The symptoms of alcoholism are highly variable among different people, however all alcoholics share the four major features of the disease: alcohol cravings, loss of control, physical dependence, and tolerance. Other symptoms may or may not be present and these include:

Early stage symptoms:

• Drinking to escape problems.
• Increasing tolerance: need for more and more alcohol to feel drunk.
• Blackouts: gaps in your memory for what happened during periods of heavy drinking.
• Hiding alcohol or sneaking drinks.
• Being unable to limit the amount of alcohol you drink.
• Thinking more and more about alcohol.
• Planning activities around drinking.

Middle stage symptoms:

• Drinking more than planned.
• Denying having a drinking problem.
• Experiencing some physical withdrawal symptoms like nausea and shaking.
• Severing social and professional relationships.
• Loss of interest in activities that don’t involve drinking.
• Personality changes and mood swings.
• Drinking right away upon waking.

Late stage symptoms:

• Exhibiting extreme social isolation.
• Reverse-tolerance: needing less and less alcohol to feel drunk (due to severe liver damage).
• Malnourishment and vitamin deficiency, which may lead to Korsakoff’s syndrome (severe amnesia caused by lack of vitamin B1).
• Having severe withdrawal symptoms such as delirium tremens (the DTs) and hallucinations.

Alcohol abuse may have some of the same symptoms as early and middle stage alcoholism, but alcohol abusers do not experience physical withdrawal symptoms, loss of control, or compulsion to drink.