Vivian Marlowe
Alcoholism, or alcohol addiction, is a progressive condition that can develop from casual drinking into dependence and addiction. The final stage of alcoholism is characterised by a complete loss of control over alcohol consumption, where the person feels they must drink. At this point, the individual’s body has become dependent on alcohol and experiences withdrawal symptoms when alcohol intake is reduced or stopped. This stage is marked by serious health problems, including liver and kidney disease, heart failure, depression, and anxiety. It often results in alcohol-related deaths for those who do not receive treatment.
| Characteristics | Values |
|---|---|
| Definition | Complete loss of control over alcohol consumption |
| Drinking frequency | Daily drinking |
| Health issues | Liver problems, weakened immune system, insomnia, weight gain, cirrhosis, pancreatitis, cancer |
| Emotional wellbeing | Shame, guilt, low self-esteem, defensiveness, mood swings, irritability, anxiety, depression |
| Social and professional issues | Marred relationships, underperformance or absences from work, risky behaviours, legal issues |
| Financial issues | Increased spending on alcohol |
| Physical symptoms | Facial redness, weight gain or loss, sluggishness, stomach bloating, increased blood pressure or heart rate, heart palpitations, vomiting, tremors, shakes, hallucinations, hyperthermia |
| Cravings | Craving for alcohol |
| Treatment | Therapy, detox, rehab, support groups |
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What You'll Learn
Alcohol tolerance and dependence
The development of alcohol tolerance is a critical factor in alcoholism. As tolerance increases, individuals may find themselves consuming larger quantities of alcohol to achieve the desired effects, such as euphoria, stress reduction, or social interaction ease. This can lead to a dangerous cycle where the person ""chases"" the initial rewarding effects of alcohol, driving further tolerance and increasing the risk of alcohol dependence. The progression from casual drinking to alcohol dependence is a complex and unique journey for each individual.
Alcohol dependence occurs when an individual's body becomes accustomed to the presence of alcohol, resulting in physical and psychological reliance. Physiological dependence is characterized by the onset of withdrawal symptoms when alcohol consumption is reduced or stopped abruptly. These withdrawal symptoms can include anxiety, confusion, shakes or tremors, increased heart rate, nausea, vomiting, and sleeplessness. The risk of developing alcohol dependence is heightened when individuals use alcohol as a coping mechanism for stress, emotions, or social situations.
The progression towards alcohol dependence is marked by specific patterns of behaviour and physical symptoms. Individuals may find themselves drinking more frequently, secretly, or experiencing memory lapses due to excessive consumption. They may also start using social gatherings as an excuse to drink and may drink to cope with negative consequences caused by drinking, such as hangovers. As alcohol dependence develops, individuals may struggle with worsening relationships and experience negative changes in their behaviour.
It is important to recognize the signs of alcohol tolerance and dependence to take early action. Early intervention can significantly alter the course of alcohol dependency. Seeking professional help or discussing drinking habits with a trusted individual can be a crucial step in addressing these issues. Additionally, taking regular breaks from alcohol and adhering to low-risk drinking guidelines can help lower the risk of developing alcohol dependence.
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Alcohol use disorder
The progression of alcoholism is often divided into distinct stages, each characterised by specific patterns of behaviour and physical symptoms. The stages of alcoholism were first introduced by researcher Elvin Morton Jellinek, who viewed alcoholism as a chronic relapsing condition that needed to be treated by health professionals. Jellinek's four theoretical stages of alcohol addiction provide a structured understanding of the deepening severity of the disease, which offers professionals and people affected by drinking problems a framework to understand the journey of an alcoholic.
The first stage of Jellinek's model, the pre-alcoholic stage, is marked by little evidence of problem drinking. The person generally experiments with alcohol and develops a tolerance as they begin drinking more regularly as a coping mechanism for anxiety, stress, or other emotions. The second stage, the early alcoholic stage, is characterised by social or binge drinking, which can turn into a problematic pattern as drinking becomes a way to relieve stress or escape challenges. The third stage, the chronic alcoholic stage, is marked by a high frequency and pattern of alcohol use that are dangerous to the individual and those around them. The final stage, the end-stage alcoholic stage, is characterised by a complete loss of control over alcohol consumption, where the person feels they must drink.
The progression from casual drinking to end-stage alcoholism is complex and unique to each person. However, the development of alcohol use disorder can be identified by certain warning signs. These include increased alcohol consumption, secretive drinking, memory lapses, and an increased frequency of drinking. Physical health warning signs include regular severe hangovers, onset of liver problems, weakened immune system, insomnia, and potential weight gain. Emotional wellbeing warning signs include feelings of shame or guilt, low self-esteem, increased irritability, and heightened defensiveness regarding one's drinking habit.
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Physical and mental health issues
Alcoholism is a progressive condition that can have severe physical and mental health consequences. The physical health impacts of alcoholism can be dire, and they include:
- Regular severe hangovers
- Liver problems, including cirrhosis, which can lead to permanent scarring and affect blood flow
- Weakened immune system, resulting in frequent illnesses
- Insomnia
- Digestive problems
- Weight gain due to excessive calorie intake
- Vitamin D deficiency
- Pancreatitis, which is a dangerous inflammation and swelling of the blood vessels
- High blood pressure
- Heart palpitations
- Nausea and vomiting
- Tremors or shakes
- Hallucinations
- In severe cases, hyperthermia
The mental health impacts of alcoholism are equally concerning and include:
- Feelings of shame or guilt
- Low self-esteem
- Increased irritability
- Heightened defensiveness about one's drinking habit
- Mood swings the day after drinking
- Feelings of guilt or regret post-drinking
- Increased stress or anxiety
- Depression
- Confusion
- Sleeplessness
- Disordered thinking
It is important to note that the progression of alcoholism is unique to each individual, and not everyone who engages in social or binge drinking will develop an alcohol use disorder. However, the repeated activation of the brain's reward system reinforces alcohol-drinking behaviours and increases the likelihood of repeated consumption. As such, it is crucial to recognise the early warning signs of alcoholism and seek help if needed.
