The 5 Types of Alcoholics

Alcohol use disorder (AUD) is a chronic, relapsing brain disease characterized by an impaired ability to control one’s drinking. Individuals with AUD continue to drink despite negative consequences, such as job loss, relationship problems, and financial difficulties. Some individuals suffering from AUD develop a physical dependence on alcohol as well, meaning they need to drink to avoid withdrawal symptoms, such as anxiety, tremors, and seizures.1

AUD is a progressive disease, meaning it typically gets worse over time. The severity of AUD is measured by the number of symptoms present and the individual consequences of the disorder. The most common symptom of AUD is craving, or a strong desire to drink alcohol. Other symptoms include:1

  • Loss of control: difficulty limiting one’s drinking once started
  • Physical dependence: needing alcohol to avoid withdrawal symptoms
  • Tolerance: the need to drink more and more alcohol to feel the same effects
  • Neglecting responsibilities: work, school, or family obligations are neglected in favor of drinking
  • Continued use despite negative consequences: drinking despite job loss, financial problems, or relationship difficulties

Individuals suffering AUD may deny or downplay the severity of their problem. This can make it difficult for friends and family members to convince them to seek help. Untreated AUD can lead to serious consequences, including liver damage, heart disease, and pancreatitis. It can also lead to accidental injuries, car accidents, and violence. If you or someone you know may be struggling with AUD, professional help is available.1

What are the Five Different Types of Alcoholics? 

AUD is a multifaceted disorder, with a variety of subtypes that specialists and clinicians have tried to distinguish based on individual drinking behaviors and characteristics. In doing so, they seek to comprehend AUD more effectively and optimize treatment. By classifying different types of alcoholics into categories, healthcare professionals aim to gain more insight into why some treatments work for some struggling individuals while failing to be useful for others.2, 7

Previous attempts at identifying different types of alcoholics largely relied on samples from patients who had already been diagnosed or sought out treatment for their illness. Nevertheless, there’s a sizeable population of AUD sufferers who have never received any form of treatment, which should be taken into consideration when attempting to classify the subtypes.2, 7

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) published a study that includes both treated and untreated participants suffering from AUD. According to this valuable piece of research, individuals suffering from AUD were divided into 5 types of alcoholics:2

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

Young Adult Type of Alcoholic

This is a category of individuals that are 18-25 years old and are suffering from AUD. This group of struggling individuals may regularly binge drink at social events or parties and may not actively realize the harm they’re putting themselves in. Drinking often begins as a social and recreational activity, developing into a disorder over time. They may lack an understanding of how their disorder is affecting their physical health, mental well-being, and relationships with others due to the fact that increased alcohol consumption is common among this age group. Common signs of young adult AUD include:3

  • Missing work or school due to hangovers
  • Blacking out after drinking binges
  • Relying on alcohol for social situations

Young Antisocial Type of Alcoholic

The young antisocial group of individuals suffering from AUD consists of individuals who experience a combination of antisocial personality disorder (ASPD) as well as an addiction to alcohol. Individuals suffering from ASPD tend to display behavior that can be seen as hostile, reckless, or irresponsible.4, 5

These struggling individuals may start drinking heavily at a much younger age than most other types of alcoholics and can have difficulty controlling their impulses or thinking before acting. The AUD is often directly caused by the personality disorder in cases like this. Alcohol abuse among this group can lead to aggressive behavior towards family members and friends or criminal activity such as vandalism or theft.4, 5

Chronic Severe Type of Alcoholic

Individuals suffering from chronic, severe AUD typically have the inability to control their cravings for the substance despite the negative consequences. These types of alcoholics may drink excessively for several days in a row and engage in compulsive behaviors such as buying large amounts of liquor even if they don’t have the money to do so.2

Withdrawal symptoms can also occur when these individuals attempt to stop drinking abruptly, causing them further physical and psychological distress, which may tempt them to resume their drinking in order to feel better. Individuals suffering from this form of AUD often experience other mental health issues as well. This can include depression, anxiety, and engaging in self-destructive or risky behaviors.2

Functional Type of Alcoholic

Functional individuals suffering from AUD typically consume large amounts of alcohol on a regular basis but still maintain social functioning and don’t appear obviously intoxicated or impaired in public settings. This type of alcoholic may participate in activities such as working full-time jobs, attending college classes, or engaging in hobbies while still relying heavily on drinking during off hours.6

These individuals often believe that they’re keeping their drinking habits under control because they can keep up with daily tasks but the reality is that their heavy intake could be taking a toll on their physical and mental health over time.6

Intermediate Familial Type of Alcoholic

Individuals under the intermediate group represent those who fall somewhere between the functional and chronic severe subtypes. These struggling individuals may find themselves experiencing more subtle impairments, such as difficulty concentrating at work, but still be able to function day-to-day without major disruptions. Still, the struggling individuals in this group carry significant risk factors associated with high-frequency binge-drinking behaviors which could result in serious medical emergencies if left unchecked long enough.2

How Should I Know Which Alcoholic Type I Am?  

