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5 Types of Alcoholics: Exploring the Spectrum

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Alcohol use disorder (AUD), the official term for alcoholism, is defined by the DSM-5 as a chronic relapsing brain disease characterized by compulsive alcohol use, alcohol abuse, loss of control over alcohol consumption, and negative emotional state when not drinking. It is associated with physical dependence, addiction, and substance abuse.

To better understand the complex nature of alcoholism, it is important to explore the different types of alcoholics and drinkers.

The types and subtypes of alcoholics differ in age of onset, drinking patterns, and co-occurring mental health disorders, such as bipolar disorder, generalized anxiety disorder, and major depression. Smoking cigarettes is also prevalent among many alcoholics.

The NIAAA researchers found that there were five distinct patterns of alcohol dependence. In this article, we will discuss the different types and subtypes of alcoholics and the connection between alcoholism and mental health disorders.

DSM-5 Definition of Alcohol Use Disorder

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) is a widely used diagnostic tool that classifies alcohol use disorder (AUD) as a chronic and relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake and a negative emotional state when not using alcohol.

The DSM-5 outlines 11 criteria to diagnose AUD, ranging from mild to severe, with 2-3 criteria indicating a mild diagnosis, 4-5 indicating a moderate diagnosis, and 6 or more indicating a severe diagnosis. These criteria include:

  1. Drinking more alcohol than intended or for a more extended period.
  2. Difficulty in stopping or controlling alcohol consumption despite a strong desire or motivation.
  3. Spending considerable time on activities necessary to obtain alcohol, use alcohol, or recover from its effects.
  4. Strong cravings or urges to drink alcohol.
  5. Continuing to drink alcohol despite how it causes interpersonal or social problems.
  6. Giving up or reducing important occupational, social, or recreational activities because of alcohol use.
  7. Using alcohol in physically hazardous situations.
  8. Continuing to drink alcohol despite knowing it is causing or worsening a physical or psychological problem.
  9. Developing tolerance or requiring more alcohol to achieve the desired effect.
  10. Experiencing withdrawal symptoms when alcohol use is stopped or reduced.
  11. Drinking more alcohol over time, or over an extended period, than the individual intended.

The DSM-5 classification of AUD helps in identifying and diagnosing individuals with AUD and enables the appropriate treatment and support to manage the disorder.

5 Types of Alcoholics

Alcoholism is a complex disorder that can take different forms. The DSM-5 recognizes AUD as a spectrum ranging from mild to severe. Along with the severity of the disorder, alcoholics can also be classified into different subtypes. Here are the five alcoholic subtypes:

  1. Young Adult Subtype:

Young adult alcoholics often begin drinking during adolescence and continue into their 20s, with many having a family history of alcoholism and struggling with comorbid substance use disorders.

This subtype tends to have less severe symptoms compared to other subtypes.

Young Adult Subtype individuals often engage in heavy drinking episodes, usually during social situations or events. They may also use alcohol to cope with stress, peer pressure, or to fit in with a certain group. This subtype is also associated with a higher likelihood of binge drinking and alcohol-related accidents, injuries, and legal troubles.

The Young Adult Subtype is also associated with a higher risk of co-occurring mental health disorders, such as depression, anxiety, and substance use disorders. This is because many young adults turn to alcohol to self-medicate and alleviate their symptoms.

It is important to note that not all young adults who engage in heavy drinking develop AUD, but for those who do, early intervention is crucial in preventing the development of more severe symptoms and complications.

Treatment for the Young Adult Subtype often involves a combination of therapies, including cognitive-behavioral therapy, motivational interviewing, pharmacotherapy, and addressing any underlying mental health disorders.

Understanding the Young Adult Subtype and its characteristics can help treatment providers and private healthcare providers identify the signs of AUD early on and seek specialty treatment programs to prevent further harm caused by substance abuse and alcoholism.

  1. Functional Subtype:

The functional subtype of alcoholism is characterized by individuals who are typically middle-aged, have a stable job and a higher level of education, and are less likely to display the social and personal problems commonly associated with alcoholism.

Functional alcoholics consume alcohol heavily but can maintain their daily functioning and responsibilities without significant disruptions.

Despite the appearance of high-functioning, individuals with functional alcoholism face significant health risks such as liver disease, high blood pressure, and other medical problems associated with heavy drinking.

Moreover, the societal and financial impact of alcoholism can be significant and may result in loss of employment, financial difficulties, and relationship problems.

The functional subtype of alcoholism represents approximately 19 percent of individuals with AUD. The condition can be challenging to recognize and diagnose due to the absence of obvious symptoms.

Many individuals with functional alcoholism may continue to consume alcohol without seeking help for years or even decades, leading to more severe forms of alcohol addiction.

Recognizing the early signs of functional alcoholism and seeking help promptly can help prevent the condition from worsening and reduce the risk of long-term complications.

It is important to note that alcohol dependence is a serious condition that requires treatment, even if the individual appears to be high-functioning.

Treatment providers such as private health care providers and specialty treatment programs can help individuals with functional alcoholism seek addiction treatment and seek treatment for underlying conditions such as bipolar disorder, generalized anxiety disorder, and major depression.

  1. Intermediate Familial Subtype:

The Intermediate Familial Subtype of AUD is characterized by a family history of alcoholism and a later onset of the disorder, typically in the early 30s.

Individuals with this subtype have a higher likelihood of having first-degree relatives with alcoholism, indicating a genetic component to the disorder. They are also more likely to experience withdrawal symptoms when they stop drinking, indicating a physical dependence on alcohol.

