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The Stages of Alcoholism

Moderate drinking isn’t a concern for most adults. However, when alcohol consumption increases, it can lead to addiction.

Alcoholism doesn’t develop overnight. It emerges from long-term alcohol misuse. Understanding the stages of alcoholism can help you seek help.

Early intervention helps reduce your risk of alcohol dependence and addiction.

It’s estimated that 17 million American adults have an alcohol use disorder (AUD). Another 855,000 Americans between 12 and 17 years of age have an AUD.

The National Institute on Alcohol Abuse and Alcoholism (NIH), 2018

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What Is Early Stage Alcoholism?

If you binge drink or blackouts, you are in the early alcoholism stage. This first stage is characterized by increased drinking and difficulties resisting it.

Early-stage alcoholics often lie about drinking. You may also start hiding drinks. For example, you may spike soda, coffee, or other beverages when nobody else is around.

During this early stage, alcohol tolerance increases. Drinkers may also become overwhelmed with thoughts of alcohol. 

What Is Middle Stage Alcoholism?

During the middle stage, symptoms become apparent to friends and family members. You may start missing work or important social events because of drinking issues or hangovers.

Middle stage alcoholics may drink at inappropriate times. This includes when looking after your children, driving, or at work. You may become more irritable, argue with your partner, friends, or family members.

During the middle stage of alcoholism, your body starts to change due to substance use.

The following physical symptoms will begin to develop during middle stage alcoholism:

  • Facial redness
  • Stomach bloating
  • Sluggishness
  • Weight gain or weight loss

At this stage, some people attempt to stop drinking. Support groups can help middle stage alcoholics with cravings and mental health issues.

What Is End-Stage Alcoholism?

End-stage alcoholism is the most severe and dangerous. At this point, you experience intense mental and health problems. Your condition may be life-threatening.

These symptoms may include:

  • Liver damage
  • Heart problems
  • High blood pressure
  • Brain damage
  • Hepatitis
  • Cancer
  • Dementia

During late-stage alcoholism, the effects of alcohol abuse are clear and visible. 

Drinking often becomes an all-day occurrence. Everything in life, including friends and family, becomes less important than drinking. Many people lose their jobs at this stage.

Diseases, such as cirrhosis of the liver or dementia can develop. End-stage alcoholics may also become paranoid. Attempts to quit drinking may lead to delirium tremens or hallucinations. 

Physical Symptoms of End-Stage Alcoholism

End-stage alcoholics experience a variety of physical side effects and symptoms, including:

  • Cirrhosis of the liver
  • Jaundice from liver failure 
  • Itchy skin 
  • Fluid retention 
  • Fatigue 
  • Malnutrition 
  • Chronic pancreatitis 
  • Heart failure 
  • Anemia 
  • Wernicke-Korsakoff syndrome, otherwise known as alcohol dementia

End-stage alcoholics are often chronically (always) drunk. If you are not drunk, you experience withdrawal symptoms.

Alcohol withdrawal symptoms include:

  • Enlarged, dilated pupils
  • Severe headaches 
  • Clammy, pale skin 
  • Loss of appetite and weight 
  • Nausea and vomiting 
  • Rapid heartbeat 
  • Shaking and Tremors 
  • Hallucinations 
  • Excessive sweating 
  • Seizures

Wernicke-Korsakoff Syndrome (WKS), also called alcohol dementia, can occur in late-stage alcoholism. This comes from a shortage of vitamin B-1, causing to dementia-like traits. 

This syndrome produces physical symptoms, including leg tremors, staggering, vision issues, and balance problems. Drooping eyelids, hallucinations, and double vision are also side effects and symptoms linked with this condition.

People experiencing WKS may also feel confused. They may have issues staying focused or learning new things.

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How Long Does End-Stage Alcoholism Last?

End-alcoholism has a high mortality rate. There are many ways the condition can kill, and most involve a significant amount of pain and suffering.

Treating the condition is difficult, but can save your life.

