Types of Alcoholics: Understanding the Signs and Symptoms

Alcoholism is a serious health issue in the US, with an estimated 14.5 million adults suffering from an alcohol use disorder (AUD). Despite its prevalence, many people do not understand that there are different types of alcoholics and that AUD can affect different individuals differently.1

For many people, the stereotype of a “typical alcoholic” is one of an unemployed man living on the street and drinking heavily every day. This image has been perpetuated by media, literature, and film in the past. However, recent studies have found that this single-minded view of alcoholism is inaccurate.2

In this article, we’ll explore these different types of alcoholics and the treatments available for them. We will also discuss common signs and symptoms to look out for so you can get help if needed. By understanding the various types of an alcohol use disorder, we can better equip ourselves to support our loved ones who may be struggling with this condition.

What are the Different Types of Alcoholics

Alcoholism is a complex disorder with various subtypes. Researchers and clinicians have attempted to categorize alcoholics based on the differences in their personal traits and drinking characteristics in order to better understand alcoholism and improve treatment. Specifically, categorizing different types of alcoholics can help explain how and why certain medications and treatment methods work for some but not for others.3

Previously, alcoholism subtypes have been identified primarily based on people who have been hospitalized or otherwise treated for their alcoholism. There is, however, a substantial proportion of patients who have never been treated, which indicates that the samples used in previous sampling for defining the different types of alcoholics did not represent a substantial portion of these individuals.2

According to a study published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), which included both treated and untreated respondents who met diagnostic criteria for alcohol dependence, there are 5 types of alcoholics. They include:2

  • Chronic severe
  • Functional alcoholics
  • Young adult alcoholics
  • Young Antisocial
  • Intermediate

Chronic Severe Alcoholic

The chronic severe alcoholic type is a severe form of an alcohol use disorder characterized by long-term heavy and consistent drinking that leads to physical and psychological dependence on alcohol. These individuals are at high risk for developing health complications and poor social functioning and have a high prevalence in society. Nearly 9% of all US alcoholics are considered chronic severe alcoholics. This type of alcoholic is most prevalent in middle-aged individuals.2

The prevalence of chronic severe alcoholic type may be higher among individuals with a family history of alcohol abuse. Studies have found that multigenerational alcohol abuse may have a genetic component and may predispose individuals to alcohol addiction.2

Additionally, individuals with chronic severe alcohol addiction are at high risk for dual diagnosis, meaning they may have co-occurring mental health conditions such as depression, anxiety, or PTSD. This can make treatment more complex, and it is essential for chronic severe types of alcoholics to receive comprehensive care that addresses both their alcohol addiction and any underlying mental health conditions.2

Chronic severe alcoholics also have high rates of smoking and substance abuse. Studies have found that individuals with alcohol addiction are more likely to smoke cigarettes and use other substances such as marijuana, cocaine, and opioids.2

Despite the high rates of health complications and poor social functioning, many chronic severe alcoholics do seek help. In fact, they make up the most prevalent type of alcoholics in treatment. Studies have found that about two-thirds of individuals with alcohol addiction seek treatment. However, access to treatment can be limited due to a lack of resources and the stigma surrounding addiction, and many individuals may not receive the help they need.2

Functional Alcoholics

Functional alcoholics, also known as high-functioning alcoholics, are a type of alcoholics who are able to maintain their daily responsibilities, such as work, school, and relationships, while still having a severe alcohol use disorder. They are not typically seen as “alcoholics” by themselves, friends, or family and may not even consider themselves as such. They tend to be middle-aged, well-educated and have stable jobs and families. However, despite their ability to function in their daily lives, they still experience significant negative consequences related to their alcohol use.2

According to data, 19.5% of alcoholics in the U.S. belong to the functional type of alcoholics. They tend to have a higher socio-economic status and are less likely to be unemployed or homeless than non-functional alcoholics. They are also more likely to be in denial about their alcohol use and may not see themselves as needing help.2

Studies have found that roughly one-third of functional alcoholics have a history of alcoholism in the family, which may indicate a genetic component to the disorder. Additionally, nearly 25% of functional alcoholics have had major depressive illness sometime in their lives, indicating that mental health issues may also be a contributing factor.2

