Updated on February 6, 2024
7 min read

End-Stage Alcoholism: Symptoms, Side Effects, and Recovery

Alcohol use disorder (AUD) is a progressive disease with varying stages of severity. The end stage is the most dangerous and can lead to life-threatening health conditions.

By the time you reach end-stage alcoholism, drinking has become integral to your life. This can harm your:

  • Relationships
  • Work 
  • School 
  • Finances
  • Mental and physical health

What Is End-Stage Alcoholism?

End-stage alcoholism, or alcohol addiction, is the most severe and dangerous stage of alcoholism. The effects of alcohol abuse are clear and visible, and drinking often becomes an all-day occurrence.

At this point, you may experience the following:

  • Intense mental and physical health problems
  • Everything, including friends and family, becomes less important than drinking
  • Job loss
  • Diseases such as cirrhosis of the liver or dementia 
  • Paranoia

Attempts to quit drinking may lead to delirium tremens or hallucinations. Without proper medical attention, end-stage alcoholism can be life-threatening.

Why is End-Stage Alcoholism Deadly?

End-stage alcoholism is deadly because it causes severe health complications. It can cause the liver to gain fat and become inflamed; this leads to liver damage. 

Severe liver damage and scarring eventually lead to liver disease or cirrhosis. More than one million people die yearly from cirrhosis, including 40,000 people in the United States.2

Liver damage can also lead to other complications because it’s responsible for removing toxins from the body. If the liver can’t function properly, the accumulated toxins can affect the following:

  • Brain: Increasing the risk of brain damage, dementia, and memory loss
  • Heart: Increasing the risk of heart attacks, high blood pressure, and stroke
  • Kidney: Increasing the risk of kidney damage and chronic kidney failure

Symptoms of End-Stage Alcoholism

End-stage alcoholics are often chronically drunk. If not, they’ll experience alcohol withdrawal symptoms.

People with end-stage alcoholism may exhibit the following symptoms:

  • Cirrhosis of the liver
  • Jaundice from liver failure
  • Itchy skin
  • Fluid retention
  • Fatigue
  • Malnutrition
  • Chronic pancreatitis
  • Heart failure
  • Anemia
  • Hallucinations
  • Tremors
  • Wernicke-Korsakoff syndrome (alcohol dementia)

Alcohol dementia can occur in late-stage alcoholism due to a shortage of vitamin B-1. Wernicke syndrome affects the brain, while Korsakoff syndrome affects the nerves and spinal cord.

What are the Side Effects of End-Stage Alcoholism?

End-stage alcoholism has physical and mental side effects. Without proper treatment, end-stage alcoholism can be fatal. According to the CDC, more than 140,000 people die from excessive alcohol use in the U.S. annually.8

The physical and mental side effects of end-stage alcoholism may include the following:

  • Liver damage
  • Heart problems
  • High blood pressure
  • Brain damage
  • Memory loss and learning problems
  • Co-occurring mental health disorders (depression, anxiety, etc.)
  • Vision issues
  • Balance Problems
  • Hepatitis
  • Cancer
  • Dementia

End-stage alcoholism can also severely affect your relationships. People with end-stage alcoholism may struggle with isolation and impaired social skills. In a recent study, 52% of heavy drinkers reported alcohol-related impacts on their relationships.2


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How is End-Stage Alcoholism Diagnosed?

There is no official diagnosis of end-stage alcoholism. Your doctor can diagnose you with an alcohol use disorder (AUD) and, from there, identify the stage of your alcoholism.

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses a list of 11 symptoms to determine the severity of AUD. Having six or more symptoms qualifies you for severe alcohol use disorder:

  1. Had times when you ended up drinking more, or longer, than you intended?
  2. More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  3. Spent a lot of time drinking? Or being sick or getting over other aftereffects?
  4. Wanted a drink so badly you couldn’t think of anything else?
  5. Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  6. Continued to drink even though it was causing trouble with your family or friends?
  7. Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  8. More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unprotected sex)?
  9. Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  10. Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  11. Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there? 

Other Stages of Alcoholism

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

The disease will initially go through the early and middle stages before reaching the end stage. Early intervention helps reduce your risk of alcohol dependence and addiction.

Early Stage Alcoholism

The first stage of alcoholism is increased drinking and difficulties resisting alcohol. You may be more prone to binge drinking and blackouts.

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. 

Middle Stage Alcoholism

During the middle stage of alcoholism, 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:

  • Drinking at work
  • Drinking while driving
  • Drinking while looking after children

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

During the middle stage of alcoholism, the following physical symptoms will begin to develop:

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

You may also exhibit personality changes while drinking. These changes include increased aggression and irritability.

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How Long Does End-Stage Alcoholism Last?

End-stage alcoholism has a high mortality rate. A study found that male alcoholics have a life expectancy of 47 to 53 years and women have 50–58 years.7

The health complications that come with end-stage alcoholism increase the likelihood of death. However, alcoholics can prolong their life if they stop drinking.

Can You Recover from End-Stage Alcoholism?

Although recovering from end-stage alcoholism can be challenging, it is possible. Various treatment options are available, even for the last stages of alcoholism.

Treatment involves quitting drinking, which can be difficult for an end-stage alcoholic. However, it can prolong their life.

The first stage of alcohol addiction recovery begins with seeking treatment. Your treatment may involve:

Alcohol withdrawal symptoms in an end-stage drinker can be fatal, so medical supervision is crucial. The success of treatment 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 to beating the disease

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How to Cope with End-Stage Alcoholism

The journey to sobriety doesn’t end with treatment. Once you finish treatment, you’ll need to maintain your sobriety.

Fortunately, various aftercare programs are available to help you avoid alcohol. Here are a few tips that can help you cope with end-stage alcoholism:


End-stage alcoholism is the most dangerous and severe stage of alcoholism. It can cause significant damage to your physical and mental health.

End-stage alcoholism can lead to long-term health issues, damage to internal organs, and brain damage. Without proper medical attention, the condition can be fatal.

However, it is still possible to recover from end-stage alcoholism. This will require professional treatment, rehabilitation, and aftercare.

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Updated on February 6, 2024
8 sources cited
Updated on February 6, 2024
  1. Understanding Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism (NIH), 2020.
  2. Rehm, J. “The risks associated with alcohol use and alcoholism.” Alcohol research & health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 2011.
  3. Alcohol facts and statistics.” National Institute on Alcohol Abuse and Alcoholism (NIH), 2020.
  4. Singal et al. “ACG Clinical Guideline: Alcoholic Liver Disease.” American Journal of Gastroenterology, 2018.
  5. Zahr, NM., and Pfefferbaum, A. “Alcohol's Effects on the Brain: Neuroimaging Results in Humans and Animal Models.” Alcohol Research: Current Reviews, 2017.
  6. Alcohol’s damaging effects on the brain.” National Institute on Alcohol Abuse and Alcoholism (NIH), 2004.
  7. Westman et al. “Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden.” Acta Psychiatrica Scandinavica, 2015.
  8. Deaths from Excessive Alcohol Use in the United States.” CDC.gov.

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