Alcohol Abuse & Addiction: Signs, Causes & Treatment

Written by Brennan Valeski

& Medically Reviewed by Jenni Jacobsen, LSW

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Article Overview:

  • Alcohol addiction is a significant issue in the United States, affecting millions of people.
  • Alcoholism has different stages: early, middle, and late, each with its own unique signs and symptoms.
  • Alcohol withdrawal can be risky and might require medical help.
  • Alcohol addiction treatment includes medical detox, residential rehab, outpatient rehab, and aftercare.
  • Relapse rates are high, but inpatient programs can greatly help, especially for those in the late stages of alcoholism.
  • The length and cost of alcohol treatment vary depending on the severity of addiction and individual needs.

Alcohol is legal for people aged 21 and above, but it can still lead to addiction. According to data from the National Institute on Alcohol Abuse and Alcoholism, 14.1 million Americans aged 18 and older struggle with an alcohol use disorder, which is the clinical term for alcohol addiction. Treatment is essential for those trapped in alcohol’s grasp, offering a chance at recovery and reducing the harm caused by alcohol misuse. 

Understanding Alcoholism and Alcohol Use Disorder (AUD)

The 2021 National Survey on Drug Use and Health (NSDUH) revealed that 10.6% of the population aged 12 and older experienced an alcohol use disorder at some point in 2021. However, only 6.3% of those in need of substance use treatment sought help. 

The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) defines AUD as a “problematic pattern of drinking leading to clinically significant impairment and distress for at least 12 months,” outlining 11 criteria. The term “alcoholism” often refers to AUD, which is its official name.

What Causes Alcohol Addiction?

Alcohol addiction may develop due to various factors, including:

  • Drinking too much alcohol or binge drinking
  • Starting to drink early (before age 15)
  • Genetics and family history 
  • Mental health conditions like depression, post-traumatic stress disorder and ADHD

Signs and Symptoms of Alcohol Addiction

Common signs of alcohol use disorder include:

  • Loss of interest in hobbies or activities
  • Avoidance of social events that don’t involve alcohol
  • Drinking alone
  • Drinking during the day
  • Hiding alcohol use
  • Drinking and driving

Symptoms of alcohol use disorder and dependence include:

  • Inability to cut down or stop drinking
  • Obsession with alcohol
  • Drinking despite adverse health or social consequences
  • Needing large amounts of alcohol to achieve the desired effect
  • Drinking to prevent withdrawal

How Does Alcohol Abuse Affect Your Health?

Alcoholism takes a toll on health and is linked to various issues, including:

  • Risky sexual behavior leading to unplanned pregnancy and sexually transmitted infections
  • High blood pressure
  • Stroke
  • Heart disease
  • Liver disease
  • Digestive problems
  • Weakened immune system
  • Increased risk of dementia
  • Mental health disorders such as depression and anxiety
  • Higher risk of cancer, including breast, mouth, throat, esophagus, voice box, liver, colon and rectal cancers

Stages of Alcoholism

Alcoholism involves three main stages: early, middle and late. Some experts introduce a fourth stage, “pre-alcoholic,” to describe alcohol misuse before AUD develops.

Stage 1: Early Stage Alcoholism

Early-stage alcoholism involves increasing alcohol consumption and growing tolerance.  Excessive drinking leads to alcohol dependence, where the brain relies on alcohol to function, resulting in withdrawal symptoms. Early-stage individuals have tolerance but can function without alcohol.

Signs of early-stage AUD include:

  • Drinking more often than usual
  • Using alcohol to cope with stress, boredom or loneliness
  • Preferring social activities that involve alcohol
  • Finding reasons to use alcohol

Stage 2: Middle-Stage Alcoholism

Individuals in the middle stage of alcoholism require alcohol to function normally. Chronic excessive alcohol use leads to physical alcohol dependence, and they need alcohol to feel normal. If they don’t drink, they may experience uncomfortable withdrawal symptoms like trembling, nausea, sweating and irritability.

