There are three or four stages of alcoholism depending on which model you look at. We think the four- stage approach is most accurate as stage one can have some concerning behaviors which should not be overlooked.

E.M. Jellinek gained attention in 1960 when he proposed the Disease Concept of Alcohol Addiction which is now widely accepted as the Disease Model. Jellinek proposed that alcoholism was a chronic, relapsing condition that required treatment.

Stage One – Pre-Alcoholic Stage
In this stage, a person uses drinking to cope with stress, manage emotions or to supplement a social lifestyle. As the drinking happens more often, the person begins to develop a tolerance to alcohol’s effects. The problem during this stage is that the physical damage is occurring and the reduced effects of alcohol due to increased tolerance leads to more frequent use and higher amounts of consumption.

Stage Two
In the three-stage model this is stage one, but the use of any substance to alter moods or deal with stress is dangerous and the negative health effects are present prior to this stage.

In stage two, a cyclical pattern of abuse appears. Drinking begins o cause additional problems in relationships, school or work and in turn, the person uses alcohol to deal with the negative emotions caused by the problems initially created by the drinking. The problems with excessive alcohol consumption are self-perpetuating and the person returns to alcohol to cope with the problems and emotions created by alcohol.

As alcoholism takes its hold, tolerance increases and signs which are normally present when a casual drinker reaches their limit, such as slurring, halting speech, and poor motor skills, are not present as the person’s tolerance levels have increased due to heavy, repeated consumption. Because of this, the problem can go unnoticed except by those closest to them.

As the person requires increasing amounts to achieve the desired results and to cope with emotions and stress caused by their drinking, their drinking patterns will begin to change, and they may turn to drinking alone, hiding/masking their drinking or lying about amounts consumed.

Stage Three
In Jellinek’s theory, he calls this the crucial stage. The user’s drinking becomes more frequent. Knowing on some level, they have a problem, they may switch types of alcohol or abstain for periods of time in an attempt to get things under control. In this stage drinking may occur predominately alone (including sneaking drinks at home) or in the presence of other alcoholics.

Hiding and rationalizing become the norm and they will frequently use excuses to justify their drinking. Loss of control is one of the major parts of this phase.

When they stop drinking, they will experience withdrawal symptoms and may drink again to avoid experiencing them. They will usually become irritable when not drinking due to withdrawal. Damage to the body is increasing with each bout of drinking.

During this stage, they will reduce social activities and neglect responsibilities and may exhibit erratic behaviors.

Stage Four
Once a person reaches this stage, once the first drink is consumed, the person loses the ability to limit consumption. In this stage, the user experiences complete loss of control and must drink.

Severe physical, health consequences may be present, and the user may be feeling some of these effects or even been warned by a physician about the severity of their condition but cannot stop on their own.

Prolonged periods of intoxication can lead to ethical deterioration, memory problems, irrational fears and resentments. Some users may experience severe withdrawal symptoms known as delirium tremens where seizures and hallucinations are common.

In this stage drinkers maintain a constant supply of alcohol or get very agitated when they don’t have any. They sacrifice social and occupational functioning and if they don’t seek help, run the risk of drinking themselves to death at this stage.

It is possible to recover at any of these stages. By the time a person reaches stage four, they most likely need a medical detox prior to starting a treatment program.  Our Substance Abuse Program is available on this site.