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Social and professional consequences
Alcoholism can have a wide range of social and professional consequences that can be devastating for the individual and those around them. Here are some of the key areas where the impact can be felt:
Relationships and Family Life
Alcoholism can lead to a breakdown in relationships and family life. Alcoholics may become emotionally distant, abusive, or neglectful of their partners and children. Their drinking may cause financial problems and create an unstable home environment. Spouses or partners of alcoholics often experience high levels of stress and may develop physical or mental health issues as a result. Children of alcoholics are at a higher risk of emotional and behavioural problems and may suffer from neglect or abuse.
Social Isolation and Stigma
Alcoholics may find themselves socially isolated as their drinking becomes a barrier to maintaining healthy relationships. They may withdraw from social activities, lose interest in hobbies, or find that their drinking drives friends and family away. Alcoholism still carries a significant stigma, and individuals may face discrimination or be ostracised by their community. This isolation can exacerbate the problem, as the alcoholic loses the support network that could help them recover.
Workplace Issues
Alcoholism can have a significant impact on an individual's professional life. Alcoholics may find it difficult to maintain regular attendance at work, and their performance may suffer due to hangovers or drinking during work hours. This can lead to disciplinary action, demotion, or job loss. Even when functioning, alcoholics may struggle with concentration, memory, and decision-making, impacting their complex tasks or managing responsibilities. The stress of trying to hide their drinking problem from colleagues can also affect their work and personal well-being.
Financial Difficulties
Alcoholism is an expensive condition. The cost of alcohol can place a significant financial strain on individuals and their families, leading to debt, bankruptcy, or even homelessness. Treatment for alcoholism can also be costly, and if left untreated, the condition may lead to job loss, compounding financial difficulties. The financial consequences can be long-lasting and impact not just the alcoholic but their entire family.
Legal Problems
Alcoholics are at an increased risk of involvement with the legal system, including arrests for drunk and disorderly behaviour or driving under the influence. They may also face legal consequences related to their work, such as losing professional licenses or disciplinary action from regulatory bodies. The legal repercussions can impact an individual's freedom, career, and reputation.
The social and professional consequences of alcoholism are far-reaching and often devastating, underscoring the importance of early intervention and treatment to prevent progression to this destructive stage.
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Treatment and recovery
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as consuming enough alcohol to reach a blood alcohol concentration of 0.08% or 0.08 grams per deciliter or greater within 2 hours. For women, this typically occurs after 4 or more drinks, and for men, it's usually 5 or more drinks within this timeframe. Binge drinking increases the risk of developing AUD, but not everyone who engages in binge drinking will become dependent or addicted. However, those who progress to alcohol dependence may have environmental or genetic factors that increase their risk.
Healthcare professionals offer two main types of evidence-based treatments for AUD: FDA-approved medications and behavioural healthcare. Acamprosate, naltrexone, and disulfiram are three non-addictive medications that can be prescribed to help individuals cut down or quit drinking. These medications work by preventing relapse, reducing the pleasurable effects of alcohol, and addressing the negative consequences of drinking.
Behavioural health interventions, such as cognitive behavioural therapy, motivational enhancement therapy, and contingency management, can also be effective. These therapies aim to normalise activity in the reward and stress circuitry of the brain and strengthen cognitive networks that help inhibit the urge to drink. Therapeutic approaches that teach mindfulness and coping skills can be particularly helpful in altering neural circuits associated with craving and building resistance to urges. Additionally, support groups such as Alcoholics Anonymous (AA), SMART Recovery, and Secular AA can provide valuable peer support and encouragement during recovery.
It is important to remember that treatment and recovery are ongoing processes, and relapse may occur. Seeking professional help and support from healthcare providers, counsellors, and support groups can significantly improve the chances of long-term recovery.
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Frequently asked questions
The final stage of alcoholism is characterised by a complete loss of control over alcohol consumption, where the person feels they must drink. At this point, the individual’s body begins to require the presence of alcohol to feel normal, known as dependence.
At the final stage, the negative consequences of alcoholism become irreversible. The user loses their job due to too many absences and alcohol-induced fights begin to end relationships. The person struggling with alcoholism is rarely without a drink but thinks no one notices.
Serious health problems can arise in the final stage, including liver and kidney disease, heart failure, depression, and anxiety. Advanced cirrhosis of the liver can be life-threatening. Pancreatitis is also a risk, as alcohol causes the pancreas to produce toxic substances that can lead to dangerous inflammation and swelling of the blood vessels.
The final stage of alcoholism is a critical point where early intervention can significantly alter the course of alcohol dependency. Therapy, detox, and rehab can help individuals regain control over their lives. Support groups can also be highly effective at this stage.
The final stage of alcoholism is often identified by an addiction specialist, but there are some key signs to look out for. These include increased alcohol consumption beyond the recommended amount, drinking in secret, and a negative impact on health, work, and relationships.
