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Stages of Alcoholism: Pre, Early, Middle & End

Last Updated: November 1, 2023

Editorial Policy | Research Policy

While treatment can be provided at any stage of alcoholism, the best outcomes occur with early treatment and intervention.

When a person develops alcoholism, clinically known as alcohol use disorder, they may go through several stages. These stages occur as the alcohol addiction progresses from its earlier or mild form to a more severe presentation of alcohol use disorder. 

Alcoholism Overview: What Is Alcohol Use Disorder?

While people often use the term “alcoholism” to refer to someone who has a severe problem with drinking, this term is not considered politically or clinically correct. Instead, the proper diagnostic term for alcohol addiction is alcohol use disorder. 

When a person develops an alcohol use disorder, they experience brain changes that make it difficult to stop drinking. This leads to compulsive alcohol use, even when it causes serious consequences in the person’s life or harms those around them. 

The 7 Stages of Alcoholism

Alcohol addiction progresses through different stages, ranging from the absence of addiction to a severe alcohol use disorder. While treatment can be provided at any stage, the best outcomes occur with early treatment and intervention. 

Stage 1: Abstinence

During the first stage of alcohol addiction, a person has not yet begun drinking. It is believed that people can develop problems related to alcohol addiction before even taking their first drink. Certain risk factors pave the way for alcohol addiction early in life.

For example, genetics play a key role in developing alcohol use disorder. Furthermore, certain environmental factors can interact with a genetic predisposition to make a person more likely to develop problems related to alcohol. For example, childhood trauma and stress from issues like social deprivation or abandonment can place a person at risk of later alcohol addiction. 

Stage 2: Initial Use

As its name might suggest, stage two marks the point at which a person begins drinking. At this point, they do not yet meet the criteria for an alcohol use disorder, but given their predispositions for alcohol addiction, the person is at risk of problematic drinking. Their use may involve only occasional drinking, including binge drinking. 

Stage 3: High-Risk Use

Once a person progresses to high-risk use, their drinking becomes dangerous and moves quickly toward addiction. The National Institute on Alcohol Abuse and Alcoholism reports that for men, heavy alcohol use is defined as consuming more than four drinks on any given day or more than 14 over a week. For women, it is defined as more than three drinks on any given day and more than seven drinks a week.

When drinking progresses to high-risk use, someone in stage three is likely to binge drink regularly or consume quantities of alcohol that place themselves and those around them in danger. 

Stage 4: Problematic Use

Next, the problems associated with alcohol misuse become more evident. A person may incur legal charges for driving under the influence or experience negative health effects, such as high blood pressure. 

Stage 5: Early Stage of Dependence

In the early stages of dependence, a person begins to lose control over their drinking. At this point, brain changes from drinking make it difficult for them to cut back. They may drink, even if it causes negative consequences, such as failure to perform at work or conflict with friends and family. 

Stage 6: Middle Stage of Dependence

Middle stage dependence is even more severe. Consequences worsen; a person may lose their job because of their addiction, drive away friends and family or develop chronic health conditions. 

Stage 7: End Stage of Dependence

At the most severe and final stage of alcohol dependence, a person critically needs treatment. If they do not reach out for treatment during this stage, alcohol dependence will lead to death. At this point, a person’s entire life revolves around alcohol consumption, and they are consistently under the influence simply to avoid withdrawal side effects. 

Treatment Options for Alcohol Use Disorder

When a person has problems with alcohol use, seeking treatment is important for them. If you or a loved one have a problem with drinking, the earlier you can seek treatment within the stages of alcoholism, the better the outcome. Early intervention addresses the issue before a person progresses to severe dependence or chronic health problems from drinking.

Alcohol use disorder is typically treated with a combination of the following modalities:

  • Medications to manage withdrawal and cravings
  • Individual and group therapy
  • Support group meetings like 12-step/AA 

Depending on the needs of the individual, alcohol addiction treatment can occur on a residential or outpatient basis. Patients in residential treatment live on-site at a facility while in rehab. In contrast, those in outpatient care live at home and attend appointments at a facility or clinic during the day. Patients with severe alcohol dependence often begin their treatment journey with a medical detox program to keep them safe and comfortable as they withdraw from alcohol, as withdrawal symptoms can be potentially fatal. 

If you don’t know where to turn for help for yourself or a loved one, a local mental health clinic or a family physician can provide information on treatment centers in your community or refer you or your loved one for services. 

Seek Help at Our Georgia Rehab Facility

If you’re seeking Georgia alcohol rehab, The Recovery Village Atlanta is here to help. We offer multiple levels of care, including medical detox, residential treatment, partial hospitalization programming and intensive outpatient care to provide evidence-based treatment at any stage of the addiction process. Our residential facility offers personal space, with privacy walls built into each room. Contact us today to learn more or get started with your recovery.

Sources

National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Use Disorder.” April 2023. Accessed August 17, 2023. 

Sebold, Miriam; Muller, Christian; Garbusow, Maria; Charlet, Katrin; Heinz, Andreas. “Neurobiology of Alcohol Dependence.” Textbook of Addiction Treatment, November 4, 2020. Accessed August 17, 2023. 

National Institute on Alcohol Abuse and Alcoholism. “Drinking Levels Defined.” Accessed August 17, 2023.