Alcohol Use Disorder (AUD), often referred to as alcoholism, is a chronic brain disease characterized by compulsive alcohol use, a loss of control over consumption, and the experience of a negative emotional state when alcohol is not being used. The disorder reflects significant changes in the brain’s circuitry involving motivation, reward, and self-control. AUD is not a sudden event, but a condition that develops along a spectrum of severity and progression over time. Understanding this progression, particularly the initial changes in behavior, is useful for identifying a developing problem before it becomes severe.
The Initial Phase of Increased Use and Tolerance
The earliest phase of problematic drinking is often termed the “pre-alcoholic” or “experimental” stage. During this time, the individual shifts from purely social use to using alcohol as a coping mechanism for managing stress, reducing anxiety, or helping to unwind. This pattern of “relief drinking” is a primary behavioral marker of this initial phase.
The most significant physiological change during this stage is the gradual development of increased tolerance. Tolerance means the brain and body become less sensitive to alcohol’s effects, requiring a person to consume larger amounts to achieve the desired feeling of intoxication or relaxation. This requirement causes drinking habits to become more routine and frequent, though they may still appear controlled to external observers. The individual rarely experiences severe social or health consequences at this point, which often allows the pattern to continue unnoticed.
Defining Early-Stage Alcohol Use Disorder
The transition from the initial behavioral phase to a diagnosable clinical condition occurs when the pattern of use crosses the threshold into Early-Stage Alcohol Use Disorder. This diagnosis is based on the criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), where meeting two to three symptoms indicates a mild severity AUD. The emergence of consequences and a demonstrable loss of control differentiate this stage from earlier, experimental use.
One of the first clinical signs is the loss of voluntary control, specifically drinking more alcohol or for a longer time than intended. Another criterion that often presents early is the increasing amount of time spent obtaining alcohol, using it, or recovering from its effects. The individual may also start to experience a persistent desire or make unsuccessful efforts to cut down or control consumption. In the early stage, a person might also begin to rely on alcohol to preemptively avoid mild withdrawal symptoms, such as anxiety or tremors.
Identifying Key Warning Signs and Behaviors
The early progression of the disorder is marked by a series of practical, observable behavioral changes that act as warning signs. A common behavior is drinking alone or secretly, which is an effort to hide the increasing quantity or frequency of consumption from family or friends. This secrecy is frequently accompanied by minimizing or lying about the actual amount of alcohol consumed.
Another significant marker is the development of blackouts, which are periods of temporary memory loss for events that occurred while intoxicated. These occur because alcohol interferes with the brain’s ability to transfer short-term memories into long-term storage. The individual may also begin neglecting responsibilities or hobbies, prioritizing drinking instead of important social or recreational activities.
An increased craving, defined as a strong urge or desire to use alcohol, also becomes noticeable in the early stages. The person may become irritable, restless, or anxious when they cannot access alcohol, indicating that their emotional state is linked to its availability.