5 Types of Alcoholics

The 5 types of alcoholics include young adults, young antisocial, functional, intermediate familial, and chronic severe, each characterized by distinct patterns of drinking behavior and associated risk factors. According to the World Health Organization’s fact sheet titled “Alcohol,” published in July 2024, an estimated 400 million people worldwide, or 7% of the global population aged 15 years and older, lived with alcohol use disorders in 2019.

The treatment for alcohol addiction includes behavioral therapies, medication-assisted treatment, and participation in support groups. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), in their publication titled “Treatment for Alcohol Problems: Finding and Getting Help,” available on their website, effective treatments for Alcohol Use Disorder (AUD) include behavioral therapies, medications, and mutual-support groups. 

1. Young Adult Subtype 

The young adult subtype consists of individuals between the ages of 18 and 24, with most developing alcohol dependence in their late teens or early twenties. Individuals in this subtype are college students or young professionals, with many having completed high school and some pursuing higher education. 

It is the most prevalent category of individuals with Alcohol Use Disorder (AUD), accounting for a significant percentage of cases. According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Alcohol Use Disorder Subtypes,” published in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2007), young adult alcoholics account for 31.5% of individuals with AUD.

This group is characterized by binge drinking behaviors, which frequently begin during adolescence and escalate into alcoholism as they transition into adulthood.

This subtype is common among young men, who exhibit higher rates of heavy alcohol consumption compared to their female counterparts. Many in this group are unmarried, and the absence of major family or career obligations contributes to excessive drinking habits. A large portion of individuals in this subtype do not seek alcohol treatment, primarily due to the belief that they control their drinking without professional help.

The main cause of Alcohol Use Disorder in this group is peer influence and the social drinking culture, particularly in college and social settings where excessive alcohol use is normalized. Genetic predisposition and family history of alcoholism also contribute to the development of alcohol dependence in this group. 

Mental health conditions such as depression and anxiety occur in some cases but at lower rates than in more severe subtypes. According to a study by Bridget F. Grant titled “The Five Typologies of Alcohol Dependence,” published in The Journal of Studies on Alcohol and Drugs (2007), only 21.1% of young adult alcoholics have a co-occurring mental health disorder, making them less likely than other subtypes to experience severe psychiatric conditions.

Compared to other subtypes, young adult alcoholics have lower rates of substance use disorders related to cigarettes and illicit drugs. However, alcohol withdrawal symptoms still occur as drinking patterns become more consistent. Cognitive Behavioral Therapy (CBT) and motivational enhancement therapy are the most effective treatment approaches for this group, as they focus on altering behavioral patterns and increasing motivation for sobriety.

According to a study by Bridget F. Grant titled “Typologies of Alcohol Dependence: A National Epidemiologic Perspective,” published in The Journal of Studies on Alcohol and Drugs (2007), the young adult subtype accounts for 31.5% of all alcohol-dependent individuals in the U.S., yet only 17% seek any form of treatment. 

2. Young Antisocial Subtype

The young antisocial subtype includes individuals with Alcohol Use Disorder (AUD) who begin drinking early and develop alcohol dependence in their late teens or early adulthood. According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Alcohol Use Disorder Subtypes,” published in National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2007), young antisocial alcoholics make up 21% of AUD cases. 

This group struggles with behavioral issues, including impulsivity and risk-taking tendencies. Many in this category have not pursued higher education due to the effects of early-onset drinking and related social or legal problems.

This subtype consists mainly of men, with a strong association between alcoholism and antisocial personality traits. Many individuals in this category exhibit signs of Antisocial Personality Disorder (ASPD), characterized by a pattern of irresponsible behavior, disregard for social norms, and frequent conflicts with the law. 

The drinking patterns in this group are severe, with frequent episodes of binge drinking and other substance use disorders, including cigarettes, cannabis, and other illicit drugs.

The primary causes of Alcohol Use Disorder in this group include genetic predisposition and environmental influences. A strong family history of alcoholism is common, accompanied by exposure to substance use disorders in early life. Peer influence and association with delinquent social circles further contribute to the progression of alcohol dependence.

