Types of alcoholics
Table of content
- What is an alcoholic?
- What are the types of alcoholics?
- How were alcoholics classified by professionals?
- What types of alcoholics are aware that they are alcoholics?
- Does the treatment of alcoholics differ for different types of alcoholics?
- Is there a difference in treatment for different types of alcoholics?
The types of alcoholics is the classification of alcoholics into five different categories established by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The organization conducted research where they surveyed 43,093 participants, screened them for alcohol dependence, and asked them questions about their family history of alcoholism, age at drinking onset, personality, and other substance use.
The five types of alcoholics include the young adult, the young antisocial, the functional, the intermediate familial, and the chronic severe type. Each category represents a unique population and provides insights into the way alcohol abuse affects every group.
The young adult type is the largest group in the list and is composed of individuals who started drinking at around age 19 and subsequently developed alcohol dependence at an average age of around 24 years old. On the other hand, the young antisocial type is made up of alcoholics who have antisocial personality disorder (ASPD). Young antisocial alcoholics often begin drinking at age 15 and tend to become alcoholics at around age 18.
The functional type of alcoholic is someone who can hold down a job and has stable relationships. Members of this subtype typically start drinking at 18, but do not develop alcohol dependence until later, at around age 37. The intermediate familial type is another group of alcoholics, composed of individuals who have a family history of alcohol abuse. Intermediate familial alcoholics begin drinking at around age 17 and become alcoholics at age 32.
Lastly, chronic severe type is the rarest type and includes people who had their first drink at around age 16 but do not become dependent on alcohol until around age 29. This group has the highest divorce and separation rates, and typically includes those who use illicit drugs.
What is an alcoholic?
An alcoholic is someone who suffers from an inability to cease drinking alcohol even though it is causing physical and psychological harm. The term also refers to a person who lacks control over their drinking habits and has abnormal cravings in the absence of alcohol.
Nowadays, however, the word “alcoholic” is increasingly seen as a negative label and people can make a lot of assumptions about the bearer of such a label. This is why healthcare and mental health organizations do not use the term anymore and instead refer to someone with drinking problems as an individual with an alcohol use disorder.
What are the types of alcoholics?
Many people have a stereotypical image of someone labeled as an alcoholic, but new alcoholism research from the NIAAA has laid that notion to rest by proving that not all alcoholics are the same. The different types of alcoholics are listed below.
1. Young adult subtype
The young adult subtype is one category of alcoholics that includes young adults who are in their mid-twenties. Young adult alcoholics have an increased risk of using alcohol in hazardous situations and also tend to drink less frequently than individuals of other types, but are more likely to binge-drink when they do. Furthermore, compared to other groups, people who fall into this subtype have a lower probability of suffering from co-occurring mental health conditions, and they also rarely seek out treatment for alcoholism. A young adult alcoholic often starts drinking at the age of 19 and develops alcohol dependence at around 24 years old. Members included in this group are also 2.5 times more likely to be male than female.
2. Functional subtype
The functional subtype includes people who can hold down regular jobs or complete occupational tasks that are expected of them, and also have stable family relationships. A huge percentage of functional alcoholics work full-time, are well-educated, and have the highest income among any of the subtypes. They also have moderate rates of cigarette smoking and are the least likely to have legal problems among other types of alcoholics. Functional alcoholics typically start drinking at around 18, but do not develop alcohol dependence until they reach 37 years old. Around 60% of this subgroup is male, while 40% is female.
An example of a functional alcoholic is an individual who is able to maintain a certain level of personal and professional success, but likely has an underlying struggle with irresistible cravings brought by alcohol use disorder.
3. Intermediate familial subtype
The intermediate familial subtype is a group of alcoholics with a family history of alcoholism. Members of this subgroup have an increased risk of suffering from major depression, antisocial personality disorder (ASPD), bipolar disorder, and obsessive-compulsive personality disorder at some point in their lives. They are also more likely to suffer from cannabis and/or cocaine use disorder. Intermediate familial alcoholics had their first drink at 17 and developed dependence at the age of 32. About 64% of this group are male and 36% are female.
An example of a person who is classified as an intermediate familial alcoholic is someone who grew up in a family where heavy drinking is practiced and adopted this drinking behavior later in life.
