The Four Stages of Alcoholism
Alcoholism is a disease that gets progressively worse as the alcoholic continues to drink and goes though
the four alcoholism stages.
Barry was a senior at the largest public school in Philadelphia. Due to a number of students who were caught
coming to school "under the influence" of alcohol, Miss Franklin, the health teacher, decided to teach her students
about alcohol abuse and alcoholism.
Due to the importance of the subject matter, Miss Franklin told her students that they would be learning about
alcohol abuse and alcoholism for an entire week.
When it came time to discuss alcoholism, Miss Franklin first decided to define what alcoholism was and then
teach her students about the four stages of alcoholism. Before going any further, Miss Franklin made it a point to
inform her students that alcoholism means the same thing as "alcohol addiction" and "alcohol dependency."
A Definition of Alcoholism
Miss Franklin then gave her class the following definition of alcoholism.
Alcoholism is a debilitating disease that gets increasingly worse as the person continues to drink in an abusive
and excessive manner. Alcoholism is best characterized by the following four components.
The Four Components of Alcoholism
- Loss of control. This means that once the alcoholic has had the first drink, he typically
continues to drink until he is intoxicated. Another way of saying this is that the alcoholic cannot limit his
drinking. As emphasized by Miss Franklin, at this point, alcohol is starting to control the drinker rather than
the other way around.
- Tolerance. This points to the fact that over time, the person needs to drink increasingly
more alcohol in order to experience a "high" or a "buzz." For instance, while it may have once taken five
bottles of beer before a person got intoxicated, it may now take nine or ten bottles of beer in order for the
person to get drunk.
- Craving. This means that alcoholics feel an extremely strong urge to drink. Often,
alcoholics will think about drinking for hours until they "give in" and start drinking. Unfortunately, this
strong "urge to drink" needs to be satisfied every day at best and multiple times throughout the day at
- Physical dependence. Not only are alcoholics physically dependent on alcohol, but when
they try to stop drinking, they experience alcohol withdrawal symptoms. Essentially, alcohol withdrawal
symptoms are responses by the drinker's brain to the sudden lack of alcohol--a situation that is contrary to
the alcohol that the person's brain was accustomed to.
Alcohol Withdrawal Symptoms
Alcohol withdrawal symptoms typically manifest themselves between 6 and 48 hours after the alcoholic has had his
Unfortunately, not only do alcoholics crave drinking, but one of the reasons that they exhibit "out-of-control"
drinking is the fear of facing alcohol withdrawal symptoms if they stop drinking.
At this point, many of the students raised their hands and wanted some examples of alcohol withdrawal symptoms.
Miss Franklin stated that alcohol withdrawal symptoms ranged from mild to moderate to severe and that in general,
they were similar to flu-like symptoms.
Miss Franklin then listed the following as some of the more common alcohol withdrawal symptom: nausea, anxiety,
vomiting, excessive sweating, the inability to sleep, throbbing headaches, confusion, and fever.
Miss Franklin then stated that all alcoholics need to get immediate professional help when facing alcohol
withdrawals due to the fact that in some instances, they can be fatal.
The Four Stages of Alcoholism: An Overview
Miss Franklin proceeded to tell her students that she was going to discuss the four stages of alcoholism that
most alcoholics go through.
When one of the students asked why Miss Franklin was going to divide the topic of alcoholism into stages, she
responded by saying that because alcoholism is such a complex subject, it is easier to understand when it is broken
up into four stages.
As a general frame of reference, Miss Franklin told the class that the alcohol-related problems experienced by
alcoholics typically get worse as they progress through the four alcoholism stages.
At this point, several students wanted Miss Franklin to give them some examples of the alcohol-related problems
manifested by alcoholics.
Miss Franklin thanked the class for their interest, and then told them that most alcoholics experience serious
problems in the following areas of their lives: health, relationships, finances, employment, and involvement with
the law (such as getting one or more arrests for "driving under the influence") (DUI).
Miss Franklin then started her discussion about the different alcoholism stages.
The First Stage of Alcoholism
Miss Franklin stated that in the first stage of alcoholism, drinking loses it's social importance for alcoholics
and becomes a way of escaping emotionally from problems, inhibitions, and from life in general. Another way of
saying this is that in the first stage of alcoholism, the alcoholic moves from mainly a "social" orientation to a
"psychological" frame of reference that is best characterized as an attempt to escape from pain and/or reality.
It also becomes apparent during the first stage of alcoholism, that the drinker needs to drink increasingly more
before getting intoxicated. At this point Miss Franklin reminded the class that this is what she earlier described
The Second Stage of Alcoholism
In the second stage of alcoholism, the craving for alcohol becomes more powerful. For instance, during this
stage the alcoholic frequently starts to drink earlier in the day, often as soon as she awakens.
Not surprising, in this stage, the alcoholic's level of tolerance increases as she needs even more alcohol in
order to get intoxicated.
