End-Stage Alcoholism: Causes, Symptoms & Treatment

Article at a Glance:

• End-stage alcoholism describes alcohol addiction resulting in serious, likely terminal health effects.
• Physical symptoms depend on the conditions the addiction has caused, including liver disease, heart disease, kidney disease, Wernicke-Korsakoff syndrome and malnutrition.
• Alcoholism can also cause mental health issues like depression, anxiety, psychosis and antisocial behavior.
• Diagnosing alcohol use disorder requires a trained healthcare professional using the DSM-5.
• Treating and recovering from late-stage alcohol addiction is possible with the proper support and medical intervention.

Heavy alcohol use for long periods 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 or extend their life expectancy.

Causes and Factors for End-Stage Alcoholism

Many factors can contribute to bringing someone to the final stages of alcoholism. They play an important role in causing the initial development of alcoholism but also increase the hold of alcohol addiction, making it more difficult to stop and contributing to it developing into an end-stage condition.

Prolonged Alcohol Abuse

The longer and more heavily you use alcohol, the more it will affect your body. Prolonged alcohol use strengthens addiction, making it harder and harder to stop drinking. This leads to long-term abuse that causes physical damage to multiple organ systems, including the liver, pancreas and brain. As this damage progresses, it becomes more permanent and compounds, eventually leading to end-stage alcoholism.

Genetics and Family History

There’s a proven genetic component to alcohol addiction that makes it more likely to occur and harder to beat. Additionally, those who grow up around alcohol or someone addicted to alcohol are more likely to drink and develop an addiction themselves. Genetics and family history both play a role in the development of alcoholism and the end-stage conditions that it eventually leads to.

Environmental Factors

Your environment plays a significant role in the onset and progression of alcoholism. Factors like peer pressure, easy access to alcohol, stress, exposure to violence and lack of family or community support can all contribute to initial alcohol use and the development of alcoholism. Additionally, societal and cultural practices related to drinking can further increase the pressure to begin or continue drinking. While your environment is rarely the only factor that leads to end-stage alcoholism, it can be a major contributor.

Mental Health Disorders

Mental health disorders can be confusing and difficult, especially if they haven’t been diagnosed yet. Someone seeking relief from the symptoms of a mental health problem often finds temporary relief in alcohol, causing them to seek out and use alcohol more heavily than others. This increases their risk of developing alcoholism. Using alcohol can also increase your risk of mental health disorders that reinforce drinking behaviors, further increasing the risk of end-stage alcoholism. 

Symptoms and Signs of End-Stage Alcoholism

While end-stage alcoholism isn’t technically a medical condition with signs and symptoms, there are many potential indicators that alcoholism is reaching the stage where it is likely to result in death in the near future.

Physical Symptoms

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

Liver Disease

Heavy alcohol use for prolonged periods can lead to inflammation of the liver, called hepatitis, which eventually leads to permanent liver scarring, 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 for. Cirrhosis will eventually be fatal as it progresses.

Heart Disease

Heavy alcohol use can cause cardiomyopathy, a condition in which the heart loses its ability to pump blood effectively. This weakening of the heart muscle is not typically reversible. It can cause many problems, eventually becoming fatal as the heart cannot pump enough blood to maintain life.

Kidney Disease

The kidneys are important in filtering our blood and maintaining healthy blood pressure. Chronic alcoholism has been shown to affect kidney function, 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 syndrome is a neurological condition primarily occurring in people with 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.

The irreversible brain damage Wernicke-Korsakoff syndrome causes can shorten your lifespan. Even when Wernicke-Korsakoff syndrome is still reversible, the complications that it causes can be fatal if proper treatment is not provided. 

Malnutrition

Alcohol contains empty calories and impairs judgment. These factors combine to make someone feel full while their ability to recognize the need for good nutrition is impaired. Malnutrition impacts your body in many ways, affecting every system and suppressing your body’s ability to fight infection or heal itself.

