Understand the 5 types of alcoholics
Although the word “alcoholic” may conjure a particular image to mind, there are actually several different types of alcoholics. Scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) conducted a survey of 43,093 individuals, screening them for alcohol dependence as well as a wide range of other factors. Of that population, 1,484 met at least three criteria for alcohol dependence in the past year, which the researchers projected to represent approximately 8 million American adults in the general population. Among these people, 68 percent were male, 71 percent were white, and 49 percent were never married. The NIAAA researchers found that there were five distinct patterns of alcohol dependence.
- Young adult subtype
- Young antisocial subtype
- Functional subtype
- Intermediate familial subtype
- Chronic severe subtype
Young adult alcohol dependents are 2.5 times more likely to be male than female. About 75 percent have never been married, 36.5 percent are still in school, and 54 percent work full time. Approximately 22 percent have a first- or second-degree family member who is also dependent on alcohol. Compared to other types of alcoholics, young adults are less likely to have psychiatric disorders or legal problems. Fewer than 1 percent of them have antisocial personality disorder. About 32 percent also smoke cigarettes, and 25 percent also use cannabis.
Only 8.7 percent of young adult alcohol dependents have ever sought treatment for their drinking problem. If they do choose to seek help, they tend to prefer 12-step programs over specialty treatment clinics or private professional practices.
The NIAAA reports that four out of five college students drink alcohol and half of those who do binge drink. They also note that each year, among college students between the ages of 18 and 24:
- At least 1,825 students die from alcohol-related accidental injuries.
- Over 690,000 students are assaulted by another student who has been drinking.
- More than 97,000 students are victims of alcohol-related date rape or sexual assault.
- About 599,000 students are unintentionally injured while they are under the influence of alcohol.
- Over 150,000 students develop alcohol-related health problems.
- About 25 percent of students experience school-related consequences from their alcohol consumption, such as being late to or missing classes, falling behind on coursework, doing poorly on homework, exams or papers, and receiving overall lower grades.
- Recurring criminal activities
- Regular fights or assaults
- Lack of regard for the safety of others
- Lack of remorse
They are also young (average age 26 years), and they have the earliest age of onset of drinking (average 16 years) and the earliest age of alcohol dependence (average 18 years). Young antisocial alcoholics drank an average of 201 days in the last year, binge drinking (consuming five or more drinks) on an average of 161 (80 percent) of those days. When they drink, their maximum number of drinks is 17, the highest of any subtype of alcoholic.
About 76 percent of this type of alcoholic are male. Only 7.6 percent have received a college degree, although another 13.4 percent are still in school. Approximately 47 percent are employed full time. Family incomes average around $32,000, the lowest among the subtypes (alongside the chronic severe subtype).
Over half of young antisocial alcoholics (52.5 percent) have a close family member who is also alcohol dependent. In addition, they also have high rates of psychiatric disorders:
- 37 percent have major depression (and 15 percent have had a major episode of depression during childhood)
- 33 percent have bipolar disorder
- 19 percent have obsessive-compulsive personality disorder
- 14 percent have social phobia
They also have high rates of substance abuse:
- 77 percent smoke cigarettes
- 66 percent meet criteria for cannabis abuse/dependence
- 29 percent have cocaine use disorder
- 22 percent have opioid use disorder
- 8 percent meet criteria for amphetamine abuse/dependence
Almost 35 percent of young antisocial alcoholics have sought help for their alcohol-dependence problems. They tend to go to self-help groups, detoxification programs, and specialty treatment programs, and they have high rates of participation in treatments offered by individual private health care providers.
The NIAAA reports that alcohol and ASPD make for a dangerous combination. People with ASPD are 21 times more likely to develop alcohol dependence in their lifetimes. Meanwhile, alcohol is more likely to increase aggressive behaviors in people with ASPD than in people without. This may be because alcohol interferes with executive functioning in the brain, which regulates and inhibits aggressive behavior. People with ASPD also show impaired executive functioning, which may make them particularly vulnerable to this effect.
About 62 percent of functional alcoholics work fulltime, 3.6 percent are in school full time, and 5 percent are retired. Nearly 26 percent have a college degree or higher, and average household income is almost $60,000, the highest among any of the subtypes. Approximately 40 percent are female, and nearly 50 percent are married.