Furthermore, more than half of this type of alcoholics are smokers, which is a significant increase compared to the general population. This may be due to the fact that alcohol and nicotine have similar effects on the brain, and individuals may use these substances together to enhance their effects.2

It is important to note that functional alcoholism is a serious condition that can lead to significant negative consequences for individuals and those around them. Despite being able to maintain their daily responsibilities, functional types of alcoholics may still suffer from physical and mental health problems, relationship issues, and financial problems, among others. Therefore, it is crucial to identify and address functional alcoholism as early as possible, to prevent these negative consequences from becoming more severe.2

Young Adult Alcoholics

Young adult alcoholics make up a significant portion of the U.S. population, with 31.5 percent of all alcoholics falling into this age group. One of the defining features of the young adult type of alcoholics is their relatively low rates of co-occurring substance abuse and other mental health disorders. This means that, for the most part, these individuals are primarily struggling with alcohol addiction and are not also dealing with other forms of addiction or mental health issues.2

Another characteristic of young adult alcoholics is a low rate of family alcoholism. This suggests that, in many cases, the individuals in this group may have developed their addiction independently and not as a result of growing up in a household with a history of alcohol abuse.2

Additionally, individuals categorized as young adult types of alcoholics are less likely to seek help for their drinking. This could be due to a number of factors, such as a lack of awareness of the resources available, a reluctance to admit the problem, or a lack of support from family and friends.2

Despite these unique characteristics, young adult alcoholics still face many of the same challenges and dangers as other types of alcoholics. Long-term alcohol abuse can lead to a wide range of physical and mental health issues. It can also have a detrimental effect on relationships, careers, and overall quality of life.2

Young Antisocial Types of Alcoholics

Young antisocial alcoholics, who constitute 21 percent of all alcoholics in the United States, have a distinct set of characteristics that differentiate them from other types of alcoholics. These individuals are in their mid-twenties and often have a history of early-onset drinking and alcohol problems. They also tend to come from families with a history of alcoholism, with over half of them having at least one family member who struggled with alcohol abuse.2

One of the most notable characteristics of young antisocial alcoholics is their high rate of co-occurring psychiatric disorders. Over half of them have been diagnosed with Antisocial Personality Disorder (ASPD), a condition characterized by a disregard for the rights of others and a tendency towards criminal behavior. Many of these individuals also have other mental health issues, such as major depression, bipolar disorder, and anxiety.2

Additionally, these alcoholics are more likely to have other forms of substance abuse as well. Over 75 percent of them use tobacco and marijuana, and a significant number are addicted to other substances, such as cocaine and opioids. Interestingly, more than one-third of these individuals seek help for their drinking, which is a higher percentage compared to other types of alcoholics.2

Intermediate Alcoholics 

Intermediate alcoholics, who make up 19 percent of all alcoholics in the United States, are a unique group of individuals characterized by their middle-aged demographic and a history of multigenerational alcoholism in their families. This suggests that they may have a genetic predisposition to addiction or that they may have learned addictive behaviors from their family members.2 

Additionally, almost half of the individuals categorized as this type of alcoholic has had a history of clinical depression, and 20 percent have had bipolar disorder, which can make their addiction even more challenging to overcome as they may be self-medicating these underlying mental health issues with alcohol. Sadly, only a quarter of intermediate types of alcoholics seek treatment for their condition.2

People in this group also tend to have a history of substance abuse, with most of them having smoked cigarettes and nearly one in five abusing cocaine and/or marijuana. This can make their addiction more severe and harder to treat, as they may have a more difficult time stopping the use of multiple substances.2

How to Determine Which Type of Alcoholics You Are? 

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is a widely used tool for identifying and diagnosing mental health disorders, including addiction. The DSM-5 includes 11 signs of addiction that may be used to help identify whether someone has an addiction to alcohol. These signs include:4

  • Drinking too much and having trouble stopping.
  • Failure to stop drinking despite multiple attempts.
  • Drinking alcohol to satisfy cravings.
  • Spending a significant amount of time obtaining alcohol, consuming it, and recovering from its effects.
  • Drinking despite damaging social interactions and relationships.
  • Inability to fulfill regular life obligations as a consequence of drinking.
  • Drinking alcohol instead of participating in recreational activities.
  • Consumption of alcohol in hazardous or dangerous situations.
  • Drinking, despite knowing it will have negative effects on your physical, emotional, social, and other well-being.
  • Drinking more to feel “normal,” indicating a higher tolerance to alcohol.
  • Experiencing symptoms of withdrawal when the effects of alcohol wear off.

