Is a glass of wine every night a problem? What about getting hammered every Friday? What are the chances of slipping into dependency if you only drink on holidays with good company? How do you know if you're just having a drink or if you've already been caught in the system? And if you suspect you're on a dangerous path, can you slow it down?

These questions often hover in the back of our minds. It's generally understood that alcoholism is a disease with both physical and mental roots, something clearly seen in its symptoms. To understand where you or someone you care about might stand, we need to look at the stages of this illness. While a formal diagnosis should always come from an addiction specialist, knowing the map can help you recognize the terrain.

The Four Phases of Dependence

Think of alcoholism as having three main stages, preceded by a kind of overture—a pre-stage where the trouble begins. This initial phase is often called abuse. To determine which phase a person is in, professionals look at five key symptoms. Let’s explore how these symptoms evolve through the pre-stage and the three subsequent stages of alcoholism.

1. Tolerance to Alcohol
   This is about how much your body can handle.
   • Pre-stage (Abuse): Tolerance is low. Remember your first drinks? It didn't take much to feel the effects.
   • Stage 1: Tolerance grows significantly. You can drink for hours and still feel "lucid," able to walk home on your own.
   • Stage 2: Tolerance remains high. A person can consume large quantities of alcohol without acute poisoning.
   • Stage 3: Tolerance drops sharply. The liver is so damaged it can no longer process alcohol effectively. A small dose leads to heavy intoxication, often causing the person to pass out, wake up, and repeat the cycle.
2. Withdrawal Syndrome (The Hangover)
   How your body reacts the morning after.
   • Pre-stage (Abuse): A true hangover doesn't really exist. You might feel off, but it’s not the debilitating experience of withdrawal.
   • Stage 1: Hangovers become more pronounced and uncomfortable.
   • Stage 2 & 3: The hangover is severe. The physical and psychological distress is so intense that the person feels a desperate need for a "hair of the dog" just to function. This is a critical red flag.
3. Pathological Craving
   The mental and physical compulsion to drink.
   • Pre-stage (Abuse): There is no irresistible urge. Drinking is a choice.
   • Stage 1, 2, & 3: The craving becomes overwhelming. The desire to drink is so powerful it overrides logic and promises.

Imagine a couple on a seaside holiday, walking down a promenade lined with restaurants. They're arguing. The man, agitated, suddenly stops at a terrace, orders a large beer, and chugs it right there on the spot before they continue their walk. He didn't need a table, food, or conversation; he needed the alcohol now. That’s a pathological craving. It’s also the inability to keep a promise to yourself—deciding you won't drink for a week, only to find yourself making excuses for a "harmless" beer on day three.

4. Form of Consumption
   The pattern of drinking.
   • Pre-stage (Abuse): Episodic or rare.
   • Stage 1: Frequent. The definition is subjective, but it represents a clear shift from occasional to regular use.
   • Stage 2: Pseudo-binges. This is the "every Friday I get hammered" pattern. Drinking might start Friday and continue through Sunday afternoon, but it's contained by external responsibilities, like the need to be functional for work on Monday.
   • Stage 3: True binges. Control is gone. A person can start drinking on a Wednesday afternoon and disappear for a week, ignoring work, family, and all responsibilities.
5. Social Control
   The struggle between the desire to drink and societal obligations.
   • Pre-stage (Abuse): No struggle exists because drinking doesn't interfere with life.
   • Stage 1: Control becomes difficult. A person starts having to manage their drinking. An airline pilot, for example, might sit with a calculator trying to figure out exactly when he needs to stop drinking to be sober for a flight the next day. When a friend asks, "Ian, why not just skip drinking altogether to be safe?" he might rationalize it, saying it's just a short flight and he'll be fine.
   • Stage 2: Control is severely compromised. That same pilot might now drink anyway, simply hoping he doesn’t get caught. He is actively choosing to risk his career and the safety of others for alcohol.
   • Stage 3: Control is non-existent. There is no longer a struggle between drinking and social duty. The pilot simply drinks and doesn't show up for work.

You might notice that your own symptoms seem to fall into different categories. This is normal. But if there’s one symptom that serves as a powerful litmus test, it's the hangover. Psychiatrists often cut to the chase with one question: "Do you take a drink in the morning to feel better?" Answering "yes" is often enough to diagnose second-stage alcoholism on its own.

