How Many Types of Alcoholics Are There?
Nearly 90 percent of adults in the United States report drinking alcohol in their lifetime, as of the national survey in 2015, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) publishes. Alcohol is a common and socially acceptable mind-altering substance that many people consume on a regular basis with few issues. Women who drink fewer than seven drinks a week and men who drink less than 14 drinks a week are considered at low risk for developing an alcohol use disorder (AUD).
Patterns of chronic heavy drinking or binge drinking can lead to physical dependence and addiction. NIAAA publishes that in 2015 over 15 million American adults battled alcohol addiction. Alcoholics are unable to control how much and how often they drink, and generally, they are unable to stop drinking on their own. Alcoholism is a diverse and complicated disease, and there are many factors that can make one person more vulnerable than another to suffer from it. For example, researchers indicate that alcoholism is heritable about half of time, meaning that genetics and family history are involved in the onset of the disease around 50 percent of the time, the journal Psychological Medicine publishes. Biological and environmental factors, as well as a person’s age when they first drink alcohol, can also be contributing factors to alcohol abuse, dependence, and addiction.
Different Types of Alcoholics
As a complex disease, it should serve as no surprise that there are different types of alcoholics. The National Institutes of Health (NIH) report that there are five subtypes of alcoholism, which include:
- Chronic severe alcoholic: Nine percent of American alcoholics fit this subtype.
- Functional alcoholic: Twenty percent of alcoholics in the US fit this subtype.
- Young adult alcoholic: This is the largest subtype with 31.5 percent of American alcoholics falling into this group.
- Young antisocial alcoholic: About 21 percent of alcoholics in the US fit this subtype.
- Intermediate familial alcoholic: Nineteen percent of American alcoholics are contained in this subtype.
While over 6 percent of the American adult population suffers from AUD, only about 10 percent of those who need help for alcohol abuse and addiction actually seek out professional treatment, NIAAA publishes. By better understanding the different types of alcoholics, treatment methods can be better fitted to the individual, making them more desirable and effective for a healthy recovery.
Chronic Severe Alcoholic
Individuals who fall into the chronic severe alcoholic subtype are generally middle-aged men who started drinking young. This subtype has many problems with alcohol beginning at a young age, and criminal behavior is common. The chronic severe alcoholic subtype is likely what people think of when they think of alcohol addiction, as people battling chronic severe alcoholism likely have difficulties functioning in everyday life, are often unable to hold down jobs, may lose their homes and families, suffer from multiple health issues, and have many behavioral, interpersonal, and social issues related to alcohol abuse.
Chronic severe alcoholics usually have a family history of alcoholism and suffer from co-occurring mental health disorders at very high rates. Many of those battling chronic severe alcoholism also suffer from antisocial personality disorder, bipolar disorder, depression, or anxiety disorders, and they often also abuse additional substances, such as cocaine, opioids, marijuana, and cigarettes.
Due to the severity of alcohol dependence, high rate of co-occurring psychiatric disorders, and criminal behavior, chronic severe alcoholics seek treatment at higher rates than other subtypes. The severity of alcoholism is typically tied to how often a person will seek treatment, and NIH reports that two-thirds of chronic severe alcoholics will seek professional help.
Most people think of alcoholism or addiction as a devastating disease that tears the bottom out of life – and it is. Someone with an alcohol use disorder can be expected to face all sorts of consequences, including:
- Arrests for drunk driving.
- Job losses.
- Marital difficulties.
- Withdrawal symptoms between drinks.
When experts define alcohol abuse or alcoholism, they often refer to these sorts of consequences as evidence of a problem. The Centers for Disease Control and Prevention suggests, for example, that alcohol abuse is a pattern of drinking that has the potential to harm a person’s relationships and the person’s ability to work. Here, the consequences of the drinking define the illness.
However, some people struggling with alcohol misuse have not yet faced these consequences, or faced many of them. These people may still be drinking to excess, and they may face very real consequences in time, but they may feel safe in the moment. They may head to work in the mornings with no issues, and drive home at night with a clear head. They may keep their drinking under wraps at parties and family functions, and they may never slip up in front of strangers. But these people might drink to excess in the privacy of their own homes every single night, and they may be unable to control how much they drink when they start drinking.
In every industry, functional alcoholism is a big deal. When a politician is driving while under the influence or a manager is making poor choices due to being hungover or drunk on the job, it impacts everyone they work with, the clients they serve, the people around them, and the actual work they produce—and that’s in addition to the impact their use of substances has on them personally, their close friends, and their family members.
