5 Types of Alcoholics According to the NIAAA

There is no set description for a “typical” alcoholic. Everyone who suffers from alcohol use disorder (AUD) has their own unique set of circumstances

However, identifying similarities can help people identify what kind of alcoholic they are. In this blog article, we cover the different types of alcoholics and how they can seek help to stay sober.

How Do People Become Alcoholics?

There are many reasons why someone might develop drug and alcohol dependence. It may include one or several of the following:

• To cope with stress
• To cope with symptoms of mental health disorders like bipolar disorder and major depression
• To drink recreationally or socially
• To relieve boredom
• Because they are physically dependent on alcohol
• As part of a daily routine

Genetic, environmental, and psychological factors influence the risk of becoming an alcoholic. Some may be more inclined to develop alcoholism due to their genetics and family history, while others may develop alcoholism due to environmental and psychological factors.

What Factors Contribute to Alcoholism?

Specific risk factors that contribute to the development of different alcoholism subtypes include:

• Genetics: A family history of alcoholism is likely to create genetic predispositions to alcohol misuse, especially when exposed at a young age.
• Psychological factors: Mental health issues like generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, bipolar disorder, and clinical depression can cause alcohol-related issues.
• Personality traits: Impulsive individuals with sensation-seeking behavior may engage in heavy drinking.
• Availability: Easy access to alcohol can make it more likely for someone to drink alcohol regularly.
• Stress: Individuals regularly exposed to stressful situations may use substance abuse as a coping mechanism.

Researchers identify alcoholism subtypes using these risk factors while also taking into account:

• The current age of the individual
• The age at which the individual started drinking

5 Types of Alcoholics According to the NIAAA

Identifying the specific type of alcoholic makes it easier to understand and treat people’s problems.

A study by scientists at the NIAAA, part of the National Institutes of Health (NIH), analyzed 1,484 survey respondents who met specific diagnostic criteria for alcohol addiction. The study included people both in treatment and not seeking treatment.

The effort was made to categorize different types of alcoholics, partly to dispel the myth that there is a typical alcoholic.

The categorization considers a person’s:

• Age
• Background
• Current situation
• Medical issues
• Family history of AUD
• Symptom patterns of alcohol dependence and abuse
• Age of onset of regular drinking and alcohol problems
• Presence of additional SUD and mental health disorders

The results revealed five subtypes of alcoholics, which are as follows:

1. The Young Adult Alcoholic

In the U.S., the young adult alcoholic subtype comprises 31.5% of all alcoholics. This demographic’s average age is 24, with most being male, single, still in school, and with family histories of alcoholism.

Young adults tend to drink less often than older alcoholics, but they binge drink more. The young adult subtype also often abuses other substances besides alcohol and rarely seeks treatment.

Some outgrow their problem drinking, while others develop an addiction to alcohol as they age.

Other statistics related to young adult alcoholics in the U.S.:

• 75% are unmarried
• 36.5% are in school
• 54% are employed full-time
• 8.7% seek treatment

2. The Young Antisocial Alcoholic

In the U.S., the young antisocial subtype comprises 21% of all alcoholics. The young antisocial alcoholic subtype starts drinking at 15 and develops an AUD around 18. Most young antisocial alcoholics are also male (about three-quarters of the group).

Unlike young adult alcoholics, antisocial alcoholics don’t drink socially with peers. Instead, antisocial alcoholics drink alone and typically struggle with co-occurring mental health problems. 

These mental health problems can include:

• Major depression (37%)
• Bipolar disorder (33%)
• Obsessive-compulsive personality disorder (19%)
• Social phobia (14%)

Drinking alcohol may exacerbate aggressive behaviors demonstrated by individuals with antisocial personality disorder (ASPD). The following criteria characterize ASPD:

• Recurring criminal behavior
• Regular fighting or assaults
• No regard for the safety of others
• Lack of remorse
• Impulsiveness
• Deceitfulness
• Irresponsibility

Many young antisocial alcoholics also have other substance use disorders, including addiction to cigarettes, marijuana, and opiates. On average, this alcoholic type will consume 17 drinks at a time.

Other statistics on young antisocial alcoholics:

• 7.6% have a college degree
• 13.4% are in school
• 47% are employed full-time

3. The Functional Alcoholic

In the U.S., functional alcoholics comprise 19.5% of all alcoholics. They often have steady jobs, relationships, decent family incomes, and have accomplished a higher education.

Most functional alcoholics are middle-aged (around 41) who started drinking around age 18. Around 60% of functional alcoholics are males.

Functional alcoholics consume alcohol daily or at least several times per week. They account for about a fifth of all alcohol addictions.

While functional alcoholics may not binge drink, they do drink more alcohol than the average person. This group also tends to suffer from moderate depression.

Functional alcoholics have an average household income of almost $60,000 and the lowest rates of legal issues. In addition, 17% seek substance addiction treatment at private facilities. 

Of the alcoholism subtypes, functional individuals are less likely to relapse.

Other statistics on functional alcoholics:

• 62% are employed full-time
• 3.6% are in school
• 5% are retired
• 26% have a college degree or higher
• 50% are married

4. The Intermediate Familial Alcoholic

In the U.S., the intermediate familial alcoholic subtype comprises 19% of all alcoholics. Intermediate familial alcoholics are similar to functional ones but are more likely born with a genetic predisposition to alcoholism.

