What Is End-Stage Alcoholism? (2022)

What Is End-Stage Alcoholism?

End-stage alcoholism, or late-stage alcoholism, is the final stage of an alcohol use disorder, resulting in serious physical and mental conditions as well as other life consequences from years of alcohol misuse.

Alcohol use disorder is a progressive disease that includes a beginning, middle, and end stage, which can result in life-threatening health conditions. It's not often talked about, but left untreated, alcohol use disorder can be a fatal disease. In fact, it contributes to about 88,000 deaths annually in the U.S., making alcohol the third leading preventable cause of death in the United States.

By the time a person reaches end-stage alcoholism, drinking has taken over their lives and has likely had a negative impact on relationships, work or school, finances, and overall health. If a person tries to quit drinking on their own during end-stage alcoholism, they may experience severe symptoms of withdrawal, including tremors and hallucinations. One of the most severe consequences of alcohol withdrawal is called delirium tremens ("the DTs"), which if left untreated, can be fatal.

How to Gauge the Severity of Alcohol Withdrawal Symptoms

Symptoms

End- or late-stage alcoholism can cause a variety of physical and mental health conditions, including:

  • Cirrhosis
  • Jaundice from liver failure
  • Itchy skin
  • Fluid retention
  • Fatigue
  • Malnutrition
  • Chronic pancreatitis
  • Heart failure
  • Anemia
  • Wernicke-Korsakoff syndrome (also called alcohol dementia)

Alcoholic Liver Disease/Cirrhosis

When the liver can no longer metabolize alcohol fast enough and sends it back into the bloodstream over and over, it causes the liver to harden and scarring of the tissue (cirrhosis) can occur. Cirrhosis is the final stage of alcohol-related liver disease.

According to the CDC, more than one million people die each year of cirrhosis, including over 40,000 people in the United States.

In the early stages of alcoholic liver disease, you may not have any symptoms at all, however, after years of heavy use, may you recognize the following:

  • Digestive problems: Abdominal swelling, dry mouth, bleeding from enlarged esophageal veins
  • Dermatological issues: Yellowing of the skin (jaundice), red spider-like veins, redness on your feet
  • Brain and nervous system: Memory problems, numbness in extremities, fainting

Malnutrition

Chronic, long-term drinking can contribute to malnutrition by replacing foods needed for essential nutrients and by interfering with absorption, storage, or metabolism of the essential nutrients. This can also lead to anemia, when your red blood cell (RBC) count is lower than normal or there's a problem with the hemoglobin protein inside those cells.

Chronic Pancreatitis

Damage to the pancreas from drinking alcohol may cause no symptoms for many years, before culminating in a sudden attack of pancreatitis. Roughly 70% to 80% of cases of chronic pancreatitis are due to chronic alcohol use. People with chronic pancreatitis tend to experience three primary health problems: pain, malabsorption of food leading to weight loss, ordiabetes.

Cardiovascular Health

By the time you or someone you love reaches end-stage alcoholism, you may be contending with a host of heart troubles, including:

  • Angina, caused by a stable blockage in a coronary artery
  • Damage to the heart muscle (alcoholic cardiomyopathy)
  • High blood pressure, which is a risk factor forcoronary artery disease
  • Increased risk of heart failure and stroke
  • High blood triglycerides, which increases the chance of developing heart disease

Brain Disorders

Research has shown that long-term alcohol misuse can have a lasting impact on the brain, although some areas may recover with abstinence. Alcohol can damage the brain in many ways. The most serious effect isKorsakoff's syndrome, characterized in part by an inability to remember recent events or to learn new information.

Eye Problems

During end-stage alcoholism, a person may struggle with involuntary rapid eye movement (nystagmus) or weakness and paralysis of the eye muscles due to thiamin (vitamin B1) deficiency. This deficiency can also cause dementia if not treated immediately.

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Cancer

After drinking chronically for many years, a person increases their risk of several cancers, including:

  • Mouth
  • Throat
  • Liver
  • Esophagus
  • Colon
  • Breast cancers

Diagnosis

While there's no official diagnosis for end-stage alcoholism, your doctor will be able to diagnose you with an alcohol use disorder and be able to identify your stage based on the severity and amount of time you've been misusing alcohol as well as your current health.

