Stages of Alcoholism


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

The First Stage of Alcoholism

Alcoholism Stages. The research literature verifies that alcoholism is a disease that progresses through various alcoholism stages.

For instance, in the first stage of alcoholism, drinking is no longer social but becomes a means of psychological escape from problems, stress, and inhibitions.

More specifically, early in the disease a person starts to depend on the mood altering capabilities of alcohol.

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

For instance, it is typical for individuals in the first stage to start gulping a few drinks before attending a social function and increasing social drinking to 3 to 5 drinks per day.


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

  • Increasing tolerance

  • Lack of recognition by the person that he or she is in the early stages of a progressive illness

  • Gross Drinking Behavior - more frequent drinking of greater amounts

  • A conscious effort to seek out more drinking opportunities

  • An ability to drink great amounts of alcohol without any apparent impairment

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

  • Boasting and a "big shot" complex

The Second Alcoholism Stage

In the second stage of alcoholism, the need to drink becomes more intense. Typically at this stage, the individual starts to drink earlier in the day.

As tolerance increases, moreover, the person drinks because of his or her dependence on alcohol, rather than because of psychological tension relief.

During this alcoholism stage, "loss of control" does not yet manifest itself on a regular basis; it is, nevertheless, gradually observed by others such as family members and friends.

Also at this stage of the disease, the drinker may begin to feel shame and to worry about his or her drinking.

Frequently during this stage, drinkers unsuccessfully attempt to quit drinking.

In fact, drinkers in this stage of alcoholism may change brands of alcohol or switch from hard liquor to beer or wine.

Additionally, to help quiet the internal conflict they now experience, drinkers during this stage start to resort to denial of their drinking problem.

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

Rather than focusing on their drinking as the cause of the many problems they experience, drinkers in this stage typically start to blame others and things external to themselves for their difficulties.

Classic Alcoholic Behaviors in The Second Stage of Alcoholism

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

  • Increasing physical problems

  • More frequent blackouts

  • Denial

  • Increasing tolerance

  • Drinking because of dependence rather than for stress relief

  • Sporadic loss of control

  • Blaming problems on others and on things external to themselves

  • Sneaking extra drinks before social events

  • Unsuccessful attempts to stop drinking

  • Feelings of guilt and shame

  • Chronic hangovers

The Third Stage of Alcoholism

In the third stage of alcoholism, the loss of control becomes more predominant, meaning that the individual is unable to drink according to his or her intentions.

For example, once the individual takes the first drink, he or she can no longer control what will happen, even though the intention might have been to have at most two or three drinks.

During this stage of the disease, the drinker typically starts to experience serious work-related, relationship, and financial problems.

In addition, he or she starts to avoid friends and family and experiences a loss of interest in things that used to be important.

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

Eye-openers are usually taken to calm the nerves, lessen a hangover, or to quiet their feelings of remorse the drinker 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 and shelter.

Interestingly, at this stage of the disease, rather than experiencing an increase in tolerance, the drinker usually experiences a DECREASE in alcohol tolerance.

This means that less alcohol is required to feel its effects.

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

That is, due to the fact that most drinkers during this stage will not disclose the extent of their drinking, they rarely receive any lasting medical treatment.

Even when they admit a small part of the "truth" concerning their drinking behavior to a health care practitioner or to their doctor, they typically fail to follow through with the medical instructions, therefore accomplishing little, if anything of significance regarding their disease.

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

  • Avoidance of family and friends

  • A decrease in alcohol tolerance

  • Serious financial, relationship, and work-related problems

  • Neglect of necessities such as food

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

  • Aggressive and grandiose behavior

  • Eye-openers

  • Increasing tremors

  • Loss of interests

  • The start of physical deterioration

  • Loss of control has become a pattern

  • Half-hearted attempts at seeking medical aid

  • Frequent violent or destructive behavior

  • A decrease in alcohol tolerance

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

  • Unreasonable resentments

  • Problems with the law (e.g, DUIs)

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

  • Loss of willpower

The Fourth Alcoholism Stage

The fourth and final stage of alcoholism is characterised by a chronic loss of control.

In the earlier stages of the disease, the individual may have been successful in maintaining a job.

Now, however, drinking starts earlier in the day and typically continues throughout the day.

Not surprisingly, few, if any, full-time jobs can be maintained once an individual is in this state of mind.

In the earlier stages of the disease, 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 must drink in order to function.

During the fourth stage of alcoholism, benders are typical. More precisely, in this stage, the alcoholic gets helplessly drunk and may remain in this condition for a number of days.

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

During this stage, the alcoholic usually manifests an utter disregard for everything, including job, family, food, and shelter.

Ironically, these occasional "flights into oblivion" are perhaps best described as drinking to get away from the problems 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, however, alcoholics get "the shakes" whenever they try or are forced to refrain from drinking.

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

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

The DTs are a potentially fatal type of alcohol withdrawal that will result unless the alcoholic receives immediate medical care.

After an attack of the DTs, many alcoholics promise to never drink again. Regrettably, most of them do not and can not fulfill their promise.

Consequently, they eventually 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 close at hand (to avoid "the shakes") becomes the most important thing in the life of the alcoholic.

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

Once the alcohol is secured, alcoholics will usually hide their bottles so that they can get a drink whenever they need it, which usually means any hour of the day or the night.

The Late Stages of Alcoholism. It can be noted that the third and fourth stages of alcoholism represent the late stages of alcoholism.

These are the stages that are best typified by chronic alcoholism, an almost total lose of control over one's drinking, worsened physical deterioration, continued tremors, and impaired thinking.

While the disease is certainly the worst during the late stages of alcoholism, it is still possible during these stages in some circumstances for alcoholics to recover from alcoholism via professional treatment.

The bottom line here is this: no matter what alcoholism stage you are in, even if it is one of the late stages of alcoholism, getting immediate professional alcohol treatment is your best option for sobriety, better health, and recovery.

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

  • Vague spiritual desires

  • Benders, or lengthy intoxications

  • Persistent remorse

  • Moral deterioration

  • The realization of being out of control

  • Indefinable fears

  • The possibility of alcoholic psychosis

  • Impaired thinking

  • The "DTs"

  • Devaluation of personal relationships

  • Loss of tolerance for alcohol

  • Unreasonable resentments and hostility toward others

  • "The shakes"

  • An obsession with drinking

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

  • The collapse of the alibi system

  • Continual loss of control

  • Auditory and visual hallucinations

Conclusion: Stages of Alcoholism

Alcoholism Stages. Research has shown that alcoholism is a disease that progresses through four alcoholism stages.

From the information articulated above and from the research literature it can be concluded that the four stages of alcoholism paint a bleak picture for those who are alcohol dependent and who exhibit chronic alcoholic behavior.

This is especially the case if the person is in one of the late stages of alcoholism.


It might be the case that learning about the destructive consequences and the degenerative nature of alcoholism may not make a much of an impact on most of those who are already chronically alcohol dependent.

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

And as far as those who are involved in chronic alcoholic behavior, even if they are in the late stages of alcoholism, it is imperative for them to get immediate alcohol treatment from professionals so that they stop their hazardous drinking, and start on the road to alcohol recovery.