Compared to other subtypes, this group has a higher occurrence of co-occurring disorders, including major depression, bipolar disorder, and anxiety disorders. Many individuals also struggle with alcohol withdrawal symptoms, making treatment more complex. 

Given the severity of symptoms, an integrated approach to alcohol treatment is necessary, addressing both mental health conditions and substance use disorders. Cognitive Behavioral Therapy (CBT) and structured rehabilitation programs have been effective, particularly when combined with interventions for managing antisocial behavior and addressing co-occurring substance use.

3. Functional Subtype

The functional subtype represents a segment of individuals with Alcohol Use Disorder (AUD) who maintain stable lives, excelling in their careers and personal relationships. This group begins drinking in late adolescence and develops alcohol dependence in their mid to late thirties. They are generally middle-aged, with a mean age of approximately 41 years. 

According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Alcohol Use Disorder Subtypes,” published in National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2007), functional alcoholics represent 19.5% of those with AUD.

Educationally, many have attained higher levels of education, including college degrees, contributing to their professional success. Demographically, this subtype has a higher proportion of males. 

A significant characteristic of this group is the ability to maintain daily responsibilities and social relationships despite their alcohol dependence. They drink every other day, consuming five or more drinks on over half of those occasions. 

The primary causes of AUD in this subtype are multifaceted, involving a combination of genetic predisposition and environmental factors. Compared to other subtypes, functional alcoholics exhibit lower rates of co-occurring substance use disorders and legal issues. They have moderate rates of smoking but lower incidences of other drug dependencies. 

In terms of treatment, only a tiny percentage of individuals in the functional subtype have sought help for their drinking problems. When they do seek assistance, they prefer private healthcare providers or 12-step programs. 

4. Intermediate Familial Subtype

The intermediate familial subtype encompasses individuals with Alcohol Use Disorder (AUD) who often begin drinking during their teenage years and develop alcohol dependence in their early thirties. This group is middle-aged and has a notable familial link to alcoholism, with many having close relatives who also struggle with alcohol dependence. 

According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Alcohol Use Disorder Subtypes,” published in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2007), the intermediate familial subtype comprises 19% of those with AUD. 

They maintain full-time employment and have achieved higher levels of education. However, this subtype is also associated with co-occurring mental health disorders, including major depression and bipolar disorder. Substance use disorders involving tobacco, cannabis, and cocaine are also prevalent within this group.

According to a study by Howard B. Moss titled “Subtypes of Alcohol Dependence in a Nationally Representative Sample,” published in Alcoholism: Clinical and Experimental Research (2007), the intermediate familial subtype is characterized by a significant familial history of alcoholism and higher rates of co-occurring mental health disorders. 

The treatment for intermediate familial subtypes of alcoholics includes self-help groups, detoxification programs, and behavioral therapies. 

5. Chronic Severe Subtype

The chronic severe subtype is characterized by the early onset of drinking, beginning in adolescence, and a rapid progression to alcohol dependence. According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Alcohol Use Disorder Subtypes,” published in National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2007), the chronic severe subtype accounts for 9% of those with AUD. 

Individuals in this group have a strong family history of alcoholism and exhibit high rates of co-occurring mental health disorders, including antisocial personality disorder, depression, and anxiety. Additionally, there is a significant prevalence of other substance use disorders, such as dependence on cigarettes, cannabis, and opioids.

According to a study by Victor M. Hesselbrock titled “Are there empirically supported and clinically useful subtypes of alcohol dependence?” published in Addiction (2003), the chronic severe subtype is distinguished by early onset of drinking, a strong familial history of alcoholism, and high rates of co-occurring mental health and substance use disorders. 

In terms of treatment, individuals in this subtype are more likely to seek help for their drinking problems compared to other subtypes. Comprehensive treatment approaches that address both alcohol dependence and co-occurring disorders are essential. This includes a combination of behavioral therapies, medication-assisted treatment, and support groups to manage the complex needs of this population effectively.