Quitting drinking can prolong the life of the drinker. Success depends on several factors: 

  • How much damage has already been done to the body when they stop drinking
  • The quality of medical care the patient is receiving
  • How committed the patient is in beating the disease

End-stage alcoholism often ends in death. However, it is possible to overcome your addiction, even at this stage.

Why Is End-Stage Alcoholism Deadly?

End-stage alcoholism is deadly because it causes health complications. Liver damage is common. The liver gains fats and becomes inflamed, leading to liver scarring. Liver damage leads to liver disease or cirrhosis. 

Liver damage can lead to other severe complications because it is a vital organ. The liver is responsible for hundreds of tasks to ensure the body is working as healthily as possible.

Additional health complications also occur from end-stage alcoholism, including heart problems and brainstem stroke. Risks of dementia and cancer also increase. End-stage alcoholics may also develop brain damage and hepatitis.

According to the CDC, more than one million people die each year of cirrhosis, including over 40,000 people in the United States.

CDC

Is it Possible to Recover from End-Stage Alcoholism?

End-stage alcoholism has a high mortality rate. However, even in the last stages of alcoholism, various treatment options are available.

The first stage of alcohol addiction treatment is likely to be medically supervised detox. This helps rid the body of toxins and manages withdrawal symptoms.

Alcohol withdrawal symptoms in an end-stage drinker can be fatal, so medical supervision is crucial. Seizures occur in over five percent of patients.

Most seizures happen within four days after quitting. If the patient does not experience a seizure within the first four days of detox, the chances of it occurring reduces by 90 percent.

Alongside medical detox, an ongoing rehabilitation program can help patients fully recover from alcoholism. There is always hope that it can get better instead of worse.

Alcoholism Statistics

14.5

Million

People in the United States have Alcoholism

7.2

Percent

Of Americans with AUD have received treatment.

95

Thousand

People die from alcohol-related cases each year.

Common Questions and Answers

How many alcoholics die from alcoholism?

In the U.S., about 95,000 people (68,000 men and 27,000 women) die from alcohol-related causes every year.

What causes death from alcoholism?

Alcohol-induced cancers, drunk driving car accidents, alcohol poisoning, heart failure, violence, and liver damage are the leading causes of alcohol-related death.

Can alcoholism cause sudden death?

Yes, alcoholism can cause sudden death, especially if you overdose or experience alcohol poisoning.

What is the average age of death for an alcoholic?

Sudden death from alcoholism is most common in men older than 50, but it can happen to any chronic alcoholic at any time.

Treatment Options for Alcohol Abuse & Addiction

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These prograInpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days. However, they may be longer in some instances. Throughout an inpatient program, you will live on-site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterward.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program. Some PHPs provide food and transportation. However, this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat AUD. MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.
  • Support Groups Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be the first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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Resources

MORE
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Alcohol use disorder (AUD), National Institute on Alcohol Abuse and Alcoholism (NIH), https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders 

Rehm, Jürgen., The risks associated with alcohol use and alcoholism., Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 34,2, 2011, 135-43, https://pubmed.ncbi.nlm.nih.gov/22330211/ 

Alcohol facts and statistics, National Institute on Alcohol Abuse and Alcoholism (NIH), February 2020, https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics 

Singal, Ashwani K MD, MS, FACG1; Bataller, Ramon MD, PhD, FACG2; Ahn, Joseph MD, MS, FACG (GRADE Methodologist)3; Kamath, Patrick S MD4; Shah, Vijay H MD, FACG4 ACG Clinical Guideline: Alcoholic Liver Disease, American Journal of Gastroenterology: February 2018 - Volume 113 - Issue 2 - p 175-194, https://pubmed.ncbi.nlm.nih.gov/29336434/

Zahr, Natalie M, and Adolf Pfefferbaum., Alcohol's Effects on the Brain: Neuroimaging Results in Humans and Animal Models., Alcohol research : current reviews vol. 38,2 (2017): 183-206, https://pubmed.ncbi.nlm.nih.gov/28988573/ 

Alcohol’s damaging effects on the brain, National Institute on Alcohol Abuse and Alcoholism (NIH), October 2004, https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm

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