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Types of Alcohol Problems

Alcohol abuse and alcoholism can develop in many ways. There is no such thing as a typical or normal alcoholic. Everyone who suffers from an alcohol use disorder (AUD) has their own unique set of circumstances.

The causes of alcohol dependence vary from person to person. Therefore, the best treatment for one person might not work for the next. One of the best ways to find a successful treatment program is to understand the different types of alcohol abuse and alcoholism.

The three main types of alcohol problems are commonly described as:

Binge drinking

Binge drinking is defined as excessive alcohol use. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines it as drinking to where your blood alcohol concentration (BAC) reaches .08 grams or more. This requires approximately five drinks for males and four drinks for women within a two hour timespan.

Alcohol abuse

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

Alcohol dependence (alcoholism)

Alcoholism is now medically referred to as alcohol use disorder (AUD). It is a chronic disease characterized by an inability to control your alcohol consumption.

Official medical diagnoses of alcohol use disorder will categorize the disorder as mild, moderate, or severe.

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5 Types of Alcoholics According to the NIAAA

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

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

  • The young adult alcoholic
  • The young antisocial alcoholic
  • The functional alcoholic
  • The intermediate familial alcoholic
  • The chronic severe alcoholic

The effort was made to categorize different types of alcoholics, in part, to dispel the myth that there is a typical alcoholic. Identifying the category into which a person with a drinking problem falls also makes it easier to understand the root of the problem and choose a rehab that will be the most effective.

The categories acknowledge a person’s:

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

In the past, any effort made to categorize alcoholics focused primarily on hospitalized individuals or those receiving treatment. Since only about one-fourth of people with alcoholism received treatment, the previous information did not represent many other individuals struggling with alcoholism.

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5 Types of Alcoholics Explained

The five different types of alcoholics include young adult, young antisocial, functional, intermediate familial, and chronic severe alcoholics:

1. Young Adult Alcoholics

The young adult subtype makes up about a third of the alcohol use disorders (AUD) in the United States. The average age of these individuals is 24. Young adult alcoholics tend to drink less frequently than older alcoholics, but they binge drink – sometimes more than a dozen drinks in one situation.

Any young person can have a drinking problem, but the majority of young adult alcoholics tend to be male and single. Many are still in school. In most cases, they have moderate rates of a co-occurring substance abuse issue and a family history of alcoholism. They also rarely seek treatment for their addiction.

Some young-adult alcoholics outgrow their problem drinking, while others develop an addiction to alcohol as they get older.

In the U.S., young adult alcoholics comprise 31.5 percent of all alcoholics.

2. Young Antisocial Alcoholics

The young antisocial subtype starts drinking around age 15 and develops an alcohol use disorder around age 18. Unlike young adult alcoholics, young antisocial alcoholics do not drink socially with peers. Instead, antisocial alcoholics drink alone and typically struggle with other issues.

Unlike regular young adult alcoholics, antisocial alcoholics tend to have a family history of alcoholism. They also typically suffer from co-occurring mental health problems, such as bipolar disorder, depression, antisocial personality disorder, or social anxiety disorder.

Many of them also abuse other substances, including cigarettes, marijuana, and opiates. On average, this type of alcoholic will consume 17 drinks at a time. Three-quarters of this group are males.

In the U.S., young antisocial alcoholics comprise 21 percent of all alcoholics.

3. Functional Alcoholics

The functional subtype accounts for about a fifth of all alcohol addictions. This means despite their addiction to alcohol, they hold steady jobs, are in relationships, have decent family incomes, and tend to have a higher level of education. Most are middle-aged (around 41) and started drinking around age 18. They consume alcohol daily or at least several times per week.

While functional alcoholics may not binge drink, they do drink more alcohol than someone without a problem would consume. This group also tends to suffer from moderate depression. Sixty percent of functional alcoholics are males.

In the U.S., functional alcoholics comprise 19.5 percent of all alcoholics.

4. Intermediate Familial Alcoholics

Intermediate familial alcoholics are similar to functional alcoholics. However, the intermediate familial subtype is more likely to be born with a genetic predisposition to alcohol. This group usually starts drinking around age 17 and develops alcoholism later in life, around age 32.

About half of the alcoholics in this group come from families where there are other people with alcohol problems. They have a high probability of suffering from an antisocial personality disorder, depressing, generalized anxiety disorder (GAD), and bipolar disorder. They also have high rates of cigarette, marijuana, and cocaine addiction.

In the U.S., intermediate familial alcoholics comprise 19 percent of all alcoholics.

5. Chronic Severe Alcoholics

The chronic severe subtype accounts for the fewest number of alcoholics. It is one of the most devastating types of alcoholism. It includes the highest percentage of people struggling with antisocial personality disorders, divorce, co-occurring mental illness, and other substance abuse issues. This group experiences the highest rate of alcohol-related emergency room visits, problems at work, social issues, and withdrawal experiences.

The majority of people in this group are men in their late 20s, around 29, who started drinking around age 15. The good news is people in this group seek treatment at a higher rate than other groups. They are also the most likely to participate in detox programs at inpatient treatment centers and other rehabilitation programs.

In the U.S., chronic severe alcoholics comprise 9 percent of all alcoholics.

Treatment Options for Alcohol Abuse & Addiction

  • Inpatient Programs — Inpatient treatment is the most intensive and effective option for alcohol addiction treatment. These programs usually last 30, 60, or 90 days, however they may be longer in certain cases. Throughout the duration of an inpatient program you will live on site in a safe, substance-free environment. You will go through medically supervised detoxification first, then behavioral therapy and other services will be added to your regimen. Many of these treatment programs will assist you with an aftercare program afterwards.
  • Partial Hospitalization Programs (PHPs) PHPs are the second most intensive alcohol addiction programs. They are sometimes referred to as intensive outpatient programs (IOPs). Partial hospitalization programs provide comparable services to inpatient programs. These may include detoxification, medical services, behavioral therapy, support groups, and other holistic or custom treatments. The main difference between PHPs and inpatient programs is that in a partial hospitalization program, you return home and sleep at your house. Some PHPs provide food and transportation, but this varies by program. PHPs are ideal for new patients, as well as patients who have completed an inpatient program and still require intensive treatment.
  • Outpatient Programs Outpatient programs are less intensive than inpatient programs and PHPs. They are best for people who are highly motivated to achieve sobriety and have responsibilities at work, home, or school. Outpatient treatment programs customize your treatment sessions around your personal schedule. Outpatient programs can help new patients achieve success. They may also be a part of aftercare programs once a patient completes an inpatient program or PHP.
  • Medication-Assisted Therapy (MAT) Certain patients will qualify for medication-assisted therapy. Some medications can assist you throughout detoxification and withdrawal. Others can reduce cravings and normalize your bodily functions. Disulfiram (Antabuse), acamprosate (Campral), and naltrexone (Revia and Vivitrol) are the most common medications used to treat Alcohol Use Disorder. MAT can help prevent relapse and increase your chance of recovery if combined with other therapies.
  • Support Groups Support groups are peer-led organizations made of people dedicated to helping each other stay sober. They can be a first step towards sobriety or a component of an aftercare plan. Many of these programs follow the 12-step approach.

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Resources

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“Researchers Identify Alcoholism Subtypes.” National Institutes of Health (NIH), 29 Sept. 2015, www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes. Accessed 10 Dec. 2018.

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