words, because the body has now become tolerant of alcohol, you may have to drink larger amounts of it to feel buzzed or drunk.   

Drinking excessively causes damaging effects to the body such as the symptoms of withdrawal. Each time you sober up, the body is not only hungover but is confused when no alcohol is being consumed.

  • Nausea 
  • Tremors 
  • Sweating 
  • Irritability 
  • Insomnia 
  • Diarrhea  

Stage 5: Addiction

The last and final stage of alcoholism is addiction. In this stage, a person is officially defined as having alcoholism. They have become addicted to alcohol, characterized by the need to physically and psychologically drink.  

What are the Health Impacts of Long-Term Alcohol Use?

In the late stage of AUD, the health consequences become more severe and often irreversible: 

Serious Health Issues: Development of liver diseases such as cirrhosis, pancreatitis, and other alcohol-related health problems. 

Mental Health Decline: Increased risk of depression, anxiety, and other mental health disorders. 

Social Isolation: Further withdrawal from social connections, leading to isolation and loneliness. 

Complete Physical Dependence: Alcohol is needed for all daily functioning. 

Severe Health Crises: Frequent hospitalizations and critical health conditions are common. 

High Risk of Mortality: Increased risk of death from organ failure, accidents, or other complications related to alcohol use. 

Diagnosis and Recognizing Alcoholism: How is Alcohol Use Disorder Diagnosed?

Recognizing and diagnosing alcohol use disorder is a critical step in getting help. Early diagnosis can prevent the progression of the disorder and improve recovery outcomes. 

Diagnostic Criteria for AUD

Healthcare professionals use specific criteria to diagnose AUD, primarily based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

  • Increased amounts or longer periods of alcohol consumption than intended. 
  • Persistent desire or unsuccessful attempts to cut down or control alcohol use. 
  • A great deal of time spent obtaining, using, or recovering from alcohol. 
  • Cravings, or a strong desire or urge to use alcohol. 
  • Recurrent alcohol use failing to fulfill major role obligations at work, school, or home. 
  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. 
  • Important social, occupational, or recreational activities given up or reduced because of alcohol use. 
  • Recurrent alcohol use in situations where it is physically hazardous. 
  • Alcohol use continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. 
  • Tolerance, as defined by either a need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or a markedly diminished effect with continued use of the same amount of alcohol. 
  • Withdrawal, as manifested by either the characteristic withdrawal syndrome for alcohol or alcohol (or a closely related substance) is taken to relieve or avoid withdrawal symptoms. 

Treatment Options: What Treatment Options are Available for Alcohol Use Disorder in St. Louis?

Treatment for alcohol use disorder varies depending on the severity and the individual’s specific needs. In St. Louis, several options are available, each focusing on different aspects of recovery. 

The first step in treating AUD is often detoxification, which must be medically supervised to manage withdrawal symptoms safely. Facilities like Sana Lake Recovery provide monitored detox programs to ensure patient safety and comfort. 

Ongoing therapy is crucial for long-term recovery. Therapeutic approaches may include: 

  • Cognitive Behavioral Therapy (CBT): Helps individuals in developing skills to change negative thinking and behaviors. 
  • Motivational Interviewing: A method that enhances motivation to change. 
  • Family Therapy: Involves family members in the recovery process to improve support systems. 
  • Medication-Assisted Treatment (MAT): MAT can be an effective part of treatment, using medications like naltrexone, disulfiram, or acamprosate to reduce craving and withdrawal symptoms. 

Long-term support groups such as Alcoholics Anonymous (AA) or other community support groups can provide ongoing encouragement and accountability. Comprehensive rehabilitation programs, often available through facilities like Sana Lake Recovery, offer structured treatment environments designed to address all facets of AUD. 

Recovery From Alcoholism is Possible at Sana Lake Recovery Center

At Sana Lake Recovery Center, we educate our members on the stages of alcoholism to help them cope with their disease. People must recognize the signs and symptoms of alcohol use disorder to identify the problem and receive the necessary help that they need.   

With several treatment programs including inpatient rehab, outpatient treatment, and sober living, Sana Lake has got you covered.

To learn more about the stages of alcoholism, and how you or a loved one can receive the help needed to reach long-term sobriety, contact us today.

SAMHSA, Center for Behavioral Health Statistics and Quality. 2022 National Survey on Drug Use and Health. Table 5.9A—Alcohol use disorder in past year: among people aged 12 or older; by age group and demographic characteristics, numbers in thousands, 2021 and 2022. [cited 2024 May 14]. Available from: 

L. T. C. (2021). Stages of Alcoholism. University of Maryland Baltimore.

Hasin, D. (2003). Classification of Alcohol Use Disorders. Alcohol Research & Health, 27(1), 5-17. 


Picture of Ashley Murry LCSW
Ashley Murry LCSW
Ashley Murry, LCSW, is the Chief Clinical Officer at Sana Lake Recovery. She oversees clinical operations, ensuring effective treatment strategies and compliance. Before this, she was Program Director at Gateway Foundation, managing care programs and collaborating with state departments. Ashley has also served as Director of Clinical Services at Treatment Management Company, improving staff retention and clinical standards. She holds a Master's in Social Work from the University of South Florida and a Bachelor's in Social Work from Saint Leo University. She is licensed in Florida, Arizona and Missouri.
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