Nobody wakes up one day and suddenly they’re an “alcoholic”. Physical and psychological dependence on alcohol builds over time – it's a complex and messy process. In many cases, it’s possible to pinpoint where it began or even when it got worse. For some, this process can be broken down into four stages, and that’s what we’re talking about today.
At SUN Behavioral, we know that around 18% of Delaware’s residents participate in binge drinking. Many don’t know when their relationship with alcohol becomes unhealthy, and we want to help. Let’s talk about the four stages of alcohol use disorder (AUD).
Alcohol use disorder, or “alcoholism” as some may call it, is the inability to stop consuming alcohol – even when it’s hurting you (or the people you care about). Some people believe AUD is just a choice or a disease. At SUN Behavioral Delaware, we know AUD is much more complicated than that. Often rooted in trauma or triggered by mental health conditions, alcohol use (or misuse) sometimes begins as a form of self-medication.
We also know that the desire to stop drinking isn’t always enough. Alcohol impacts brain chemistry. When it’s consumed for long periods, things like withdrawal and cravings are common, which can make it feel impossible to stop drinking on your own. It is both biological and psychological. Simply treating alcohol use won’t work – the whole person needs to be considered when discussing recovery. While these stages are considered to be the most “common”, we know that each person is unique and so is their journey. We only hope that this guide will help those who might be looking to prevent the progression of AUD.
Just like a new relationship, there’s a honeymoon phase with alcohol. It’s called the pre-alcoholic stage. The first stage of AUD almost feels like no stage at all, but it’s where everything begins. During the pre-alcoholic stage, it isn’t likely that you (or anyone around you) will notice a “problem.” This is also known as the experimental stage. It’s when you’re first discovering alcohol. People often keep their alcohol use limited to weekends or evenings with friends.
This is also when alcohol becomes an option as a coping strategy. Things you may have done before, like writing in your journal or calling a friend when upset, might fall to the wayside. Alcohol is your new way to unwind. It’s a fun and easy way to “let loose”. During this stage, people sometimes believe they’ve discovered a brilliant way to manage stress. At this point, you’re not leaning on alcohol too heavily, but your tolerance is developing. One beer doesn’t make you feel as good as two. A few weeks later, two beers don’t make you feel as good as three. This is how it begins.
Stage two is where patterns or routines begin. Many times you won’t even realize this is what’s happening. It becomes a habit – something you do that just feels natural. During this stage, many people find that anything becomes an excuse to drink – social gatherings, a bad day at work, a promotion, a graduation. Any kind of event, joyous or stressful, is a reason.
This is also the stage when hangovers become more prevalent, and the phrase “hair of the dog” becomes a motto to live by. You may find yourself drinking the morning after a binge to cope with the hangover.
Anxiety following a night of drinking is so common it has a name: “hangxiety.” During this stage, many will drink in excess to avoid this at all costs. The relationship between yourself and alcohol has begun to shift. It is both causing your pain and “curing” it at the same time.
This stage is what most of us think of when we hear the words “alcoholic” or “alcoholism”. It’s when alcohol begins to become a priority in your life. This is when someone is drinking frequently, maybe nightly, and often alone. You may begin your mornings with an alcoholic beverage, or you may add alcohol to your coffee. You might find yourself sneaking drinks at work or daydreaming about when you get to go home so you can drink.
This is also the stage when relationships begin to decay due to alcohol use. When alcohol becomes your priority, it’s hard to focus on anything else – even the relationships that matter to you. Your behavior will likely change at this stage, as well. You’ll become more reclusive because you hesitate to be in a place where you can’t drink. Heavy drinking can lead to massive hangovers that keep you from other activities, so you may struggle with your job or schoolwork.
Health is also impacted at this stage. People who have reached the middle alcoholic stage may develop fatty liver or steatosis. Stomach issues, particularly irritable bowel syndrome, may occur. Sleep will be impacted, so your mood will be unstable and irritability is common. Drinking heavily also impacts adequate hydration, so your skin might look dull. Feeling “tired” or “unwell” is a regular occurrence.