It’s important to note that the DSM-5 is not a diagnostic tool with the intended purpose of determining the specific type of alcoholic an individual is; it’s more focused on identifying the presence of addiction. However, in conjunction with other symptoms, it may help narrow down which type of alcoholic an individual belongs to. Therefore, it is important for individuals to seek professional help from a health professional who can provide a proper diagnosis and recommend an appropriate treatment plan.4

Based on the available data and signs and symptoms of different types of alcoholics, the following checklist may help indicate which type you or your loved one may belong to:

Young Adult Alcoholics:2

  • Relatively low rates of co-occurring substance abuse and other mental disorders.
  • Low rate of family alcoholism.
  • Rarely seek any kind of help for their drinking.
  • Close to the legal drinking age, usually in college.

Young Antisocial Alcoholics:2

  • Tend to be in their mid-twenties.
  • Had early onset of regular drinking and alcohol problems.
  • History of alcoholism in the family.
  • Diagnosed with Antisocial Personality Disorder.
  • Depression, bipolar disorder, and anxiety problems.

Intermediate Alcoholics:2

  • Middle-aged.
  • Tend to come from families with multigenerational alcoholism.
  • Presence of a co-occurring mental health disorder.
  • Likely to smoke or use illegal drugs such as marijuana or cocaine.

Functional Alcoholics:2

  • Can maintain their job and relationships while still drinking heavily.
  • Able to conceal their drinking habits.
  • Less likely to show physical signs of alcohol abuse.
  • May not have the desire to change their drinking habits.

Chronic Severe Alcoholics:2

  • Dealing with severe addiction.
  • Social and employment status are affected by drinking.
  • Shows more physical signs of alcohol abuse, such as slurred speech or unsteady gait.
  • May have a history of blackouts, hospitalization, and legal problems.
  • Diagnosed with one or more comorbid psychiatric disorders.
  • Likely dealing with an addiction to smoking or illegal drugs.

It’s important to note that these symptoms are not definitive, and a proper diagnosis should be made by a mental health professional. It is also important to note that not all alcoholics fit into a single category. Some types of alcoholics may exhibit characteristics of more than one category.2

Get Treatment Help for All Types of Alcoholics 

Treatment options for alcoholics vary depending on the type of alcoholism they have. It’s important to note that seeking professional help is vital in overcoming addiction. For young adult alcoholics, treatment options include cognitive-behavioral therapy, which can help them identify and change negative patterns of behavior associated with their drinking. Additionally, motivational interviewing, which is a client-centered counseling method that helps individuals explore and resolve ambivalence about changing their drinking behavior, can be helpful.5

For young antisocial types of alcoholics, a comprehensive approach that addresses both their addiction and comorbid psychiatric disorders is essential. This may include individual and group therapy, as well as medication management.5

For intermediate alcoholics, treatment options include a combination of counseling and medication management. This may include individual and group therapy, as well as medications such as naltrexone, which can help reduce cravings for alcohol.5

For functional and chronic severe types of alcoholics, treatment options include inpatient or outpatient rehabilitation programs, detoxification, and medication-assisted treatment (MAT) such as naltrexone, acamprosate, and disulfiram.5

It is important to note that there is no one-size-fits-all approach to treating alcoholism, and a tailored treatment plan that takes into account the stage of an alcohol use disorder, an individual’s specific needs, and circumstances is crucial for success. American Addiction Centers (AAC) offers a variety of evidence-based treatment options for individuals struggling with alcoholism, including inpatient, outpatient, and aftercare programs.5

If you or a loved one is struggling with alcoholism, don’t wait to seek help. The first step is to reach out for support. American Addiction Centers (AAC) can provide the guidance and resources you need to start the journey to recovery, such as various treatment plans and costs. You can reach out to them anytime by calling their 24/7 hotline.

Frequently Asked Questions