4. Young antisocial subtype
The young antisocial subtype is a classification of alcoholics who have the highest probability of suffering from antisocial personality disorder among the subtypes. This group is also characterized by high rates of co-occurring mental health disorders, such as depression, bipolar disorder, and social phobia. Young antisocial alcoholics also have a high likelihood of suffering from other substance abuse disorders, including marijuana, cigarettes, and opioids. Of this type, around ¾ or 76% are male and 24% are female.
An example of a young antisocial alcoholic is someone who has a history of conduct disorder before 15 years old and has numerous issues with unexcused absences at school, lying to parents, fighting, and theft.
5. Chronic severe subtype
The chronic severe subtype consists of individuals who engage in heavy drinking almost every day, or almost 248 days a year. Chronic severe alcoholics have the highest probability of having blood relatives who suffer from alcoholism among any subtype. They also experience the highest rate of alcohol-related emergency department visits and tend to spend a lot of time recovering from the effects of alcohol. This subgroup usually starts drinking at age 16 and become alcoholics later, at age 29. About 65% of individuals classified as chronic severe alcoholics are male and 35% are female.
An example of a chronic severe alcoholic is a person who consumes alcohol at dangerously high levels that their addiction interferes with many areas of their life. They are often unemployed, have no contact with family or friends, and have multiple unsuccessful attempts at cutting back on alcohol.
How were alcoholics classified by professionals?
Alcoholics were classified by professionals based on various factors, such as current age, age at first alcohol use and alcohol dependence, a family history of alcoholism, the presence of co-occurring psychological disorders, and the presence of other substance use disorders.
Scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, were able to reveal the 5 types of alcoholics by using these factors in an analysis of individuals with alcohol dependence.
What factors should be considered when categorizing the different types of alcoholics?
The identification of alcoholism subtypes helped reduce the harmful stigma attached to alcoholism. The factors that should be considered when categorizing the different types of alcoholics are listed below.
- Current age of the individual: Age is an important demographic factor that could be used to reveal whether there is a strong correlation between certain age groups and the risk of alcoholism. From a health perspective, age is also a critical risk factor for alcohol dependence.
- Age at drinking onset: Age at first alcohol drink is a risk factor that may increase the severity of alcohol dependence and the risk for alcohol-related morbidity later in life.
- When alcohol dependence began: Knowing the age of an individual when they developed alcohol dependence is crucial in categorizing the national sample of individuals involved in the study by NIAAA.
- Family history of alcoholism: As with any other addiction, experts also believe that alcohol use disorder can run in families. A family history of alcoholism can influence an individual’s risk of developing alcohol dependence at some point in their lives.
- Presence of co-occurring mental health disorders: Revealing the presence of mental health disorders that occur alongside alcoholism may help identify treatment options for afflicted people.
- Presence of other substance use disorders: Knowing the presence of other substance use disorders in people with alcoholism can help provide necessary information on what treatment programs should be available for those who have these conditions.
What types of alcoholics are aware that they are alcoholics?
The functional subtype and the young antisocial subtype are the types of alcoholics that have higher probabilities of being aware that they are alcoholics. Although functional alcoholics are not especially likely to seek treatment, of all subtypes, they are the least likely to report alcohol-related problems. Therefore, individuals included in the functional subtype are also the least likely to face the legal consequences of alcohol abuse.
On the other hand, young antisocial alcoholics are more likely to become aware of their condition because there is evidence their group has the highest treatment-seeking rate among other subtypes.
Does the treatment of alcoholics differ for different types of alcoholics?
The treatment for regular alcoholics is the same with individuals who are categorized as belonging to the different types of alcoholics. Members of different kinds of alcoholics often seek self-help groups, 12-step programs, and treatment from healthcare providers as their treatment options. These treatments are similarly used for anyone who suffers from alcohol use disorder.
However, generally speaking, medically assisted detox and withdrawal, as well as cognitive behavioral therapy (CBT) or a combination of these modalities, remain the most effective treatment for alcohol use disorder.
Is there a difference in treatment for different types of alcoholics?
Yes, there is a difference in treatment for different types of alcoholics. According to the study from NIAAA, members of the young adult and functional subtypes are more likely to seek help through 12-step programs.
On the other hand, individuals who are categorized as intermediate familial, young antisocial, and chronic severe alcoholics tend to consider self-help groups, detoxification programs, and specialty alcohol withdrawal treatment programs for their treatment options.