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Updated on September 14, 2023
8 min read

The Link Between Alcohol and Narcissistic Personality Disorder

What is Narcissistic Personality Disorder (NPD)?

Narcissism is a personality trait expressed as selfishness, an extreme sense of entitlement, attention seeking, and a lack of empathy.

Narcissism has two types, with each type having distinct characteristics:2

  1. Grandiose or overt narcissism: A socially dominant interpersonal style. Grandiose narcissists are usually arrogant, manipulative, self-assured, or aggressive.
  2. Vulnerable or covert narcissism: A neurotic-antagonistic style. Vulnerable narcissists may be overly sensitive, insecure, defensive, and anxious because of an underlying shame. They also have fragile self-esteem.

Narcissistic personality disorder (NPD) is a mental health condition defined as persistent symptoms of narcissism that significantly impact a person’s quality of life.

Signs and Symptoms of NPD

The signs and symptoms of NPD and its severity vary. However, many people with NPD can:

  • Have an exaggerated sense of self-importance 
  • Exaggerate talents or traits 
  • Need excessive admiration
  • Have a sense of entitlement 
  • Expect consistent recognition 
  • Believe they’re superior to others
  • Take advantage of people to get what they want
  • Look down on others
  • Be unable to understand others’ emotions and show empathy
  • Come across as conceited and pretentious
  • Be preoccupied with fantasies of wealth, power, success, beauty, or brilliance

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What is a Narcissistic Alcoholic?

A narcissistic alcoholic is someone who either possesses narcissistic traits due to their alcoholism or is someone who has NPD and drinks alcohol because of their disorder.

Narcissistic personality disorder and alcoholism are co-occurring disorders. Co-occurring disorders are substance use disorders and mental disorders that exist at the same time.

Alcoholics are not always narcissists, and narcissists aren’t always alcoholics. However, alcoholism can cause some people to develop narcissistic traits.

When some people drink, they become arrogant, self-centered, and self-righteous. These traits can also describe someone with NPD. 

Similarly, a narcissistic personality disorder can make a person vulnerable to alcoholism. People with NPD may use drinking as a coping mechanism to hide underlying shame.2, 4

10 Ways Narcissists and Alcoholics are Similar

Narcissists and alcoholics share common characteristics:7

1. Driven by Cravings

Both alcoholics and narcissists suffer from severe cravings. Alcoholics crave alcohol, while narcissists crave attention and the feeling of superiority.

2. Entitled and Self-Centered

Narcissists believe relationships are all about them. They are extremely self-interested and often don’t think of other people’s feelings and emotions.

Alcoholics believe that drinking comes first, even at the expense of the needs of their loved ones. Their need to drink alcohol often negatively affects their relationships, as they put their drinking before others’ feelings.

3. Blame Others

Narcissists rarely apologize for their mistakes and often blame others. To narcissists, admitting mistakes is a sign of weakness. They also blame others for making them act as they do, rather than taking responsibility. 

Alcoholics will give many excuses for their alcohol consumption rather than take responsibility. Often, they will blame everyone but themselves for their extreme alcohol consumption.

4. Avoid or Hide Shame

Narcissists avoid shame as it is a sign of weakness. Instead, they shame other people for their wrongdoings to avoid their feelings.

Similarly, alcoholics avoid shame through drinking. Drinking alcohol numbs emotions, making it easier to avoid these negative feelings. 

5. Opportunistic

Narcissists feel they can do whatever they want at the expense of other people. That’s because narcissists constantly try to manipulate people to get what they want. Often, they want time, money, and power.10

Alcoholics are opportunistic and resourceful at getting their drinks, no matter the cost. People with AUD will use and manipulate others to get to alcohol. 

6. Defensiveness

Both narcissists and alcoholics will become defensive once people confront them about their actions. 

They both may withdraw or be stern. They might also attack others who point out the things they want to deny or hide.

7. Dishonesty

Narcissists will lie to promote their image and avoid criticism. They will also lie to get what they want, whatever that may be.11 

Alcoholics will say they can stop drinking anytime they want. They will also deny when they had a drink or that their drinking has unhealthy consequences. Additionally, many alcoholics will lie about how many drinks they had or when they had their last drink.

8. Refusal to Self-Reflect

Narcissists dislike self-reflection. Instead, they take on personality traits that may not be their own to make themselves look more powerful or interesting. 

Similarly, alcoholics avoid reflecting on their insecurities and lack of self-esteem by drinking. They avoid their inner feelings and thoughts by drinking excessive amounts of alcohol.

9. Arrogant and Manipulative Behavior

Narcissists are arrogant and manipulative. They often show emotions designed to promote a positive image of themselves. 

Alcoholics may cry over the costs of their addiction. But crying is meaningless because they still won’t stop drinking. 

10. Destructive Behavior

A narcissist exhibits destructive behavior due to a lack of empathy and authentic emotions. They often hurt people because they don’t have the ability or want to understand other people’s emotions.  

Alcohol addiction affects an alcoholic’s behavior and the way they treat people, as well. People who spend time around alcoholics or narcissists will also feel the destructive effects of their actions. 

They may experience arrogance, manipulation, rejection, and a lack of empathy. Destructive behavior makes it hard for narcissists and alcoholics to maintain relationships.


