Untreated alcoholism is a terminal disease comprised of four stages–the fourth being the end. According to the NIAAA, an estimated 88,000 people (62,000 men and 26,000 women) die annually from alcohol-related deaths. This makes alcoholism the third leading cause of preventable death in the United States. End-stage alcoholism carries defining physical markers and symptoms. Though it is not irreversible, it is very difficult to treat and has a high mortality rate. There are many ways it can kill, and most involve a significant amount of suffering. There is always hope though. Addiction-related medicine and treatment have come leaps and bounds through the 21st century, and if the patient is willing to try and recovery, anything is possible. Of course, the sooner a person looks to get treatment, the easier the disease and its many complications are to treat. Knowing what to look for in a person who may be suffering from alcoholism is imperative. If the chronically addicted are to get help, they must first know they are chronically addicted.
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The Development of End-Stage Alcoholism
No one simply wakes up one morning with end-stage, chronic, terminal alcoholism. Like all other types of addiction, alcoholism develops in stages. Knowing what stage of alcoholism yourself or a loved one is in can allow you to gauge the level of treatment that might be necessary to ensure a proper and healthy recovery. There are several schools of thought on how many stages of addiction there truly are, but most prevailing and popular theories recognize that there are four. Following is a brief description of each:
- Stage 1: This is typically referred to as the experimental stage. Here, people will use a substance such as alcohol for the first few times out of curiosity or due to other factors such as peer pressure or a rite of passage. There is generally no change in behavior and substance use is contained. Most people without addiction problems never progress beyond the first stage.
- Stage 2: Referred to as the social stage. In this stage, someone is likely to use in a social situation or for acceptance in a certain context (such as on a date, or at a football game). Here, the person still feels normal and contains the substance use to social situations, though there can be signs of developing dependence that the budding alcoholic might not recognize.
- Stage 3: Typically referred to as the instrumental stage. In this stage, undeniable substance abuse appears. Many prevailing examples of it shine through, such as drinking to numb emotions, to cope with day to day challenges, or for any specific purpose. As the use escalates, tolerance will develop and more alcohol will need to be drank to attain the desired result. As tolerance grows, dependence develops and a person’s social settings are limited to where the substance use is acceptable. There is a fear of being without the substance.
- Stage 4: The compulsive stage is the stage of full-blown addiction. Here, a person’s main preoccupation in life is the use of the substance, and he or she will do anything to get it. Shame develops and the person will attempt to hide the fact that he or she is drinking compulsively. Social circumstances deteriorate and a cycle of loss emerges. The addict loses or shuns employment, friends, and family. Health begins to degrade.
Alcoholics develop a serious physical dependency on the drug as well as the psychological dependence, which makes them particularly hard to treat. This also comes with a host of symptoms that are unique to the alcoholic in the late stage of alcoholism.
Physical Symptoms of Alcohol Withdrawal
One of the primary physical symptoms of late stage alcoholism is that the alcoholic is chronically drunk. If the person is not drunk, he or she is likely in a state of withdrawal. Alcohol withdrawal comes with a host of symptoms that are generally easy to identify. A person is likely dealing with end-stage alcoholism if he or she shows signs of:
- Enlarged, dilated pupils with a sensitivity to light
- Severe headaches
- Clammy, pale skin
- Loss of appetite, and subsequently, weight
- Nausea and vomiting
- Rapid heartbeat
- Shaking and Tremors
- Excessive sweating
Make no mistake about it, alcohol withdrawal in an end-stage alcoholic can absolutely be fatal, and should be done under medical supervision. Seizures occur in over 5% of patients suffering from abrupt cessation of alcohol after years of heavy use. Most seizures occur within four days’ cessation of alcohol. If the alcoholic makes it through the first four days without a seizure, chances are reduced by 90% that he or she will have one.
Cardiac Complications from End-Stage Alcoholism
There are also cardiac complications to consider in the end-stage alcoholic. The heart is being damaged by alcohol while the alcoholic is still drinking. However, if the alcoholic happens to stop drinking for any extended period of time, the autonomic nervous system causes the person’s heart rate to skyrocket. Since the heart is already likely in poor condition due to years of nutritional and physical neglect, there is a significantly increased chance of a myocardial infarction, or heart attack. Alcoholic cardiomyopathy comes with warning signs and symptoms. The late-stage alcoholic should see a physician immediately if he or she suffers from:
- Shortness of breath
- Swelling of the feet, legs, and ankles
- Dizziness or fainting
- Loss of appetite
- A weak or irregular pulse
Alcoholic cardiomyopathy often proves fatal. It should be treated immediately.
