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Colin MacKenzie M.D.
December 13, 2020
 Image by Michal Jarmoluk from Pixabay 

Early Alcoholic Stage

 

Introduction

The early alcoholic stage is the second stage of alcoholism. It succeeds the pre-alcoholic stage which is discussed in the blog titled “The Pre-Alcoholic Stage of Alcoholism”. You may find yourself moving from the pre-alcoholic stage with the progressive consumption of alcohol. Rather than drinking at social gatherings or just on weekends, you may start drinking more frequently and consistently.

Social and Behavioral Changes

This stage of alcoholism is characterized by the start of the consistent use of alcohol, not only during typical social and cultural events, but also outside of them.  During this stage, the first struggles between cravings for alcohol and the inability to resist become apparent.  Though some people develop the realization that it may be problematic, denial is typical. Relatives and friends often begin to have concern for the alcohol use, and their concerns are often met with lies and secretive use.   

You may become infatuated with thoughts of alcohol use such as:

  • “When can I drink next?
  • Where can I get a drink?
  • How can I bring alcohol to the event?”

This stage is also characterized by the development of tolerance, which may have started in the pre-alcoholic stage. 

Tolerance

Tolerance involves the body’s adaptations to regular exposure to alcohol such that you need increasing amounts of alcohol in order to achieve the same effects.  The body recognizes the alcohol as a toxin and will “ramp-up” its ability to metabolize the alcohol such as increasing hepatic enzymes to break down the alcohol more quickly. Other organs, like the brain, will make changes to compensate for the intoxicating effects so that exposure to alcohol will not as easily cause neurological impairment such as sedation.  You may notice that you can consume increasing quantities of alcohol while still functioning normally.[3] Larger quantities of alcohol are required to cause inebriation. For example, you may need four to five rounds of alcohol to feel as drunk as two rounds used to feel. You may notice yourself drinking more and more to attain the preferred mood-altering effects. However, your body can only tolerate so much alcohol. You may not feel it, but alcohol starts to affect you and you may enter the next stage of alcoholism.

Alcohol-Related Blackouts

Alcohol-related blackouts are defined by a complete lack of, or inconsistencies in, the recollection of events that occur while you are intoxicated.[4] These inconsistencies occur when you drink sufficient alcohol to briefly impede memory consolidation, a process by which memories are transformed from short-term to long-term storage, in a brain region called the hippocampus. Usually a blood alcohol level of 0.16% or higher is needed to impair memory formation.  However, the use of other substances, like benzodiazepines or binge drinking, can cause blackouts at a lower blood alcohol concentration.  Some evidence suggests that a rapidly increasing blood level predisposes to blackout, thus binging on an empty stomach or being female, can increase the risk of these events. 

Blackouts should not be confused with passing out. Passing out is the loss of consciousness while blackouts occur while conscious. 

Many people find blackouts very distressing as they cannot recall inappropriate behaviors they may have engaged in or may have been perpetrated on them.  People are often shocked to find out from others what happened the night before. Blackouts can occur at any time, even in those without an alcohol use disorder.  

Treatment

Early alcoholism is not an uncontrollable condition. It is the start of what can prove to be a horrible journey, not only for you, but your friends and family as well. However, it is easier to recover from this stage than the later ones. A thorough investigation into the reasons behind the alcohol consumption may provide you the best opportunity for long-term recovery from alcoholism. You may have to find different means to manage the stress, trauma, or grief that led you to drink to excess in the first place. Professional counseling, group therapy, medications, or some combination of them may prove to be useful.