Stages of Alcoholism

Addiction to alcohol is a serious condition that can begin with the first few drinks and can end in long-term suffering and death. There are seven recognized stages of alcoholism, but unfortunately, many people do not seek help until the later stages if they decide to seek help at all.

Initial Use

Initial use of alcohol often occurs in the teenager or early adult years. Often, in the first stage of experimentation, it may be just a drink or two.

Some people never surpass this stage, and quickly find that they either don’t care to drink alcohol or chose to do so only on rare occasions. Those who do increase to regular but non-abusive use enter in the social stage of alcoholism.

Example: Donna has a glass of beer at her party at age 16. She doesn’t care for the taste and doesn’t drink again until her 21st birthday when she is encouraged to do so by friends.

Social Use

The typical social drinker may consume alcohol up to a few times per month but sometimes can go for days or even weeks without a drink. Also, then they do imbibe, it’s usually low-key and only a couple of servings, such as two glasses of beer or wine with dinner.

People who drink socially may or may not ever progress to high-risk use, which is the next stage.

Example: Joe, age 30 and his family go out to eat at their favorite restaurant twice a month for dinner, and sometimes meet up with friends. He usually orders two beers, and she orders one margarita. Neither drink at home or outside of setting similar to this.

High-Risk Use

High-risk use often involves either binge-drinking or drinking just enough to pose a danger to oneself or others, such as getting behind the wheel of a vehicle or becoming too intoxicated to ward off sexual advances or assaults.

During this stage, hangovers may become more frequent, as well as partaking in a “hair of the dog” the next day to help ease acute withdrawal symptoms such as shakiness, headache, and lethargy.

Example: Taylor, age 22 is in college, and she and her friends go out once or twice a week to parties or clubs. On those nights, Taylor has been regularly seen drinking several beers and multiple shots of tequila.

One morning, Taylor found herself in her dorm by herself but didn’t remember how she got there.

Problematic Use and Early Dependency

Problematic use is characterized by an ongoing pattern of adverse consequences related to drinking. These can include family conflict and relationship strain, legal troubles, financial difficulties, and neglect of responsibilities such as school or work due to alcohol.

Early dependency is identifiable when alcohol withdrawal symptoms are regularly occurring when the user undergoes periods of sobriety.

Some alcoholics hold it together better than others, however – in this stage and the next, “high-functioning alcoholics” can continue to exist. These are people who manage somehow to regularly drink to excess yet still tend to other priorities and maintain a livelihood for themselves and their family.

Example: David, 35, works a 40-hour-per-week job, is married, and has an infant daughter. Every day, he goes to the bar after his shift with co-workers and drinks several beers to the point he is moderately intoxicated.

Despite being over the legal limit, he drives home and spends an hour or so with his daughter before he and wife put her to bed. His wife is generally unhappy with this habit, however, and has asked him several times to cut back or quit.

Middle Dependency

In the middle stage of dependency, both drinking habits and problems continue to worsen.

During this stage, the person is probably going to great lengths to hide the severity of their problem, such as stashing alcohol and sneaking around to get it.

At this point, adverse effects may become irreversible depending on how long the drinker remains in this stage. Marriages may crumble, jobs may be lost, and legal troubles such as multiple DUIs may have occurred. There may be damage to critical organs such as the liver or pancreas, and brain functions such as memory and concentration may be noticeably impaired.

Example: Abby has been drinking heavily on and off for about 15 years, and is currently an active alcoholic. She was convicted of a series of DUIs years earlier, and at age 45, has been unable to regain a driver’s license or own a car.

She is separated from her husband of ten years because he couldn’t take the drinking any longer and she refused to get help. Abby used to own a home with her husband, but now she stays in her elderly parent’s guest room and does odd jobs in between binges. She suffers from early stage alcoholic liver disease and high blood pressure due to alcoholism.


At the crisis stage, the alcoholic probably knows that he or she is in a “do or die” situation and receives an ultimatum from loved ones or oneself. At this point, he or she must choose to seek treatment or be willing to succumb to their condition.

Moreover, drinking has become synonymous with waking life, and without intervention, the person suffering is unlikely to get any better.

Example: Larry, age 65, started drinking with his older brother when he was 14. Now retired for about two years, he has regularly spent several hours a day at the local bar drinking with others in a similar situation.

Larry isn’t just drinking at the bar anymore, however. He takes a drink when he first awakens and doesn’t stop until he passes out. He’s always intoxicated and has fallen several times in the past few weeks. He’s also visited the emergency room on multiple occasions due to excessive alcohol use.


The deeper into the stages of alcoholism you enter, the tougher it is to quit drinking. While some people seek help in the high-risk stage, most do not until they reach some level of problematic use and dependency. While treatment can be successful at any stage, early intervention is always desired to minimize damage to both the person suffering and their loved ones, as well as give families the earliest possible opportunity to heal.

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