Progressive Stages of Alcohol Addiction

It is a well established fact that addiction is a disease, and a progressive one at that.  The disease can be broadly classified into three different stages: Early stage, middle stage, late stage. Each stage is characterized by certain behaviours and cognitive mechanisms. In addiction recovery the client and family are helped to identify the current stage of addiction the client is currently in. Families approach de-addiction treatment centres usually in the last stage.

In the early stage, the individual begins to sneak drinks/drugs. He also becomes preoccupied with alcohol/drugs and spends time in thinking of ways to obtain, use or hide his substance abuse. Then in order to what is popularly called as “chasing the high”, he begins to change his consumption pattern by gulping the drink fast instead of sipping it, or using other ways to speed up the drug intake for example, injecting directly. He will also start avoiding reference to his using and start to experience memory blackouts. These blackouts render him incapable of remembering certain incidents or periods of time while he was under the influence. This in turn is indicative of an increased drug tolerance.  Well wishers may suggest drug and alcohol de-addiction centre’s as a preventative measure. Next, he will also begin to feel the need to use before and after social occasions. This suggests a compromised ability to integrate into a social structure (parties, weddings, other social occasions); and is often also accompanied by isolation. Soon after this comes ‘relief drinking’where he begins to feel uncomfortable in situations without the alcohol/drugs.

In the middle stage, the user experiences a loss of control over his use. The value system begins to get affected, along with an increased frequency of relief drinking/using there is dishonesty about the use, and its consequences. The user will try to come up with different ways to hide or lie about using. Often others are also made to lie to protect him against the consequences of his using. Now he starts experiencing ‘morning craving’and needs a drink or to use his drug as soon as he wakes up. Due to his loss of control, he tries periods of forced abstinence or attempts to change geographical location to bring using under control but they are not successful. Others around him disapprove of his using. Aggression and rationalization is common. In alcohol de-addiction treatment the cognitive distortions, such as rationalization, minimizing, diverting are addressed. This is often part of a greater problem of denial, which is a primitive self defense mechanism against the harsh reality of the addict’s addiction and its losses. It is because of this denial that addiction recovery is greatly delayed. He also builds unreasonable resentments and devalues personal relationships. Unable to sustain a job, he often loses it. At this point majority of his drinking/using is done alone.  Grandiosity is evident in an attempt to cover up feelings of low self esteem. He once again attempts to control but fails. Poor eating is common. Sexual drive is affected.

In the late stage of drug and alcohol addiction, he experiences shakes and tremors and in order to control them, he starts to go on lengthy binges. Thinking and cognitive processes are impaired. Irrationality prevails. The guilt experienced in the previous stage turns into persistent remorse. Addressing this guilt is a big part of addiction recovery. Emotional instability increases, and tolerance decreases. Physical health and moral standards deteriorate significantly. At this stage, he is usually admitted into a drug and alcohol de-addiction centre for treatment or into a psychiatric hospital. By this stage he has exhausted all alibis and if help is still not sought, it usually results in death.

It is important to recognize that not all symptoms need to occur at each stage to move on to the next one. Further, they may not occur in the same order as outlined above. However the progression of the disease of addiction follows a predictable curve, and if left untreated, the consequences are fatal. It is important to note that the addict can enter addiction recovery in any stage of the disease so that it can get arrested.