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How Does Alcohol Affect a Narcissist?

Pathological narcissism (both grandiose and vulnerable types) is also associated with alcoholism. 

A study of college students showed that both grandiose and vulnerable narcissisms are positive predictors of alcohol misuse.5  In addition, the study found that:

  • Grandiose narcissists often use alcohol to enhance their grandiosity 
  • Grandiose narcissists will deny that they have a drinking problem and insist that their drinking behavior is normal
  • Grandiose narcissists may even be proud of their drinking, especially if it makes them stand out 
  • Vulnerable narcissists usually drink to hide underlying shame about their NPT  
  • Vulnerable narcissists use alcohol as a coping mechanism, which makes them prone to addiction 
  • Unlike grandiose narcissists, vulnerable narcissists are likely to admit that they have an alcohol problem

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What is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) describes a person’s chemical and psychological dependence on alcohol. It’s a progressive illness that gets worse over time. 

A person is diagnosed to have an alcohol use disorder if they meet at least 2 of the 11 criteria of DSM-5:6

  1. Drink more than intended
  2. Can’t stop drinking once started 
  3. Have excessive alcohol cravings 
  4. Spend too much time drinking
  5. Drink so much that it interferes with their family, job, or school
  6. Develop alcohol tolerance 
  7. Continue drinking even though it causes troubles
  8. Continue drinking even though it causes depression, anxiety, and other health problems 
  9. Avoid other activities to drink
  10. Get involved in harmful situations due to drinking
  11. Experience withdrawal symptoms 

Depending on the number of met criteria, the severity of a person’s alcohol use disorder will be classified as: 

  • Mild: 2 to 3 symptoms
  • Moderate: 4 to 5 symptoms
  • Severe: 6 or more symptoms

Treatment for Alcoholism and Narcissistic Personality Disorder

Diagnosing and treating co-occurring disorders can be difficult. This is true with alcoholism and narcissistic personality disorder, which have overlapping symptoms. 

For this reason, it’s crucial to treat co-occurring disorders simultaneously. Treating only one (alcoholism or narcissistic personality disorder) increases the chances of relapse. 

There are many treatments for NPD and AUD. They include:

  • Inpatient Treatment: A type of rehab where a person lives in the treatment facility full-time
  • Outpatient Treatment: A type of rehab where a person maintains aspects of their personal life while still coming into the treatment facility for services
  • Psychotherapy: Cognitive behavioral therapy (CBT) can help people cope and change thinking patterns
  • Medications: Certain medications can help treat both mental illness and alcoholism

Is Someone With Narcissistic Personality Disorder More Likely to Relapse?

There appears to be no significant relationship between narcissistic personality disorder and substance use relapses.

However, when people with alcoholism and narcissistic personality disorder start drinking again, they may hide or deny it. Or, they may feel they failed and blame others for their failure.

Therefore, simultaneous treatment of alcoholism and narcissistic personality disorder is essential. If only one condition is treated, the person’s chances of relapse will increase. 

Treatments include behavioral therapies and medications. There are support groups for emotional and social support. They are also places where people share tips on how to deal with both conditions.

Seek treatment and support if you or someone you know has alcohol use and narcissistic personality disorders. 

Coping With a Narcissistic Alcoholic Loved One

Living with or loving someone who exhibits traits of a narcissistic alcoholic can be taxing. It’s important to take care of yourself to be able to help or take care of other people.

There are support groups available to help. Al-Anon is a group for people who struggle with someone in their life with AUD. The meetings are free of charge and open to the public.


  • Narcissism is a personality trait, while narcissistic personality disorder is a mental illness
  • A narcissistic personality disorder is a disorder where a person has an extremely inflated sense of self-importance
  • Narcissism and alcoholism are co-occurring disorders and share similar qualities like being entitled, self-centered, defensive, and dishonest 
  • Treating alcoholism and narcissistic personality disorder with a dual diagnosis will decrease the chances of relapse
Updated on September 14, 2023
10 sources cited
Updated on September 14, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. Yakeley, J. “Current Understanding of Narcissism and Narcissistic Personality Disorder.” BJPsych Advances, 2018.
  2. Jauk et al. “Addiction and the Dark Triad of Personality.” Frontiers in Psychiatry, 2019.
  3. Mitra et al. “Narcissistic Personality Disorder.” StatPearls Publishing, 2021. 
  4. Welker et al. “Grandiose and vulnerable narcissism: Associations with alcohol use, alcohol problems and problem recognition.” Journal of American college health, 2019.
  5. Understanding Alcohol Use Disorder.” National Institute on Alcohol Abuse and Alcoholism.
  6. Neuharth, D. “10 Ways Narcissists and Alcoholics Are Similar.” Psychology Today, 2020.
  7. Dual Diagnosis.” MedlinePlus, U.S. National Library of Medicine. 
  8. Gaber et al. “Relationship between Personality Disorders and Relapses among Sample of Substance Abuse Patients.” J Psychol Clin Psychiatry, 2016.
  9. Grapsas et al. “The “Why” and “How” of Narcissism: A Process Model of Narcissistic Status Pursuit.” Sage Journals, 2019.
  10. Elaad et al. “The relations between deception, narcissism and self-assessed lie- and truth-related abilities.” Psychiatr Psychol Law, 2020.
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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.
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