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Alcohol Use Disorder Stages: Recognizing and Treating the Condition

Alcohol Use Disorder Stages: Recognizing and Treating the Condition

There are four stages of alcohol use disorder (AUD): pre-AUD, mild, moderate, and severe.

Alcohol consumption rose during the COVID-19 pandemic, with excessive drinking increasing by 21%, according to a national survey of adults in the United States. Many Americans found themselves progressing through the stages of alcohol use disorder (AUD). This is expected to lead to an upsurge in alcohol-related health problems if left untreated. Fortunately, help is available through professional treatment programs, and the earlier you address AUD, the easier it is to achieve lasting recovery. 

Overcoming alcohol dependence can feel impossible, especially when trying to do it yourself. But with Confidant Health’s online medication-assisted treatment for alcohol use disorder, you never have to feel alone on your journey. Enrolling in our online treatment for AUD differs from participating in Alcoholics Anonymous (AA). No matter how many times you’ve tried to quit alcohol, we can help make your next attempt more successful with the support of our professional team. Download our app today to find out how our virtual medication-assisted treatment can make all the difference in your recovery. 

What Is Alcohol Use Disorder?

Alcohol use disorder (AUD) is the term given to an inability to moderate or discontinue one's alcohol consumption regardless of negative effects. You may have also heard it referred to as alcoholism or alcohol addiction. However, alcohol use disorder is the preferred term as it acknowledges the validity of chronic alcohol misuse as a medical condition.

Alcohol use disorder (AUD) is one of the most common forms of addiction, impacting nearly 1.4 percent of the world’s population. In the United States, an estimated 14.1 million adults and 414,000 young people aged 12-17 struggled with alcohol use disorder in 2019.

Common Causes of Alcohol Misuse

Alcohol misuse, sometimes called alcohol abuse, refers to drinking alcohol excessively. More specifically, alcohol misuse involves drinking:

  • More than fourteen drinks per week or more than four per occasion for men 
  • More than seven drinks per week or more than three per occasion for women and people 65 and older

Although these numbers indicate alcohol misuse, having more than three or four drinks per occasion doesn’t mean you will develop AUD. You may consume this amount at the occasional party or happy hour event without it becoming a problem. 

So, why can some people consume alcohol moderately without ever becoming addicted while others drinking the same amount eventually find that they can’t stop? Although alcohol use disorder may appear to affect people randomly, there are several factors that can increase the risk of alcohol misuse and developing AUD: 

  • Being the victim of abuse
  • Family history of alcohol misuse or AUD
  • A desire for approval from others
  • Impulsiveness
  • Low self-esteem
  • Peer pressure
  • Poverty
  • Untreated mental health disorders

If you have one or more of the above risk factors, that doesn’t guarantee you will misuse alcohol. However, awareness can help you remain more vigilant about your susceptibility. You can then practice moderation or abstinence to lower your chances of developing alcohol dependence.

Signs of Alcohol Misuse

How do you know if someone in your life is misusing alcohol? People tend to have different ideas on what constitutes drinking too much. Knowing how to tell the difference between the occasional overindulgence and alcohol misuse can help you see if it’s time to talk with your loved one about their consumption. 

Some common signs of alcohol misuse include:

  • Being deceptive about the amount of alcohol consumed
  • Denying there is a drinking problem
  • Driving while under the influence
  • Getting upset if there is no alcohol available
  • Memory loss or blackouts while drinking
  • Spending time drinking instead of working or engaging with family or friends

If you spot the above signs in someone you care about, they may be at high risk for AUD if alcohol misuse continues. Talk to them about your concerns for their well-being, and encourage them to seek treatment if needed to cut back on drinking.

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Symptoms of Alcohol Use Disorder

Alcohol misuse can quickly lead to alcohol use disorder if not addressed. Once a person has developed AUD, they will likely need the help of professionals to eliminate alcohol from their life. Consider the following physical, psychological, and behavioral symptoms of alcohol use disorder so you’ll know if you or a loved one may need to enroll in a program for AUD. 