What are the Types of Drinkers?

The types of drinkers are social drinkers, binge drinkers, heavy drinkers, and problem drinkers. Understanding these categories aids in recognizing drinking patterns and implementing appropriate interventions to promote healthier behaviors.

The types  of drinkers are explained below:

• Social Drinkers: These individuals consume alcohol primarily in social settings, such as gatherings, parties, or events, without the intent to become intoxicated. Their drinking is moderate and infrequent, aligning with societal norms and not leading to significant personal or social issues. For example, having a glass of wine during dinner with friends or a beer while watching a sports game would be characteristic of social drinking.
• Binge Drinkers: Binge drinking involves consuming a large amount of alcohol in a short period, leading to a blood alcohol concentration (BAC) of 0.08% or higher. In the United States, this pattern corresponds to consuming five or more drinks for males or four or more drinks for females within about two hours. Binge drinking is associated with various health risks, including accidents, injuries, and long-term health issues.
• Heavy Drinkers: Heavy drinking is defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as consuming more than four drinks on any day or more than 14 drinks per week for men, and more than three drinks on any day or more than seven drinks per week for women. Heavy drinkers consume alcohol regularly and in large quantities, increasing the risk of developing alcohol use disorders and other health complications.
• Problem Drinkers: Problem drinkers experience difficulties in their lives due to alcohol consumption, even if they do not meet the criteria for alcohol dependence. This includes neglecting responsibilities at home or work, encountering legal issues, or continuing to drink despite relationship problems. Problem drinking is a precursor to more severe alcohol use disorders if not addressed.

What is Alcohol Use Disorder (AUD)?

Alcohol Use Disorder (AUD) is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences. It encompasses a spectrum of drinking behaviors, ranging from mild to severe, and is diagnosed based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

According to the 2023 National Survey on Drug Use and Health (NSDUH), approximately 28.9 million individuals aged 12 and older in the United States had Alcohol Use Disorder (AUD) in the past year, representing 10.2% of this age group. This includes 16.8 million males (12.1%) and 12.0 million females (8.3%). 

The prevalence of AUD emphasizes the importance of recognizing its signs and seeking appropriate treatment. Effective interventions include behavioral therapies, medication, and support groups, all aimed at helping individuals achieve and maintain sobriety.

How is Alcohol Use Disorder Diagnosed?

Alcohol Use Disorder (AUD) is diagnosed through a comprehensive evaluation that includes patient interviews, assessment of drinking patterns, and application of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Healthcare providers assess the severity of AUD by determining how many DSM-5 criteria are met within a 12-month. 

The severity is classified as follows:

• Mild: Presence of 2-3 symptoms.
• Moderate: Presence of 4-5 symptoms.
• Severe: Presence of 6 or more symptoms.

The DSM-5 criteria for diagnosing AUD include the following:

1. Alcohol is consumed in larger amounts or over a longer period than intended.

2. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.

3. A significant amount of time is spent in activities necessary to obtain, use, or recover from alcohol.

4. Craving or a strong desire or urge to use alcohol.

5. Recurrent alcohol use results in failure to fulfill major role obligations at work, school, or home.

6. Continued alcohol use despite persistent or recurrent social or interpersonal problems caused or exacerbated by its effects.

7. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

8. Recurrent alcohol use in situations where it is physically hazardous.

9. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem likely caused or worsened by alcohol.

10. Tolerance is defined as either:

• A need for markedly increased amounts of alcohol to achieve intoxication or the desired effect.
• A markedly diminished effect with continued use of the same amount of alcohol.

11. Withdrawal, as manifested by either:

• The characteristic withdrawal syndrome for alcohol.
• Alcohol (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.

What are the Treatments for Alcohol Use Disorder?

The treatments for Alcohol Use Disorder (AUD) include detoxification, behavioral therapies, medications, mutual-support groups, and aftercare programs. Behavioral therapies, such as cognitive-behavioral therapy (CBT), involve working with healthcare providers to change drinking behaviors through counseling.