About 31 percent of functional alcoholics have a close family member who also has alcohol dependence. They have moderate rates of major depression (24 percent) and smoking cigarettes (43 percent), and low rates of anxiety disorders, other substance use disorders, and the lowest rates of having legal problems (fewer than 1 percent). Fewer than 1 percent of these individuals have antisocial personality disorder.
Only 17 percent of functional alcoholics have ever sought help for their alcohol dependence. Those who do tend to make use of 12-step programs and private health care professionals. Functional alcoholics make up 19.4 percent of alcohol-dependent individuals. This group tends to be older (average age 41 years), has a later age of first drinking (average 19 years), and a later onset of alcohol dependence (average age of 37 years). They tend to drink alcohol every other day (an average of 181 days per year), and they consume five or more drinks on an average of 98 (54 percent) of those days. On drinking days, they tend to consume a maximum of 10 drinks.
They have the highest rates of employment among alcoholics, with 68 percent working full time and with an average family income of nearly $50,000 a year. Nearly 20 percent have a college degree. About 64 percent are male, while about 38 percent are married and 21 percent are divorced.
Intermediate familial alcoholics have elevated rates of mental illness:
- 47 percent have major depression
- 22 percent have bipolar disorder
- 19 percent have obsessive-compulsive disorder
- 15 percent have a generalized anxiety disorder
- 5 percent have antisocial personality disorder
They also have higher rates of substance use/abuse:
- 57 percent smoke cigarettes
- 25 percent have cannabis use disorder
- 20 percent have cocaine use disorder
Almost 27 percent of intermediate familial alcohol dependents have sought help for their drinking problem. They tend to prefer self-help groups, detoxification programs, specialty treatment programs, and individual private health care providers.
The majority of chronic severe alcoholics are male (65 percent). They also have the highest divorce rates, with 25.1 percent divorced and 8.6 percent separated, and only 28.7 percent married. Only 9 percent have a college degree, and they also have the lowest employment rate, with only 43 percent of chronic severe alcoholics employed full time and 7.6 percent both unemployed and permanently disabled.
Chronic severe alcoholics have the highest rate of family members who also experience alcohol dependence, at 77 percent. They are most likely to have mental illnesses:
- 55 percent have depression
- 47 percent have antisocial personality disorder (the second-highest rate, after young antisocial alcoholics)
- 34 percent have bipolar disorder
- 26 percent have social phobia
- 25 percent have dysthymia
- 24 percent have generalized anxiety disorder
- 17 percent have panic disorder
Substance abuse is also common:
- 75 percent smoke cigarettes
- 58 percent have cannabis use disorder
- 39 percent have cocaine use disorder
- 24 percent have opioid use disorder
Chronic severe alcoholics experience the most pervasive symptoms:
- Highest rate of emergency room visits related to drinking of any subtype
- 94 percent drink larger/longer amounts than intended
- 92 percent drink despite experiencing problems from drinking, such as at work, school, in relationships, or while driving
- 88 percent experience withdrawal symptoms
- 83 percent have repeatedly tried to reduce their drinking
- 64 percent spend significant time recovering from drinking
- 48 percent reduced meaningful activities, like hobbies or family time, because of alcohol
Almost 66 percent of chronic severe alcoholics have sought help for their alcoholism. They have the highest rates of attendance at self-help groups, detoxification programs, and specialized rehabilitation programs, and the highest rates of treatment in inpatient programs. When seeking treatment, they tend to turn to social workers, psychologists, psychiatrists, and private physicians.
Alcohol treatment with Dr. Kevin Wandler
Getting help for alcoholism
If you find that the above descriptions resemble you or a loved one, you’re not alone. The NIAAA reports that 17 million American adults have an alcohol-use disorder, making up 7.2 percent of the adult population. Leaving alcohol abuse untreated is dangerous – the CDC found that excessive alcohol use causes almost 90,000 deaths annually.
Fortunately, there is help. At The Recovery Village, we offer evidence-based treatment methods that can address every aspect of each client’s treatment needs. We want to guide you down the path to recovery – call today to learn more.