Stages of Alcoholism Part II – Mid and Late Stage Alcoholism

stage alcoholism
November 30, 2014
|   Updated:
September 15, 2023

Like I said last week, no one turns around one day and is suddenly an alcoholic. Alcoholism is progressive, the speed of progression is different for each individual, and some fall deeper into the addiction before deciding to get help. This blog will look at the mid and late stages of alcoholism.

Mid-Stage Alcoholism

Mid-stage alcoholism becomes difficult for a person to hide from friends, family and employers. A person in this stage of alcoholism is compelled to drink just to maintain normal functioning. This often looks like having a drink when they first wake up, sneaking drinks in during the day (maybe during lunch or when driving from place to place), and drinking at night. If they don’t have a drink, cravings take over and withdrawal symptoms become apparent. The person doesn’t drink just to get drunk anymore, but because they brain and the body “need” alcohol.

Many in the mid-stages of alcoholism feel ashamed of their addiction, so they drink alone at home or they spend most of their time with other addicts. In both cases, family members and friends from before the addiction just don’t matter as much as they used to.

This is a stage where many alcoholics do seek help, finding it very hard to manage their lives when they’ve basically dismantled their own support system. If they don’t seek help of their own volition, they may find themselves in treatment anyway, due to legal problems associated with their drinking or a mandate from their employer.

Contrary to popular belief, there is no distinct “rock bottom” stage where all alcoholics begin to see the error of their ways and decide to sober up. Some continue to drink even as problems mount, or because problems mount and they don’t know how to handle them. Some give up on trying to stop drinking because it can be hard and often takes several tries. Without a concerted and continuous effort to change, alcoholism continues to progress.

Late Stage Alcoholism

Late stage alcoholism is where the body and the mind begin to fail. It may take weeks or it may take years to get to this point. It depends on a lot of factors, including the person’s health before they started drinking; how often, how much and how long they drink; their age and gender, etc. In other words, there is no delineating line or time frame to go by, but once someone is this far advanced, it can be hard, if not impossible, to come back.

At this point, life is an unending battle with withdrawal. The person cannot feel normal no matter how much they drink, and they feel anxious, confused, and physically sick when they are not drinking.  Their liver may be so damaged it cannot metabolize much alcohol at all, so very small amounts of alcohol will get the person intoxicated. Tolerance also begins to fail because the body no longer tries to adapt to the sheer amount of alcohol coming in.

The person has likely lost their job, close relationships and maybe even housing at this point. Cognitive function and memory are severely impaired. Some will already have permanent brain damaged due to WK Syndrome, while others will have reversible impairments. It’s likely they have quit eating due to digestive issues and may be dangerously underweight. Their immune systems are compromised, putting them at risk for infections.

Obviously, this is not a happy place to be. Alcohol might seem like the only comfort left for these people. Choices at this stage of alcoholism are few: keep drinking and face more isolation, liver failure, coma or death, or try to stop drinking and face the hardest uphill climb of their lives. Again, like in mid-stage, the legal system may step in, especially if the person is a threat to others or has dependent children.

If not, it doesn’t mean that this person can’t get sober, but it will take a lot of treatment, including medically assisted detox and likely months of inpatient therapy. This may seem like a lot of effort for someone seen as a “no good drunk” but the transformation can be amazing once a person truly believes he has value.

About the Author

Kathleen Esposito is a certified addictions counselor in the Pacific Northwest. She helps individuals recover from drug, alcohol and gambling dependencies through group and individual therapy and regularly speaks at treatment centers.

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