Signs of mid-stage AUD include:

  • Drinking regularly outside of social settings
  • Losing interest in alcohol-free social activities
  • Strained relationships with friends and loved ones
  • Experiencing withdrawal symptoms when not drinking
  • Showing physical signs of alcohol addiction, such as weight gain, bloating, and facial redness

Stage 3: Late-Stage Alcoholism

Late-stage alcoholism means physical dependence on alcohol. Now, drinking is no longer a choice but a necessity. People with late-stage alcoholism face a high risk of severe and potentially life-threatening conditions like alcoholic liver disease and heart disease.

Late-stage alcoholism requires professional intervention. Chronic heavy alcohol use leads to significant changes in brain chemistry. These neurotransmitter changes include increased GABA levels and reduced effectiveness of NMDA. Essentially, brain activity is reduced. 

When someone stops alcohol use abruptly in late-stage alcoholism, GABA and NMDA levels return to normal, removing the “brake” on brain cell activity. This can lead to cellular hyperexcitability, potentially causing seizures, delirium tremens or a heart attack.

Signs of late-stage AUD include:

  • Malnutrition
  • Cognitive decline
  • Erratic behavior
  • Financial and legal problems
  • Severe health issues

Alcohol Withdrawal and Detox

Quitting alcohol requires professional guidance because alcohol withdrawal symptoms can be dangerous and require medical supervision throughout the detox process.

Symptoms of Alcohol Withdrawal

Even people in the early stage of AUD may experience withdrawal symptoms when they stop drinking:

  • Headaches
  • Irritability
  • Anxiety
  • Cravings
  • Insomnia
  • Restlessness

Middle and late-stage AUD withdrawal can bring more severe symptoms, including:

  • Tremors
  • Excessive sweating
  • Low-grade fever
  • Nausea and vomiting
  • Diarrhea
  • Rapid heart rate and breathing
  • Psychomotor agitation (repetitive, purposeless movements)
  • Increased anxiety and emotional distress

Severe alcohol withdrawal may include life-threatening symptoms that need immediate medical attention, such as:

  • Respiratory depression
  • Seizures
  • Delirium tremens (hallucinations, delirium, confusion, loss of touch with reality)
  • Heart attack

Alcohol Withdrawal Timeline

The timelines for alcohol withdrawal vary slightly depending on whether it’s early, middle or late-stage alcoholism. Symptoms typically appear 6-8 hours after the last drink. Mild and moderate withdrawal symptoms peak around 72 hours after the last drink and often subside within a week. Severe AUD withdrawal can last several weeks. 

Post-acute withdrawal syndrome (PAWS) can affect a small number of people who have gone through detox. Withdrawal symptoms may last weeks, months or even years in severe cases.

Levels of Care in Alcohol Addiction Treatment

Overcoming alcohol use disorder involves various treatment options. It’s crucial for anyone considering sobriety to consult an addiction specialist.

Comprehensive AUD treatment includes:

  • Medical detox: Necessary for cases with a high risk of withdrawal. Medical detox provides 24/7 professional supervision and may include medications to reduce withdrawal severity.
  • Inpatient rehab: After detox, most people move on to inpatient (residential) rehab. These programs offer a safe environment and evidence-based therapies like cognitive-behavioral therapy.
  • Outpatient rehab: Those in the early stages of AUD can start their recovery with intensive outpatient programs or transition to outpatient options after inpatient care.
  • Aftercare: Crucial for long-term recovery, aftercare programs provide resources and support as individuals adjust to a sober lifestyle.

Relapse rates are high among those with AUD. However, inpatient programs have shown effectiveness in reducing relapse rates.

Interventions for Alcohol Use Disorder

Sometimes, loved ones need to come together to encourage a person with alcohol use disorder to seek help. This intervention can be a crucial step toward recovery.

Common intervention types include:

  • The Simple Intervention: A one-on-one conversation expressing concerns and encouragement.
  • The Johnson Intervention: A group of concerned loved ones confronting the person about their addiction.
  • Family System Intervention: Addressing enabling behaviors within the family unit that prolong addiction.
  • Crisis Intervention: Immediate intervention following a dangerous incident, such as an overdose or arrest.

