Stages of Alcoholism

Unless someone has worked in the alcoholism (the current term is Alcohol Use Disorder, AUD) treatment field for a significant period of time, they likely don’t possess the knowledge necessary to identify stages of alcoholism. Healthcare workers in general identify alcoholism in the late stage, when just about anyone can diagnose the problem. The art of addiction treatment is to identify the problem in the early and middle stages. Most alcoholics don’t respond to intervention or treatment and die prematurely when they reach the late stage of alcoholism. All healthcare and mental health workers should receive comprehensive training on the recognition of early and middle stage alcoholism.

In order to make a difference with alcoholism, a chronic brain disorder that kills more people than all other drug addictions combined, there must be experienced counselors, licensed therapists, nurses, psychologists and physicians dedicated to working in the field of alcoholism treatment. All health care workers who see patients in early and middle stage alcoholism should have the proper education to recognize signs and symptoms related to early and middle alcoholism. I’ve talked to dozens of doctors and nurses who say they get very little training on alcoholism, much less learning to recognize the stages of alcoholism. It’s critical when someone in early or middle stage alcoholism reaches a healthcare provider that they’re diagnosed properly and a referral is made to addiction treatment — otherwise these people will be in and out of emergency rooms, immediate care and their family physicians offices presenting one symptom after another and receiving symptomatic care. The fundamental problem of alcoholism must be addressed with a sense of urgency at the first signs of alcoholism, not in the late stage when nothing much can be done.

The trick is to distinguish situational alcohol abuse from early or middle stage alcoholism. An experienced alcohol treatment healthcare professional can accurately separate the drinker who just went through a divorce and hits the bar scene too much for a period of time from the drinker who’s gradually progressing through the stages of alcoholism. It takes, however, asking pertinent questions and getting information from the family or some significant other, if possible. Then it requires the requisite knowledge of nuances to assess the information. The tendency with healthcare workers who don’t have a comprehensive understanding of alcoholism, though, is to give the drinker the benefit of the doubt, especially if the drinker doesn’t fit the image of an alcoholic that people carry in their heads. A young, bright college student who is kind and charming doesn’t fit the image of an alcoholic for most people but could be an early stage alcoholic, just as much as the scruffy young drinker with tattoos and a police record for alcohol related offenses, who everyone can easily see as a alcoholic.

Alcoholism will continue to be an undertreated and mistreated medical condition as long as healthcare workers aren’t taught to recognize the condition early on before it’s too late.