Crippling alcoholism: definition, causes, stages, and treatments

Crippling alcoholism is a term used to refer to someone who does not fit the stereotypical view of an alcoholic, yet has drinking problems they may downplay or fail to recognize on their own.

The causes of crippling alcoholism include genetics, environmental factors, mental health conditions, traumatic experiences, stress, and a lack of coping skills. Because they do not experience the typical effects of alcohol use disorder (AUD), it may be harder to recognize high-functioning alcoholics.

The symptoms of crippling alcoholism include being unable to reduce or quit alcohol, drinking over a longer period than was intended, needing to drink more to achieve the same “high”, spending a lot of time drinking, thinking about it, or recovering from its effects, glassy eyes and bloated, puffy face, uncontrollable shaking or tremors, and neglecting important duties in favor of drinking.

The risk factors for crippling alcoholism are a family history of drinking problems, a history of trauma, co-occurring mental health problems, and drinking early in life.

Knowing the stages of AUD is important to distinguish a high-functioning alcoholic from someone who suffers from alcohol use disorder. The stages of alcohol use disorder include pre-alcoholic, early alcoholic, middle alcoholic, and late alcoholic.

What is crippling alcoholism?

Crippling alcoholism is a term used to describe an individual who abuses alcohol but is able to hold down a job, pay their bills, and maintain good relationships with family and friends, making them seem like they are living a great, normal life.

This seemingly normal outside life can also be used as an excuse for them to deny their dependence on alcohol. They may think that because they are leading a fulfilling and productive life, they cannot be called an alcoholic.

What is the other term for crippling alcoholism?

The other term for crippling alcoholism is high-functioning alcoholism. As the term suggests, it describes a person who functions at a higher level than others when it comes to daily life activities, but struggles with the harmful use of alcohol.

High-functioning alcoholics are also often high achievers who seem to have their lives in control. Their success might make an outsider think they have everything sorted out and could distract them from the fact that the person has a drinking problem.

When does crippling alcoholism start?

Crippling alcoholism starts when an individual drinks more than his or her daily or weekly limit. According to the Frequently Asked Questions about Alcohol page from the Centers for Disease Control and Prevention (CDC), the standard definition of heavy drinking for men is 15 drinks or more per week. For women, heavy drinking is typically described as 8 drinks or more per week.

Drinking heavily over an extended period of time can make it impossible to maintain major responsibilities at work or at home and may put you or those around you in danger by driving under the influence of alcohol, blacking out, or engaging in risky behaviors.

How common is crippling alcoholism?

Crippling alcoholism is common. The Alcohol Facts and Statistics page published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) indicates that in 2021, 29.5 million persons over the age of 12 (10.6% of this age group) had alcohol use disorder.

Furthermore, according to research-based information on alcohol’s effects on health from the NIAAA, the fourth-leading preventable cause of death in the United States is alcohol-related causes, which account for about 140,000 annual deaths (around 97,000 men and 43,000 women).

What are the causes of crippling alcoholism?

The causes of crippling alcoholism involve different contributing factors that increase one’s risk of becoming a high-functioning alcoholic. The causes of crippling alcoholism are listed below.

• Genetics
• Environmental factors
• Mental health conditions
• Traumatic experiences
• Stress
• Lack of coping skills

1. Genetics

Alcoholism is a complex genetic disease, and half of its risk is influenced by genes, according to an article entitled, “Genetics of Alcohol Use Disorder” published in NIAAA.

Genetics becomes a cause of crippling alcoholism by predisposing an individual to the negative and addictive effects of alcohol. These genetic markers may be inherited from blood relatives who suffer from alcohol use disorder or other substance use disorders.

Heredity is one of the causes of crippling alcoholism because it influences one’s preference for alcohol, vulnerability to alcoholism, and how their body responds to the substance.

2. Environmental factors

The environmental risk factors for high-functioning alcoholism may include the availability of alcohol, peer pressure, and norms supporting more or less drinking.

These environmental influences may increase one’s risk of being a high-functioning alcoholic by encouraging harmful drinking habits. For instance, the influence of a peer group can make someone engage in heavy drinking in an attempt to be accepted by their friends.

Environmental factors are also considered as one of the causes of crippling alcoholism because they may enable or normalize the excessive consumption of alcoholic beverages, either as a way to be valued or as a social lubricant.

3. Mental health conditions

A mental health condition that occurs with another disorder is called a co-occurring condition. Conditions that commonly co-occur with AUD are depression, bipolar disorder, schizophrenia, anxiety and antisocial personality disorder, as stated in a 2023 article entitled, “Is Alcohol Use Disorder a Mental Illness?” from Healthline.

