There are, and have been, many theories about alcoholism. The most prevailing theory, and now most commonly accepted, is called the Disease Model.
Its basic tenets are that alcoholism is a disease with recognizable symptoms, causes, and methods of treatment. In addition, there are several stages of the disease which are often described as early, middle, late, treatment and relapse.
While it is not essential to fully define these stages, it is useful to understand them in terms of how the disease presents itself.
This series of articles describes the signs and symptoms of each stage as well as exploring treatment options.
- Early or Adaptive Stage
- Middle Stage
- Late Stage
- Treating Alcoholism
- Relapse to drinking
2 – The Middle Stage of Alcoholism
There is no clear line between the early and middle stages of alcoholism, but there are several characteristics that mark a new stage of the disease.
Many of the pleasures and benefits that the alcoholic obtained from drinking during the early stage are now being replaced by the destructive facets of alcohol abuse. The drinking that was done for the purpose of getting high is now being replaced by drinking to combat the pain and misery caused by prior drinking.
One basic characteristic of the middle stage is physical dependence. In the early stage, the alcoholic’s tolerance to greater amounts of alcohol is increasing. Along with this, however, the body becomes used to these amounts of alcohol and now suffers from withdrawal when the alcohol is not present.
Another basic characteristic of the middle stage is craving. Alcoholics develop a very powerful urge to drink which they are eventually unable to control. As the alcoholic’s tolerance increases along with the physical dependence, the alcoholic loses his or her ability to control drinking and craves alcohol.
The third characteristic of the middle stage is loss of control. The alcoholic simply loses his or her ability to limit his or her drinking to socially acceptable times, patterns, and places. This loss of control is due to a decrease in the alcoholic’s tolerance and an increase in the withdrawal symptoms. The alcoholic cannot handle as much alcohol as they once could without getting drunk, yet needs increasing amounts to avoid withdrawal.
Another feature of middle stage alcoholics is blackouts. Contrary to what you might assume, the alcoholic does not actually pass out during these episodes. Instead, the alcoholic continues to function but is unable to remember what he or she has done or has been. Basically, the alcoholic simply can’t remember these episodes because the brain has either stored these memories improperly or has not stored them at all. Blackouts may also occur in early stage alcoholics.
Impairment becomes evident in the workplace during the middle stage. The alcoholic battles with loss of control, withdrawal symptoms, and cravings. This will become apparent at work in terms of any or all of the following:
- increased and unpredictable absences,
- poorly performed work assignments,
- behavior problems with co-workers,
- inability to concentrate,
- increased use of sick leave, and
- possible deterioration in overall appearance and demeanor.
This is the point where the alcoholic employee may be facing disciplinary action.