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Are There Different Types of Alcoholics?

For many, the term “alcoholic” brings about a certain image or idea. However, not all alcoholics fall into this typical stereotype. 

In the past, drinking-related abuse fell into four main categories: problem drinking, binge drinking, alcohol abuse, and alcoholism. However, these categories left much to be desired when it came to understanding alcoholism and treatment options.

Alcoholics can be separated into five different categories based on many different factors. These factors include:

  • Your current age.
  • The age you started drinking. 
  • When alcohol dependence began.
  • Family history of alcoholism. 
  • The presence of co-occurring mental health conditions.
  • The presence of additional drug use and substance abuse disorders.

Young adults under the age of 30 represent the largest groups of alcoholics in the United States, with college drinking and binge drinking being a major problem.

National Institute on Alcohol Abuse and Alcoholism

The Five Subtypes of Alcoholics

To better understand alcoholism, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) evaluated alcoholics and how they are different. Their research led to the development of five different types of alcoholics. 

The five subtypes are young adult, young antisocial, intermediate familial, functional, and chronic severe. Each subtype is unique and offers a bit more insight into alcohol abuse. 

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Young Adult Alcoholics

The young adult subtype is surprisingly the most prevalent, making up almost 32 percent of alcoholics. Much of this is due to the acceptance of college drinking and the fact that students and other people of a young age are more likely to binge drink. 

With four out of five college students drinking alcohol, you can understand why this subtype is the largest. College binge drinking can be very dangerous for those in this group. The NIAAA reports drinking contributes to over 1,500 deaths per year, as well as assaults, sexual assaults, date rape, and car crashes. 

The average age in this group is about 24 years, with the average age of dependency beginning at age 19. They are 2.5 more times likely to be male than female. Other major characteristics of this subtype include:

  • While the most prevalent, this group tends to drink less frequently than the other alcoholics, with an average of 143 days a year. Binge drinking is most prevalent, with more than five drinks consumed on 73 percent of the average 143 days with the maximum average being 14 drinks on a single occasion.
  • Less than 22 percent have family members with a history of alcoholism and there is a low incidence of mental health disorders.
  • Only about 9 percent seek help for alcohol and, when they do, it is most often 12-step groups.

Young Antisocial Alcoholics

The young antisocial subtype accounts for 21 percent of alcoholics with an average age of 26 years. This group is characterized by an antisocial personality disorder, which includes behaviors such as criminal activity, legal problems, lack of regard for safety, lack of remorse, impulsiveness, deceitfulness, and irresponsibility. 

The combination of these mental illnesses and alcohol often makes for a very dangerous combination. This group has the earliest onset of drinking, with the average age being 15 and the start of alcohol dependency at 18 years of age, with 75 percent being male. 

Other common characteristics of young antisocial alcoholics include:

  • On average, this group drinks of 201 days a year, drinking five or more drinks 80 percent of those days, with the largest average maximum of drinks in a day at 17.
  • About 53 percent have multiple generations of alcohol dependency, 37 percent suffer from major depression, 14 percent from social phobias, 33 percent from bipolar disorder, and 19 percent from obsessive-compulsive disorder.
  • Young antisocial subtypes have a high occurrence of smoking and drug abuse. 66 percent abuse cannabis, 8 percent abuse amphetamines, 29 percent have a high probability for cocaine abuse, and 22 percent abuse opioids.
  • Approximately one-third percent of young antisocial alcoholics seek treatment for their alcohol dependence. The main treatment choices are self-help groups, specialty treatment programs, detox programs, and private health care providers.
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Intermediate Familial Alcoholics

The intermediate familial subtype is typically connected to a high rate of family addiction history. When heavy drinking is the norm in a family, people tend to fall into drinking as a normal behavior. 

Genetic predisposition is a major factor in this subtype, making it very difficult for drinkers in this subtype to avoid alcohol problems. This subtype accounts for about 19 percent of all alcoholics, with an average age of 38 years old. 

Drinking for these individuals typically begins at 17 and alcohol dependence begins at 32. 64 percent of individuals in this subtype are male. 

