Experts use the term alcohol use disorder to describe a broad spectrum of alcohol abuse and alcohol dependence, conditions more commonly referred to as alcoholism.
Alcohol use disorder (AUD) is estimated to affect over 15 million Americans and can range in severity from mild to severe.
Nearly 90,000 Americans die annually due to alcohol-related causes and one third of driving-related deaths are linked with alcohol use.
Alcohol dependence is progressive, and many professionals use a stage-model to distinguish where an individual’s symptoms and condition lay on a continuum. E. Morton Jellinek studied the effects of alcohol abuse and in 1950 he proposed that the disorder moved through progressive phases. Today the term Jellinek Curve is used by many professionals to describe the phases through which alcoholism can progress. His paradigm is not used by all clinicians but it has been a popular model among 12-Step groups.
A diagnosis of AUD is made using criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In general, a medical professional will evaluate a patient’s condition by asking questions which align with the book’s criteria. For example, questions such as, “have you wanted a drink so badly you couldn’t think of anything else?”, “have you spent a lot of time drinking?”, and “have you continued to drink even though it causes trouble with your family or friends?” are typical queries.
Other questions include, “do you find that drinking often interferes with your responsibilities?” and “have you found that your usual number of drinks have less effect than before?”
Alcoholism has been termed a progressive condition, in other words it can evolve over time creating more and more serious consequences in an individual’s life.
The early stages of alcoholism/AUD are characterized by:
- Frequent attempts to cut down on or stop drinking
- Drinking in spite of others’ concerns
- Drinking more than planned
Over time the body becomes more and more tolerant to alcohol, requiring more and more of the substance in order to achieve the desired effect. As alcoholism grows more severe, loss of control and blackouts are possible, and personality changes can appear.
Withdrawal symptoms appear when a person is dependent on alcohol but unable to use, and include:
Based on Jellinek’s work, many experts view the first, early phase of alcoholism as what is termed the pre-alcoholic phase. During this time period, an individual begins drinking in social situations and realizes that alcohol provides advantageous effects, e.g., relief from stress and feelings of pressure. As such, alcohol becomes a basic, albeit unhealthy, coping method.
In general, it’s not unusual for loved ones not to notice any signs of trouble developing, while at the same time alcohol tolerance gradually develops. Ironically, the alcoholic feels that they function better when drinking although this can be chalked up to the fact that issues are often ignored and thus not confronted.
Next, the middle or prodromal phase is one in which a person specifically uses alcohol as a coping mechanism with the following symptoms typical:
- Significant hangovers
- Dramatic rise in alcohol consumption
- Possible blackouts that begin to occur more frequently
When high levels of alcohol aren’t in the person’s system in this stage, they feel physically unwell and seek alcohol as a means to feel well or normal. In this stage the body’s organs are under assault from the adverse effects of elevated alcohol consumption.
At this point it is common for an individual to enter a vicious cycle in which drinking becomes a means of mediating the unpleasant symptoms of alcoholism, thereby perpetuating destructive behavior.
For example, as alcoholism progresses the body’s cells become tolerant to the effects of alcohol, requiring higher levels to “function” and if the individual stops drinking the body experiences a type of shock because it now anticipates a certain level of alcohol in order to operate.
Because of this overwhelming need for the body to perform with alcohol in it, the ability to resist drinking is affected by strong physiological signals to consume alcohol.
Here are some of the common signs of middle stage alcoholism:
- Reduced social activity and/or unreliable behavior
- Relationship issues including changes in friends
- Chronic drinking in non-social settings
- Withdrawal symptoms when not drinking, e.g. irritability, nausea, sweating
Finally, the last stage of alcoholism, also known as end stage alcoholism, is marked by a full-blown addiction for which alcohol detoxification can mean the difference between life and death. At this point the individual spends the bulk of their time drinking or seeking alcohol and this stage is characterized by psychological and physical issues such as malnutrition and the inability to comprehend the damage wrought by alcohol abuse.
The body’s deterioration is hastened by the inability of cells to generate bone, blood and tissue and to repair themselves.
At this point it’s common for jobs to have been lost and relationships to have been damaged as drinking has become the individual’s sole obsession.
Mental effects of end stage alcoholism include emotional instability, confusion, and an inability to remain alert. In extreme cases, liver, heart, gastrointestinal and respiratory illnesses develop and the following conditions are examples of such illnesses:
- Chronic Bronchitis
End stage alcoholism is dire, but it does not come with an automatic death sentence.
Recovery is possible for most people with AUD and begins with treatment. The first step is to reach out to a medical professional who can assess your or your loved one’s needs and help you to get the help you need in order to recover.
Lifelong recovery is possible: all you need to do is reach out. Starbent Recovery was founded on the belief that people suffering from addictive disorders, trauma, and other co-occurring issues can thrive in the right environment.
Our professional, dedicated staff have the understanding, experience, and compassion necessary to support each resident’s clinical treatment team goals. We offer individualized tier level programs, and guidance with residents’ personal recovery and independent living goals.
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