Miss Franklin once again highlighted the shift from the social to the psychological in the first stage of
alcoholism. She then pointed out that the shift from psychological stress-relief in stage one gives way in the
second stage to drinking in order to satisfy the alcoholic's dependence on alcohol. Indeed, at this point, rather
than aiming for an emotional escape from pain, the alcoholic needs to drink in order to simply function on a daily
While the alcoholic does not exhibit a total loss of control over her drinking in this stage, those who are
closest to the alcoholic, such as family members and friends, begin to notice the inability of the drinker to limit
her drinking. Also during this stage of the disease, the alcohol-related problems of the alcohol become more
observable by coworkers, family members, friends, and in some instances by neighbors.
In this stage, various physical symptoms of the disease such as the following increase: stomach problems,
blackouts (that is, a kind of alcohol-induced amnesia), hangovers, and tremors of the hands.
Miss Franklin then highlighted another "sign" during this alcoholism stage: rather than looking in the mirror
and seeing the cause of her alcohol-related problems, the alcoholic starts to blame others and circumstances that
are external to herself.
Another key characteristic of alcoholics during this stage are the half-hearted attempts they make at getting
alcohol treatment for their drinking problem. While some alcoholics during this stage do in fact try to stop
drinking, most of them start drinking again as soon as they start to experience alcohol withdrawal symptoms.
The Third Stage of Alcoholism
Due to the fact that alcoholism is a progressive disease, Miss Franklin noted that it should come as no surprise
that the alcoholic's loss of control over his drinking becomes even worse and more noticeable during the third
stage of alcoholism. For example, even if the alcoholic intended on having only one or two drinks, once he reaches
this stage, he typically drinks until he is intoxicated.
In a similar manner, the alcoholic starts to experience even more serious relationship, employment, financial,
health, and legal problems in this stage.
In the third stage of alcoholism, the alcoholic becomes even more alcohol-centered as he starts to avoid family
and friends and displays a lack of interest in events and activities that he used to enjoy. For instance, the
alcoholic may have been a passionate baseball fan all of his adult life. Once he reaches this stage of alcoholism,
however, he may totally avoid going to baseball games or refuse to watch them on TV.
In a similar manner, during this stage, the alcoholic starts to neglect basic necessities such as personal
hygiene, food, water, shelter, and, as mentioned above, personal interaction with others.
Eye-openers are another characteristic behavior of this stage of alcoholism. Essentially, eye-openers reflect
the need to drink whenever the alcoholic awakens. While the alcoholic occasionally had a drink the first thing in
the morning during the second alcoholism stage, during the third stage, this behavior, however, becomes more
When questioned by others about this need to drink the first thing in the morning, most alcoholics claim that
they do so in order to take away the discomfort of a hangover or to "calm" their nerves. Sadly, eye-openers are
often an attempt to quiet the remorseful feeling the alcoholic many have about his drinking behavior.
The Fourth Stage of AlcoholismAccording to Miss Franklin, the fourth and
final alcoholism stage is best typified by the alcoholic's total loss of control over her drinking. This
usually means that alcoholics during this stage get inebriated several times throughout the day. To a great
extent, this is mainly because they need to drink in order to function on a daily basis and also because they
are terrified of going through alcohol withdrawals if they don't get the alcohol they need.
Since alcoholics during this stage drink so frequently, they obviously have a very difficult time maintaining a
Miss Franklin pointed out that not unlike the other alcoholism stages, alcoholics in this stage experience
increasingly more severe alcohol-related problems. For instance, during the final stage of alcoholism, alcoholics
often go on benders. That is, they get extremely drunk and remain intoxicated without interruption for several days
As another example of the final stage of alcoholism, alcoholics during the earlier stages may have exhibited
trembling hands in the morning after getting inebriated the previous night. In the final stage of alcoholism,
however, alcoholics not only regularly experience trembling hands but they also have tremors that affect their
Unfortunately, when "the shakes" (as these tremors are called) are experienced along with visual and auditory
hallucinations, alcoholics experience a condition known as "the DTs." Miss Franklin stressed to the class that the
DTs are not only terribly uncomfortable and disturbing but that they are also a potentially fatal type alcoholism
withdrawal that usually takes place in the final stage of alcoholism unless alcoholics get prompt alcoholism
Not surprisingly, when alcoholics experience "the DTs" many of them promise to themselves and to others to quit
drinking for good. Unfortunately, most alcoholics at this stage of alcoholism do not and cannot follow through on
their promise. As a consequence, most of them return to their hazardous and abusive drinking and, in turn, the
vicious cycle of their alcohol-related problems start once again.
Conclusion: The Four Stages of Alcoholism
It should come as no surprise that the students in Miss Franklin's classroom were sad to learn what alcoholics
go through as their alcohol addiction progresses through the four alcoholism stages.
To counter their sadness, Miss Franklin told her students that in most cases, professional alcohol treatment is
indeed the best response to alcoholism and that alcohol treatment can be successful and lead most alcoholics on the
road to sobriety and alcohol recovery.
Having said this, Miss Franklin pointed out that in certain instances when alcoholics have progressed too far
into their disease, however, some of them are too far gone to receive any significant benefit from alcohol
Even though the students were bothered by the realities of alcoholism in Miss Franklin's presentation, they were
grateful that Miss Franklin cared enough about them to teach them about alcoholism and the four stages that
alcoholics typically go through as they progress through their alcohol addiction.