Other characteristics include:

  • 47 percent suffer from major depression, 22 percent from bipolar disorder, 19 percent from obsessive-compulsive disorder, and 15 percent from a generalized anxiety disorder.
  • 47 percent have a family member with alcohol dependency.
  • 27 percent seek help for their drinking with the most common treatment options being self-help groups, specialty treatment programs, detox programs, and private healthcare providers.

Functional Alcoholics

Alcoholics in the functional subtype are able to balance their drinking with their personal and professional life. In many cases, you may not expect a functional alcoholic to have a problem. In this group, many do not believe they have a drinking problem until they start experiencing health issues, often resulting in liver, heart, or other medical complications. 

The functioning alcoholic subtype accounts for 19.4 percent of alcoholics. In addition, people in this group tend to be in their early 40s. Initial drinking typically begins around 18 years of age and alcohol dependence does not begin until around age 37. 

Other main characteristics of functional alcoholics include:

  • On average, this group drinks every other day, averaging 181 days a year. 
  • Nearly 50 percent are married, 62 percent work full-time, and 26 percent have a college degree or higher.
  • 31 percent have a family member with alcohol dependence. They also have a 24 percent probability of major depression.
  • 17 percent in this group seek help for their drinking. 12-step programs or private health care professionals are the top treatment choices.

Chronic Severe Alcoholics

The chronic severe subtype is the least prevalent, accounting for only about 9 percent of alcoholics. However, this group is the most severe, with heavy drinking being common almost daily. Drinking affects almost every aspect of daily life. 

In many cases, this alcohol addiction leads to emergency room visits and severe medical health complications. Alcoholics in the chronic severe subtype tend to drink more than intended, even after drinking causes negative consequences. In many cases, they are unable to stop drinking on their own. 

The average age is 38 and most have their first drink at 16. Although, alcohol dependency typically doesn’t start until the age of 29. 

Other common characteristics include:

  • This group drinks the most often. On average, they drink 247 days out of the year, with more than five drinks on 69 percent of those days. The daily maximum drink average is 15.4
  • This group has the highest rate of family members with alcohol dependency at 77 percent.
  • Higher probabilities also occur with other substance use, such as smoking, cannabis, cocaine, and opioids.
  • Nearly 66 percent of chronic severe alcoholics seek treatment and have the highest attendance in self-help groups, specialty treatment programs, detox programs, and inpatient programs.
  • This group has the lowest education levels and the lowest rates of employment.

If you or a loved one is suffering from alcohol use disorder (AUD), it’s important that you seek addiction treatment. Contact a health professional or a local treatment center to review your rehabilitation options.

Alcoholism Treatment Options

Luckily there are a number of treatment options for all types of alcoholics. In order to set yourself up for a successful recovery, the type of treatment program should be carefully selected based on your individual needs.

The most common types of alcoholism treatment are:

Inpatient Treatment — Inpatient treatment is the most intensive and effective type of addiction treatment. Patients sleep at the treatment facility and undergo all portions of the program from detoxification to aftercare with medical supervision.

Outpatient Treatment — Outpatient treatment is a good option for people who have responsibilities that they cannot give up (such as family, work, or school), as well as a high level of motivation for getting sober.

Medically Assisted Treatment (MAT) — If you are a good candidate, it may be advisable to undergo MAT. A psychiatrist may prescribe medications (such as disulfiram, naltrexone, and acamprosate) that are to help reduce cravings and encourage sobriety.

Resources

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“College Drinking.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 19 Aug. 2016, https://www.niaaa.nih.gov/alcohol-health/special-populations-co-occurring-disorders/college-drinking.

Moss, Howard B, et al. “Subtypes of Alcohol Dependence in a Nationally Representative Sample.” Drug and Alcohol Dependence, U.S. National Library of Medicine, 1 Dec. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2094392/.

“Researchers Identify Alcoholism Subtypes.” National Institutes of Health, U.S. Department of Health and Human Services, 29 Sept. 2015, https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes.

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