Within the category of alcoholism, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has identified five different types of alcoholics, each of which struggles with their own version of the disorder.
- Young adult
- Young antisocial
- Intermediate familial
- Chronic severe subtype
The 5 Types of Alcoholics
The five types of alcoholics are based on distinct patterns of drinking and related behaviors. They also take into account other mental health problems that may exist as well as family experiences that may impact their experience with addiction.[2,3]
1. Young Adult Subtype
Young adult alcoholism is a subtype of alcoholism that affects individuals who are typically in early adulthood and have started drinking early, usually during their teenage years and sometimes before. In some cases, they may also use illicit drugs during this time as well.
Young adult alcoholics are often impulsive, antisocial, and engage in risk-taking activities, which can lead to negative consequences, such as problems with the law, school problems, or issues with their close relationships.
For the young adult subtype of alcoholic, the brain is still developing. Early introduction of alcohol to that development process can mean a lifelong struggle with addiction, mental health issues, and an increased risk of life-altering and potentially deadly accidents.
Treatment is usually found in the form of abstinence that is supported by professional addiction treatment professionals who can help them address mental health difficulties that arise and provide coping mechanisms that are age-appropriate.
2. Young Antisocial Subtype
This subtype refers to people, usually in their 20s, who display antisocial personality traits (engaging in aggressive, confrontational, and impulsive behaviors), which usually start with early alcohol consumption. This subtype tends to be characterized by an increased prevalence of antisocial personality disorder and a history of alcohol use disorder (AUD) in the family.
Individuals with young antisocial subtype AUD might have difficulty controlling their impulses and show a lack of empathy. Due to their aggressive, confrontational behavior while drinking alcohol, they may be more likely to develop co-occurring issues with substance abuse and the law.
The treatment of young antisocial alcoholism almost always includes treatment of co-occurring psychological issues. These untreated conditions often play a part in the desire for and use of alcohol. If they go untreated, recovery from AUD is unlikely.
3. Functional Subtype
The functional subtype of alcoholism refers to individuals who are typically middle-aged and well-educated, with stable jobs and family lives despite their abuse of alcohol.
People characterized by this subtype will still experience the negative consequences of heavy alcohol consumption, but they are often able to maintain their responsibilities and function socially. This can make it difficult to identify AUD in these individuals.
This subtype can have a slower onset of alcohol dependency compared to the other subtypes. They may also be adept at concealing how much alcohol they consume as well as the consequences of that use.
The treatment of functional alcoholics involves addressing underlying issues that trigger the urge to drink and helping the person to understand the impact alcohol has on their career, family, and health. Support from family, friends, and peers can be a positive factor in helping functional alcoholics find their way back to sobriety.
4. Intermediate Familial Subtype
The intermediate subtype of alcoholism can be identified by a significant family history of addiction and a higher probability of co-occurring mental health disorders.
This subtype includes people who begin drinking in their teens and are at a higher risk of developing alcohol-related problems as they get older. They may experience genetic vulnerabilities and have a higher prevalence of mental health issues as well.
Treatment for the intermediate familial subtype may involve addressing both the alcohol abuse issues and any underlying psychiatric disorders, so they can develop coping mechanisms that help them to manage both disorders for the long term.
5. Chronic Severe Subtype
A history of AUD in one’s family, the development of alcohol abuse early on in life, and a current severe AUD are classified as chronic severe alcoholism.
Signs of chronic severe subtype include the following:
- Problems with relationships
- Difficulty maintaining employment
- Co-occurring mental health disorders
- Physical health problems
Treatment for chronic severe subtypes usually begins with a medical detox period and continues with an intensive treatment program for co-occurring mental health disorders and AUD. Clients in treatment should also receive support managing any legal issues, finding work, and connecting with housing.
How Do I Know If I Have a Problem With Alcohol?
If you’re wondering if you have a drinking problem, you likely do to some degree. Here are some questions to ask yourself that can help you determine if you might have problematic drinking patterns:[4-7]
- Have you experienced relationship issues, legal problems, or health concerns as a result of your alcohol consumption?