Some typical physical symptoms of AUD include:

  • Blacking out or forgetting things that happened while drinking
  • Experiencing withdrawal symptoms if you stop drinking
  • Needing a drink first thing in the morning to reduce hangover symptoms or shakiness
  • Developing a tolerance or needing to drink more to achieve the same effects as before


Some common psychological symptoms of AUD are:

  • Being unable to stop thinking about having a drink
  • Feeling unable to stop or cut back on drinking
  • Feeling guilty about how much or often you drink
  • Development or worsening of anxiety and depression
  • Cognitive impairment, such as difficulty with focus, attention, and memory


Some behavioral symptoms of AUD you may notice are:

  • Choosing alcohol over other activities you once enjoyed
  • Continuing to drink even after experiencing adverse effects
  • Drinking more than intended
  • Spending much of your time drinking or recovering from the effects of drinking

The above symptoms demonstrate how powerful alcohol use disorder can be, making it challenging to quit alone. For many people, professional treatment is the only way to move forward in their recovery.

Stages of Alcohol Use Disorder

Understanding the stages of AUD can help you know how far along you may be toward developing an addiction to alcohol. This can shine a light on problem drinking, so you know when having a few drinks to relax has turned into requiring alcohol to function. Remember, these steps do not necessarily occur in order, and some steps may be skipped. 

Stage 1: Pre-AUD

The earliest stages of alcohol use disorder involve experimentation with alcohol. During stage one, people may consume large amounts of alcohol in a short period, also referred to as alcohol misuse or binge drinking.

Binge drinking is considered to be consuming four or more alcoholic beverages within two hours for women and five or more for men. This quantity may seem typical at a party or other social event. Although occasional binge drinking may not indicate future alcohol use disorder, it can still lead to adverse side effects, so you shouldn't take it lightly.

Stage 2: Mild AUD

Once alcohol misuse or binge drinking increases in frequency or continues despite consequences, you have moved into stage two. Instead of limiting drinking to special occasions, you start to consume alcohol regularly, possibly every weekend. You may start drinking when you feel stressed, angry, depressed, or anxious. Alcohol becomes a tool for transforming how you feel. You have a few symptoms of AUD.

Stage 3: Moderate AUD

You advance to stage three when frequent alcohol misuse starts adversely affecting your health, finances, relationships, and job. Your mental health can suffer, exacerbating symptoms of anxiety or depression. You may have difficulty sleeping, which can impair your work performance.

If you drive under the influence, you can encounter legal and financial issues and possibly lose your job. Your partner, children, or other loved ones may become concerned about your drinking. All of this can pile on the stress, triggering more desire to drown your troubles in alcohol, further perpetuating the cycle.

Stage 4: Severe AUD

You cannot moderate your consumption despite the consequences. Alcohol dependence is indicated by tolerance or the need to increase the amount you drink to achieve the same results. The need for alcohol is more powerful than your ability to abstain.

You will also likely experience withdrawal symptoms if you go without alcohol for too long. After alcohol leaves your system, you may feel nauseous, shaky, sweaty, and irritable. You may also have difficulty sleeping and notice that your heartbeat is irregular or rapid.

Severe SUD also includes powerful cravings for alcohol. Your thoughts may be occupied with when you’ll have your next drink, and all other areas of your life take a backseat to alcohol consumption. Once you have developed AUD, the safest and most effective way to quit is with the support of professionals.

It is important to note that although you may only recognize symptoms of stage one in your life, that doesn't mean you don't need professional help to quit drinking. The early stages of AUD can be a warning sign that you should consider making some changes to your alcohol consumption. If you find this too difficult, you may need the support of addiction treatment.

Health Risks of Alcohol Use Disorder

Alcohol use disorder can be detrimental to your relationships, job, and finances. Over time, it can also cause various health problems, such as:

You can heal some of the above health conditions with abstinence, proper nutrition, therapy, or medical interventions. Others are more serious and can cause permanent damage, so it is vital that you seek treatment for AUD as early as possible.  


