Types of Alcoholics: Different Subtypes of Alcoholism

What is Alcohol Use Disorder (AUD)?

Alcohol use disorder (AUD) is a chronic brain disease marked by a compulsive need to drink alcohol despite negative consequences. AUD ranges from mild to severe and can lead to serious health problems such as liver damage, heart disease, and depression.

People with AUD often struggle with stopping drinking even when they want to. AUD can cause lasting changes in brain function, making relapse a common challenge. The condition affects behavior, mental health, and physical well-being. Over time, untreated AUD can lead to alcohol dependency and even death.

Factors such as genetics, family history of alcoholism, early age of drinking onset, and co-occurring mental health conditions like bipolar disorder influence the likelihood of developing AUD.

Importance of Categorizing Types of Alcoholism

Categorizing alcoholics into subtypes helps researchers, clinicians, and families understand the diverse nature of alcohol addiction. The National Institute on Alcohol Abuse and Alcoholism and other research bodies have shown that alcoholism is not a one-size-fits-all condition.

Different types of alcoholics suffer for different reasons and require tailored treatment approaches. Here’s why categorization matters:

• Personalized Treatment: Knowing the subtype helps healthcare providers design effective alcohol treatment plans suited to individual needs.
• Improved Diagnosis: Differentiating types aids in recognizing co-occurring disorders such as antisocial personality disorder or bipolar disorder, which can complicate recovery.
• Better Support: Close family members and support networks can understand behaviors and challenges specific to each subtype, fostering empathy and effective intervention.
• Research and Prevention: Typologies guide future research and prevention efforts by identifying risk factors and progression patterns unique to each group.

How Do You Identify Different Kinds of Alcoholics?

Identifying the subtype of a person struggling with alcohol can help determine the best approach to treatment. Here are some general signs to consider:

• Age of onset of drinking or AUD
• Pattern and frequency of alcohol use
• Mental health diagnoses such as bipolar disorder or antisocial personality disorder
• Family history of alcoholism
• Use of other substances
• Ability to maintain responsibilities, such as work or relationships

A medical professional or addiction specialist can assess these factors and help determine the most accurate classification.

The Different Types of Alcoholics

A major study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) identified five main subtypes. These reflect the varied ways AUD presents in different people.

1. Young Adult Subtype

• Prevalence: Roughly 31% of alcoholics
• Age: Begins heavy drinking in late teens or early 20s
• Traits: Binge drinking, but rarely seeks help
• Mental Health: Few co-occurring issues
• Family Influence: May or may not have a family history of alcoholism
• Challenges: Risk of developing long-term health problems and social consequences if heavy drinking continues unchecked.

The young adult subtype includes college students and young professionals. While they may not drink every day, they often consume large amounts when they do. Many in this group don’t realize they meet the criteria for alcohol use disorder.

2. Young Antisocial Subtype

• Prevalence: Around 21% of alcoholics
• Age: Starts drinking young; develops AUD by age 18
• Traits: Risky behavior, legal trouble, poor relationships
• Mental Health: Often has antisocial personality disorder, depression, or anxiety
• Substance Use: Commonly abuses drugs along with alcohol
• Challenges: Alcohol abuse exacerbates antisocial traits, leading to aggression, impulsivity, and legal problems.

This group is harder to treat due to behavioral issues. They often resist authority and have trouble building trust. Early intervention is key.

3. Functional Subtype

• Prevalence: About 19%
• Traits: Maintains jobs and relationships, drinks daily or frequently
• Mental Health: Often experiences anxiety or bipolar disorder
• Family: May have close family members with AUD
• Denial: Many don’t believe they have a problem
• Challenges: Health problems accumulate over time; the ability to function masks the severity of alcohol use disorder, delaying intervention.

Functional alcoholics are high-functioning individuals who hide their drinking. They are often middle-aged, educated, and financially stable. Despite outward appearances, they are at risk for serious health problems like liver disease and heart issues.