The 5th edition of the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5) by the American Psychiatric Association uses the following 11 symptoms to indicate an alcohol use disorder. If you have six or more, you're diagnosed as having a severe alcohol use disorder:

  1. Alcohol is often taken inlarger amountsor over a longer period than was intended.
  2. There is a persistent desire or unsuccessful efforts tocut down or controlalcohol use.
  3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
  4. Craving, or a strong desire or urge to use alcohol.
  5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
  6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
  7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
  8. Recurrent alcohol use in situations in which it is physically hazardous.
  9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
  10. Tolerance, as defined by either of the following: a) A need for markedly increased amounts of alcohol to achieve intoxication or desired effect, or b) A markedly diminished effect with continued use of the same amount of alcohol.
  11. Withdrawal, as manifested by either of the following: a) The characteristic withdrawal syndrome for alcohol b) Alcohol (or a closely related substance, such as a benzodiazepine) is taken to relieve or avoid withdrawal symptoms.

The Diagnostic Criteria for Substance Use Disorders

Treatment

End-stage alcoholism is dire but not hopeless. Treating the alcohol use disorder, along with the health problems caused by chronic, heavy drinking, may be possible. The first step will likely be a medically supervised detox, which will help rid your body of toxins and manage the symptoms of withdrawal.

Rehabilitation for alcohol dependence will also be necessary, including:

  • Medications: Antabuse (disulfiram), Revia or Depade (naltrexone), Campral (acamprosate)
  • Behavior therapy: Cognitive therapy, rational emotive behavior therapy, rational behavior therapy, rational living therapy, anddialectic behavior therapy
  • Support groups: Alcoholics Anonymous (AA), SMART Recovery, Rational Recovery, Women For Sobriety, Secular Organizations for Sobriety (SOS)

Once you quit drinking, your body can begin to recover from some of the damage or, at the very least, prevent it from getting worse.

The Benefits of Quitting Alcohol

Coping

By the time a person is in end-stage alcoholism, there can be no denying that drinking has taken over their life and damaged their health. Recovery will not be easy at this point, but it will be worth the work. Now is the time to line up support from addiction specialists, mental health professionals, friends and family, and others living with an alcohol use disorder. You don’t have to alone during this difficult and scary time.

For Friends and Family

Watching a loved one endure the end stages of alcoholism can be frustrating and lonely. The feeling of powerlessness is stifling as you watch someone you care about slowly deteriorate physically and mentally while they may even continue to refuse to admit their drinking is problematic. For those who need help and don't want it,interventionmay be the only alternative.

Even if your loved one seeks help, you may still need help and support to overcome the effects. Many people refer to alcoholism as a "family disease" because it can have a major impact on all members of the family whether they realize it or not.

If you or a loved one are struggling with substance use or addiction, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357for information on support and treatment facilities in your area.

For more mental health resources, see ourNational Helpline Database.

(Video) Alcoholic Liver Disease, Animation

5 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Rehm J. The risks associated with alcohol use and alcoholism.Alcohol Res Health. 2011;34(2):135–143.

  2. National Institute on Alcohol Abuse and Alcoholism. Alcohol Facts and Statistics.

    (Video) The Stages of Alcoholism Explained

  3. Singal AK, Bataller R, Ahn J, Kamath PS, Shah VH.ACG clinical guideline: Alcoholic liver disease.Am J Gastroenterol. 2018;113(2):175-194. doi:10.1038/ajg.2017.469

  4. Centers for Disease Control and Prevention. Chronic Liver Disease and Cirrhosis.

  5. Zahr NM, Pfefferbaum A. Alcohol's effects on the brain: Neuroimaging results in humans and animal models.Alcohol Res. 2017;38(2):183–206.

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FAQs

What are the signs of end of life for an alcoholic? ›

In the end-stages of alcoholism there are noticeable health conditions, like jaundice from liver failure. There are also more subtle signs like itchy skin, fluid retention, fatigue, and bleeding. If you know someone who drinks regularly and has these symptoms, call a treatment provider to discuss treatment options.

