Recognising & Dealing With Physical Addiction

Hi my name is Jack and I am a stage 4 alcoholic.

I don’t want to focus too much in this article on the different stages of alcoholism – not because I think information about the other stages is unimportant, but because the fourth stage is so unique among drug usage that there are some critical factors I want to discuss for anyone in need of help or knowing of someone who might need help.

Stage four alcoholism’s primary indicator is a physical addiction to alcohol. Put another way, a person at stage four actually has to do one of two things – drink or detoxify under medical supervision – or they run a serious risk of death.

When I say they must drink, I do not mean the psychological craving many indicate by saying or thinking “I could really use a drink” or “I NEED a drink.” I mean that their body’s central nervous system will begin to break down during withdrawal, causing high risks of:

• seizures
• hallucinations
• profuse sweating and dehydration
• severe shaking or tremors
• alcoholic psychosis
• decrease in tolerance to alcohol
• further and severe loss of motor control skills

If you believe you may be physically addicted to alcohol, do not attempt to “quit cold turkey” or to otherwise do it on your own. You would be needlessly risking your life.

If you know someone who may be physically addicted, do not attempt to be the sole or primary facilitator of a physical withdrawal. It will be tempting to try to help your friend or loved one - especially for people who like to help “fix things for other people.”  But in reality, there is little you can directly do for a stage four alcoholic until they have completed a medically-supervised physical detoxification.

Alcohol is the only drug where withdrawal from it can kill you. Someone I know who has worked in substance abuse recovery for decades once said:

Alcohol is the worst when it comes to hardcore addictions. I’ve worked with heroin junkies while they went cold turkey, and they wished they were fuckin’ dead but they didn’t die. I’ve seen stage four drunks in withdrawal have seizures and not make it out.”

I know first-hand what stage four alcoholism feels like. I reached a point while I was drinking where I literally was drinking to avoid a withdrawal that I knew was very likely to be permanently physically and mentally damaging if not directly fatal.

Some key indicators that someone may be physically include:

• very shaky hands after waking up in the morning
• needing at least one drink first thing in the morning to calm those shakes
• waking up two or three times during the night to get a drink
• profuse sweating and/or disorientation after a few hours without a drink
• extremely blurry vision, very bloodshot and/or watery eyes

When attempting to diagnose physical addiction, it is important to also remember a few myths or misconceptions.

A stage four alcoholic may still be somewhat functional. Their acquired tolerance to alcohol will, for a time, remain quite high. The stage four will not always appear drunk at first glance. Many stage four alcoholics begin to lose their tolerance in the latter part of stage four, and at this point their ability to conceal their drinking will diminish correspondingly.

The good news is that there are effective protocols and treatments to physically detox a stage four alcoholic. Librium and Ativan are two of the primary medications used to keep the body from seizing up during the process.

Stage four is the terminal point of the progressive disease of alcoholism. Once a person has reached stage four, they must choose between a certain and premature death or a comprehensive treatment program that begins with physical detox.

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