This later stage of alcohol use disorder is often thought of as the point where someone loses complete control over how much they drink. To function normally, the late-stage “alcoholic” will need to drink. This is also the stage where withdrawal symptoms occur when alcohol isn’t present in your system. Intense cravings for alcohol are also common. If you’re in this “end-stage”, it means you can’t function without alcohol. No matter how badly you want to stop or reduce your drinking, you can’t.
All of these stages have signs to look out for if you’re concerned about AUD in yourself or someone you love. In all of these stages, there is one common denominator: the difficulty in controlling your alcohol use, even if you can see it’s hurting you or the people you love. Let’s reiterate some common signs of an AUD:
There is no specific point or stage at which your drinking “should” concern you. If you’re questioning yourself and wondering whether or not you’re making healthy choices, it’s already a concern. If you feel like you’re having a hard time controlling how much you drink, it might be a good time to talk to your doctor.
A “strategy” might not be the best word when you’re approaching a loved one’s drinking. Yes, your end result is for them to be happy and healthy. However, this is not something you can control.
If you’re concerned about a family member or someone you care about, it can be overwhelming to wonder whether or not they have a “problem”. Keep in mind that oftentimes, what someone with AUD needs is your support – not your judgment. It can feel impossible to watch someone lose control of their drinking without being able to help, but encouraging them is sometimes all you can do. Supporting positive changes in their lives is invaluable. If you’re concerned about someone’s drinking, it may be time to have an open dialogue with them expressing your feelings.
If you or someone you love is having a hard time controlling how much alcohol you drink (or how often you drink), it might be time to seek treatment. At SUN Behavioral Delaware, we know that every patient’s healing journey is unique. That’s why we offer a large variety of treatment programs for alcohol use disorder.
Alcohol detox happens in the first 72 hours after your last drink. It’s the process your body goes through to flush the alcohol out of its system. During this time, your body is working hard to rid itself of any toxins left behind. This is when withdrawal symptoms usually start, peak, and subside.
SUN Behavioral Health’s Alcohol Detox happens during this time. You’ll come in and meet with one of our clinicians to be assessed for your needs and to create some goals for yourself. People who choose detox stay in our facility so we can monitor their condition, treat their withdrawal symptoms, and help them heal safely and efficiently.
Inpatient treatment provides patients with a stable and supportive environment. Here, they can focus on their recovery while being surrounded by trained and licensed professionals and others who are going through the same thing.
During inpatient treatment, patients stay on sight at the rehab facility 24/7. They get to experience a wide variety of activities and programs during their day from individual therapy sessions and group sessions to activities such as yoga or hobbies that help rebuild new habits and focus the mind on healing.
If inpatient treatment doesn’t work for your schedule or your lifestyle, outpatient and PHP can help. Outpatient programs can also act as a stepping stone between inpatient and the end of treatment. This type of care usually does not require patients to stay at the facility while being treated. When visiting the facility, patients spend time in customized sessions throughout the day. This can be beneficial for full-time employees seeking treatment because it allows patients to continue to maintain a life outside of treatment.
If you or someone you know is living with an alcohol use disorder, SUN Behavioral Delaware can help. If you have any questions or would like to learn more about our available treatment options, call us today at 302-604-5600 so we can help you get your life back!
Alcohol use disorder, or “alcoholism” as some may call it, is the inability to stop consuming alcohol – even when it’s hurting you (or the people you care about).
If you’re questioning yourself and wondering whether or not you’re making healthy choices, it’s already a concern. If you feel like you’re having a hard time controlling how much you drink, it might be a good time to talk to your doctor.
Supporting positive changes in their lives is invaluable. If you’re concerned about someone’s drinking, it may be time to have an open dialogue with them expressing your feelings.