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.
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.
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.
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.
Cravings for alcohol, alcohol replacing meals, uncharacteristic actions and behaviors while drinking, blackouts, and an inability to control the frequency and duration of drinking episodes are signs of alcohol addiction and dependence. These issues can be addressed in a professional treatment program.
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.
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.