Most intermediate familial alcoholics begin drinking around age 17 and develop alcoholism later in life, around age 32. About half of this group comes from families with alcohol problems and are likely to suffer from mental disorders. They also have high rates of cigarette, marijuana, and cocaine addiction.

Of the five alcoholic subtypes, intermediate familial individuals have the highest employment rates and an average family income of $50,000 yearly.

Other statistics on intermediate familial alcoholics:

• 68% are employed full-time
• 20% have a college degree
• 38% are married
• 21% are divorced

5. The Chronic Severe Alcoholic

In the U.S., chronic severe alcoholics comprise 9% of all alcoholics. The chronic severe subtype is the smallest but most severe of all the categories of alcoholism. Most are men in their late 20s who started drinking around age 15.

Chronic severe alcoholics include the highest percentage of people struggling with co-occurring psychiatric disorders and other substance abuse issues. This group also experiences the highest alcohol-related emergency room visits, work and social problems, and withdrawal.

The good news is they’re more likely to seek treatment than those in other groups at 66%. They are also the most likely to participate in detox programs at inpatient treatment centers with private health care providers.

Other statistics on chronic severe alcoholics:

• 28.7% are married
• 25.1% are divorced
• 9% have a college degree
• 43% are employed full-time
• 7.6% are permanently disabled

Some people may transition between different alcoholic types based on changing life circumstances, but this probability depends on various factors, including their response to treatment.

What are the Types of Alcohol Problems?

The five types of alcoholics deal with one or more alcohol problems. The best way to find a successful treatment program is to understand alcohol issues in-depth.

The three main types of alcohol problems are:

1. Binge Drinking

Binge drinking is excessive alcohol use. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines it as drinking until your blood alcohol concentration (BAC) reaches .08 grams or more.

Binge drinking equates to roughly five drinks for men and four for women within two hours. However, these numbers can vary depending on your alcohol tolerance and other biological responses.

2. Alcohol Abuse

Alcohol abuse is the excessive consumption of alcohol. It can happen on individual occasions (binge drinking) or habitually.

3. Alcohol Dependence (Alcoholism)

The medical term for alcoholism is alcohol use disorder (AUD). It’s a chronic disease marked by an inability to control alcohol consumption.

These 11 symptoms help determine whether someone has an AUD:

1. Drinking larger amounts of alcohol over a longer period.
2. Difficulty cutting down on excessive drinking.
3. Spending a lot of time getting, drinking, or recovering from alcohol.
4. Feeling strong urges or cravings to drink.
5. Ignoring work, school, and relationships with friends and family to drink.
6. Continuing to drink despite social or interpersonal issues.
7. Stopping or reducing important social, work, or recreational activities due to alcohol use.
8. Continuing to use alcohol in risky situations.
9. Continuing to drink despite knowing it causes you physical, mental, and social problems.
10. Developing a high alcohol tolerance.
11. Experiencing withdrawal symptoms.

Official medical diagnoses of AUD categorize the disorder as mild, moderate, or severe. The severity of their AUD depends on the number of symptoms they have:

• 2 – 3 symptoms: Mild
• 4 – 5 symptoms: Moderate
• 6 or more symptoms: Severe

According to a survey conducted by the NIAAA, of the eight million people considered alcohol-dependent:

• 68% are male
• 71% are white
• 49% are unmarried

Do Alcoholics Know They Are Alcoholics?

Not all alcoholics know they suffer from a substance abuse problem because denial is a regular and expected aspect of alcoholism. As exceptions, functional and young antisocial alcoholics are more likely to be aware of their drinking problem.

Family members and friends can recognize the type of alcoholic by observing their loved one’s behaviors and their impact on relationships. Still, professional guidance is often needed to provide effective support.

Do Different Alcoholics Undergo Specific Treatment Types?

Since the causes of alcoholism vary from person to person, the best treatment for one might not work for the next. While treatment for all alcoholics remains generally similar, some may respond better to different addiction support types than others.

Generally, the most effective specialty treatment programs combine the following:

• Medically assisted detox
• Cognitive behavioral therapy (CBT)
• 12-step programs

The young adult and functional alcoholic subtypes seeking addiction treatment will most likely benefit from 12-step programs. In comparison, people from the young antisocial, intermediate familial, or chronic severe alcoholic subtype are more likely to consider:

• Self-help
• Detoxification
• Medically assisted programs

Long-term outcomes and prognosis depend on various factors. Still, people dealing with AUD can achieve and maintain sobriety with appropriate treatment and support.

Summary

There’s no one way to describe a ‘typical alcoholic’ since alcoholism develops differently from person to person. However, the National Institutes of Health (NIH) performed a study to categorize different alcoholics to note their similarities.

Knowing where you or your loved one falls under the five categories of alcoholics can help you recognize and understand the signs of a developing addiction. It can also serve as a guide to what treatment programs can help best.

If you’re dealing with alcohol use disorder (AUD) and need help to stay sober, reach out to an addiction specialist to help get the treatment you need.