Types Of Alcoholics

The Types of Alcoholics

Not all alcohol use disorders (AUD) are the same. AUD is defined in the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5), as being either a mild, moderate, or severe problematic type of drinking behavior that leads to distress and adverse consequences. Yet, despite the negative effects of alcohol abuse, alcoholics continue to drink.

According to the National Survey on Drug Use and Health (NSDUH), 10.2% of Americans over the age of 12 had an alcohol use disorder in 2023. Due to various risk factors, circumstances, age, and histories, alcohol use disorders will likely fall into one of five categories. Knowing which type someone is can help determine appropriate alcohol treatment.

Young Adult Subtype

The young adult alcoholism classification consists of individuals aged 18 to 25. People in this subtype are often college students, while others are directly entering the workforce from high school. Some are living independently for the first time, while others may be married with children. The types of drinking behaviors in this group are just as varied, from abstinence to binge drinking to heavy drinking. NSDUH results show the following:

• 5,123, or 9.2%, of people in this age group had an AUD
• 1,353 were 18 to 20
• 3,770 were 21 to 25

Most young adults with alcohol use disorders were male, Caucasian, non-Hispanic high school graduates. Those with some college classes or an associate’s degree also had a high percentage of AUDs.

Young Antisocial Subtype

A young antisocial with an AUD is also likely to meet the criteria for antisocial personality disorder (ASPD). Their behaviors violate the boundaries of others, such as:

• Aggression
• Impulsiveness
• Neuroticism
• Deceitfulness
• Recklessness
• Lack of remorse

The DSM-5 criteria for ASPD include having at least three of the above-listed behaviors, evidence of conduct disorder in their teen years, and ASPD symptoms not consistent with bipolar disorder or schizophrenia. Results from the 2023 NSDUH show that using drugs while drinking (called polysubstance use) occurs most among young adults, with 5.9% having both drug and alcohol use disorders.

Alcohol misuse can exacerbate the symptoms of ASPD, while misusing alcohol can trigger the symptoms of ASPD.

Functional Subtype

Functional alcoholism refers to people who have an alcohol dependence but can function at work, at home, at school, and socially. Their drinking behaviors do not seem to interfere with accomplishing their daily responsibilities. Eventually, however, this will not be the case.

Characteristics of a functional subtype typically include the following:

• Middle-aged
• Employed
• Married or in a relationship
• Well-educated
• Family history of alcohol misuse
• Co-occurring mental health disorder

NSDUH results show that 10% of Americans over the age of 26 have an AUD. Of that 10%:

• 5% are between 26 and 29
• 1% are between 30 and 34
• 13% are between 35 and 39
• 4% are between 40 and 44
• 5% are between 45 and 49

High-functioning alcoholics often wait until after all their responsibilities are complete before they begin drinking. They tend to be private drinkers and may be self-medicating anxiety, depression, or other mental health symptoms. They may deny they have a drinking problem despite having a tolerance or alcohol withdrawal symptoms when they go without alcohol.

Intermediate Familial Subtype

The intermediate familial subtype refers to people with an AUD who have first- or second-degree family members with alcohol use disorders. Not only do they inherit the genetics of AUD from their relatives, but they also have grown up in an environment that supports alcohol misuse.

Risk factors for this alcoholic classification include engaging in alcohol use at an early age, usually as a teen, and possibly at the encouragement of family members. Many have additional addictions, like smoking, gaming, gambling, and drugs. They also have co-occurring mental health disorders, just like their family members.

Chronic Severe Subtype

The chronic severe subtype consists of characteristics of all the other different types of alcoholics. People with this type have close family members with substance use and mental health disorders. They, too, struggle with untreated mental health symptoms, probably since they were teenagers, which is usually when they begin experimenting with substances. Chronic severe subtypes can have antisocial personality disorder. The combination of their co-occurring disorders prevents them from being able to function at work and in other areas.