In addition, individuals with the Intermediate Familial Subtype tend to have experienced trauma or other adverse childhood experiences, which may contribute to the development of the disorder. They may also have more psychiatric comorbidities, such as depression and anxiety disorders, making a recovery more challenging.

This subtype is more common in men and is characterized by a more stable life than the Young Adult and Young Antisocial Subtypes. Individuals with the Intermediate Familial Subtype often have stable relationships and hold steady jobs, but they still struggle with AUD. They may drink to cope with stress or anxiety and have difficulty controlling their alcohol intake.

Treatment for the Intermediate Familial Subtype of AUD may include medication-assisted treatment, therapy, and participation in support groups. Family members may also play a significant role in supporting their loved ones through recovery. It is important to seek treatment as early as possible, as the longer an individual with AUD goes without treatment, the greater the risk of long-term health and social consequences.

  1. Young Antisocial Subtype

The Young Antisocial subtype is characterized by the early onset of alcoholism, with symptoms typically beginning before age 25.

This subtype is associated with a higher prevalence of comorbid antisocial personality disorder, and other substance use disorders such as cocaine and marijuana abuse.

Those with this subtype have a history of delinquent behavior, such as stealing or fighting, and may have legal issues due to alcohol abuse. They may also exhibit impulsive and reckless behavior and problems with interpersonal relationships.

Research suggests that individuals in the Young Antisocial subtype tend to have a family history of alcoholism and a genetic predisposition to alcoholism.

This subtype tends to respond poorly to traditional forms of treatment, such as psychotherapy or self-help groups. Instead, specialized interventions that address the alcohol use disorder and underlying personality disorder may be necessary for successful treatment.

Young Antisocial alcoholics are at a higher risk for alcohol abuse and alcohol addiction, and early intervention is critical.

Private healthcare providers and specialty treatment programs may offer tailored services to those struggling with this subtype.

Clinicians must be aware of the Young Antisocial subtype, as early identification and intervention may improve treatment outcomes. In addition, individuals with this subtype may be at higher risk for legal and other social problems related to their alcohol use, making early intervention all the more critical.

  1. Chronic Severe Subtype:

The Chronic Severe Subtype of alcoholism is considered the most severe and debilitating subtype. Individuals with this subtype typically have a long history of heavy alcohol use and often have a co-occurring mental health disorder. They may also have a family history of alcoholism and exhibit severe withdrawal symptoms when attempting to quit drinking.

Chronic severe alcoholics may experience physical health problems such as cirrhosis of the liver and pancreatitis, as well as cognitive impairment and neurological damage. This subtype may also be associated with criminal behavior, including driving under the influence and domestic violence.

To manage their withdrawal symptoms and address any underlying health conditions, intensive medical treatment may be necessary for chronic severe alcoholics. In addition to medical treatment, behavioral therapies such as cognitive-behavioral therapy (CBT) and contingency management may help address the psychological aspects of alcohol dependence and promote abstinence.

Studies have also shown that participation in self-help groups can benefit a chronically severe alcoholic as they provide social support and a sense of community for those in recovery.

Individuals with chronic severe alcoholism need comprehensive treatment that addresses their physical and psychological needs. Long-term sobriety may be difficult to achieve, but with the appropriate treatment and support, individuals with chronic severe alcoholism can achieve and maintain recovery.

Alcoholism and Mental Health Disorders

Alcoholism is commonly associated with mental health disorders. This means that individuals with AUD are more likely also to have a mental health disorder.

Some mental health disorders commonly associated with alcoholism include bipolar disorder, anxiety disorders, major depression, and obsessive-compulsive disorder.

These disorders can significantly impact a person’s life and may make it more difficult for them to recover from alcoholism. Healthcare professionals need to consider the possible co-occurrence of mental health disorders when treating alcoholism.

Seeking Treatment for Alcoholism

Dealing with alcohol addiction can be a challenging and overwhelming experience. Alcohol addiction can affect individuals of all ages, genders, and backgrounds. It can be especially challenging for individuals struggling with mental health disorders.

At NuView Treatment Center, we understand the complexities of addiction and offer specialized treatment programs to help individuals achieve long-term recovery. Our treatment programs address various subtypes of alcohol addiction, such as chronic severe alcoholics, functional alcoholics, intermediate familial alcoholics, young adult alcoholics, and young antisocial alcoholics.

Our approach is compassionate and person-centered, addressing the unique circumstances and personal challenges each client faces with personalized care. We utilize various therapy options, such as outpatient and intensive outpatient treatment, partial hospitalization, individual therapy, group therapy, medication-assisted therapy, and other levels of care options, to help ease addiction symptoms and achieve lasting sobriety.

We understand that seeking treatment for alcohol addiction can be a difficult decision, and we provide a supportive environment for individuals to begin their journey toward recovery.

If you or a loved one is struggling with alcohol addiction, seek treatment today. Contact NuView Treatment Center to take the first step towards achieving long-term recovery.

Frequently Asked Questions

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The five types of alcoholics are young adult, young antisocial, functional, intermediate familial, and chronic severe.

A young adult alcoholic is a person who begins drinking alcoholic beverages at a young age and continues with binge drinking in their early adulthood.

A young antisocial alcoholic is a person who started drinking young and exhibits symptoms of antisocial personality disorder. They may also engage in other risky behaviors.

A functional alcoholic is a person who appears to have control over their drinking and can maintain their responsibilities but is still consuming alcohol excessively.

A chronic severe alcoholic is a person who is physically alcohol dependent and experiences severe withdrawal symptoms if they attempt to quit. They may also have other health issues related to their alcohol consumption.

An intermediate familial alcoholic is a person who has a family history of alcoholism and may have a genetic predisposition to alcohol addiction. They may also have other mental health issues, such as bipolar disorder or major depression.

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Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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