4. Intermediate Familial Subtype

• Prevalence: 19%
• Traits: Begins drinking in adolescence; develops dependence by age 30
• Family History: Strong family history of alcoholism
• Mental Health: Depression and anxiety are common
• Substance Use: May also abuse other drugs
• Challenges: Complex cases due to multiple substance use and mental health issues; increased risk of chronic health problems.

This group is often affected by both genetic and environmental factors. They tend to have long-term issues with alcohol and benefit from structured treatment.

5. Chronic Severe Subtype

• Prevalence: 9%, but the most severe
• Traits: Long history of alcohol addiction, severe withdrawal symptoms
• Mental Health: High rates of bipolar disorder, anxiety, and depression
• Substance Use: Frequently uses other substances
• Treatment: Most likely to seek alcohol treatment
• Challenges: Severe health problems, social dysfunction, and high risk of mortality due to alcohol-related diseases.

This chronic severe subtype is the most extreme form of AUD. Chronic severe alcoholics typically need medical detox, inpatient rehab, and long-term therapy. Many rely on structured support like a 12-step program for ongoing sobriety.

Other Models of Alcoholism Typing

In addition to the NIAAA model, researchers have proposed other ways to classify alcoholics:

Type I vs. Type II Alcoholism

Type I and Type II alcoholism are two distinct subtypes of alcohol dependence that differ primarily in their age of onset, genetic and environmental influences, personality traits, and associated behaviors.

Type I Alcoholism is characterized by a later onset, typically after age 25, and requires a combination of genetic predisposition and environmental factors to develop. Individuals with this type often experience binge drinking episodes with periods of abstinence and exhibit a progressive worsening of alcohol abuse.

Type II involves early onset, strong genetic influence, impulsive and antisocial behaviors, and primarily affects males. People with this subtype tend to drink continuously rather than episodically and often engage in antisocial behaviors such as fighting and criminal activity. The severity of alcohol abuse in Type II alcoholics tends to remain stable over time rather than progressively worsening.

Primary vs. Secondary Alcoholism

This distinguishes between alcohol being the main issue or secondary to another mental health disorder. Common conditions include:

• Bipolar disorder
• Antisocial personality disorder
• Depression
• Post-traumatic stress disorder

These systems are used in both research and clinical practice. They help pinpoint what drives alcohol abuse and alcoholism in individual cases.

Treatment for primary alcoholism mainly focuses on the disorder. Meanwhile, secondary alcoholism requires integrated treatment of both alcoholism and primary psychiatric disorder.

Recognizing Functional Alcoholics

Functional alcoholics are a particularly challenging group to identify because they maintain appearances of success despite their heavy drinking. Signs include:

• Drinking as a reward or to cope with stress.
• Drinking in secret or hiding consumption.
• Developing a high tolerance to alcohol.
• Neglecting responsibilities occasionally but excelling at work or socially.
• Rationalizing their drinking habits.
• Experiencing withdrawal symptoms like irritability or shakiness.
• Mood swings and drinking alone.

Understanding these signs can help close family members intervene before health problems worsen.

Effective Alcohol Treatment and Recovery Options

Stopping drinking is a difficult but achievable goal with the right support. Evidence-based alcohol treatment includes:

• Behavioral Therapies: Cognitive-behavioral therapy (CBT) and motivational enhancement therapy help change drinking behaviors.
• Medications: Certain FDA-approved medications reduce cravings and withdrawal symptoms.
• Mutual-Support Groups: 12-step programs like Alcoholics Anonymous (AA) provide peer support and a structured recovery path.
• Integrated Care: For those with co-occurring disorders, simultaneous treatment of mental health and alcohol use disorder is essential.
• Family Involvement: Support from close family members improves outcomes and helps maintain sobriety.

Alcohol Rehab Near Me

Understanding the types of alcoholics can make a life-changing difference. Whether you’re dealing with young adult alcoholism, a functional alcoholic, or the chronic severe subtype, knowing where you fit can guide your path to recovery.

If you or a loved one is struggling with alcoholism, help is always available. Our addiction treatment facilities in Scottsdale, Arizona, provide personalized care for everyone. Don’t ignore the signs and reach out for help and support.

Recovery starts with understanding—and now, you have the knowledge to take that first step.