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Alcoholic Liver DiseaseAlcoholic Liver Disease can have a much more rapid onset than previously thought. Though many people can manage to drink without ever damaging their livers, there is now evidence that once a threshold has been reached, damage will occur. Thankfully, the liver is the only internal organ that can regenerate. Unfortunately, it can only do so much. The liver of an end-stage alcoholic generally endures more than is can be expected to and come out healthy. Alcoholic Liver Disease often leads to hepatitis or cirrhosis, which is a scarring of tissues of the liver. The liver cannot heal cirrhosis. Many end-stage alcoholics die from liver disease. Signs and symptoms of liver disease are:
- Accumulation of fluid in the legs (edema)
- Accumulation of fluid in the abdomen (ascites)
- Jaundice of the skin, mucous membranes, or whites of the eyes
- Redness of the palms of the hands
- In men, testicle shrinking and growth of breasts
- Easy bruising and abnormal bleeding
If you or someone you know and care about is suffering from any of those signs, contact your physician immediately.
Wet Brain, or Alcoholic Brain Damage
Also known as Wernicke-Korsakoff syndrome, wet brain is a neurological condition found in end-stage alcoholics. It develops due to a thiamine (vitamin B1) deficiency. Thiamine is an essential nutrient not created by the body. A person must consume it to reach their daily amount. Alcoholics typically have a poor diet, and alcohol also suppresses the breakdown and use of thiamin by the body. It does so by suppressing the enzyme that moves thiamine to an active state and also actively removes thiamin from the liver. Thiamine is essential to the production of several neurotransmitters in the brain, and without adequate thiamine, the tissue of the brain begins to deteriorate. Wet brain is the accumulation of two separate syndromes. The symptoms can vary depending on whether the person is suffering from Wernicke’s encephalopathy or Korsakoff’s psychosis. Wernicke’s encephalopathy symptoms include:
- Loss of mental activity that can lead to coma or death
- Loss of muscle coordination that can lead to a slow, unsteady gait
- Severe memory impairment
The NIAAA estimates that 90% of alcoholics suffering from Wernicke’s go on to develop Korsakoff’s as well. Korsakoff’s symptoms include:
- Vision changes
- Drooping eyelids
- Violent outbursts
Alcoholic wet brain is not curable or reversible. It is fatal in up to 20% of cases. However, if a physician catches the condition in time for treatment, the progression of the disease can be slowed or possibly stopped. This is only if the patient can manage to quit drinking.
End-Stage Alcoholism Life Expectancy
Once a patient has been diagnosed with any of the comorbidities that occur with end-stage alcoholism, life expectancy can be as short as six months. Many hospitals that will perform liver transplants on end stage alcoholics require a period of six months’ abstinence. It is unfortunate that many alcoholics at this point in their drinking careers cannot achieve six months’ abstinence. The disease is generally fatal by the time it reaches this point.
Recovery from End-Stage Alcoholism is Possible
Statistics are grim for the final days of an alcoholic. There is a point of no return as far as what the body can handle from alcohol consumption. However, even though alcoholism develops into a chronic, compulsive condition, it can be reversed. Recovery is possible. With a strong support group and steady rehabilitation program, some people can make a full recovery from alcoholism. So long as it has not passed the point of no return, there is always hope. After a supervised medical detox to overcome the physical dependency to alcohol, the patient can begin to work on the underlying issues that they have long been masking with their substance abuse.
However, even if the alcoholic has passed the point of no return and is going to die from his or her alcoholism, stopping can still have benefits. First, it can absolutely prolong the life of the patient. How long it extends the patient’s life varies with a number of factors, such as how much damage has already been done when they stop, how good the medical care is that the patient is receiving, and last but not least, how strong the fight still is in the patient. When faced with this grim fate, if the patient decides to finally overcome his or her alcoholism, he or she can go to grave knowing that they have finally beat the demon that has kept him or her down for so long. They can also manage to enjoy their last few days on this planet to their fullest if they are sober. At this point, quality of life matters over quantity. For a disease that robs someone of their quality of life, stopping, even when facing the inevitable, is a victory. That victory can lead the mindset of the patient to improve immensely, even at the end. If you or someone you know is suffering from anger and alcoholism, don’t let it get to this point. You are worth fighting for. Recovery is always possible, no matter how far into your illness you are. Sometimes we just have to change our definition of recovery a bit, and that’s okay. And in all likelihood, if you are considering trying to stop drinking, you are not past the point of no return. Talk to your doctor if you are physically addicted to alcohol, and don’t make any rash, reactionary decisions. You can quit. You just need to be smart about it.
Frequently Asked Questions
What is an Alcoholic?
What is Alcohol Use Disorder (AUD)?
- Having frequent memory blackouts.
- Continuing to drink even though it is causing you to feel depressed or anxious.
- Continuing to drink even though doing so contributes to other health problems you may be having.
- Drinking or recovering from drinking is causing problems in your life.
- Going through withdrawal when the effects of alcohol wear off.
- Having cravings or strong urges to consume alcohol.
- Trying to cut down or stop drinking, but finding it impossible.
The more symptoms of AUD you have, the more reason you should seek out a change in your life. Alcoholism is a problem that only gets worse unless something is done to help.
Do You Have to Drink Every Day to be an Alcoholic?
Can End-Stage Alcoholism be Treated?
Should Families Consider an Intervention if They Have Alcoholic Loved Ones?
Is Alcoholism Genetic?
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