Watching Out for Red Flags
Functional alcoholics typically do not fit the general stereotype for the disease, as alcohol does not regularly interfere with their daily life obligations. In fact, a functional alcoholic will often be middle-aged, professional, educated, married with a family, and keep up appearances as having their lives in order. NIH reports that around half of all functional alcoholics have been smokers, 30 percent have a family history of alcoholism, and 25 percent have suffered from major depression at some point in their lives.
The very fact that the person is still employed and still “functional” in terms of managing bills and keeping up appearances to family and friends may be the worst part of functional alcoholism. These external characteristics are often used by them to justify that they are “just fine” and they “don’t really have a problem.”
While someone who was fired due to their drinking, who lost their home, or who otherwise more vividly exhibits the symptoms of serious alcohol use will clearly be identified as someone in need of treatment by their loved ones, a functional alcoholic may make their concerned family members question themselves and not push for treatment that is so desperately needed.
Families, spouses, and coworkers may enable the alcoholic behavior of a functional alcoholic since the person remains successful and is able to continue taking care of things personally and professionally despite their drinking. Functional alcoholics will often lead a kind of “double life,” however, and compartmentalize their professional lives separate from their drinking identity. Even though they may not hit “rock bottom” as often as the chronic severe alcoholic, Psychology Today warns that functional alcoholics still suffer consequences of their drinking and may often be in denial that they need professional help.
So how can you tell when someone is really living with an addiction if the typical signs of alcoholism are not visible? Over time, red flags will become more apparent. Someone with a growing alcohol problem may:
- Have cravings for alcohol.
- Drink instead of eating.
- Display uncharacteristic actions and behaviors while drinking.
- Suffer blackouts.
- Become unable unable to control the frequency and duration of drinking episodes.
- Have a doctor tell them to stop or cut back on drinking.
- Spend an exorbitant amount of money at bars or at liquor stores.
- Hide bottles of alcohol in the car, around the house, or at the office.
- Do few activities that don’t involve alcohol. If alcohol is not allowed or nowhere to be found, then the person may refuse to attend, leave in the middle, or sneak alcohol in.
- Often be the butt of drinking-related jokes.
- Deny that they’ve faced negative consequences related to their alcohol use.
Why Does a Functional Alcoholic Need Treatment?
The saying goes that everyone is “fine” until they aren’t.
It is important to remember that if there are clear issues associated with drinking—including problems in relationships, health issues, mood and mental health difficulties, financial struggles, etc.—today’s functionality may be fleeting. That is, the job, the respect of the community, and the support of friends and loved ones can all disappear in an instant if drinking continues.
The saying goes that everyone is “fine” until they aren’t. If your hope is to help your loved one avoid the terrible fall you see coming, then you do not have to give up on helping them to get the treatment they need.
Young Adult Alcoholic
The largest subtype of alcoholics, the young adult alcoholic subtype is made up of people around the age of 24 who typically have been battling alcohol addiction since the age of 20. This subtype may not drink as often as the other subtypes of alcoholics; however, when they do drink, they consume alcohol in a binge pattern.
The Centers for Disease Control and Prevention (CDC) reports that binge drinking is one of the most common forms of alcohol consumption in America with the highest rate of intensity and prevalence of binge drinkers being people between the ages of 18 and 24. Binge drinking is a pattern of drinking that usually involves drinking five or more alcoholic beverages in a sitting for a man or four for a women. This raises a person’s blood alcohol concentration (BAC) rapidly and above the legal limit of 0.08 g/dL.
The CDC reports that binge drinking is a dangerous pattern of alcohol consumption, and 90 percent of the alcohol consumed by youths in the United States is through binge drinking. Binge drinking leads to over 80,000 American deaths annually and is a contributing factor for alcohol dependence and addiction.
People in the young adult alcoholic subtype rarely have a family history of addiction and don’t usually suffer from co-occurring mental health disorders. Young adult alcoholics also rarely seek help for alcohol abuse. About one out of every 10 young adults (those between the ages of 18 and 25) engaged in heavy drinking in 2014 and over one-third binge drank, the National Survey on Drug Use and Health (NSDUH) publishes.
Underage and young drinking is a public health concern that can cause a multitude of emotional, behavioral, social, physical, and interpersonal problems without proper attention. Drinking changes the way the brain works, and drinking before the brain is fully developed increases the odds for alcohol-related and addiction problems later in life. The young adult alcoholic will probably not drink every day, but alcohol will still be a significant influence in the person’s life.
