Alcoholism Stages


Alcoholism is a progressive degenerative disease that can be better understood when it is analyzed and evaluated via the four alcoholism stages.

Unfortunately, the fourth, or the last alcoholism stage is also known as the stage that is associated with "chronic alcoholism."

In spite of the debilitating and devastating consequences of this disease through all four of the stages of alcoholism, the hope for alcohol recovery is real if alcoholics can get the professional treatment they need before the disease progresses too far.


Alcoholism Stages: The First Stage

In the first stage of alcoholism, drinking is no longer social but becomes a means of emotional escape from stress, problems, and inhibitions.

More precisely, early in the disease an individual starts to depend on the mood altering effects of alcohol.

Another defining characteristic of the first stage of alcoholism is that a gradual increase in tolerance develops, meaning that increasing amounts of alcohol are required for the person to "get high" or to "feel the buzz."

For example, it is typical for individuals in the first stage of alcoholism to start gulping a few drinks before attending a social activity and then to increase social drinking to 3 to 5 drinks per day.

The following list includes some of the classic alcoholic behaviors in the first stage of alcoholism:

  • Boasting and a "big shot" complex

  • A conscious effort to seek out more drinking opportunities

  • Drinking is not social but a psychological escape from stress and problems

  • Gross Drinking Behavior - more frequent drinking of greater amounts

  • Increasing tolerance

  • A capability to drink relatively great amounts of alcohol without any apparent impairment or negative result

  • An unawareness by the individual that he or she is in the early stages of a progressive illness

Alcoholism Stages: The Second Stage

In the second stage of alcoholism, the need to drink becomes more intensified.

For instance, it is typical during this stage for the person to start to drink earlier in the day.

As tolerance increases, furthermore, the individual drinks not because of emotional stress relief or tension release, but instead because of his or her dependence on alcohol.

During this stage, while the "loss of control" has not yet manifested itself on a regular basis, it is, nonetheless, starting to become noticed by others such as family members and friends.

Also during this stage of the illness, the drinker may begin to feel embarrassment and to be more concerned about his or her drinking.

Often during this stage, drinkers are unsuccessful in their attempts to quit drinking.

For example, drinkers may occasionally switch brands of alcohol or change from hard liquor to wine or beer.

To help quiet the internal conflict they now feel during this stage, moreover, many drinkers start to deny their drinking problem.

In this stage, alcoholism physical symptoms such as blackouts, hangovers, hand tremors, and stomach problems increase.

What is more, instead of seeing their drinking as the cause of the many difficulties they experience, however, drinkers in this stage usually start to blame others and things external to themselves for their problems.

The following list characterizes some of the classic alcoholic behaviors and alcoholism physical symptoms in the second stage of alcoholism:

  • Feelings of guilt and shame

  • Unsuccessful attempts to stop drinking

  • Blaming difficulties on others and on things external to themselves

  • Increasing tolerance

  • Drinking because of dependence rather than for emotional tension relief

  • Sneaking extra drinks before social events

  • Denial

  • Chronic hangovers

  • More frequent blackouts

  • Sporadic loss of control

  • Increasing physical problems

Alcoholism Stages: The Third Stage

In the third stage of alcoholism, the loss of control becomes more pronounced.

This means that the individual is not able to drink in accordance with his or her intentions.

For example, once the individual takes the first drink, he or she typically can no longer control further drinking behavior, in spite of the fact that the intent might have been to have just a "few drinks."

It should be emphasized that a key aspect of this stage of the illness is the following: the drinker often starts to experience serious financial, relationship, and work-related difficulties.

In the third stage of alcoholism, the drinker starts to avoid friends and family and shows a lack of interest in things and activities that once were fun or important.

Also common during this stage are "eye-openers," that is, drinks that are taken whenever the alcoholic awakens.

Eye-openers taken mainly to lessen a hangover, "calm the nerves," or to quiet the feelings of remorse the drinker occasionally experiences after a period of time without a drink.

As the drinking increases the individual starts to neglect most things of importance, even necessities such as food, water, shelter, and personal interaction.

At this stage of the disease, it is interesting to note that instead of experiencing an increase in tolerance, the drinker often experiences a decrease in alcohol tolerance.

This essentially means that less alcohol is required to feel its effects (that is to get "drunk").

The third stage of alcoholism also means that increased alcoholism physical symptoms are noticed both by the alcoholic and by family members and friends.

And finally, during this stage, the drinker typically makes half-hearted attempts at getting medical help.

Simply put, since most drinkers during this stage fail to disclose the extent of their drinking, they infrequently receive any lasting medical treatment.

Even when they admit a small portion of the "truth" regarding their drinking behavior to a health care practitioner, they usually fail to follow through with the medical protocol, thus accomplishing little, if anything of importance concerning their illness.