- Do you find it hard to limit or control your drinking after you start?
- Have you tried to cut down or stop drinking but found it challenging or been entirely unsuccessful?
- Do you feel a strong urge or craving to drink alcohol throughout the day or in certain situations?
- Have you neglected or reduced participation in activities you once enjoyed in favor of drinking?
- Do you continue to drink alcohol despite knowing the harmful effects it can have on your mental or physical health?
- When you try to quit drinking for a significant amount of time, have you experienced withdrawal symptoms, such as anxiety or nausea?
- Has your tolerance for alcohol increased over the years, causing you to need to drink more to get the same effect?
- Has anyone in your family, your close friends, or your peers voiced concern over your drinking habits?
- Have medical professionals mentioned health issues you may be experiencing due to heavy drinking, such as high triglycerides, signs of liver dysfunction, or other symptoms of alcohol abuse?
If you answered “yes” to any of these questions it could indicate that you have a drinking problem. Talk to your doctor or an addiction treatment professional to get an official diagnosis of AUD. Even if you don’t yet have AUD, problematic drinking and alcohol abuse should be addressed before it progresses to AUD.
How Can I Determine Which Type of Alcoholic I Am?
You may not be able to identify your type of alcoholism, but you can have a general idea of where you fall on the spectrum. This will help you to begin the process of seeking treatment. Here are some things to look for:[2,8]
- You may be a young adult or antisocial subtype if you’re in your teens or 20s and already have alcohol problems. Mental health issues make it hard for you to deal with the expectations of teachers or legal authorities.
- If you’re in your 30s or older, or you didn’t start to have problems with alcohol use until you were in your late 20s, you could be a functional subtype alcoholic, though you may also fall into the intermediate familial or chronic severe subtype. You may be a functional subtype if you can manage your responsibilities and keep your drinking secret from others. For example, you still have a full-time job.
- If you struggle with maintaining employment, you frequently hear from your loved ones that you need to stop drinking, you struggle with co-occurring symptoms of depression or anxiety, and there is a familial history of AUD, you may be an intermediate familial subtype.
- If you have long struggled with AUD like many people in your family and experience significant mental health symptoms that make it impossible for you to maintain employment or manage responsibilities like your finances or family, you may be in the chronic severe subtype.
The specific subtype of alcoholic you are doesn’t matter as much as simply getting help does. Regardless of the type of alcoholic you are, the key is to get treatment before the disorder worsens and the damage becomes more severe.
- Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. Published 2020. Accessed October 18, 2023.
- Researchers identify alcoholism subtypes. National Institutes of Health (NIH). Published September 29, 2015. Accessed October 18, 2023.
- Early drinking and its association with adolescents’ participation in risky behaviors. Calvert WJ, Keenan Bucholz K, Steger-May K. Journal of the American Psychiatric Nurses Association. 2010;16(4):239-251.
- Adolescent substance use and the brain: Behavioral, cognitive and neuroimaging correlates. Hamidullah S, Thorpe HHA, Frie JA, Mccurdy RD, Khokhar JY. Frontiers in Human Neuroscience. 2020;14.
- The ability of single screening questions for unhealthy alcohol and other drug use to identify substance dependence in primary care. Saitz R, Cheng DM, Allensworth-Davies D, Winter MR, Smith PC. Journal of Studies on Alcohol and Drugs. 2014;75(1):153-157.
- Binge drinking and alcohol problems among moderate average-level drinkers. Holahan CJ, Holahan CK, Moos RH. American Journal of Preventive Medicine. Published online June 2022.
- Diagnosis and pharmacotherapy of alcohol use disorder. Kranzler HR, Soyka M. JAMA. 2018;320(8):815-824.
- A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions. Higgins-Biddle JC, Babor TF. The American Journal of Drug and Alcohol Abuse. 2018;44(6):578-586.