Young Antisocial Alcoholic
With an early onset of difficulties with alcohol abuse and alcoholism, individuals in the young antisocial alcoholic subtype are typically in their mid-20s and generally began struggling with alcohol addiction earlier than other subtypes. About half have a family history of alcoholism, and about three-quarters also smoke cigarettes and abuse marijuana. NIH reports that many also battle addiction to other substances involving things like opioids and cocaine.
Fifty percent of the young antisocial alcoholic subtype also suffer from antisocial personality disorder (ASPD). ASPD regularly co-occurs with alcohol abuse and addiction, as the National Institute on Drug Abuse (NIDA) reports that individuals battling ASPD are more likely to also battle drug and alcohol addictions. ASPD is indicated by a lack of remorse for one’s actions, impulsivity, disregard for rules, and violation of the rights of others. This personality disorder can make a person more likely to experiment with drugs and alcohol, and therefore more vulnerable to addiction. Criminal behavior and legal troubles are common symptoms of the young antisocial alcoholic subtype.
Around one-third of young antisocial alcoholics will seek treatment for addiction.
Intermediate Familial Alcoholic
While they often begin drinking when nearing young adulthood, around age 17, intermediate familial alcoholics typically won’t struggle with alcohol-related issues until their mid-30s, CBS News reports. This subtype will typically be middle-aged, and half will have a familial link to alcoholism. Around 50 percent of intermediate familial alcoholics will also have suffered from depression and 20 percent from bipolar disorder.
NIH reports that most smoke cigarettes, and as many as one out of every five also struggles with issues related to marijuana and cocaine abuse. Most intermediate familial alcoholics are gainfully employed, and many are married with families. They may also have a college degree. Around one-quarter of this subtype of people struggling with alcohol addiction will seek out a professional treatment program.
What Are the Risks of Alcohol Abuse?
Someone who drinks to excess on a regular basis can face very real health problems due to ongoing alcohol abuse. The British website DrinkAware points out that people who drink heavily over a period of several weeks or months can develop very high levels of alcohol-related enzymes in the gut. That means people who drink heavily often need to keep drinking heavily to feel the impact of alcohol. The body has become accustomed to drink, so smaller sips do not have the same power.
Drinking heavily can put a great deal of strain on the body, as each sip requires intense liver and kidney work. Those organs move into overdrive to clear alcohol from the blood, and constant exposure to alcohol can cause cell death in these organs. In extreme cases, these organs can stop functioning, and a transplant might be required.
In addition to kidney and liver damage, Mayo Clinic suggests that heavy drinking can cause:
- Certain types of cancer.
- High blood pressure.
- Sudden death for people who already have cardiovascular disease.
- Heart damage.
Regardless of the subtype, alcoholism is a treatable disease. Thorough assessments can help treatment providers to determine what the right type and level of care might be for a person battling alcohol addiction. For instance, when co-occurring mental health issues are also present, an integrated treatment plan is ideal.
In the case of significant alcohol dependence, medical detox and medications are often necessary in addition to therapeutic treatment methods. Highly trained professionals can guide families and loved ones into a treatment program that will be optimal for enhancing a sustained recovery.
Talking to a Loved One About Getting Help
Families that suspect a loved one is dealing with alcoholism need to take action. One way to do so is to regularly have informal talks about your loved one’s drinking. Discuss your family member’s alcohol use openly and bring up the idea of treatment.
If your loved one is still high-functioning, they may be harder to persuade, as you may not have dramatic consequences to point to when you relay your concerns. For example, you may not be able to discuss job losses, pending litigation, or loss of parental rights, as those things have not happened yet. But what you can do is discuss the real changes they have seen, even if they seem small, and point out how those changes worry you.
For example, if your loved one can no longer stay awake in the evenings to help with their child’s homework, you may discuss how the child is upset that they can longer get parental help and how they’ve lost the sense of closeness that came from that activity.
Understand that it often takes many conversations like these for your loved one to agree to consider treatment. In the meantime, the family might help by removing alcohol from the home and looking for ways to make family celebrations free of alcohol or temptations to drink. You can also get help for yourself by attending groups like Al-Anon and Codependents Anonymous, where you can get support, learn more about the disease of alcoholism, and learn ways to create healthy boundaries for yourself and your family.
If you’re worried about a loved one and want to talk about treatment, we’re here 24/7 at .