The Jellinek Curve & the Stages of Alcohol Addiction
Drinking alcohol is commonplace throughout our society. Many people drink to celebrate a special occasion, relax and unwind, or socialize with friends. While the occasional drink usually isn’t a cause for concern, many people lose control of their drinking over time and become addicted to or dependent on alcohol. This condition is known as alcohol use disorder.
According to the National Survey on Drug Use and Health, 28.3 million people in the U.S. met the criteria for an alcohol use disorder in 2020.1 Alcohol use disorder is a medical condition associated with an impaired ability to control alcohol use or stop drinking despite the consequences on a person’s health, relationships, and occupation.2
American physiologist Elvin M. Jellinek was a pioneer in the field of alcohol research.3 Jellinek developed a theory that alcohol addiction progresses in stages. His model, the Jellinek Curve, describes each stage of alcohol addiction and illustrates the progressive phases of alcohol use disorder.
Knowing the stages of alcohol misuse can help you identify problematic drinking in yourself or a loved one so you can get help before problem drinking develops into an alcohol use disorder.
Who Is Elvin M. Jellinek?
Elvin M. Jellinek (1890–1963) was at the forefront of addiction science and theories of alcoholism as an illness.4 He began researching alcohol addiction in 1939 after being commissioned to research the effects of alcohol use.4
Jellinek continued his alcohol research as an associate professor at Yale University and directed the Yale Summer School of Alcohol Studies from 1941 to 1950.4, After leaving Yale, he worked with the World Health Organization and Canadian academic institutions for several years. He later returned to the U.S., where he conducted research at Stanford University’s Institute for the Study of Human Problems until he died in 1963.4
Jellinek, who was among the first to view alcoholism as a chronic disease that requires treatment, is widely lauded as a pioneer in addiction research. He theorized that problematic drinking follows a common trajectory through 4 phases/stages that every person with alcohol addiction experiences, along with corresponding physical and mental characteristics at each stage.4
The Stages of Alcoholism & The Jellinek Curve
Jellinek is perhaps best known for his concept of the progressive phases of alcoholism, commonly referred to as the “Jellinek Curve.”4 This model details the stages of alcohol addiction. Each stage is associated with specific changes in a person’s behavior and social functioning.4
While not everyone who struggles with alcohol misuse will fit into these stages, it can be helpful to be aware of each stage—especially if you are concerned about your drinking or a loved one’s alcohol use.
Based on Jellinek’s theory, the 4 stages of alcohol addiction include the following:
- Pre-alcoholic phase.
- Prodromal phase.
- Crucial phase.
- Chronic phase.
The pre-alcoholic phase is associated with “relief drinking” and increased alcohol tolerance.4 Relief drinking is when someone drinks to relieve negative feelings.5 While drinking may not be a problem for people in this phase, it has the potential to be a turning point that leads to addiction (sometimes referred to as “gray area drinking“). People may think drinking alcohol helps them cope with negative feelings, but it actually shifts the focus away from healthy coping mechanisms.
The prodromal phase is known as the “early warning phase.” In this phase of alcohol use, relief drinking has become more frequent.4 Drinking is no longer a strictly social activity, and people may begin to drink in secret to hide how much they are drinking.4 In this phase, people generally still feel like they have control over their drinking and may not have difficulties with their work or families. This is sometimes referred to as being a “functioning alcoholic,” or functional alcoholism.
Prodromal phase symptoms of early alcohol addiction include:4
- Using drinking to cope with negative feelings.
- Feeling guilt or shame around one’s drinking.
- Drinking in secret and/or being sneaky about how much alcohol is consumed.
- Being unable to talk about their drinking with others.
- Feeling increasingly dependent on alcohol.
- Blacking out more frequently, or not having any memory of what occurred while drinking.
The crucial phase is when a person begins to lose control over their drinking.4 At this point, a person’s drinking problem is more noticeable, both to themselves and others. The person may experience negative consequences as a result of their drinking in the crucial phase, such as money or work troubles. Looking at the Jellinek curve, this could be considered middle alcohol addiction.
Common crucial phase symptoms include: 4
- Avoiding family and friends.
- Feeling remorse or regret about alcohol consumption and/or drunk behaviors when sober.
- Making promises to themselves or others to stop drinking but are unable to follow through.
- Behavioral changes, including increased aggression.
- Drinking earlier in the morning.
- Experiencing tremors in the morning before drinking.
- Neglecting previous interests.
- Beginning to deteriorate physically, and even neglecting to eat.
- Troubles with work and/or finances.
The chronic phase of alcohol addiction is when a person engages in prolonged periods of intoxication.4 In this stage, the person is fully unable to control their drinking and is also unable to initiate any change.4 They can’t think clearly, are often afraid and are obsessed with drinking.4 This is closest to what we now call severe alcohol use disorder or severe alcohol addiction.
Common chronic phase symptoms of alcohol use disorders include:4
- Lengthy periods of intoxication.
- Spending less time with friends and family and more time with other chronic drinkers.
- Drinking is a priority above all else: obsessive thoughts about alcohol, when to drink, how to get more alcohol, and who to drink with.
- Unable to create positive life changes.
- Increased anxiety, resentment, and fears that are not always based in reality.
Excessive drinking can have serious consequences in a person’s life. This could include accidents and injuries, violent behaviors (toward others or oneself), alcohol poisoning, high-risk sexual encounters, and pregnancy issues.6 The negative effects of alcohol on the heart, liver, brain, and other internal organs can also lead to serious health issues like cardiovascular and/or liver disease, various cancers, reduced immune function, and cognitive impairment.6 Alcohol can also impact mental health and lead to disorders like depression or anxiety. It may alienate a person from their family, friends, and work, leading to unemployment and other issues.6
If you’re not sure if your drinking is a problem, click here to take the free alcohol assessment quiz.
The Progression of Alcohol Recovery
Alcohol use disorder is a disease, but it is treatable.2 When someone is ready to stop drinking and seek help at an alcohol addiction treatment program, the path to recovery can begin. Through evidence-based treatments, behavioral therapies, mutual support groups, and/or medications for alcohol use disorder, people can achieve sobriety and maintain a healthy life and long-term recovery.2
The Jellinek Curve includes recovery and rehabilitation as a stage of alcohol addiction. Along with showing the progression of the disease, the curve shows that recovery and healing are achievable with the right support and treatments. Even those who feel trapped in the cycle of addiction can break free from alcohol misuse.
Markers of the rehabilitation and recovery phase include:4
- Having a true desire to get help and change.
- Learning that alcohol use disorder is a disease.
- Working with healthcare professionals and starting treatment.
- Beginning to care more about oneself, including physical appearance and financial health.
- Developing new interests, and spending time in healthier ways.
The Jellinek Curve turns upward when a person is in recovery, leading to:4
- Clearer thinking.
- Hope for the future.
- Improved self-esteem.
- Courage and strength to stay in recovery.
- Meaningful connections with others and strong support networks.
Find Out If Your Insurance Plan Covers Alcohol Addiction Rehab
American Addiction Centers (AAC) is a leading provider of evidence-based treatment for alcohol misuse and alcohol use disorder (AUD). To find out if your insurance covers alcohol addiction treatment at an AAC facility, contact us at or fill out the form below to verify your insurance online. Your information is kept 100% confidential, and there is no obligation to enter treatment.