You may be unsure if your drinking is a problem, but you can receive an accurate diagnosis from your provider. During your assessment, your provider will refer to the criteria for alcohol use disorder (AUD) as indicated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5). They will ask if, over the past 12 months, you have:

  • Spent much of your time drinking or recovering from drinking
  • Had occasions where you drank more than intended
  • Tried to stop drinking or cut back your consumption but couldn’t
  • Had times when all you could think about was drinking
  • Had incidences when you were unable to take care of your work or family responsibilities due to drinking
  • Stopped engaging in activities you once enjoyed to allow more time for drinking
  • Put yourself in risky situations while drinking
  • Continued drinking despite experiencing negative effects
  • Had withdrawal symptoms after alcohol’s effects wore off
  • Found that you needed to increase your alcohol intake to get the same buzz

Your provider will determine the severity of AUD by the number of symptoms you have. If you have two to three of the above criteria, your condition is considered mild AUD. Four to five symptoms indicate moderate AUD, and six or more symptoms signify severe AUD.


Treatment for AUD consists of several components:


For many people, alcohol use disorder stems from anxiety, depression, stress, low self-esteem, trauma, or struggles with mental health. These triggers for alcohol misuse must be addressed to help you succeed in recovery from AUD. Therapy will help you learn how to identify triggers, manage stress and mental health conditions, and establish lifestyle changes to promote a sober lifestyle.


Medications can help you overcome AUD by minimizing the discomfort of withdrawal symptoms, treating mental health disorders, alleviating cravings, and preventing further alcohol misuse. Acamprosate, disulfiram, and naltrexone are three commonly used medications for AUD treatment. 


Support from loved ones is crucial for managing AUD, but you should also seek the support of professionals and your peers in recovery. Enrolling in a treatment program offers the expertise of therapists, physicians, social workers, and other providers who can guide you through each step. It would help if you also considered attending support group meetings, such as Alcoholics Anonymous (AA), as these provide long-term support from others in similar situations. 


It is easier to prevent alcohol misuse than to overcome alcohol use disorder, and you can avoid the risks to your mental, physical, and financial well-being. If you recognize the signs of stage one of AUD in yourself, try these tips to stop alcohol misuse in its tracks and prevent it from progressing to the next stage:

  • Make an effort to practice moderate drinking, which is no more than one drink per day for women and two for men. 
  • Learn how to reduce alcohol cravings to make it easier to abstain.
  • Enlist the help of those close to you to keep your drinking under control. 
  • Talk with your provider if you are concerned about your alcohol consumption. 

You can also help your loved ones if they are misusing alcohol by setting goals for moderation together and holding one another accountable.

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Alcohol Use Disorder FAQs

What is the life expectancy of a person with alcohol use disorder?

People who drink excessively can shorten their life span by an average of 29 years

How long does it take to recover from alcohol use disorder?

Recovery from AUD differs for each person, so there is no predetermined length of time to recover. Withdrawal symptoms can last from a few days to a few weeks, but it can take several years for your body to fully heal from the effects of AUD.

How do doctors test for alcohol use disorder?

Doctors diagnose alcohol use disorder using the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

Get Online Help for AUD at Confidant Health

Getting help during the early stages of AUD can help prevent the most severe effects of this condition. Whether you see yourself dabbling in stage one or struggling in stage five, Confidant Health is here to help you recover. Our online medication-assisted treatment for alcohol use provides you with the support of our caring team of experts. Download our app today to find out how virtual medication-assisted treatment can help you cut back on drinking.

This article has been medically reviewed by
Erin Hillers
Erin Hillers
Erin Hillers
Nurse Practitioner

Erin is a Nurse Practitioner with 8 years of experience in midwifery and women's health. She has spent the past 5 years specializing in the treatment of opioid and alcohol use disorders.

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