Alcohol use disorder (alcoholism) is a complex disease that doesn’t always look the same or affect people in the same ways.
According to a 2015 survey by the National Institute on Alcohol Abuse and Addiction (NIAAA), about 16 million adults in the United States and 623,000 teens between the ages of 12 and 17 are estimated to have an alcohol use disorder (AUD), or alcoholism.
Through scientific research, the NIAAA has identified five separate subtypes of alcohol dependence. These five subtypes differ from one another in: who they affect, how common they are, severity, and other identifying characteristics.
The five types of alcoholics include:
- young adult
- young antisocial
- intermediate familial
- chronic severe
There is no subtype of alcohol dependence that is ‘safe’ enough to ignore. Alcohol abuse and addiction grows worse over time and can have significant effects on a person’s health, relationships, and general quality of life.
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Understanding the different subtypes of alcoholism can better help people identify a drinking problem and determine the most effective methods for treatment.
Explaining The 5 Types Of Alcoholism
Although many people may have a picture in their head of how they would describe the ‘typical alcoholic’, there is no set of characteristics that perfectly describes every alcoholic.
Through scientific research that analyzed the data of nearly 1500 respondents, NIAAA scientists found evidence to support the existence of five distinct subtypes of alcoholism.
These five subtypes of alcoholism differ from one another in:
- age of onset: when people first begin drinking and develop alcohol dependence
- length of time: how long they have been abusing alcohol
- impact: how much the alcohol abuse has affected a person’s ability to function in their daily life
- symptoms: differences in the symptoms experienced by alcoholics
- co-occurrence: the presence of other co-occurring mental and substance use disorders
Although some alcoholics may fare better than others in their daily lives, the common ground all types of alcoholism share is their negative effects over time. A small problem with alcohol is very likely to grow into a larger problem over time without treatment.
Many people don’t seek help for themselves or a loved one with a drinking problem due to shame, embarrassment, or being unable to recognize the problem for what it is. Learning about the five types of alcoholics can strengthen this understanding.
Young Adult Subtype
Young adults make up a significant number of those who meet the criteria for an alcohol use disorder in the United States. The young adult subtype of alcoholism makes up about 31.5 percent of those who struggle with a drinking problem.
On average, young adult alcoholics develop an alcohol dependence by the age of 20, and the average age of alcoholics within this subtype is about 24.
The age group that makes up this subtype is at a time in life when many people in the United States are attending college. College campuses are well-documented as common settings for people to begin binge-drinking, which refers to drinking more than four (for women) or five (for men) drinks within a two-hour window.
Being in an environment where heavy drinking is common can support the idea for many people that heavy drinking is ‘normal’ and make a person less likely to admit they have a problem.
In addition, young adult alcoholics are:
- less likely to drink as often as other alcoholics, but binge-drink when they do
- less likely to have co-occurring mental health or substance use disorders
- less likely to have a close relative with an alcohol problem
- rarely seek help for their drinking problem
Functional (high-functioning) alcoholics make up about 20 percent of people who struggle with alcohol abuse or addiction. Functional alcoholics are often working adults who, despite having a serious drinking problem, maintain the appearance of being well-adjusted.
Functional alcoholics may continue to hold a steady job, have a family, and attend to other personal responsibilities. This stability, however, is not sustainable. Over time, functional alcoholics will likely have greater difficulty managing the effects of their drinking on their health and other aspects of their life.
Among functional alcoholics:
- about one-third have a family history of alcoholism (close relative with an alcohol problem)
- many are middle-aged, well-educated, and have families
- are more likely to have stable relationships
- about one-quarter have experienced major depression
- about 50 percent smoke cigarettes
Young Antisocial Subtype
Not to be confused with the young adult subtype, people who fit within the young antisocial category of alcoholism are more likely to begin drinking in their teens and have co-occurring mental health problems. About 21 percent of people with alcohol dependence fit within this category.
The average age of a young antisocial alcoholic is 26, and most begin drinking around the age of 15. This age of onset is younger than is common among young adult alcoholics. However, this is not the only difference. Several other characteristics also differentiate the two types of alcoholism.
Among young antisocial alcoholics:
- more than half meet the diagnostic criteria for antisocial personality disorder (ASPD)
- many struggle with bipolar disorder, depression, or anxiety
- many have a family history of alcohol abuse or addiction
- more than 75 percent smoke cigarettes or marijuana
Unlike the young adult subtype, young antisocial alcoholics are also more likely to seek help for their drinking.
Intermediate Familial Subtype
About 19 percent of alcoholics in the United States are affected by intermediate familial alcoholism. This type of alcoholism affects people who are middle-aged and often have close relatives who have struggled with alcohol dependence.
People within this subgroup are the most likely of all alcoholics to be employed, with nearly 70 percent employed full-time.
Among people with intermediate familial alcoholism:
- most begin drinking by age 17 and develop alcohol dependence by their early 30s
- about half have co-occurring depression
- 20 percent have bipolar disorder
- high rates of cocaine abuse and smoking marijuana
- less than 27 percent ever seek help for their drinking
Chronic Severe Subtype
Chronic severe alcoholism is the rarest type, affecting less than 10 percent of people with an alcohol problem. This type of alcoholism is most common in middle-aged people who began drinking at a young age and later developed serious dependence.
Chronic severe alcoholics are more likely to:
- be divorced and unemployed
- have depression and other co-occurring mental health problems
- use illicit drugs
- engage in criminal activities
- experience alcohol withdrawal
Although most chronic severe alcoholics begin drinking at a young age, most do not develop a dependence on alcohol until later, by the age of 30.
Almost 70 percent of chronic severe alcoholics seek treatment for their drinking problem at some point in their lives. This makes them the most likely among all other alcoholics to seek treatment.
How Do I Know If I Have A Problem?
For many people, the lines between what constitutes a problem with alcohol can be blurry, especially in younger adults. The reasons for why a person develops alcohol dependence or addiction can vary based on personal circumstances and other biological factors.
If you’re questioning whether or not you or someone you know has a drinking problem, it’s likely that your concern is well-grounded. Alcohol is the most commonly abused drug in the United States, yet drinking problems often fly under the radar due to stigma and lack of understanding of the illness.
Common signs of alcohol abuse and alcoholism include:
- drinking to avoid negative feelings or memories of trauma
- being unable to cut down on how much you’re drinking
- continuing to drink despite experiencing negative effects on health, relationships, ability to work, and social life
- finding less pleasure in other activities and hobbies
- developing a higher tolerance for alcohol
- developing feelings of depression or anxiety as a result of your drinking habits
- experiencing withdrawal effects within 24 hours of your last drink
At Vertava Health, our treatment programs for alcohol abuse and addiction provide treatment plans that are customized to meet each patient’s needs. This includes considerations for people who are pregnant, in college, working, or have financial barriers.
It is never too soon to reach out for help. If you have experienced any of the symptoms listed above, or are worried about the drinking habits of a loved one, don’t wait to seek treatment.
Contact one of our treatment specialists today for more information about alcohol use disorders and options for treatment.