These mental health conditions and crippling alcoholism have a bidirectional relationship, which means that while a certain mental illness may increase someone’s risk of turning to alcohol in an attempt to self-medicate, the chemical changes that take place in the brain while binge-drinking may also result in mental health issues.

Mental health disorders are regarded as one of the factors that contribute to crippling alcoholism because people who suffer from psychological issues may consume excessive amounts of alcohol to cope with life’s daily stresses.

4. Traumatic experiences

Traumatic experience refers to any terrifying event that one has experienced or witnessed, and which caused them physical, emotional, or psychological harm. Traumatic events may include accidents, natural disasters, serious illness, or sexual and physical assault.

Traumatic experiences become a cause of crippling alcoholism by triggering trauma-related symptoms, which people escape from by drinking alcohol. However, the sedating effects of alcohol are short-lived and may actually worsen symptoms in the long run.

Distressing events that cause trauma are also considered as factors that contribute to the development of crippling alcoholism because people who experienced great distress often want to distract themselves from their problems and drown out unwanted memories with alcohol.

5. Stress

Stress is the body’s normal reaction to any difficult situation or demanding circumstance that makes us feel pressured. Although it is a normal human response to potentially threatening or dangerous events, stress can become unhealthy once it starts affecting your day-to-day life.

Stress can be a cause of crippling alcoholism by causing highly stressed people to adopt alcohol consumption as a coping strategy to reduce stress. Individuals who are easily stressed are more likely to adopt this unhealthy coping mechanism.

Stress is one of the factors that contribute to crippling alcoholism because high levels of stress can alter the digestive enzymes, which may influence how one processes alcohol. Furthermore, a page entitled, “Alcohol Alert,” from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) suggests that cortisol – the main stress hormone – also has an effect on the reward or “pleasure” systems of the brain. Experts believe this may contribute to alcohol’s reinforcing effects by encouraging drinkers to consume more alcohol to get the same results.

6. Lack of coping skills

A lack of coping skills refers to the absence of healthy coping mechanisms that help an individual manage negative or difficult emotions. Examples of a maladaptive coping mechanism include avoiding a person or situation that causes stress, or engaging in self-harm.

Poor coping skills can become a cause of crippling alcoholism by leading people to think that they can use alcohol to deal with unusually stressful situations. However, the substance only offers temporary respite from reality, but prolonged alcohol consumption can contribute to anger issues, violent behaviors, and a handful of mental disorders.

Lastly, unhealthy coping mechanisms are regarded as one of the causes of crippling alcoholism because they are attempts to temporarily reduce negative feelings, which alcohol is very efficient in doing, at least in the short-term.

What are the stages of alcoholism?

The stages of alcoholism are crucial to understand in order to distinguish between a high-functioning alcoholic and someone who suffers from alcoholism. The stages of alcoholism are listed below.

• Stage 1: Pre-Alcoholic
• Stage 2: Early alcoholic
• Stage 3: Middle alcoholic
• Stage 4: Late alcoholic

Stage 1: Pre-Alcoholic

The pre-alcoholic stage involves experimentation with alcohol and mainly using the substance to get through different circumstances, such as to relax after a long day, help them feel more comfortable in social situations, or get them to fall asleep more easily.

This phase becomes a warning sign that alcohol consumption may turn into something serious by increasing a person’s tolerance for alcohol as they begin drinking more regularly, thinking it is a good coping mechanism for negative emotions.

The pre-alcoholic stage can be considered a symptom of alcoholism, since it is a tough stage when any actual drinking issues are still hard to spot because they have not yet developed into compulsive drinking behaviors.

Being in the pre-alcoholic stage can be identified by watching out for its signs, including increasingly using alcohol as a stress reliever, inability to be around people without an alcoholic drink at a social event, and using alcohol as a coping mechanism on a more regular basis.

Stage 2: Early alcoholic

The early alcoholic stage is a transitional stage where a pattern of alcohol misuse starts to develop, as stated by an article entitled, “The Four Stages of Alcoholism,” published in American Addiction Centers.

It becomes an indicator of potential alcoholism by increasing an individual’s patterns of drinking, which involves a cycle of regular binge-drinking, blacking out, and repeatedly failing at attempts to cut back on drinking alcohol.

The early stage is regarded as a symptom of alcoholism because this is usually where people try to find out how far they can go with their alcohol experimentation. As a result, they engage in binge-drinking, where men drink more than five drinks in a span of two hours, while women consume four drinks in a two-hour period.

To identify early stage alcoholism, it is important to look for its signs, including frequent binge-drinking, blacking out, consuming large amounts of alcohol under the pretense of having a good time or relaxing after a long work week, and repeatedly failing at attempts to quit or cut back on alcohol consumption.

