Updated on 3/8/2023

There are four stages of alcohol use disorder (AUD): pre-AUD, early-AUD, middle stage-AUD and late stage-AUD, though various treatment centers may recognize these stages differently. This blog outlines the stages that lead to alcohol use without control, and explains risk factors that increase an individual’s risk of developing an AUD.

Content reviewed by Nicholas G. Glines

In 2019, nearly 14.5 million individuals age 12 and older struggled with alcohol use disorder (AUD) in the United States. Despite the wide range of consequences it can cause, drinking alcohol remains a widely acceptable and normalized behavior. AUD is a complex and chronic illness that affects how an individual thinks, acts and behaves. No one is born with AUD; it develops from a combination of risk factors.

AUD develops in stages. Becoming familiar with the risk factors, warning signs and treatment options for alcohol abuse and AUD can help reduce the number of individuals who are actively struggling with it by bringing awareness to the problem before it fully develops.

Risk Factors for Alcohol Use Disorder

AUD is a condition characterized by a loss of control over alcohol use despite the negative consequences that it may cause. AUD is often used synonymously with alcohol abuse, alcohol dependence, alcohol addiction and alcoholism. As it is a brain disorder that affects each person differently, it can range in severity and intensity of symptoms. Repeated alcohol use, especially caused by AUD, causes long-lasting changes in the brain that makes individuals incredibly vulnerable to relapse.

There are several risk factors that increase an individual’s risk of developing AUD. In general, these risk factors include:

  • An individual’s genetic makeup
  • Family history of alcohol use or AUD
  • Family history of co-occurring mental health problems
  • History of trauma
  • The presence of co-occurring conditions
  • Drinking at an early age

For those who drink, risk factors may depend on:

  • How much alcohol is consumed
  • How often alcohol is consumed
  • How quickly alcohol is consumed
  • Alcohol misuse, such as binge drinking or heavy alcohol use

The Stages of Alcohol Use Disorder

Every treatment facility and program may recognize the stages of AUD differently. In 1960, researcher Elvin Morton Jellinek comprised four theoretical stages of alcohol addiction, each characterized by distinct changes in mental and social functioning. These stages are:

Stage 1: Pre-AUD

This stage recognizes individuals who drink but experience minimum consequences due to their drinking habits. Individuals who fall in this stage may drink for purposes of experimentation. At this phase, there is no developed tolerance to alcohol or use of alcohol to self-medicate. Warning signs may include a desire to use alcohol to “fit in” or to appease curiosity.

Stage 2: Early AUD

This stage includes individuals who drink regularly and may start to experience consequences because of their drinking habits. It is a transitional stage that highlights the instigation of substance misuse rather than just substance use.

While drinking becomes more regular, an individual may start to use alcohol as means of feeling more comfortable, social or relaxed. They may or may not be using alcohol as a conscious coping mechanism; however, substance use becomes more normalized in their life. Warning signs may include feeling a need to drink at social events or drinking as a way to relieve symptoms of stress or anxiety.

Stage 3: Middle Stage AUD

This stage is the most critical of the development of AUD as it is characterized by frequent and consistent alcohol use. An individual will likely begin to experience interpersonal conflict within their relationships as a result of their drinking habits. They feel the need to use larger quantities of alcohol more frequently to achieve the desired effects, which is the result of increased tolerance.

Individuals will likely experience worsening mental and physical health symptoms, such as feeling sick more often when sober than when under the influence or intrusive thoughts about obtaining and using alcohol. Warning signs may include notable interpersonal conflicts, drinking every day or multiple times throughout the day, or changing to friend groups that enable drinking habits.

Stage 4: Late Stage AUD

The final stage of AUD is characterized by a complete loss of control over alcohol use. In other words, a person feels that they need to drink to function. When the individual is not consuming alcohol, they experience intense withdrawal symptoms and cravings that perpetuate repeated substance use. Warning signs include emotional dysfunction (both while under the influence and while sober), hiding how much or how often alcohol is being used or being unable to maintain personal responsibilities.

Treatment Options for Alcohol Use Disorder

AUD can, and often does, result in serious physical and emotional consequences. Rather than allowing alcohol to become the most important thing in your life, recognize that there is a surplus of treatment resources available to kickstart recovery. No substance can compare to the love experienced through strong family and other relationships as well as the beauty experienced through mindfulness of the present moment.

There is no better time for treatment than now, no matter what stage you’re in. However, you first have to recognize the different treatment options available to help treat alcohol abuse and AUD. There are behavioral therapies, mutual-support groups and medications which can be used in combination with each other to increase the effectiveness of treatment. Start by meeting with your primary care physician to discuss different treatment options and local facilities that can kickstart your recovery.

New Hope Ranch is a men’s-only addiction treatment center that specializes in the treatment of alcoholism. At the ranch, men are given an opportunity to achieve and maintain sobriety with the help of constant support from staff and peers in recovery. We will help you navigate recovery challenges with ease. Call us today to learn more at (737) 600-8565.