What is Terminal Alcoholism?
End-stage alcoholism or late-stage alcoholism is the end-stage alcohol use disorder that leads to severe physical and mental discomfort, as well as other life consequences from years of alcohol abuse.
Alcohol use disorder is a progressive disease that includes initial, intermediate, and terminal stages that can lead to life-threatening health conditions. It’s not often talked about, but untreated alcohol use disorder can be a fatal disease..In fact, it accounts for about 88,000 deaths per year in the US, making alcohol the third leading preventable cause of death in the US...
By the time a person reaches terminal alcoholism, drinking will have taken over their life and likely negatively impacted relationships, work or school, finances, and general health. If a person tries to stop drinking on their own during end-stage alcoholism, severe withdrawal symptoms, including tremors and hallucinations, can occur. One of the most serious consequences of alcohol withdrawal is delirium tremens (“the DTs”), which can be fatal if left untreated.
End-or late-stage alcoholism can cause a variety of physical and mental illnesses, including:
- Jaundice due to liver failure
- Itchy skin
- Fluid retention
- Chronic pancreatitis
- Heart failure
- Wernicke-Korsakoff syndrome (also called alcohol dementia)
Alcoholic liver disease / cirrhosis
If the liver can no longer metabolize alcohol quickly enough and keeps sending it back into the bloodstream, the liver hardens and scars in the tissue (cirrhosis) can occur. Cirrhosis is the end-stage of alcohol-related liver disease...
More than a million people die from cirrhosis each year, including over 40,000 people in the United States, according to the CDC...
In the early stages of alcoholic liver disease, symptoms may not appear at all. However, after years of intensive use, you can see:
- Digestive problems:: Abdominal swelling, dry mouth, bleeding from enlarged esophageal veins
- Dermatological problems:: Yellowing of the skin (jaundice), red spidery veins, reddening of the feet
- Brain and nervous system:: Memory problems, numbness in the extremities, fainting
Chronic, long-term drinking can contribute to malnutrition by replacing foods needed for essential nutrients and by affecting the absorption, storage, or metabolism of the essential nutrients. This can also lead to anemia if your red blood cell (RBC) counts are lower than normal or if there is a problem with the hemoglobin protein in these cells.
Damage to the pancreas from alcohol may not cause symptoms for many years before it leads to a sudden attack of pancreatitis. About 70% to 80% of chronic pancreatitis cases are due to chronic alcohol consumption. People with chronic pancreatitis tend to have three primary health problems: pain, malabsorption of foods that lead to weight loss, or diabetes.
If you or someone you love reaches end-stage alcoholism, you may be struggling with a number of heart problems, including:
- Angina caused by a stable blockage in a coronary artery
- Damage to the heart muscle (alcoholic cardiomyopathy)
- High blood pressure, which is a risk factor for coronary artery disease
- Increased risk of heart failure and stroke
- High blood triglycerides which increase the chance of heart disease
Research has shown that long-term alcohol abuse can have a lasting impact on the brain, although some areas can recover from abstinence..Alcohol can damage the brain in many ways. The most serious effect is Korsakoff syndrome, which is characterized in part by the inability to remember recent events or to obtain new information.
During end-stage alcoholism, a person may struggle with involuntary rapid eye movement (nystagmus) or weakness and paralysis of the eye muscles due to a thiamine (vitamin B1) deficiency. This deficiency can also lead to dementia if not treated immediately.
After years of chronic drinking, a person increases the risk of several types of cancer, including:
- Breast cancer
Although there is no official diagnosis for end-stage alcoholism, your doctor can diagnose you with an alcohol use disorder and identify your stage based on the severity and length of time you’ve been abusing alcohol, as well as your current alcoholic health.
The American Psychiatric Association’s 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses the following 11 symptoms to indicate an alcohol use disorder. If you have six or more, you will be diagnosed with severe alcohol use disorder:
- Alcohol is often consumed in larger amounts or for a longer period of time than intended.
- There is an ongoing desire or unsuccessful effort to reduce or control alcohol consumption.
- Much time is spent on activities that are necessary to conserve alcohol, consume alcohol, or recover from its effects.
Craving, or having cravings, or an urge to consume alcohol.
- Recurrent alcohol consumption results in critical role commitments being missed at work, school, or at home.
- Continued use of alcohol despite persistent or recurring social or interpersonal problems caused or exacerbated by the effects of alcohol.
- Important social, professional or leisure activities are given up or reduced due to alcohol consumption.
- Recurrent alcohol use in situations where it is physically dangerous.
- Alcohol use continues even though it is known that there is an ongoing or recurring physical or mental problem, likely caused or made worse by alcohol.
Tolerance, as defined by one of the following definitions: a) the need for significantly increased amounts of alcohol in order to achieve poisoning or desired effects, or b) significantly reduced effects with continued use of the same amount of alcohol.
- Withdrawal manifested by any of the following symptoms: a) The characteristic withdrawal syndrome for alcohol b) Alcohol (or a closely related substance such as a benzodiazepine) is taken to relieve or prevent withdrawal symptoms.
Terminal alcoholism is terrible, but not hopeless. Treatment of the alcohol use disorder, as well as the health problems caused by chronic heavy drinking, may be possible. The first step will likely be a medically supervised detox, which will rid your body of toxins and alleviate withdrawal symptoms.
Rehabilitation for alcohol addiction is also required, including:
- Medication: Antabus (Disulfiram), Revia or Depade (Naltrexone), Campral (Acamprosat)
- Behavior therapy: Cognitive Therapy, Rational Emotional Behavior Therapy, Rational Behavior Therapy, Rational Life Therapy, and Dialectical Behavior Therapy
- Support groups: Alcoholics Anonymous (AA), SMART Recovery, Rational Recovery, Women for Sobriety, Secular Sobriety Organizations (SOS)
Once you stop drinking, your body can recover from some damage, or at least keep it from getting worse.
When a person is in the terminal stages of alcoholism, it cannot be denied that drinking has taken over their life and damaged their health. Restoring won’t be easy at this point, but it’s worth the work. Now is the time to bring together the support of addiction specialists, mental health professionals, friends and family, and anyone with an alcohol use disorder. You don’t have to be alone during this difficult and scary time.
For friends and family
It can be frustrating and lonely to watch a loved one endure the end stages of alcoholism. The feeling of powerlessness is suffocating as you watch someone you care about slowly deteriorate physically and mentally, while they may even continue to refuse to admit that their drinking is problematic. For those who need help and don’t want it, intervention may be the only alternative.
Even if your loved one seeks help, you may need help and support to overcome the effects. Many people refer to alcoholism as a “family disease” because it can have a significant impact on all family members, whether they notice it or not.
If you or a loved one is struggling with substance use or addiction, contact the National Substance Abuse and Mental Health Agency (SAMHSA) helpline at 1-800-662-4357 Information about support and treatment facilities in your area.
Additional mental health resources can be found in our National Helpline Database.