Stage 3: Middle alcoholic

The middle alcoholic stage is the phase where a person’s problem with alcohol use becomes increasingly obvious, especially to their loved ones, such as friends or family members. While some people can masterfully conceal their drinking issues, one drawback of this is as one becomes more of an expert at lying to others, they also get better at lying to themselves.

Middle stage alcoholism becomes a sign of alcoholism by changing how a person responds to alcohol, making them more irritable and causing them to constantly crave an alcoholic drink.

This phase is also considered an indicator of alcoholism because this is where one’s drinking problem worsens while they downplay the amount of alcohol they drink and find all sorts of excuses to defend their drinking behaviors.

Identifying someone in the middle alcoholic stage is possible by watching out for its signs, including alcohol cravings, decreased productivity at work, and failure to fulfill major family obligations.

Stage 4: Late alcoholic

The late alcoholic stage is the final stage of an alcohol use disorder, when physical and mental issues begin to appear and when withdrawal symptoms can be intensely uncomfortable.

This phase is also known as end-stage alcoholism, and it becomes a symptom of high-functioning alcoholism by drastically changing a person’s priorities, with alcohol consumption taking a big chunk of their everyday life.

The late alcoholic stage is one of the signs of crippling alcoholism because it involves a total loss of control over alcohol use, where a person feels they are physically compelled to drink, and they cannot function normally without alcohol.

Identifying if someone is in the late alcoholic stage is possible by looking for common symptoms, such as serious medical conditions like liver disease or depression, intense cravings for alcohol, financial problems, legal stresses, job loss, family conflicts, estranged marriages, and experiencing severe withdrawal symptoms when attempting to quit drinking.

What are the symptoms of crippling alcoholism?

The symptoms of crippling alcoholism involve different alcohol use behavior patterns. The symptoms of crippling alcoholism are listed below.

• Unable to reduce or quit alcohol: People with high-functioning alcoholism find it hard to cut or curb drinking alcohol. This is because it has become a habit for them to use alcoholic beverages to self-soothe and relieve the stress they feel.
• Drinking over a longer period than was intended: When one starts developing tolerance for alcohol, they may find themselves consuming larger amounts of alcohol for longer periods of time than what they originally planned.
• Needing to drink more to achieve the same “high”: Individuals who become dependent on alcohol often notice that they need to drink more to achieve the same “feel good” effects they first had when they started drinking alcohol.
• Spending a lot of time drinking, thinking about it, or recovering from its effects: Once a person is hooked on alcohol, it takes up too much of a person’s time. They spend a huge part of their day thinking about their next drinking session, engaging in activities needed to obtain alcohol, and recovering from its effects.
• Glassy eyes and bloated, puffy face: Alcohol causes people to have dry eyes as it causes blinking to slow down, giving the eyes a glassy appearance. The substance can also cause water retention in the face, causing it to appear bloated and puffy.
• Uncontrollable shaking or tremors: Alcohol shakes and tremors occur when a person who has regularly consumed large amounts of alcohol suddenly stops drinking. To counteract the sedative effects of alcohol, the brain reacts by increasing nerve activity, leading to tremors, anxiety, hyperactivity, and other withdrawal symptoms.
• Neglecting important duties in favor of drinking: Crippling alcoholism can result in impaired cognitive functions and physical capabilities, which eventually leads to failure of fulfilling duties to family members or at the workplace. Negative effects include decreased productivity at work or eventual job loss, family violence, child neglect and abuse, and poor parenting.

Who is at risk for crippling alcoholism?

Those who have a family history of drinking problems, a history of trauma, individuals with mental health problems, and people who begin drinking early in life are the most at risk for crippling alcoholism.

People with blood relatives who have drinking problems are at a greater risk for high-functioning alcoholism due to inherited genes that make them more susceptible to the condition.

Those with a history of trauma are also at risk because they commonly use alcohol to deal with painful memories and emotions, as is the case for individuals suffering from mental health problems.

Finally, people who begin drinking early in life also run the risk of becoming high-functioning alcoholics later in life because of their long history of drinking. It can also impact how their brain develops and delay their puberty.

What can I expect from crippling alcoholism?

You can expect to suffer from significant negative effects on your health, relationships, and overall quality of life if you struggle with crippling alcoholism. It is a serious form of alcohol dependence that can lead to severe physical and psychological issues.

A wide array of physical health problems, mental health disorders, legal problems, relationship problems, and financial difficulties can arise from high-functioning alcoholism.

How is crippling alcoholism diagnosed?

Crippling alcoholism is diagnosed by screening for unhealthy alcohol use with the help of alcohol screening tools, physical exam, laboratory tests, a drinking patterns questionnaire, or psychological evaluation.

While there is no single test that can diagnose high-functioning alcoholism, these tests can help evaluate a person’s drinking habits and identify any medical conditions which may have resulted from heavy drinking.