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a book published by the American Psychiatric Association (APA), which outlines all the recognized mental health conditions that can be diagnosed.8

The DSM-5 includes criteria to diagnose various disorders of AUD. AUD is characterized by a pattern of excessive drinking that leads to significant impairment or distress in a person’s life. It is divided into two categories: mild, moderate and severe. Mild AUD means there are two to three symptoms present within a 12-month period; moderate AUD denotes four to five symptoms within 12 months; and severe AUD requires at least six symptoms during the same time period.8, 9

In order to make an accurate diagnosis of AUD, clinicians must review several elements including:10

  • Patterns of drinking
  • Problems related to alcohol use (legal issues, physical consequences, etc.)
  • Any psychological or social issues associated with alcohol use
  • Family history of substance abuse
  • Co-occurring mental health conditions like depression or anxiety

With this information, clinicians can then determine if someone meets the criteria for an AUD diagnosis according to the DSM-5 guidelines. Still, the DSM-5 is not enough to determine what group of individuals struggling with AUD the treatment-seeking individual is part of. The clinician can help the treatment-seeking individual determine this through careful assessment.9, 10

Young Adult Group:2-4

  • Low rates of co-occurring mental health disorders
  • Low rates of family AUD history
  • Don’t tend to seek help for their disorder
  • Are close to the legal drinking age

Young Antisocial Types of Alcoholics:2, 5

  • Typically in their mid-twenties
  • Had an early onset of AUD
  • Higher rates of family AUD history
  • Around half is diagnosed with ASPD
  • High rates of co-occurring substance use disorder

Intermediate Familial Group:2

  • Middle-aged
  • Multigenerational AUD in families
  • Often suffering from a co-occurring mental health disorder

Functional Types of Alcoholics:2, 6

  • Able to maintain a job and perform most of their duties
  • Able to act conceal signs of intoxication
  • Less likely to recognize the disorder for what it is

Chronic Severe Group:2

  • More likely to have suffered legal or relational consequences of AUD
  • More obvious symptoms of AUD
  • Higher possibility of severe withdrawal symptoms
  • Often suffer from co-occurring mental conditions
  • High rate of co-occurring substance abuse disorder

Get Help for All Types of Alcoholics in Nevada  

Treatment options for different types of alcoholics can vary depending on the severity of the disorder and individual needs. For young adults with AUD, cognitive behavioral therapy (CBT) is often recommended to help them identify underlying issues that may be contributing to their drinking.2, 7

Other forms of psychotherapy, such as dialectical behavior therapy (DBT), can also be beneficial in helping young adults recognize and manage their triggers. In addition to counseling, medications like naltrexone or acamprosate can be used to limit cravings and reduce relapse risk.1-3

Treatment for functional treatment-seeking individuals typically involves both individual and group therapy sessions. Through individual therapy, these struggling individuals can gain insight into what drives their drinking behavior, as well as develop new coping strategies for managing stress or difficulty in relationships. Group therapy allows those with similar experiences to share stories and provide support for one another in recovery. Medications such as disulfiram or naltrexone may also be used to reduce cravings and potentially enhance recovery efforts.1, 2, 6

Treatment plans for individuals who suffer from both AUD and ASPD should address both mental health issues such as impulsivity or aggression along with interventions aimed at substance abuse reduction. Evidence-based treatments like Motivational Interviewing (MI) may be effective for this population by helping them explore their motivations for change, set goals for sobriety, develop coping skills and increase motivation for treatment adherence. Medications like naltrexone or acamprosate may also be helpful in reducing cravings associated with relapse risk.1, 2, 4, 5

Intermediate familial treatment-seeking individuals’ interventions should include evidence-based treatments like CBT which can help them identify underlying issues that trigger unhealthy patterns while developing healthier coping mechanisms. In addition, pharmacological management may be considered including medications like Naltrexone and Acamprosate.1, 2

Chronic severe drinkers often suffer from long-term physical damage due to years of heavy alcohol abuse. These individuals commonly struggle with co-occurring mental health issues such as depression or anxiety which make it difficult to maintain abstinence even when committed to recovery efforts after detoxing.1, 2

An interdisciplinary team is necessary when treating this type of alcoholic since there will likely need to be involvement from psychiatrists, primary care physicians, counselors/therapists, nutritionists/dietitians, etc., all working together towards a common goal. This plan could include evidence-based psychotherapeutic approaches such as CBT & DBT coupled with medications like Disulfiram and Naltrexone alongside lifestyle modifications & exercise programs if medically appropriate, all tailored around the patient’s unique needs & preferences.1, 2

Finding treatment

Treatment-seeking individuals can benefit from using SAMHSA’s treatment locator to find an appropriate facility for their needs. Struggling individuals may also benefit from evidence-based private treatment at American Addiction Centers (AAC). AAC consists of statewide treatment facilities designed to help individuals struggling with AUD and other forms of substance abuse get professional medical help and begin their recovery.

After the initial intake and diagnosis, treatment typically begins with a full detoxification from alcohol to stabilize the struggling individual and prepare them for further recovery. This process is strictly medically supervised by experienced staff, well-versed in helping individuals struggling with withdrawal symptoms overcome this stage of treatment. Further into treatment, the struggling individual will have the opportunity to use different elements of the program to their advantage, including psychotherapy, group therapy, medically-assisted therapy and more. AAC offers various payment options, from insurance to sliding scale fee payment. You or your loved one can reach them through a dedicated helpline and discuss the struggling person’s situation.

Frequently Asked Questions