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Types of Alcohol Problems

There is no such thing as a typical alcoholic. Everyone who suffers from alcohol use disorder (AUD) has their own unique set of circumstances.

The causes vary from person to person. Therefore, the best treatment for one person might not work for the next.

The best way to find a successful treatment program is to understand the different types of alcohol issues.

The three main types of alcohol problems are:

1. Binge drinking

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

This is roughly five drinks for males and four drinks for women within a two-hour time span.

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 your alcohol consumption.

These 11 symptoms can be used to determine whether someone has an AUD:

  1. Drinking more and more alcohol (larger amounts or over a longer period of time).
  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 members 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. Continue to use alcohol in risky situations
  9. Continuing to drink despite knowing it is causing you physical, mental, and social problems.
  10. Developing a high alcohol tolerance
  11. Experiencing withdrawal symptoms

The severity of their AUD depends on the number of symptoms they have:

  • Two to three is mild
  • Four to five is moderate
  • Six or more is severe

Official medical diagnoses of alcohol use disorder 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 effort was made to categorize different types of alcoholics, in part, to dispel the myth that there is a typical alcoholic. Identifying the specific type of alcoholic makes it easier to understand and treat the problem.

The categories acknowledge 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:

The young adult alcoholic

Young adult alcoholics make up about a third of the alcohol use disorders (AUD) in the United States. Their average age is 24. They tend to drink less often than older alcoholics, but they binge drink more.

The majority of young adult alcoholics are male and single. Many are still in school. In most cases, they have family histories of alcoholism.

They also often abuse other substances besides alcohol and rarely seek treatment.

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.

The young antisocial alcoholic

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 don't drink socially with peers. Instead, antisocial alcoholics drink alone and typically struggle with other issues.

Antisocial alcoholics tend to have a family history of alcoholism. They also often suffer from co-occurring mental health problems, such as bipolar disorder and depression.

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.

The functional alcoholic

Functional alcoholics, in many ways, live normal lives despite their addiction. They have steady jobs, relationships, decent family incomes, and often a higher level of education. Most are middle-aged (around 41) and started drinking around age 18.

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 average. 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.

The intermediate familial alcoholic

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

About half of this group comes from families with alcohol problems. come from families with alcohol problems. They have a high likelihood of suffering from a mental illness. They also have high rates of cigarette, marijuana, and cocaine addiction.

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

The chronic severe alcoholic

The chronic severe subtype is the smallest but most severe of all the categories of alcoholism. It includes the highest percentage of people struggling with co-occurring mental illness and other substance abuse issues.

This group also experiences the highest rate of alcohol-related emergency room visits, work and social problems, and withdrawal. The majority are men in their late 20s who started drinking around age 15.

The good news is they're more likely to seek treatment than those in other groups. They are also the most likely to participate in detox programs at inpatient treatment centers.

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

Treatment Options for Alcohol Abuse & Addiction

Here are some of the best treatments for AUD:

Inpatient Programs

Inpatient treatment is the most intensive and effective option for alcohol addiction treatment.

These programs usually last 30, 60, or 90 days. They may be longer in some cases.

Throughout an inpatient program, you'll live on-site in a safe, substance-free environment.

You'll go through medically supervised detox first, then behavioral therapy. Other services may be added to your regimen.

Many of these treatment programs assist you with an aftercare program afterward.

Partial Hospitalization Programs (PHPs)

PHPs are the second most intensive alcohol addiction programs. They're sometimes called intensive outpatient programs (IOPs). PHPs provide comparable services to inpatient programs.

These services may include:

  • Detox
  • Medical services
  • Behavioral therapy
  • Support groups
  • Other holistic or custom treatments

The main difference between PHPs and inpatient programs is that you return home and sleep at your house during a partial hospitalization program.

Some PHPs provide food and transportation. This varies by program.

PHPs are ideal for new patients and those who have completed an inpatient program and still require intensive treatment.

Outpatient Programs

Outpatient programs are less intensive than inpatient programs and PHPs. They're best for people who are highly motivated to achieve sobriety. Patients usually have responsibilities at work, home, or school.

These programs customize your treatment sessions around your schedule.

Outpatient programs may be part of aftercare once a patient completes an inpatient program or PHP.

Medication-Assisted Therapy (MAT)

Certain people qualify for medication-assisted therapy. Some medications can assist you throughout detox and withdrawal. Others can reduce cravings and normalize your bodily functions.

The most common medications used to treat AUD are:

  • Disulfiram (Antabuse)
  • Acamprosate (Campral)
  • Naltrexone (Revia and Vivitrol)

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 the first step towards sobriety or part of an aftercare plan.

Many of these programs follow the 12-step approach.

Resources

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  1. Researchers Identify Alcoholism Subtypes.” National Institutes of Health, U.S. Department of Health and Human Services, 29 Sept. 2015.
  2. Keyes, Katherine M., et al. “Alcohol consumption predicts incidence of depressive episodes across 10 years among older adults in 19 countries.International Review of Neurobiology, vol. 148, 2019, pp. 1-38.
  3. National Institute on Alcohol Abuse and Alcoholism. “Alcohol Facts and Statistics.https://www.niaaa.nih.gov/.
  4. National Institute on Alcohol Abuse and Alcoholism. “Treatment for Alcohol Problems: Finding and Getting Help.https://www.niaaa.nih.gov/.
  5. National Institute on Alcohol Abuse and Alcoholism. “Alcoholism and Psychiatric Disorders.pubs.niaaa.nih.gov.
  6. National Institute on Alcohol Abuse and Alcoholism. “What is a Standard Drink?pubs.niaaa.nih.gov
  7. Quello, Susan B., et al. “Mood Disorders and Substance Use Disorder: A Complex Comorbidity.Science & practice perspectives, vol. 3, no. 1, 2005, pp. 13-21. www.ncbi.nlm.nih.gov.

Related Pages

Alcohol Addiction Resources

High-Functioning Alcoholics

Alcohol Addiction Resources

Symptoms of Alcohol Use Disorder (AUD)

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