End-Stage Alcoholism

Key takeaways:

  • After years of heavy alcohol abuse, the liver begins to fail at metabolizing alcohol fast enough and begins to pump it back out into the bloodstream. Over time, this causes the liver to harden and creates scarring on the liver tissue, known as cirrhosis.
  • Chronic pancreatitis is caused by alcoholism in nearly 80% of all cases. Though many people may experience no symptoms for many years, pancreatitis attacks can be sudden and aggressive.
  • Alcohol dementia, also called Korsakoff's syndrome, is a severe consequence of chronic alcohol abuse and has lasting and degenerative effects similar to Alzheimer’s. Some areas of the brain may repair if alcohol consumption stops, though many symptoms of alcoholic dementia are irreversible. 

Sometimes referred to as late-stage alcoholism, end-stage alcoholism is for many the final outcome of an alcohol use disorder; the culmination of years of alcohol addiction that results in both psychological and physical health conditions.

What is end-stage alcoholism?

Alcoholism, or an alcohol use disorder, (AUD) is a devastating disease that if left untreated can lead to severe health conditions and often death.[1] End-stage alcoholism is the final part of long-term alcohol abuse and addiction, often characterized by negative impacts of alcohol use on personal life, work, relationships, and health. 

For most people in end-stage alcoholism, the addiction is so severe and the physical dependence so strong that if they attempted to quit drinking altogether then they would experience potentially fatal withdrawal symptoms. The most life-threatening of these is delirium tremens (DTs), a condition that causes uncontrollable shaking and hallucinations. 

In addition to this, there are many life-threatening health conditions that arise from long-term alcohol abuse. In fact, around 95,000 people (approximately 68,000 men and 27,000 women) die from alcohol-related causes per year, with alcohol being the third-leading preventable cause of death in the United States.[2]

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Symptoms of end-stage alcoholism

There are many health conditions and symptoms related to end-stage alcoholism. Some cause mild irritation and defects while others often claim the lives of those afflicted. The most common health conditions associated with late-stage alcoholism include:

  • Cirrhosis/liver disease
  • Jaundice from liver failure 
  • Alcoholic dementia (Also called Wernicke-Korsakoff syndrome)
  • Chronic pancreatitis
  • Cardiovascular problems/heart failure
  • Cancer
  • Eye problems
  • Itchy skin
  • Fluid retention
  • Digestive issues, fatigue, and malnutrition

Alcoholic liver disease (cirrhosis)

After years of heavy alcohol abuse, the liver begins to fail at metabolizing alcohol fast enough and begins to pump it back out into the bloodstream. Over time, this causes the liver to harden and creates scarring on the liver tissue, known as cirrhosis. Cirrhosis is often the final stage of alcoholic liver disease and is both severe and incurable. 

People with AUDs may develop alcoholic liver disease over many years without realizing. Early warning signs include swollen abdomen, dry mouth, blood in the mouth or stool, weight loss, nausea, loss of appetite, and jaundice.[5]

It is estimated that alcoholic liver disease claims over one million lives per year, 40,000 of which are American.[4]

Malnutrition, digestive problems, and anemia

After prolonged, chronic alcohol abuse the body begins to fail with absorption, metabolism, and storage of essential nutrients. This can often lead to malnutrition as well as anemia, a blood condition where the red blood cell count is lower than normal or there is a problem with the proteins in the cell.

Chronic pancreatitis

Chronic pancreatitis is caused by alcoholism in nearly 80% of all cases. Though many people may experience no symptoms for many years, pancreatitis attacks can be sudden and aggressive.[1] The main health problems associated with chronic pancreatitis include weight loss due to malabsorption, severe abdominal pain, and often diabetes. As with alcoholic liver disease, there is no cure for chronic pancreatitis.

Cardiovascular issues

Alcohol abuse puts an incredible strain on the body's cardiovascular system, often creating issues with the heart and blood vessels as well as contributing to high cholesterol. Those who are at end-stage alcoholism will often face one of these heart related conditions:  

  • Angina
  • Heart failure and stroke
  • High blood triglycerides, which can lead to heart disease
  • Alcoholic cardiomyopathy (damaged heart muscle)
  • Coronary artery disease

Alcoholic dementia

Alcohol abuse can have devastating and long-term effects on brain function and cognition. Over-consuming alcohol can impact coordination, memory, judgment, and decision-making ability by damaging brain cells as well as by starving the brain of nutrients due to malnutrition. 

Alcohol dementia, also called Korsakoff's syndrome, is a severe consequence of chronic alcohol abuse and has lasting and degenerative effects similar to Alzheimer’s.[6] Some areas of the brain may repair if alcohol consumption stops, though many symptoms of alcoholic dementia are irreversible. 

Skin and other visible afflictions

Alcoholism has many visible side effects associated with it, so much so that some are synonymous with the condition. ‘Alcoholic nose’, ‘alcohol bloat’, and ‘alcoholic eyes’ are all conditions associated with heavy drinkers. You can read more about how alcoholism affects appearance here

Eye problems

Alcoholism doesn’t just result in bloodshot eyes. During end-stage alcoholism, some people may develop involuntary rapid eye movement (nystagmus) or a thiamin (vitamin B1) deficiency that results in weakness or paralysis of the eye muscles. This can also play a role in the development of alcoholic dementia.

Cancer

The risk of developing multiple forms of cancer is increased after chronic alcohol abuse. Most often we associate liver cancer with alcohol, but the scope goes much further. The most common types of alcohol-related cancers are: [7]

  • Mouth
  • Throat (pharynx)
  • Voicebox (larynx)
  • Esophagus
  • Liver
  • Colon and rectum
  • Breast
  • Skin

Treatment for end-stage alcoholism

While addressing an alcohol use disorder before it develops into end-stage alcoholism offers the best chances of successful recovery without lasting health complications, treatment is still available even in the most severe cases of alcoholism. 

Most people in end-stage alcoholism will require a medically assisted detox to help manage severe and life-threatening withdrawal symptoms. Medications used in treating alcohol withdrawal include Antabuse (disulfiram), Revia or Depade (naltrexone), and Campral (acamprosate).  

Inpatient and outpatient treatment programs will also offer a range of therapies designed to help identify triggers for alcohol abuse as well as develop coping mechanisms and dealing with emotional trauma that may be associated with alcohol. Common therapies used in alcohol use disorder treatment include cognitive-behavioral therapy (CBT) rational behavior therapy, emotive behavior therapy, and dialectic behavioral therapy. 

Once treatment is complete, ongoing recovery and addiction management can begin. Overcoming alcoholism is a life-long commitment that requires dedication and resolve. There are numerous support groups that can help with long-term sobriety, including Alcoholics Anonymous (AA), SMART Recovery, Secular Organizations for Sobriety (SOS), Women for Sobriety, and Rational Recovery.

If you or someone you know is in end-stage alcoholism, it is not too late to get treatment. Call an addiction specialist such as SAMHSA today to get advice and support with seeking treatment for alcohol addiction.