Seek Alcohol Addiction Treatment at The Recovery Village Indianapolis Drug and Alcohol Rehab

For those seeking alcohol addiction treatment, The Recovery Village Indianapolis Drug and Alcohol Rehab stands as a beacon of hope. Located within the heart of Indy, we offer a comprehensive array of treatment options, including inpatient care, partial hospitalization, and intensive outpatient services. Our facility features specialized trauma care options, including EMDR and trauma-focused group therapy.

When you or a loved one are ready to embark on the path to recovery, our Recovery Advocates are here, ready to assist. Reach out to learn more about our tailored treatment programs, designed to cater to your specific needs and situation.

Frequently Asked Questions About Alcohol Abuse

Tailored treatment is key, as no single approach suits everyone struggling with alcohol addiction. Alcohol use disorder is often addressed through counseling, medication and support groups.

How Long Is Alcohol Rehab?

The duration of alcohol rehab depends on the severity of addiction and individual needs. The National Institute on Drug Abuse recommends at least three months of treatment for optimal outcomes. For example, if you complete a 30-day inpatient rehab, transitioning to aftercare programs like outpatient counseling is crucial.

What Is the Cost of Alcohol Rehab?

The cost of alcohol treatment varies based on factors like length, treatment level and insurance coverage. Inpatient programs are more expensive than outpatient care. Luxury facilities with extra amenities have higher costs as well. Insurance may cover some treatment expenses, so we recommend talking about this with your provider or rehab facility.

How Does Alcohol Rehab Work?

The alcohol rehab process varies depending on the specific treatment type. Many treatment courses start with medical detox to manage withdrawal symptoms. This is followed by ongoing treatment programs that include individual and group counseling, medication management and support groups.


National Institute on Alcohol Abuse and Alcoholism. “Understanding Alcohol Use Disorder.” April 2021. Accessed March 9, 2023. 

The Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2021 National Survey on Drug Use and Health.” December 2022. Accessed March 9, 2023. 

Centers for Disease Control and Prevention. “Alcohol Use and Your Health.” April 14, 2022. Accessed March 9, 2023. 

Leggio, Lorenzo; Lee, Mary R. “Treatment of Alcohol Use Disorder in Pat[…]holic Liver Disease.” The American Journal of Medicine, February 2018. Accessed March 9, 2023. 

Muncie, Herbert; Yasinian, Yasmin; Oge, Linda. “Outpatient Management of Alcohol Withdrawal Syndrome.” American Family Physician, November 1, 2013. Accessed March 9, 2023. 

Bayard, Max; McIntyre, Jonah; Hill, Keith; Woodside, Jack. “Alcohol Withdrawal Syndrome.” American Family Physician, March 15, 2004. Accessed March 9, 2023. 

Bahji, Anees; Crockford, David; El-Guebaly, Nady. “Neurobiology and Symptomatology of Post-Acute Alcohol Withdrawal: A Mixed-Studies Systematic Review.” Journal of Studies on Alcohol and Drugs, 2022. Accessed March 9, 2023. 

Senn, Smerald; Volken, Thomas; Rosner, Susanne; Wieber, Frank. “What is the relapse risk during treatment? Survivor analysis of single and multiple relapse events in inpatients with alcohol use disorder as part of an observational study.” Journal of Substance Abuse Treatment, July 2022. Accessed March 9, 2023.

National Institute on Drug Abuse. “Principles of Drug Addiction Treatmen[…]Third Edition).” September 18, 2020. Accessed March 9, 2023.

Rethinking Drinking. “What are the symptoms of alcohol use disorder (AUD)?” National Institutes of Health. Accessed December 1, 2023. 

University of Maryland Baltimore. “Stages of Alcoholism.” August 19, 2021. Retrieved December 1, 2023. 

American Psychological Association. “Johnson Intervention.” 2011. Accessed December 1, 2023.


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