Medications approved by the U.S. Food and Drug Administration (FDA) for alcohol addiction treatment include naltrexone, acamprosate, and disulfiram, which help reduce cravings and discourage alcohol consumption. Mutual support groups like Alcoholics Anonymous (AA) offer peer support for individuals aiming to quit or reduce their drinking. 

According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), combining these approaches is effective in treating AUD. 

The treatments for alcohol use disorder are explained below:

• Detoxification (Detox): Detoxification is the initial phase in treating AUD, focusing on safely managing the acute physical symptoms of withdrawal as the body eliminates alcohol. According to the American Society of Addiction Medicine (ASAM) in their publication titled “The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management,” available on their website, detoxification is a critical first step in managing alcohol withdrawal syndrome, involving the medical and psychological stabilization of individuals who are discontinuing alcohol use. 

This process is conducted under medical supervision to monitor and alleviate withdrawal symptoms, which range from mild anxiety to severe complications like seizures. Medical professionals administer medications to mitigate these symptoms and ensure patient safety. Detox is a critical first step in preparing individuals for ongoing treatment by stabilizing their physical health.

• Medication-Assisted Treatment (MAT): MAT involves the use of FDA-approved medications in conjunction with counseling and behavioral therapies to treat AUD comprehensively. Medications such as naltrexone, acamprosate, and disulfiram play distinct roles. Naltrexone blocks the euphoric effects of alcohol, reducing the incentive to drink. Acamprosate helps normalize brain activity disrupted by chronic alcohol consumption, thereby reducing cravings. Disulfiram induces unpleasant reactions when alcohol is consumed, serving as a deterrent. According to a study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) titled “Naltrexone for Alcoholism Treatment,” published in Alcohol Alert (2000), naltrexone has been shown to reduce relapse rates in individuals with AUD by approximately 36%. These medications, when combined with behavioral therapies, address both the physiological and psychological aspects of AUD, enhancing the likelihood of sustained recovery.
• Behavioral Therapies: Behavioral therapies aim to modify drinking behaviors through structured counseling sessions. One effective approach is Cognitive-Behavioral Therapy (CBT), which helps individuals identify and change thought patterns that lead to harmful drinking. According to a study by Longabaugh et al. titled “Combined Cognitive-Behavioral Therapy and Motivational Interviewing for Alcoholism: Effects on Drinking Behavior,” published in Journal of Consulting and Clinical Psychology (1996), CBT combined with motivational interviewing resulted in a 58% reduction in drinking days. CBT equips patients with coping strategies to handle triggers and stressors, thereby reducing the risk of relapse. Other behavioral therapies include Motivational Enhancement Therapy (MET), which enhances an individual’s motivation to change, and Contingency Management, which provides tangible rewards for positive behaviors like abstinence.
• Support Groups: Support groups offer a communal environment where individuals share experiences and provide mutual encouragement in the journey toward sobriety. Organizations such as Alcoholics Anonymous (AA) utilize a 12-step program that fosters personal accountability and spiritual growth. These groups provide a sense of belonging and understanding, which is instrumental in maintaining long-term sobriety. According to a study by Kaskutas titled “Alcoholics Anonymous Effectiveness: Faith Meets Science,” published in Journal of Addictive Diseases (2009), individuals attending AA had about a 20% higher likelihood of maintaining abstinence compared to non-attendees. Participation in support groups complements formal treatment by offering continuous peer support and reinforcement of coping strategies.
• Aftercare Programs: Aftercare programs are designed to provide ongoing support following the completion of initial treatment phases. These programs include continued counseling, participation in support groups, and access to resources that assist with reintegration into daily life. Aftercare aims to prevent relapse by addressing challenges that may arise post-treatment, such as stress, social pressures, or co-occurring mental health disorders. By maintaining a connection to therapeutic support, individuals are better equipped to navigate the complexities of long-term recovery.

Each of these treatment modalities plays an important role in a comprehensive approach to overcoming AUD, addressing both the immediate and long-term challenges associated with recovery.