Mental Health Symptoms

In addition to physical health problems, alcoholism can cause debilitating mental health issues. Alcoholism can also make symptoms of an underlying mental condition worse. People with mental health conditions may try using alcohol to self-treat their condition, leading to an alcohol use disorder and worsening their original disorder. When alcohol addiction and a mental health condition are present at the same time, this is a co-occurring disorder.

Depression and Anxiety

Alcohol can cause depression and anxiety or enhance them if they are already present. While this might not seem connected to end-stage alcoholism initially, depression can lead to suicidal thoughts, especially as it worsens. These thoughts can eventually cause someone to take action, leading to a successful suicide attempt. If you have thoughts about harming yourself, this is not normal, and you should talk to a healthcare professional about them.

Psychosis

Chronic alcoholism can lead to a dangerous psychological condition called psychosis. Psychosis is a detachment from reality and can lead to serious injury. A condition called alcohol hallucinosis can occur, causing hallucinations that seem real. This can lead someone to act dangerously, such as attempting to fly by jumping off a high building or walking in traffic because they believe they are somewhere other than an active roadway.

Insomnia and Sleep Disorders

Alcohol keeps people from reaching the deep, restorative stages of sleep. This causes tiredness and fatigue the next day. When someone drinks daily, they never get the sleep they need. This has long-term health effects, contributing to physical and mental problems. It affects brain health significantly and suppresses your immune system. Insomnia rarely causes end-stage complications itself but can be a meaningful contributor.

Social Consequences

End-stage alcoholism often goes hand-in-hand with many negative social consequences. While these are not necessarily always connected with end-stage alcoholism per se, they are indicators that more serious alcoholism is present.

Strained Relationships

When alcohol addiction is present, you will seek out and prioritize drinking. Often drinking results in behavioral changes that make it harder to maintain healthy relationships. This frequently creates a scenario where you must choose between alcohol and a relationship. The addictive nature of alcohol tends to hurt relationships when this choice has to be made and leads to seriously strained relationships that affect even your closest family members and friends.

Financial Difficulty

Alcohol is expensive. This fact alone causes alcoholism to exert a serious financial strain. Advanced alcoholism can also affect your ability to hold down employment, especially jobs that create a good income. Additionally, alcohol leads to medical complications that increase your medical expenses. All these factors combine, causing alcohol to seriously increase the financial strains in your life.

Employment Challenges

Alcohol addiction can lead you to drink when you shouldn’t. This can cause you to show up to work hungover or drunk. It could also cause you to drink on the job. Drink and work don’t mix well, potentially leading to mistakes, bad interactions with customers or fellow employees and tardiness or excessive absences. This makes it harder to hold down a job. It is important to note that while alcoholism can lead to employment challenges, many functioning alcoholics can work effectively. Having a job that you are successful in does not mean that you do not have a problem with alcohol.

Phases of Addiction Leading To End-Stage Alcoholism

While the medical community does not clearly define distinct phases 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 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 done for pleasure but for necessity.

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.

Detox and Withdrawal Management

The first stage to overcoming alcoholism is to stop using alcohol and get through the physical withdrawal symptoms that follow quitting alcohol. Alcohol withdrawal is the most dangerous form of withdrawal, and it is important to seek medical help during detox. A medically-assisted detox will help you stay as safe and comfortable as possible, giving you the best chance of success and making the entire experience more comfortable. 

Someone in even the most advanced stages of alcoholism will benefit from stopping. The more advanced the alcoholism is, however, the more important it is that you seek medical help during the detox process.

Rehab Programs

Rehab is another major part of alcoholism treatment after medical detox. While medical detox gets you off of alcohol, rehab helps you stay off of it. Rehab teaches you ways of coping without alcohol and helps you recognize and defeat cravings rather than giving in to them. Rehab can be outpatient or inpatient. Due to the serious nature of end-stage alcoholism, inpatient rehab, where you stay and live in the rehab facility, is almost always recommended.

Lasting sobriety often requires 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 free from alcohol.