What is End-Stage Alcoholism?

Last Updated: April 10, 2023

Editorial Policy | Research Policy

Heavy alcohol use for long periods of time can lead to alcoholism, which can eventually be terminal.

End-stage alcoholism is not technically a medical term, but it is used to describe an alcohol addiction that creates serious, likely terminal health effects. End-stage alcoholism is also called late-stage alcoholism and affects those who have been addicted to alcohol for some time. While the term “end-stage alcoholism” implies that death may be the next step in the disease process, alcoholism does not have to be fatal, and those with late-stage alcoholism may still be able to experience some degree of recovery.

Physical Symptoms

End-stage alcoholism is normally used to describe a situation where alcohol use makes death likely if it is continued. Because end-stage alcoholism can be related to a variety of different causes, the physical symptoms will depend on the conditions the alcoholism has caused.

Liver Disease

Heavy alcohol use for prolonged periods of time can lead to inflammation of the liver, called hepatitis, that eventually leads to permanent scarring of the liver, called cirrhosis. Cirrhosis is a chronic, irreversible disease that gradually affects the liver. It can only be cured with a liver transplant, which most heavy alcohol users will not be eligible for9. Cirrhosis will eventually be fatal as it progresses.

Heart Disease

Heavy alcohol use can cause cardiomyopathy1, a condition in which the heart loses its ability to pump blood effectively. This can cause a myriad of problems and can eventually be fatal as the heart is unable to pump enough blood to maintain life.

Kidney Disease

The kidneys play an important role in filtering our blood and maintaining healthy blood pressure. Chronic alcoholism has been shown to affect kidney function2, potentially causing kidney failure that may lead to the need for dialysis. Kidney damage may also heighten the risk of chronic hypertension, or elevated blood pressure. This can increase the risk of heart attack and stroke.

Wernicke-Korsakoff Syndrome

Wernicke-Korsakoff syndrome8 is a neurological condition that primarily occurs in people who have an alcohol addiction. Wernicke-Korsakoff syndrome is caused by low levels of thiamine (vitamin B1) and can cause irreversible brain damage. Low thiamine levels are common in late-stage alcoholism for two reasons: because of how alcohol affects the body’s ability to absorb vitamin B1, and because of the malnutrition that accompanies alcohol abuse.

Malnutrition

Alcohol contains empty calories and impairs judgment. These two factors combine to make someone feel full while their ability to recognize the need for good nutrition is impaired.

FAQs

What health disorders is excessive alcohol use known for?

According to the CDC, excessive alcohol use is known to cause high blood pressure, heart disease, stroke, liver disease, cancer, poor pregnancy outcomes, injuries, sexually transmitted infections, and alcohol poisoning.

Mental Health Symptoms

In addition to physical health problems, alcoholism can also cause mental health issues that can be debilitating. Some of the most common mental health symptoms caused by alcoholism include4:

Alcoholism can also make symptoms of an underlying mental condition worse. People with mental health conditions may also try using alcohol to self-treat their condition, leading to an alcohol use disorder and worsening of their original disorder. When alcohol addiction and a mental health condition are present at the same time, this is called dual diagnosis or co-occurring disorders5.

Phases of Addiction

While the medical community does not clearly define distinct phases6 of addiction, there are several commonly accepted phases that someone who develops an addiction is likely to experience:

  • Occasional misuse: Addiction will normally begin with occasional misuse, where there may be an episode of binge drinking or heavy drinking, but these episodes are rare and not part of the person’s normal life.
  • Increased use: In the next phase of addiction, the occasional episodes of misuse become more routine, and heavy alcohol use will occur multiple days in a row.
  • Problem use: This phase of addiction is often when someone first realizes that an alcohol use disorder may be developing. Alcohol use will start to become a problem and may affect relationships, work or other activities. This effect may initially be minor, and someone may be described as having a “functional addiction”.
  • Dependence: Dependence occurs when the body requires the presence of alcohol to function normally. Someone who is dependent on alcohol will start to have physical withdrawal symptoms if they go without a drink for more than 6–10 hours.
  • Addiction: Addiction occurs when someone drinks out of a physical and psychological need for alcohol. During this phase, drinking is not something that is done for pleasure, but rather for necessity.

Diagnosing End-Stage Alcoholism

Because end-stage alcoholism is not technically a medical term, it does not have a clinical definition that allows for it to be diagnosed. The only form of alcoholism that can be diagnosed clinically is alcohol use disorder, which can be diagnosed as mild, moderate, or severe.

Diagnosing alcohol use disorder requires a trained healthcare professional who is licensed to diagnose the condition. Doctors will use the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM–5) to diagnose alcohol use disorder7, and they may ask several questions to evaluate and diagnose, like if you:

  • Had times when you ended up drinking more, or longer, than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over other aftereffects?
  • Wanted a drink so badly you couldn’t think of anything else?
  • Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

Answering yes to 2–3 of these questions indicates a mild alcohol use disorder. Moderate is defined as yes to 4–5 of these questions, while severe is defined as answering yes to six or more.

These questions should be discussed with a doctor. While this list can help you decide if you need to seek help, only a licensed medical professional can diagnose alcohol use disorder.

Treating and Recovering from End-Stage Alcoholism

While end-stage diseases are normally terminal, there is no clinically-recognized condition called end-stage alcoholism. Someone who has a late-stage alcohol addiction can still overcome their addiction.

Lasting sobriety will often require professional help, especially if late-stage alcoholism is present. The Recovery Village Cherry Hill at Cooper is committed to helping people in South Jersey with an alcohol use disorder achieve long-term sobriety. We invite you to learn more about how we have helped many people with alcoholism overcome their addiction and live a life free from alcohol.

Fight addiction with evidence-based, expert care.

Questions?

Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.

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Sources

  1. Maisch, B. “Alcoholic cardiomyopathy.” Herz, August 2016. Accessed December 8, 2021.
  2. Cecchin, E. & De Marchi, S. “Alcohol misuse and renal damage.” Addiction Biology, 1996. Accessed December 8, 2021.
  3. Centers for Disease Control and Prevention (CDC). “Excessive Alcohol Use.” November 23, 2021. Accessed December 8, 2021.
  4. Shivani, Ramesh; Goldsmith, R. Jeffrey; & Anthenelli, Robert M. “Alcoholism and Psychiatric Disorders.” Alcohol Research & Health, 2002. Accessed December 8, 2021.
  5. National Library of Medicine. “Dual Diagnosis.” MedlinePlus, August 10, 2021. Accessed December 8, 2021.
  6. Legg, Timothy J. “Stages of Alcoholism.” Healthline, August 4, 2017. Accessed December 8, 2021.
  7. National Institute on Alcohol Abuse and Alcoholism. “Alcohol Use Disorder: A Comparison Betwe[…]DSM–IV and DSM–5.” April 2021. Accessed December 8, 2021.
  8. Shelat, Amit M. “Wernicke-Korsakoff syndrome.” MedlinePlus, 30 November 2021. Accessed December 8, 2021.
  9. Johns Hopkins Medicine. “Destigmatizing Liver Transplant for Pati[…]Alcohol Use Disorder.” Johns Hopkins Inside Tract, February 15, 2021. Accessed December 15, 2021.