The following list features some of the classic alcoholic behaviors in the third stage of alcoholism:

  • The development of an alibi system, an elaborate system of excuses for their drinking

  • Problems with the law (e.g, DUIs)

  • The start of physical deterioration (more pronounced alcoholism physical symptoms)

  • Half-hearted attempts at seeking medical treatment

  • Neglect of necessities such as food, shelter, and water

  • An increase in failed promises and resolutions to one's self and to others

  • Aggressive and grandiose behavior

  • Loss of interests

  • Frequent destructive or violent behavior

  • A decrease in alcohol tolerance

  • Unreasonable resentments

  • Increasing tremors

  • The loss of control has become a pattern

  • Serious financial, work-related problems, and relationship problems

  • A decrease in alcohol tolerance

  • Eye-openers upon awakening

  • Loss of willpower

  • Avoidance of friends and family


Alcoholism Stages: The Fourth Stage

The fourth and last stage of alcoholism is characterized by a chronic loss of control.

It is this almost total loss of control that helps characterize this stage as the "chronic alcoholism" stage.

In the earlier stages of the illness, the individual may have been successful in maintaining employment.

Due to the fact that drinking typically starts earlier in the day and usually continues throughout the day, however, few, if any, full-time jobs can be maintained under these circumstances.

In the earlier stages of the illness, the alcoholic had a choice whether he or she would take the first drink.

After taking the first drink, the alcoholic usually lost all control and would then continue drinking.

In the last stage of alcoholism, however, alcoholics no longer have a choice: they simply must drink in order to function.

During the fourth stage of alcoholism, benders are typical.

More specifically, in the fourth stage of alcoholism the drinker frequently gets helplessly drunk and may remain in this situation for a number of days.

The unattainable goal for the alcoholic while involved in his or her bender is to experience the "high" they once felt.

There is a certain irony in the fact that these occasional "flights into oblivion" are probably best articulated as drinking to get away from the difficulties caused by drinking.

In the second or third stages of alcoholism the person's hands may have trembled slightly on mornings after getting drunk the previous night.

In the final stage of alcoholism, conversely, alcoholics get "the shakes" whenever they try or are forced to abstain from drinking.

These tremors are an indication of a severe nervous disorder that now affects the entire body.

When "the shakes" are combined with hallucinations, moreover, the result is known as "the DTs" or delirium tremens.

The DTs are a potentially fatal type of alcoholism withdrawal that will take place unless the alcoholic receives immediate medical treatment.

The shakes, hallucinations, and the DTs mark a point in the illness where alcoholism physical symptoms have reached their peak.

After an attack of the DTs, numerous alcoholics promise to never drink again.

Regrettably, most of them do not and cannot fulfill their promise. As a consequence, they typically return to drinking and the alcoholic behaviors start all over again.

In the fourth and final stage of alcoholism, having an easily accessible supply of alcohol near by becomes critically important for the alcoholic.

Why? The ability to drink whenever he or she wants to helps avoid "the shakes" that are common during this stage of the disease.

Indeed, during this stage, the alcoholic will do almost anything to get the alcohol he or she requires.

Once the alcohol is secured, not surprisingly, alcoholics will usually hide their bottles so that they can get a drink whenever they need it, regardless of the fact that it can be any hour of the day or the night.

And finally, during this stage of the illness the alcoholic usually manifests an utter disregard for everything, including family, job, food, and shelter.

Without question, this stage is most closely associated with the term "chronic alcoholism."

The following represents some of the classic alcoholic behaviors in the fourth stage of alcoholism:

  • Nameless fears and anxieties such as feelings of impending destruction or doom

  • Impaired thinking

  • The loss of tolerance for alcohol

  • The "DTs" (one of the most dangerous of the alcoholism physical symptoms)

  • Moral deterioration

  • Indefinable fears

  • Benders, or lengthy intoxications

  • Unreasonable hostility and resentment toward others

  • An obsession with drinking

  • Devaluation of personal relationships

  • "The shakes"

  • The breakdown of the alibi system

  • Chronic and continual loss of control

  • Persistent remorse

  • Visual and auditory hallucinations

  • Ambiguous spiritual yearnings

  • Possible alcoholic psychosis

  • The awareness of being out of control

Conclusion: Alcoholism Stages

From the information outlined above, it can be determined that the four alcoholism stages paint a dreary picture for those who are alcohol dependent.

And this is especially the case concerning the fourth stage of alcoholism, the "chronic alcoholism" stage.


Indeed, as the alcoholics progress through the different alcoholism stages, they not only have more pronounced and worse alcoholism physical symptoms, but they also suffer from moral, spiritual, and emotional problems that get progressively worse as the disease continues.

It might be the case that an awareness about the damaging results and the debilitating nature of alcoholism may not make a significant impact on most drinkers who are already chronically alcohol dependent.

It is hoped, however, that by exposing our youth to the facts about alcoholism BEFORE they start abusing alcohol will prevent many of them from experiencing the unhealthy and devastating realities suffered by most alcoholics.