Definition of a Chronic Alcoholic

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Alcoholism is how most people describe someone who cannot control their drinking. To be diagnosed as an alcoholic, a person must meet certain criteria as established by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The diagnostic indicators of alcoholism can be either mild, moderate, or severe. These three levels are also called alcohol use disorder, or AUD.

Still, the more common term is alcoholic or alcoholism, but medical professionals prefer to diagnose a person with a form of AUD as one of the three ranges. The criteria for each degree of AUD depends on how many symptoms the individual is experiencing.

What is End Stage Alcoholism?

End-stage alcoholism is the most severe form of AUD as alcoholism. It is also what occurs to someone who is a chronic alcoholic. End-stage alcoholism means the individual drinks heavily every day and is experiencing medical and psychiatric conditions because of their drinking. When a person reaches end-stage alcoholism, drinking has taken over their lives and has likely had a negative impact on relationships, work or school, finances, and overall health.

If a person tries to quit drinking on their own during end-stage alcoholism, they may experience severe symptoms of withdrawal, including tremors and hallucinations. This degree of alcoholism is often fatal, causing cirrhosis of the liver, pancreatitis, jaundice, heart failure, malnutrition, paranoia, suicidality, and psychosis.

How Is A Person Diagnosed with a Severe AUD?

The number of symptoms a person must exude when diagnosed with severe AUD is 6 or more of the 11 symptoms outlined by the DSM 5.  The diagnostic classification that is used requires that someone answer yes to a minimum of 2 questions to determine what degree of AUD a person has.

If you or a loved one has experienced any two of the symptoms from the following criteria/questionnaire in the past year, this person can be diagnosed as having an AUD. When 2 symptoms are present it is mild, more than two but less than 5 is moderate and 6 or more is a severe AUD. The criteria include, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 2022) are as following:

  1. Alcohol is often taken in larger amounts or over a longer period than was intended. [Do you drink more than you mean to?]
  2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. [Do you want to stop but can’t?]
  3. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects. [Is drinking taking over your life?]
  4. Craving, or a strong desire or urge to use alcohol. [If you can’t drink, are you thinking about drinking?]
  5. Recurrent alcohol use results in a failure to fulfill major role obligations at work, school, or home. [Is your drinking getting in the way of day-to-day activities?]
  6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol. [Is drinking getting in the way of your relationships?]
  7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use. [Are you sitting things out because of alcohol?]
  8. Recurrent alcohol use in situations in which it is physically hazardous. [Are you drinking in risky settings or doing risky things while drinking?]
  9. Alcohol use continues despite knowledge of a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. [Do you know drinking isn’t good for you, but you do it anyway?]
  10. Tolerance, as defined by either of the following: a need for markedly increased amounts of alcohol to achieve intoxication or desired effect or a markedly diminished effect with continued use of the same amount of alcohol. [Do you need to drink more than you used to?]
  11. Withdrawal, as manifested by either the characteristic withdrawal syndrome for alcohol or alcohol (or a closely related substance, such as a benzodiazepine), is taken to relieve or avoid alcohol withdrawal symptoms. [Do you feel it when you stop drinking?]

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) describes alcohol use disorder as “an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.”

Common Behavioral symptoms of AUD

Someone with AUD spends a lot of time thinking about alcohol and cannot control how much they consume. It is also someone who drinks excessive amounts of alcohol most days of the week and will often drink alone or in secret. This person will also experience blackouts and be arrested for DUI or other alcohol-related crimes. AUD behavioral symptoms also include minimizing how much they drink or lying about it.

They will also have no interest in activities where there is no alcohol involved. Alcoholics also get agitated easily when sober and may become aggressive when drinking. Other signs to watch for are hiding alcohol in the car or house, drinking more than others at events, and always saying they need alcohol to feel better, even if it is a good day.

What is Alcohol Withdrawal?

Alcohol withdrawals are most prevalent for someone with severe AUD or chronic alcoholism and cause dangerous physical withdrawal symptoms. This person can have a life-threatening seizure, stroke, or another dangerous medical emergency without medical attention.

Alcohol withdrawal symptoms will begin very soon after the person has stopped drinking and the alcohol is wearing off. Alcohol withdrawal symptoms include the following:

  • Sweating
  • Nausea and vomiting
  • Hand Shaking
  • Insomnia
  • Anxiety and panic attacks
  • Increased blood pressure
  • Heart palpitations
  • Dry heaving
  • Muscle cramps
  • Hallucinations
  • Seizures
  • Depression and suicidal thoughts

What Treatment Helps Alcoholism?

The most recognized treatment type for AUD is evidence-based treatment. It utilizes behavioral therapy methods to help someone with alcoholism understand what is happening to their mind and emotions that drive them to drink and not be able to stop.

The most well-known form of behavioral therapy for AUD is cognitive behavioral therapy and dialectical behavioral therapy. Other evidence-based therapy methods include motivational interviewing, one on one counseling, holistic therapy practices, and trauma therapy.

To learn about our programs that are evidence-based, reach out to us now for same-day admission to our best New Jersey alcohol detox and rehab programs.

Medically Reviewed: January 24, 2023

Dr Ashley

Medical Reviewer

Chief Editor


All of the information on this page has been reviewed and verified by a certified addiction professional.

Dr Ashley Murray obtained her MBBCh Cum Laude in 2016. She currently practices in the public domain in South Africa. She has an interest in medical writing and has a keen interest in evidence-based medicine.

All of the information on this page has been reviewed and verified by a certified addiction professional.

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