Alcohol misuse can happen in stages. These stages may lead to alcohol use disorder in some people.

Alcohol use disorder (AUD) is a condition that is characterized by the inability to control or stop the consumption of alcohol despite potential negative consequences socially, occupationally, or health-wise.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) states that in 2021, 28.6 million adults over the age of 18 in the United States experienced AUD.

Alcohol misuse can occur in stages. Not everyone who uses or misuses alcohol will develop AUD.

This article explains the different stages of alcohol misuse and how to find support if a person needs it.

People used to refer to alcohol use disorder as alcoholism, and the people with it as alcoholics. Experts have increasingly seen these terms as negative and unhelpful labels. Today, instead of people being alcoholics, professionals refer to them as people with AUD.

Was this helpful?
Broken glass of red wine on the floorShare on Pinterest
Sami Sert/Getty Images

In this stage, people may be simply experimenting with alcohol consumption. They can be moderate drinkers with the occasional instance of binge drinking.

The Centers for Disease Control and Prevention (CDC) define moderate drinking as:

  • 2 drinks or less a day for males
  • 1 drink or less a day for females
  • nondrinking

They define binge drinking, the most common form of excessive drinking, as 5 or more drinks in a single occasion for males and 4 or more drinks in a single occasion for females.

The CDC also note that drinking less alcohol is better for a person’s health.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

Was this helpful?

Middle-stage misuse is not a medical term. Healthcare and mental health professionals may describe this stage as mild AUD.

In this stage, a person may begin to experience cravings for alcohol. They can also begin to develop a dependence on it. An individual’s dependence on alcohol may also become more apparent to those around them.

A person experiencing the middle stage of alcohol misuse can also find that they experience some symptoms of withdrawal. These may include:

These symptoms can lead someone to drink more to relieve withdrawal symptoms.

Healthcare and mental health professionals may describe this stage as moderate AUD.

In this stage, a person’s dependence on alcohol is growing. They typically have developed AUD.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) refers to this as moderate AUD. In moderate AUD, a person shows signs of four to five of the symptoms of AUD.

A person may have moderate AUD if they answer yes to four to five of the following questions. In the past year, has the individual:

  • found themselves drinking more or for a longer time than they had planned to?
  • had the desire to cut back, stop drinking, or attempted to, but could not?
  • spent a lot of time drinking or recovering from drinking?
  • experienced a strong urge or need to drink?
  • found that drinking or being sick from drinking interfered with family, job, or school?
  • continued drinking even though it negatively affected relationships with family or friends?
  • stopped or decreased activities that once brought joy in order to drink?
  • participated in harmful or dangerous situations while drinking or after drinking, such as driving while under the influence?
  • continued drinking even when it causes feelings of anxiety or depression, or aggravates other health conditions?
  • experienced the need to drink more in order to feel the effects of alcohol?
  • experienced symptoms of withdrawal as alcohol wore off?

Read more about alcohol use disorder.

Healthcare and mental health professionals may describe this stage as severe AUD.

In this stage, an individual can feel they have lost control over their alcohol consumption. They may feel they must drink in order to get through their day.

The DSM-5-TR refers to this stage as severe AUD.

With advanced-stage alcohol misuse, a person’s body may feel as though it physically needs alcohol in order to function as it usually would.

A person with severe AUD will generally have heavy alcohol consumption. The CDC define heavy drinking as 15 or more drinks per week for males and 8 or more drinks per week for females.

Excessive alcohol use over time can lead to various chronic and serious health conditions, including:

  • high blood pressure
  • heart disease
  • stroke
  • liver disease
  • digestive issues
  • cancer, such as breast, colon, liver, and throat cancer
  • weakened immune system
  • learning and memory issues
  • mental health conditions, such as anxiety and depression

A person with severe AUD will almost always experience symptoms of withdrawal when the alcohol in their body begins to wear off.

Read more about alcohol withdrawal.

Speaking with a healthcare or mental health professional can be a positive first step. They can recommend treatment for AUD, which may include medications and behavioral therapies.

Various organizations can also offer help and support for people with AUD and their families. These include:

Learn how to help a person with AUD.

There are different stages of alcohol misuse. Not every person will experience each stage and not everyone who consumes alcohol will develop alcohol use disorder (AUD).

The stages range from moderate consumption and occasional binge drinking to severe AUD.

If a person believes they may be drinking excessively or may have developed AUD, they should speak with a healthcare or mental health professional or reach out to a support organization.