The Reasons We Pour the First Glass

How does one arrive at the pre-stage of abuse? The reasons can often be grouped into three categories.

The Tension Reducer (Pre-Neurotic Level)
Here, a person drinks without a deep-seated inner conflict. They drink simply to "relieve tension." They come home from work and need a drink to switch off, to transition into evening mode. This is also where "chemical sleep" comes in—using a specific amount of alcohol as a sleeping pill to quiet a racing mind. This pattern is easily passed down through generations. A child sees a parent use alcohol to relax and learns that this is the tool you use to cope with stress.

The Emotional Anesthetic (Neurotic Level)
This involves drinking to numb a specific internal conflict or neurosis. People drink away loneliness, finding that watching a show with a bottle of wine feels less empty. They drink away unhappy love or the pain of being in a loveless marriage. Unfulfilling work and gnawing anxiety are also common culprits. Alcohol is used as a kind of antidepressant, a way to temporarily lower the volume on pain.

But this is a profound illusion. Alcohol is the ultimate depressant. While it may provide a few hours of relief, the next day brings a dopamine crash. The hangover amplifies every negative feeling: the loneliness becomes crueler, the marriage more hateful, the anxiety more terrifying.

The Social Lubricant (Instrumental Level)
This is when alcohol is used as a tool to achieve a social goal. It’s the drink you have to feel comfortable joining a new group of friends or to fit in with colleagues at a new job. It’s the liquid courage before a date or sex with a new partner. Holiday celebrations also fall into this category—alcohol becomes an instrument for having fun. The danger is when these events become too frequent, and drinking becomes the only way to navigate social situations.

A Sobering Outlook

According to World Health Organization reports, the timeline from abuse to diagnosed alcoholism can be stark. It takes an average of 10 years for a woman and 16 years for a man to progress from the pre-stage to the second stage.

If you recognize that your relationship with alcohol has become a systematic, complicated one, there are essentially three paths forward.

1. Continue drinking. The stages will progress, and if you embrace the "hair of the dog," they will progress much faster.
2. Attempt to limit yourself. Through willpower, you may be able to regain control, especially in the pre-stage or first stage. Resources like Alcoholics Anonymous exist worldwide and offer a community of support.
3. Seek professional help. If you are at the second or third stage, willpower is often not enough. This is the time to ask loved ones for help in getting to a hospital or treatment center.

Final Thoughts

First, be honest with yourself. You're not just "enjoying a cozy night in with a bottle of wine" five times a week; you may be abusing alcohol with a poor prognosis.

Second, remember that alcohol is not an antidepressant; it is a depressant. A great way to think of it is as joy borrowed from tomorrow. Borrowing that joy for a rare celebration is one thing. But borrowing it senselessly just to get through another Tuesday night only digs a deeper debt of misery for the next day.

Finally, a few simple rules can serve as guardrails:

• Never drink alone.
• Don't drink for "bad" reasons—when you're sad, lonely, or hurting.
• Never, ever use alcohol to cure a hangover.

Alcoholism is a chronic disease. There is no going backward. If you progress to the second stage and then get sober, a single drink years later won't return you to the first stage; it will drop you right back into the second. The path only moves forward. Don't pave that path for yourself. The sooner you recognize the problem and seek a diagnosis from a professional, the easier it will be to step out of the system for good. I wish you all health.

References

• Jellinek, E. M. (1960). The Disease Concept of Alcoholism. Hillhouse Press.
  This foundational work first introduced the idea of alcoholism as a progressive disease with distinct phases. Jellinek's model, which describes a progression from early psychological relief drinking to a final chronic stage with physical deterioration, provides the historical and conceptual basis for the stage-based approach discussed in the article.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  This manual is the standard for psychiatric diagnosis in the United States and many other parts of the world. The section on "Alcohol Use Disorder" (pp. 490–497) lists the official criteria used by clinicians, which directly correspond to the symptoms mentioned, such as tolerance, withdrawal, craving, and loss of control over consumption.
• Maté, G. (2008). In the Realm of Hungry Ghosts: Close Encounters with Addiction. Knopf Canada.
  This book explores the deep psychological roots of addiction, arguing that it is often a response to trauma, pain, and emotional loss. It provides powerful support for the "neurotic level" of drinking, explaining how individuals use substances to self-medicate feelings of loneliness, anxiety, and despair, as described in the article. Chapter 15, "The Essential Process," is particularly relevant.