It is also important to note that the term “crippling alcoholism” is not a diagnosable condition recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The closest medical condition to it, which also involves a problematic pattern of alcohol use, but is recognized by the DSM-5 is called alcohol use disorder (AUD).

What are the available treatments for crippling alcoholism?

Treatments for crippling alcoholism can be combined and adapted to each patient’s needs. The available treatments for crippling alcoholism are listed below.

• Medically supervised detox: Withdrawal symptoms from quitting alcohol can be extremely unpleasant, if not life-threatening. Medical detox helps the body get rid of the effects of alcohol in a safe and controlled environment where there is a medical team nearby who can supervise and support the patient.
• Individual or group therapy: You can better understand your unhealthy drinking habits with the aid of counseling and therapy for both groups and individuals, according to an article entitled, “Alcohol use disorder” published in Mayo Clinic.
• Support groups: Support groups available for high-functioning alcoholics include Alcoholics Anonymous, SMART Recovery, and Celebrate Recovery. These alcohol support groups allow people who share similar experiences and struggle to have a safe space where they can offer each other support.

What are the complications of crippling alcoholism treatment?

The complications of crippling alcoholism treatment may increase in severity with each episode, and may include tremor, restlessness, anxiety, insomnia, nausea, low-grade fever, profuse sweating, rapid breathing, seizures, cardiovascular complications, Wernicke-Korsakoff syndrome, and disturbances in mood, thought, and perception, according to a study on the complications of alcohol withdrawal by Louis A. Trevisan, M.D., Nashaat Boutros, M.D., Ismene L. Petrakis, M.D., and John H. Krystal, M.D., published in 1998 in the journal Alcohol Health and Research World.

Furthermore, first-line medications used in treating alcohol use disorder (AUD), such as naltrexone and acamprosate, may also cause side effects or complications. For instance, Mayo Clinic’s page about Naltrexone (Oral Route) states that the more common side effects of the medication are mild to moderate abdominal or stomach cramping or pain, nausea or vomiting, headache, anxiety, nervousness, restlessness, difficulty sleeping, joint or muscle pain, and unusual tiredness.

On the other hand, according to an article about acamprosate published in MedlinePlus, some side effects that the medication can cause include upset stomach, diarrhea, loss of appetite, dry mouth, dizziness, weakness, anxiety, trouble falling asleep or staying asleep, and sweating.

It’s worth noting that the above-mentioned health effects are just a tiny part of the complications of crippling alcoholism. Excessive alcohol consumption over a long period of time can contribute to a plethora of short- and long-term health issues.

Can crippling alcoholism be treated?

Yes, crippling alcoholism can be treated with the help of available treatment options, such as medical detox, psychological counseling, and support groups. These intervention methods can be combined and tailored to the physical and emotional needs of the patient.

Suddenly stopping alcohol use can cause serious withdrawal symptoms, therefore seeking professional treatment and detoxing in a medically supervised setting helps the affected individual make sure that they can clear their body of toxins in the safest way possible.

How to prevent having a crippling alcoholism?

Crippling alcoholism can be prevented by following some important tips to curb unhealthy drinking habits, including controlling alcohol intake, having no alcohol at home, changing your after-work routine, finding healthier alternatives to drinking, and asking for support.

First, you can control your alcohol intake by setting a limit on how much you are going to drink. The Frequently Asked About Alcohol Page from the Centers for Disease Control and Prevention states that drinking in moderation is possible by restricting intake to two drinks or fewer per day for men and one drink or fewer per day for women.

Keeping alcohol out of your home can also help limit your drinking. After all, if you have easier access to alcohol, the more likely it is that you’ll be tempted to consume it. Making your home a drink-free zone can help you avoid this slippery slope.

Next, if you have made it a habit to reach for a glass of liquor to relax after a busy day at work, you might want to try changing your after-work routine. In relation to that, you can find healthier alternatives to drinking, such as reading a book, going for a walk, or other activities that do not involve alcohol.

Finally, cutting down on alcohol may not always be easy for everyone, and asking for support from loved ones is not a sign of weakness. In fact, it takes considerable strength to let others know about your struggle and to let them know that you need their support. A stable social support can significantly help in letting you know that you are not alone in your journey to recovery.

Is moderation management helpful in preventing alcohol abuse?

Yes, moderation management is helpful in preventing alcohol abuse. According to an article entitled, “Alcohol Moderation Management: Programs and Steps to Control Drinking,” published in American Addiction Centers, the goal of alcohol moderation management is to assist people in setting objectives and personal drinking limits, and it is designed for those who haven’t yet developed a widespread pattern of alcohol abuse.

Therefore, these programs may be more feasible than abstinence for some people who do not want to give up alcohol totally, because moderation management acknowledges that every drinking issue is unique and that there is no one-size-fits-all approach.