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Updated on August 17, 2022

The Jellinek Curve

What is the Jellinek Curve in Addiction and Recovery?

The Jellinek Curve is a U-shaped chart that describes a person’s addiction progression.  

It’s made up of 5 stages:1

  1. Pre-alcoholism
  2. Prodromal or early alcoholism
  3. Crucial or middle alcoholism
  4. Chronic or late alcoholism
  5. Recovery or rehabilitation
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Each stage has notable symptoms, which are described in the following sections. 

The Jellinek Curve’s goals include:   

  • To help people understand their alcohol addiction: The curve is a helpful way to identify what stage the person is currently in.
  • To show alcohol addiction as a progressive disease: The curve shows that addiction can worsen over time if not treated. It also shows that recovery is possible. 

The Jellinek Curve is initially made for alcohol addiction. But it has also been adapted for drug use and other addictions like porn and gambling. 

However, the Jellinek Curve is not a diagnostic tool. It’s meant to educate and motivate. 

Moreover, each person’s journey is unique. Not everyone will experience each phase precisely as described. Some people may even skip certain stages.

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History of the Jellinek Curve

The Jellinek Curve was made by and named after Elvin Morton Jellinek in the 1950s. He was a physiologist at Yale University and one of the founders of modern addiction science.1

Jellinek’s research changed the way society views addiction. 

After studying people who were addicted to alcohol, Jellinek found distinct patterns. He used this information to define four stages of addiction. These stages make up the left part of the Jellinek Curve.2

Jellinek’s research also showed that addiction is a disease, not a moral shortcoming. This perspective changed the way addiction is now treated.3

Later on, the Jellinek Curve was revised by a Berlin-born doctor named Max Glatt. Glatt noticed that patients in recovery have common patterns. He added recovery as the fifth stage, making up the right part of the Jellinek Curve.1

Glatt and Jellinek are both considered pioneers in the treatment of alcohol addiction because of their research and development of the Jellinek Curve.

Jellinek Curve Phases Explained

The Jellinek Curve consists of two halves.1, 4

The left half curves downward. It represents a person’s descent from casual drinking to alcohol addiction. The first four stages make up this half. 

The right half curves upward. It represents a person’s improvement from addiction to sobriety. The fifth stage makes up this half.

Not every person will experience all symptoms of each stage. However, they could still have an addiction problem even though they don’t show any signs.

1. Pre-Alcoholism

In this stage, people no longer drink for socialization. They drink to cope with stress, anxiety, or depression. This is called relief drinking

People may not experience any adverse effects in this stage. 

Still, relief drinking is dangerous. It leads people to think that drinking is helpful and sets them up for more problems. 

People may also drink by themselves more often during this stage. 

2. Prodromal (Early Alcoholism)

In this stage, people feel like they still have control. 

They can stop drinking for a certain time, but they drink again when cravings become too strong.

People also experience more troubling signs associated with drinking, including: 

  • They start to build a tolerance for alcohol 
  • They drink more often and in larger amounts to get the same effects from drinking
  • They drink more quickly to cope with stress or emotions
  • They develop relationship or health problems 
  • They begin to neglect school or work 
  • Blackouts become more frequent because of the increased speed and quantity of drinking 
  • Hangovers are now a regular occurrence

3. Crucial (Middle Alcoholism) 

This stage is characterized by loss of control and psychological addiction. The person will:

  • Drink at odd times of the day, like first thing in the morning 
  • Promise to change their drinking behavior, but they fail 
  • Make excuses or blame others for their drinking 
  • Experience denial 
  • Hide their drinking from their loved ones
  • Spend more time and effort drinking 
  • Become more angry, irritable, and aggressive

These signs can adversely affect drinkers’ relationships, work, studies, and health. 

Their friends and family may begin to lose patience, trust, and understanding. Stress may also increase because of money or employment issues in this crucial phase.

4. Chronic (Late Alcoholism)

The chronic phase is characterized by physical dependence on alcohol. 

People go through a cycle of drinking because they’re now physically dependent on alcohol. 

If they stop drinking without medical help, they will experience life-threatening withdrawal symptoms. They will continue drinking to avoid these uncomfortable effects. But once they drink, they can no longer stop. 

Aside from withdrawal symptoms, people may experience other severe and often deadly conditions like:5

  • Alcohol intoxication
  • Cirrhosis and other liver diseases
  • Damage to the esophagus or stomach
  • Pancreatitis
  • Cancer
  • Mental health problems  
  • Memory loss and confusion
  • Alcohol-related psychosis
  • Heart attack, stroke, and other cardiovascular diseases
  • Death

They may also face homelessness, divorce, or deep financial troubles. 

Some people may never get past this stage. There are also people who hit rock bottom first before seeking help and starting recovery. 

5. Recovery/Rehabilitation

Recovery begins when people have an honest desire to change and seek help. After that, they:

  • Stop drinking 
  • Commit to becoming sober 
  • Start taking care of their mental and physical health 
  • Gain renewed self-worth and self-confidence 
  • Mend and re-establish relationships with friends and family members 
  • Strive to achieve economic stability
  • Develop healthy thinking 
  • Learn to recognize patterns that support their past addiction 

The journey towards complete recovery is steep. Some people may relapse and slide back to stage four before recovering fully. 

This makes aftercare services, group therapy, and mutual support groups essential for the rehab process. 

Interestingly, the recovery stage doesn’t flatten out on top. It continues to rise. This represents the never-ending improvements that come with a successful recovery process.

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Finding Help For Addiction

If you or some you know is suffering from substance use problems, these treatment approaches could help:6

Behavioral Treatments

This includes cognitive behavioral therapy, motivational enhancement therapy, marital and family counseling, and brief interventions

Medications

Examples are naltrexone, disulfiram, and acamprosate. These medications can help you stop drinking and protect against relapses.

Mutual Support Groups

Many treatment centers have aftercare and alumni support programs. People going through recovery are more encouraged when they meet people who successfully found sobriety.

Call to find out how much your insurance will cover
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Resources

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  1. Ward, Judit H., William Bejarano, Thomas Babor and Nicholas Allred. “Re-Introducing Bunky at 125: E. M. Jellinek’s Life and Contributions to Alcohol Studies.Journal of Studies on Alcohol and Drugs vol. 77,3 : 375-383.
  2. Venner, Kamilla L, and Sarah W. Feldstein. “Natural history of alcohol dependence and remission events for a Native American sample.Journal of studies on alcohol vol. 67,5 : 675-84. 
  3. Babor, Thomas F. “The Classification of Alcoholics: Typology Theories From the 19th Century to the Present.Alcohol health and research world vol. 20,1 : 6-14.
  4. Jellinek, Elvin. “Phases in the drinking history of alcoholics. Analysis of a survey conducted by the official organ of Alcoholics Anonymous (Memoirs of the Section of Studies on Alcohol).Quarterly Journal of Studies on Alcohol vol. 7,1 : 1-88.
  5. Alcohol's Effects on the Body.National Institute on Alcohol Abuse and Alcoholism.
  6. Treatment for Alcohol Problems: Finding and Getting Help.National Institute on Alcohol Abuse and Alcoholism.

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