What is life expectancy of an alcoholic? ›

Conclusion. People hospitalized with alcohol use disorder have an average life expectancy of 47–53 years (men) and 50–58 years (women) and die 24–28 years earlier than people in the general population.

What are the four stages of drinking? ›

If you or your loved ones need help to identify the signs of problem drinking, four stages of alcoholism have been identified: pre-alcoholic, early alcoholic, chronic alcoholic, and end-stage alcoholism.

What is the most advanced stage of alcoholism? ›

Stage 4: Late Alcoholic

At this stage, drinking becomes everything in your life, even at the expense of your livelihood, your health and your relationships. Attempts to stop drinking can result in tremors or hallucinations, but therapy, detox, and rehab can help you get your life back.

How does chronic alcoholism cause death? ›

Chronic alcoholics may die sudden- ly from trauma, intoxication, and from preexisting disease. In many cases, there is no obvious cause of death in chronic alcoholics following initial postmortem examination. Determining the cause of death in chronic alcoholics can be challenging.

What do alcoholic eyes look like? ›

One of the physical characteristics of someone who is a heavy drinker is bloodshot eyes. This change in appearance is due to alcohol abuse swelling the tiny blood vessels in the eye, enlarging their appearance and making the eyeball look red.

Can heavy drinkers live a long life? ›

The findings show that moderate to heavy drinkers are more likely to live to the age of 85 without dementia or other cognitive impairments than non-drinkers. The study, which tracked more than 1,000 middle class white men and women in California, builds on the recent research linking alcohol intake to longevity.

What are some behavioral characteristics of an alcoholic? ›

Usually, when someone is displaying these characteristics, it indicates that they are struggling with alcohol abuse.
...
Often someone who is abusing alcohol will also display the following signs and become:
  • Insecure.
  • Sensitive.
  • Impulsive.
  • Impatient.
  • Secretive.
  • Defensive.
  • Manipulative.
  • Easily aggravated.
Dec 21, 2021

How old is the oldest alcoholic? ›

Chemical analyses recently confirmed that the earliest alcoholic beverage in the world was a mixed fermented drink of rice, honey, and hawthorn fruit and/or grape. The residues of the beverage, dated ca. 7000–6600 BCE, were recovered from early pottery from Jiahu, a Neolithic village in the Yellow River Valley.

Can heavy drinkers live a long life? ›

The findings show that moderate to heavy drinkers are more likely to live to the age of 85 without dementia or other cognitive impairments than non-drinkers. The study, which tracked more than 1,000 middle class white men and women in California, builds on the recent research linking alcohol intake to longevity.

What happens during the second stage of alcoholism? ›

The second stage is increased alcohol use and building a tolerance. Early signs of cravings occur between drinking events and recovering from a night of drinking might lead to physical discomfort afterward.

What happens to your body when you drink alcohol everyday? ›

Long-Term Health Risks. Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including: High blood pressure, heart disease, stroke, liver disease, and digestive problems. Cancer of the breast, mouth, throat, esophagus, voice box, liver, colon, and rectum.

Do alcoholics sleep a lot? ›

Sleep problems, which can have significant clinical and economic consequences, are more common among alcoholics than among nonalcoholics. During both drinking periods and withdrawal, alcoholics commonly experience problems falling asleep and decreased total sleep time. Other measures of sleep are also disturbed.

Videos

1. Palliative Care for End Stage Liver Disease
(Ohio State Wexner Medical Center)
2. Progression of Alcohol and Drug Addiction - Late Stage - LastingRecovery.com
(Lasting Recovery)
3. Alcoholic Progression - The Death Spiral Explained
(Talk Sober)
4. Cirrhosis: Phil's story | NHS
(NHS)
5. End-Stage Liver cirrhosis from alcohol 
(Woody Boyd)
6. Korsakoff's Syndrome | Causes (ex. Alcoholism), Symptoms, & Possible Treatments
(JJ Medicine)

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