If a person falls into the final stage of alcoholism, they have a long history of heavy drinking. The most likely have experienced long term effects, such as liver damage, often associated with regular use of alcohol. They are in the final of the alcoholism stages.
At this point, the individual has two possible choices. One would be to stop drinking and work towards a healthier life style. The other option would be to make no changes, and die from the damage that drinking is causing.
For individuals who do not struggle with addiction, this seems like an easy choice. For someone struggling with an alcohol addiction, this may not be as simple. They may be struggling with denial. For these individuals, they are unable to recognize the negative impact that drinking has had on their life, while others find that the negative impacts are quite obvious. Effects could be seen within relationships, finances, job security and behaviors.
For many, needing to experience “rock bottom” can be a turning point in their addiction where they begin to recognize that abstaining from alcohol use would be a wise decision. It is at this point that an alcoholic is more open to options such as addiction treatment and Alcoholics Anonymous.
Characteristics of End Stage Alcoholism
Continual loss of control. Loss of control over drinking is a common characteristic among alcoholics. Many surrender to this and stop trying to fight it. At this point, alcohol has become the focus of their life and everything else falls to the back burner. Legal troubles may be present as well.
·Feelings of impending doom and destruction. The dependent drinker feels great fear of unspecified things/events. They are constantly anxious and often foresee their own destruction (death). For many, this concern is the result of realistic possibilities if they are to continue drinking. It is also important to recognize the long term effect that alcohol, a depressant, can have on a persons mood and mental health. Common depressive symptoms include loss of hope, sadness and loss of interest in activities previously enjoyed.
·Tolerance falls. Where before they were able to drink large amounts now their tolerance for alcohol falls and they get intoxicated very easily.
·Delirium Tremens. Violent shaking and sweating can occur when a heavy drinker stops drinking. This is known as Delirium Tremens (DT’s) and can occur when an individual is detoxing from alcohol. In fact 1 in 5 alcoholics who try to withdraw from alcohol without medical supervision die in the process. There are several factors that influence the severity of a person’s withdrawal symptoms which includes multiple detox’s in the past. Consult with a doctor before attempting to detox on your own.
·Ongoing remorse and guilt. Not surprisingly the drinker now feels continually remorseful. Guilt is his shadow. The feeling of guilt is often present throughout the day. Not just remorse for his drinking and his powerlessness over alcohol but toward all the pain he has caused himself and others. The missed opportunities, the shame the whole thing. These are common experiences that individuals process and work through in treatment and/or therapy. Guild is the sense of “I’ve done bad” whereas shame is more “I am bad”.
· Resentments are amplified. He or she feels unjustified anger and bitterness towards the world and everything/everybody in it. This just fuels his drinking. A me vs. the world complex. Resentments rarely impact the person they are against, and really have a negative impact on the person carrying them. Similar to shame and guilt, resentments are a common concern addressed in treatment and/or therapy.
· Alcoholic blackouts. The alcoholic blackouts are now getting longer. Days or even weeks go by without the alcoholic remembering anything. To others he may seem lucid but the drinker is on autopilot. As a result, these can be physically dangerous for the alcoholic and others around them.
· Obsession with drinking. Alcohol is on the drinker’s mind day and night. Nothing else matters. Maintaining a constant supply of drink is foremost, whatever the cost. There is also nothing that will get in the way of getting alcohol. For example, an alcoholic low on drinks would likely not think twice about walking to a gas station during a blizzard to buy alcohol. To someone who is not an alcoholic, this sounds like a crazy idea, however for the alcoholic, it is all they can think about.
· Needs system comes crashing down. All other needs including water, food, sex, shelter warmth take second place to drink. In many cases the chronic alcoholic becomes homeless but this doesn’t matter as long as drink can be found. As a result, it is not uncommon for end stage alcoholics lose weight and become dehydrated. They can encounter health concerns related to poor nutrition. Many marriages and romantic relationships do not last past this point. Living with an end stage alcoholic can become unbearable. The alcoholic has likely gotten in trouble at work or has lost their job. They have distanced themselves from friends and family due to their preoccupation with drinking.
· Frequent contact with law enforcement. Chronic alcoholism usually results in the sufferer having more and more brushes with the law. This could be for drunk driving, drunk and disorderly, assault etc. For loved ones, this can easily turn into a situation where they are enabled.
· Personal relationships collapse. Where before the dependent drinker had at least made some sort of effort to keep people in his life (though often by lying) now he just can’t be bothered. Any relationships he had left now dissolve in the drink. It takes a strong person to stand by someone in end stage alcoholism. This can include friendships, family and, unfortunately, children. Again, this is the result of their preoccupation with alcohol and drinking.
It would be unusual for the chronic alcoholic to display all these characteristics. Some of these characteristics can be observed earlier than others. For example, someone may experience trouble with law enforcement in the beginning of their addiction compared to the tail end of it, or their personal relationships can begin to collapse early.
However, if three or more are evident then it is very likely that they are in the final stages of their disease.
Without wanting to sound like a pessimist, the odds are against anybody trying to get through to a chronic alcoholic are pretty low. However, try not to let that deter you. There is never a point in addiction where it is “too late” to get sober. No matter how late it may be, a person can choose to stop drinking which may stop the adverse effects from progressing further than they already have.
To have got to this stage a person will have generally rejected many offers of help and probably been through alcoholism treatment at least once. They will be so consumed by drink and all the resentment and guilt that comes with it.
There are a few different levels of treatment that they could have tried already. This includes:
· Detoxification- Detox from alcohol and other substances (if applicable) in a medically supervised. Due to the dangers associated with alcohol detox, it is ideal that an alcoholic be supervised by health professionals.
· Inpatient Treatment Programs- Can easily follow a detoxification. The length of treatment can vary on the program itself, the severity of the person’s disease as well as insurance coverage. While in treatment, the alcoholic will be engaged in individual sessions, group sessions and psychoeducational sessions. They will learn more about the disease concept of addiction as well as how to cope with their addiction.
· Outpatient Treatment Programs- Engaging in an outpatient program is the common recommendation from inpatient programs. Returning to your normal, everyday life, can present challenges. Some predictable, and some not. Outpatient would likely include group and individual sessions to continue supporting the alcoholic through their recovery.
It is important to remember that if the individual does not want help then there is NOTHING that can be done. The individual needs to want to be in alcoholism treatment for the intervention to be effective.
It is essential you don’t blame yourself if an offer of help is rejected by someone in end stage alcoholism. This tells you more about where the person is in their addiction than anything else.
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