Stages of Alcoholism
What is alcoholism?
The word “alcoholic” conjures up the image of an out-of-control drunk who is completely unaware of his surroundings. We see them on street corners, sleeping or chattering to themselves. But in reality, if alcohol is ruling your life, moods and relationships, you probably have a problem with drinking. Alcoholism is a progressive disease and there are different stages of Alcoholism.
Drinking is an accepted social activity in our society— wine with dinner, going out for drinks with friends or celebrating special occasions. Because alcohol so commonly used and is a social lubricant, it can be hard to identify when a person’s drinking has crossed the line from social use to problem drinking.
So what is Excessive Drinking after all?
According to the Center for Disease Control:
Excessive drinking includes heavy drinking, binge drinking and any drinking by pregnant women and underage youth.
Excessive drinking is defined as:
• For women, 4 or more drinks during a single occasion or more than 1 drink per day.
• For men, 5 or more drinks during a single occasion or 2 or more drinks per day.
(www.cdc.gov/nchs/fastats/alcohol.htm)
The Statistics on Alcoholism
To understand alcoholism, it is helpful to understand the statistics of Alcoholism. In other words, Alcoholism is not as rare as you may think. Seven percent of Americans have an addiction involving alcohol, either to alcohol alone or to alcohol and one or more other substances. But more importantly,
an estimated 18 million Americans have an alcohol use disorder and 40 million are high-risk drinkers.
Addiction is a progressive disease and left untreated it gets worse rapidly. Yet too often, it is ignored, minimized and denied.
The Social Drinker:
The most important marker of a social drinker is that he or she is NOT preoccupied with drinking. They drink socially but their focus is the conversation with their girlfriends, or the football game they are watching or the wedding they attend. They do not decide on whether or not to attend a social occasion based on whether or not alcohol will be served.
Stages of Alcoholism
The Early Stage of Alcoholism: During the early stage, the person begins to experience a variety of problems associated with alcohol. They will sneak drinks, deny or lie about how many drinks they have had, feel guilty about their drinking habits but remain preoccupied when and how much they can get away with drinking.
Brenda looked forward to evenings that her husband worked late. This meant she could start drinking earlier than usual. Brenda knew that her husband kept a sharp eye on how much she was drinking. She hated it when he counted the number of drinks she had consumed that evening or cautioned her to drink more slowly and get something to eat. But when he is working late, Brenda can be relaxed and free to drink as much as she wants. When he gets home, Brenda pretends to be asleep (if she is not already passed out). At that point, she does not want to engage in conversation with her husband about his day anyway. On one occasion, when she did try to have a conversation, her husband pointed out that she was slurring her words and accused her of being “drunk”.
Recently Brenda became aware that she needed to drink more to get the same effects of intoxication. She doesn’t want to get together with her girlfriends because she believes that they notice (even when they pretend not to) how much and how fast she drinks. She believes that they judge her. So now, Brenda likes to drink alone because she feels that her friends notice. She has begun to isolate.
If you notice, Brenda has become preoccupied with alcohol, she has developed a higher tolerance for alcohol and has begun to disengage from her community and family.
The Middle Stage of Alcoholism
By the time a person has entered the middle stage of alcoholism, their problems have become more pronounced. Life has become quite unmanageable. Hangovers are frequent and yet you have begun to deal with all feelings, emotions and situations with alcohol. There are problems at work, with family and they are related to your drinking habits. Alcohol has created a vicious cycle in your life. Drinking causes difficulties in your work and relationships and yet to get over the hangover, the anxiety and nervousness that withdrawal from alcohol creates in the body, you drink more alcohol. Thus the cycle carries on.
While the alcoholic probably stop tries to stop he’s unable to do so at this point . Alcohol is needed to function. You may need to drink something in the morning to even begin functioning because if you don’t, you are anxious, unable to focus and may experience tremors in your hands. The increased anxiety, nervousness are serious health effects of alcohol addiction. Others include weight gain, risk of accidents and increased risk of a heart attack or a stroke. You have blackouts and worry about doing or saying inappropriate things during those blackouts. The alcoholic at this point faces serious family issues, including breakdown of marriages, DUIs, losing a job, etc.
Consider the example of Craig. Craig was a very successful accountant but as his drinking increased, his work became sloppy. Recently he missed an important deadline for for a very big client and client them decided to hire another tax firm. Because this was a one-time failure Craig’s boss decided to overlook it with a warning but during the meeting that he had with Craig over this matter, Craig’s boss addressed his concerns about Craig’s performance. Craig knew he was skating on thin ice and he would not be forgiven for another miss. Craig felt trapped and overwhelmed by his problems. He was himself shocked that he had to drink in the morning to get over his hangover and to reduce shaking in his hands and get his anxiety under control. When he got home in the evening Craig’s wife wanted him to help with the children but Craig only wanted to sit and drink he did not want to engage with the children or with his wife for that matter. If she nagged him about it, he would start yelling and cussing at her. In fact, there were times when Craig came close to physical confrontation with his wife. Craig’s wife had threatened to leave him numerous times and he knew that he had to get his drinking under control. He already had two DUIs in the past. The problem was that Craig could not stop. He continued to believe that his problem was not a big one. He just believed that he needed to have the willpower to drink in moderation.
Here you see the serious effects of alcoholism. Craig is unable to function without alcohol and yet alcohol exacerbates his lack of functioning. He is about to lose his job and maybe his family and yet he is unable to control his drinking. In contrast to the early stages of alcoholism, the alcoholic is no longer preoccupied with drinking; drinking has become his life. Also, tolerance is no longer an issue, the alcoholic cannot even function without alcohol. Hangovers are not dealt with aspirin and a cold shower: they have dealt with more alcohol.
Late Stage of Alcoholism
During the last stage of alcoholism, the alcoholic’s life is completely out of control. He is unable to manage any part of his life now. Health effects of alcohol addiction are evident. There are medical complications relating to liver diseases like cirrhosis or hepatitis. The person may also be at higher risk for a heart attack or a stroke. They may experience bleeding from the esophageal lining or see the beginning of alcoholic neuropathy. Depression, insomnia and suicidal ideation are very common at this stage. It is very important to note that at this stage of alcoholism person cannot and should not just stop drinking on their own. Detox should happen only under close medical monitoring. Without medical supervision, the alcoholic may have seizures and could even die due to severe withdrawal symptoms.
About Rochna:
Rochna Hazra is trained in Marriage and Family Therapy at Virginia Tech. She includes the emotional, psychological, spiritual and family aspects of a person in her work. Originally from India, she combines the Eastern traditions of mindfulness, non-judgment and a holistic approach to healing with the Western approach of realism and solution-focused action.
Rochna uses Cognitive-Behaviorial techniques to help you overcome anxiety.
Rochna is also a Certified Advanced Relapse Prevention Specialist and trained in Sex Addiction and Mindfulness-based Therapy and Relapse Prevention.
Click here to learn more about Alcoholism Treatment and my practice in Leesburg, Virginia