Instead, the chronic severe type is often unemployed or finds it hard to stay at a job long-term. They experience broken or unhealthy relationships due to their alcohol misuse, which may lead to bouts of violence. Even though their addiction creates major physical and psychological diseases, the withdrawal symptoms they experience when trying to quit are so severe they continue different types of drinking behavior to avoid them altogether.

How To Know Which Type of Alcoholic You Are

The most effective way to learn the signs of different alcoholics and subtypes is through an assessment with a licensed mental health or substance abuse treatment professional. Assessments are comprehensive and cover family history, legal consequences, mental health symptoms, relationship issues, physical impairments, employment, and more.

An assessment helps professionals create a treatment plan that meets your unique needs and preferences. You can identify different types of alcoholic treatment you prefer, such as individual therapy, group therapy, family therapy, or 12-step programs. You can choose between male or female treatment providers, inpatient versus outpatient services, and holistic treatment to support your recovery.

Is There Help for Severe Alcoholics?

Severe alcoholics can receive help, which will likely begin with alcohol detox. During a supervised detox, you are supervised by doctors and nurses 24 hours a day to ensure you have a safe and comfortable withdrawal experience.

Medication-assisted treatment (MAT) is often part of a treatment for the types of alcohol addiction. Acamprosate, naltrexone, and disulfiram are three approved treatment medications for alcohol withdrawal management and recovery.

Inpatient rehab follows detox, which is where you learn necessary recovery skills, including coping, communication, relapse prevention, and relationship building. Sober living, partial hospitalization, intensive outpatient treatment, and aftercare are additional components of a complete treatment program.

Prioritizing recovery takes time and effort but increases the likelihood of long-term sobriety.

Treatment For Alcoholism

Whether you participate in inpatient or outpatient treatment, there are effective treatment methods for the types of alcohol addiction. Your treatment team will recommend techniques based on your situation, including the following.

Behavioral Therapies

Behavioral therapies are designed to change behaviors. Most are cognitive-behavioral therapies (CBT), which focus on changing unhealthy thoughts that lead to negative behaviors. For example, thinking and telling yourself you are a failure can lead to consuming more alcohol, worsening the problem. CBTs help you identify negative thinking, replace it with healthy ones, and react positively.

Examples of CBTs for the types of alcohol addiction include:

• Dialectical behavioral therapy (DBT)
• Rational emotive behavior therapy (REBT)
• Acceptance and commitment therapy (ACT)
• Motivational enhancement (ME)
• Trauma-informed care (TIC)
• Contingency management (CT)

These behavioral therapies are adaptable for treatments that include family and friends and can be combined with pharmacotherapy and alternative therapies.

Pharmacotherapy

Pharmacotherapy is the use of medicine to supplement counseling and therapies for alcohol or co-occurring disorders. For alcohol use disorders, doctors can prescribe the following for withdrawal management:

• Acamprosate reduces cravings and improves the brain’s natural ability to produce healthy neurotransmitters.
• Disulfiram can curb alcohol use as when it is combined with alcohol, it produces a terrible reaction, such as nausea and vomiting.
• Naltrexone suppresses the euphoria and pleasurable sensations that drinking provides, making people more likely to decrease consumption.

These are just a few examples of the possible medications a healthcare provider may prescribe.

Complimentary Therapies

Holistic and alternative therapies help treat the whole person, including physical, psychological, and addictive symptoms. Examples of beneficial treatments for alcohol use disorders include:

• Mindfulness therapies
• Art or music therapies
• Animal-assisted therapies
• Exercise and nutrition
• Family and relationship therapies

Making connections with community resources should be part of everyone’s aftercare plan. After completion, you can stay connected with support to help you maintain recovery.

Find Support for Alcohol Addiction

All types of alcoholics require treatment to overcome the multiple components of addiction. Fortunately, many treatment options are available to help them start living a healthier, sober lifestyle.

Contact a treatment provider today to learn more your about available rehab options.