5 Stages of Alcoholism

Medically Reviewed By Kayla Loibl | Last Edited:  JUNE 09 ,
| 4 Sources

As alcoholism is a progressive disease, it can often be difficult to recognize the different stages of alcoholism.

For instance, most people who have an alcohol problem are not immediately recognized as such because they do not exhibit all stages of the disorder.

One stage may take months or years before moving on to another one. Often times the first few symptoms of alcoholism are ignored or laughed off by family members and friends until the evidence becomes more severe.

On average, the five stages of alcoholism will last ten years before death occurs in 25% of cases. Keep in mind that the time between each stage varies depending on many factors including the amount of alcohol consumed.

Recognizing that you, or someone you care about is struggling with alcohol can be upsetting. A normal thing to do is to look into alcoholism and learn as much as you can about it.

After reading this article, the hope is that you will have a better understanding of the stages of alcoholism. The benefit of understanding these stages is that it can help you get a good idea of what treatment options would be appropriate.

The majority of the medical field recognizes alcoholism as a disease. It is known to be chronic and progressive. Meaning, if left untreated, it will get worse and can lead to death.

Alcoholism is characterized by cravings, loss of control, physical dependence and a need for increasing amounts of alcohol to feel the same intoxicating effects.

Stages of Alcoholism tends to progress in a similar pattern, however, there may be individual differences.

What stage are you (or your loved one) in?

Alcohol Use Disorder Diagnostic Criteria

The Stages of Alcoholism

There are 5 stages of alcoholism:

The first stage is, obviously, experimenting with alcohol. Most people have consumed it before and sometimes people begin to consume it often or in large amounts, many times pushing the limits of what they can handle. At this stage, drinking is primarily social in nature.

At this stage, it is good to assess your motivations for drinking.

  • Do you drink to feel better?  
  • Do you drink to escape bad feelings or thoughts? 
  • Do you drink to reduce anxiety? 
  • Do you drink to relieve physical pain? 

If any of the answers to these questions are “yes,” there is reason to be cautious.

The second stage of alcoholism is an increase in tolerance to the substance. Typically, during this initial phase, a person seeks out alcohol in social situations. Over time, the person notices that it takes more and more alcohol to feel the same effect.

The feeling of being buzzed used to only take two beers, for instance, and now it takes six. Then, twelve and so on. Heavier forms of alcohol such as whiskey, vodka, and tequila are taken in the form of shots to get a quicker “fix”.

Someone who is likely to become an alcoholic will begin to feel some kind of mental relief from drinking in a social atmosphere. Psychological dependence may develop when this person begins to need to drink in order to do something… such as face a difficult task, have a good time or unwind at the end of the day.

A person in this stage may begin to feel guilt about the amount of drinking they are doing, or they may begin to lie about/hide their drinking from others. In this stage, people often find alcohol hard to resist when it is available.

The third stage is characterized by problems resulting from alcohol use. These problems could include relationship issues, legal issues, DUI, problems at work, anxiety or depression when not drinking, etc.

The person may become more depressed or anxiety and may start having sleep disturbances. In general, the problem begins to be apparent to friends and family.

They may question the individual and meet with defensiveness. The person may find themselves drinking at inappropriate times like when caring for children, at work, or while driving

Stages of Alcoholism

The fourth stage of alcoholism is characterized by a dependence on the substance. The person no longer feels in control of when they drink or how much they drink. Their body needs it.

Life is centered around alcohol as the top priority even over friends and family.

Additionally, when they attempt to go very long without drinking, they experience withdrawal symptoms.

The individual may begin to drink alone before going out to parties, gulp drinks and feel some guilt about his or her alcohol consumption.

Some physical signs during this stage include a red face, weight gain/loss, and stomach bloating.

Stage five is addiction. There is a physical and psychological dependence. Pleasure is gone. The person drinks out of a feeling of necessity rather than fun. They never go very long without drinking.

This is often referred to as a crisis stage because risky behavior such as drinking and driving as well as serious health conditions are likely to result. 

An alcoholic in the crisis stage is likely to eventually develop chronic health conditions as a result of the prolonged abuse of the substance. These conditions include:

  • liver damage
  • heart disease, 
  • brain damage, 
  • malnutrition, 
  • mental disorders.

In addition, the risk of suicide is greatly increased due to an increase in depression and anxiety. Additional mental health risks include dementia and paranoia.

Moreover, a person in this stage is likely to have lost control over their drinking. It can be described as a "compulsion" that the individual has no power over and they are unable to stop by themselves.

It becomes part of their daily routine, even when there isn't a problem or event happening in their life. This is why it is so important to seek treatment at this point because without professional help, he or she runs the risk of losing relationships, destroying career opportunities, getting involved with the legal system, etc.

The stages of alcoholism are different from person to person and there is no specific order in which they must take place. However, the progression can be predicted generally by dependence on the substance as well as certain patterns of behavior that happen according to level of addiction as defined by biological, psychological, and social factors.

For example, someone who begins to drink when they feel anxious or stressed out may not go beyond stage two because early use protects them from experiencing the negative consequences that might lead them into later stages of development.

Nevertheless, alcoholism at any stage can be treated. Yet, the sooner a person is able to acknowledge the need for help with alcohol dependence, the better his or her chances are for recovery and the easier it is to recover.

Much damage associated with alcoholism can be repaired and some is permanent, but recovery and maintenance of sobriety is the key to a better life.

Get Immediate Help for Alcoholism

Regardless of which alcoholism stage you or a loved one is in, there is still hope for a better future. It is best to talk to someone who can help you determine the best treatment option for your situation. It is important to remember that alcoholism is a disease and not a weakness, nor are alcoholics morally or spiritually bereft.

Treatment works, but it has to come from within. Luckily, there are people who can help. Contact a treatment provider today.

Lead Writer/Reviewer : Kayla Loibl

Licensed Medical Health Professional 

I am a Mental Health Counselor who is licensed in both New York (LMHC) and North Carolina (LPC). I have been working in the Mental Health field since 2015. I have worked in a residential setting, an outpatient program and an inpatient addictions program. I began working in Long Island, NY and then in Guelph, Ontario after moving to Canada. Read More

More on the stages of alcoholism on our main alcoholism stages page

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