No two individuals have identical reasons that lead them to develop alcohol use disorder. However, the disease itself follows a pattern, although the timeframe also varies from person to person. If you or your loved ones need help to identify the signs of problem drinking, four stages of alcoholism have been identified: pre-alcoholic, early alcoholic, chronic alcoholic and end-stage alcoholism. These categories were developed because it’s vital to help people understand alcoholism as an illness rather than a moral failing.

If you can identify with one or two stages, please understand that alcoholism is a progressive disease. It’s rare that someone would stay in the early stages indefinitely. Additionally, the DSM 5 journal indicates 11 diagnostic criteria. The presence of just two suggests a mild disorder, while six or more denotes a chronic alcohol use disorder, otherwise known as alcoholism.

Pre-Alcoholic Stage

This phase is the most difficult one to spot in someone else and equally difficult to recognize if you’re the one going through it. The way alcohol interacts with the body and mind is complex. It mimics certain chemicals that our brains naturally produce and require for functioning, called GABA and glutamate. The former causes you to relax, while the latter is excitatory and makes you more active.

The more you drink, the more your body comes to rely on ethanol to release these neurotransmitters, instead of doing it naturally. This is how physical dependence develops. During this formative stage, using alcohol becomes something you do to unwind, help you sleep or help you enjoy social situations more. Of course, drinking is regularly used in social situations, which makes early-stage alcoholism difficult to spot.

If you feel like you can’t face a party without needing a drink or must drink to relax, try to actively push yourself to attend social gatherings without alcohol and have downtime without it. If you find this impossible, it’s time to seek help.

Early-Stage Alcoholism

This stage is characterized by regular binge drinking and blackouts. Sometimes, this behavior could be a sign of experimentation, especially among young people. You may not be drinking every day, but you use alcohol frequently and can’t imagine a “good night out” without it. Drinking to excess regularly primes the mind and body for the development of a more serious alcohol use disorder.

Binge drinking is characterized by the consumption of around four drinks within two hours for women and five drinks within two hours for men. If this sounds like a normal amount to you, it’s time to seriously address your drinking habits. Enjoying the sensation of rapid onset drunkenness and drinking to seek inebriation as quickly as possible is dangerous and may indicate a deeper problem.

Middle Alcoholic Phase

During this stage, your condition may become evident to friends and family, although some people can become highly adept at hiding problem drinking. One of the main issues with this disease is how easy it becomes to lie to yourself as well. If you’re in this phase, you’ll often downplay the amount you drink and find ways of explaining away the behavior. You may start to experience consequences at work or school due to your habit and find yourself regularly hungover and craving more alcohol.

Signs such as drinking at work, while looking after children or when driving are indicators of this stage. You’ve likely become more irritable, and alcohol may start to affect you differently. You’ll need to drink more to achieve the same effects you used to feel and often pass out from alcohol. Changes in your body such as facial redness, stomach bloating, shaking, sweating and memory lapses start to affect you.

End-Stage Alcoholism

In this phase, the effects of long-term alcohol abuse will start to become apparent. You might have tried and failed to stop or cut down drinking several times, too. Alcohol consumption becomes an all-day affair, and your priorities change to facilitate drinking as the most important aspect of your life. If you’ve lost your job or you’re in financial trouble, the sadness and worry associated with these life events could make the situation worse.

Paranoia is frequently seen during this phase. Some people — known as functioning alcoholics — can still maintain their life during this phase, but this is rare and likely to lead to liver damage or other alcohol-related illnesses. If you feel like your drinking problem is chronic but your life isn’t falling apart, don’t continue down this dangerous path. This disease is progressive, and your health will eventually bear the brunt.

If you can relate to the issues outlined above or know someone who falls into any of the four categories, medical treatment in a rehabilitation facility is the most effective path to long-term recovery. To find out how to get the help you need, speak to one of Peace Valley Recovery’s addiction specialists at 215-780-1953.