Even though alcohol use disorder (AUD) is a worldwide problem and one of the most prevalent forms of substance use disorder (SUD), it’s still largely misunderstood. Probably the biggest misconception about alcoholism is that it affects everyone the same way. Everyone’s different, so their SUD may also differ. Plus, there are different types of alcoholics, each requiring a unique treatment approach. Read on to learn more about different types of alcoholics and how to recognize them.
For a long time, the general belief was that all alcoholics are the same until National Institute on Alcohol Abuse and Alcoholism (NIAAA) published the results of their survey in Drug and Alcohol Dependence. The main objective of the survey was to identify different subtypes of alcoholics using data from 1484 respondents. Results showed there are five subtypes of alcoholics.
Alcoholics in this subtype tend to engage in hazardous alcohol use and are at a high risk of alcohol withdrawal. When it comes to gender prevalence, most alcoholics in this subtype are male.
While they usually go to school, and some of them even work, young adult alcoholics drink alcohol less frequently than other subtypes, but they take higher quantities due to binge drinking. Only 8.7% of respondents in this subtype sought help for their drinking problem. They usually join support groups or 12-step programs.
The functional subtype accounts for 19.4% of respondents, who are around 41 years old. Functional alcoholics tend to have a later first-time alcohol use. The average age of initiation of drinking is 18.5 years old. For that reason, the onset of alcohol dependence is also later than in the first subtype, at 37 years.
While functional alcoholics have low rates of anxiety disorders and other SUDs, they are moderately likely to have major depression or smoke cigarettes. Of all alcoholic subtypes, people from this group are least likely to have legal problems. Also, they are least likely to keep using alcohol despite the harm it causes
Like in previous groups, most functional alcoholics are males. Almost a half of alcoholics in this subtype are married and most of them have full-time jobs, 26% of them have a college degree, and they tend to have a higher income than other types of alcoholics.
Functional alcoholics tend to drink alcohol every other day. On drinking days, they usually have at least five drinks. About 17% of functional alcoholics seek help for their drinking problem. Most of them participate in support groups whereas others receive professional treatment for alcoholism.
The intermediate familial subtype accounts for 18.8% of respondents, whose mean age is 38 years. Most alcoholics in this subtype start drinking late, at the age of 17. The average age of onset of alcohol dependence is 32 years.
Compared to other types of alcoholics, the intermediate familial subtype is more likely to have family members with alcoholism. They’re also more likely to have depression, bipolar disorder, OCD, and anxiety. Additionally, the intermediate familial alcoholics subtype is more likely to smoke cigarettes and abuse cannabis or develop cocaine use disorder.
Like in previous types, males are more prevalent than females. In terms of marital status, 21% of alcoholics of this type are divorced, and 38% are married. About 20% have a college degree. Most people in an intermediate familial subtype of alcoholics have full-time jobs. In fact, this subtype has the highest rate of employment. They usually drink at least 172 days a year, and 54% of the time, they take over five drinks. About 27% of persons in this subtype seek help for their drinking problem, usually through self-help groups, detox programs, private healthcare providers, and specialty treatment programs.
The young antisocial subtype accounts for 21.1% of people, whose average age is 26.4 years. This group has the earliest onset of alcohol drinking, at 15.5 years of age. They also have the earliest onset of AUD at 18.4 years. Alcoholics from this subtype have a high probability of family history of alcoholism, antisocial behaviors, bipolar disorder, depression, social phobia, OCD, and other SUDs including cocaine abuse, amphetamine abuse, and opioid abuse. In fact, young antisocial alcoholics are more likely to have depression or be regular smokers than alcoholics from any other group.
Most young antisocial alcoholics are males. Most of them aren’t married and are less likely to have a college degree. Less than a half of young antisocial alcoholics have full-time jobs. They usually drink 200 days a year and most of the time they take more than five drinks.
About 35% of young antisocial alcoholics seek help for their drinking problem through detox programs, self-help groups, and specialty treatment programs.
The chronic severe subtype accounts for 9.2% of respondents. The average age of chronic severe alcoholics is 37.8 years. Interestingly, they have a relatively early onset of drinking (15.9 years), but a later onset of alcoholism (29 years).
The main characteristics of chronic severe alcoholics are a high rate of antisocial behaviors, family history of alcoholism, depression, dysthymia (persistent depressive disorder), bipolar disorder, social phobia, anxiety, panic disorder, cannabis use disorder, smoking cigarettes, opioid use disorder, and cocaine use disorder.
Compared to other subtypes, chronic severe alcoholics are most likely to experience withdrawal and engage in persistent attempts to quit drinking, reduce activities due to drinking, and continue drinking regardless of the harms it causes.
This subtype is more prevalent among males. Interestingly, chronic severe alcoholics are more likely to be divorced, and only 9% of them have a college degree. The employment rate is the lowest in this subtype of alcoholics.
On average, chronic severe alcoholics drink 247 days a year, and most of the time, they have more than five drinks. Compared to other subtypes, chronic severe alcoholics are more likely to end up in the emergency room due to their drinking.
About 66% of them seek help for their drinking problem through support groups, detox programs, and rehabs.
There are five types of alcoholics. Their age of onset of drinking and alcoholism varies as well as the presence of comorbidities. Some of them are more likely to have a family history of alcoholism. Understanding different types of alcoholics help provide a more effective treatment approach but also sheds more light on the complex nature of AUD.