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Types of Alcoholics: Young Adult, Young Antisocial, Functional , Intermediate Familial and Chronic Severe

Last Updated: February 28, 2024

Editorial Policy | Research Policy

People differ in their symptoms, usage and reason for alcohol consumption. Five subtypes of alcoholics describe some of these differences.

Alcohol use disorder is common in the U.S., and understanding that addiction looks different for each person is important. People differ in their symptoms, usage and reason for drinking. Some people may use alcohol to cope with stress or mental health conditions, while others may consume it socially, out of boredom or as part of their daily routine.

What Are the Different Types of Alcoholics? 

Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) identified five types of alcoholics, including: 

  • Young Adult Subtype
  • Young Antisocial Subtype 
  • Functional Subtype 
  • Intermediate Familial Subtype 
  • Chronic Severe Subtype

Young Adult Subtype

The young adult subtype is the largest of the groups accounting for 31.5% of alcoholics. Individuals within this group are typically in their early twenties and develop alcohol dependence around 19 years old. They don’t drink as often as other subtypes, but they do have high rates of binge drinking. 

It’s less likely for them to have co-occurring mental health conditions or family histories of alcoholism. As a result, many within this group don’t seek treatment for their substance use. However, those who seek help tend to prefer 12-step programs. 

Unfortunately, since young adults are still developing, excessive alcohol use increases their risk of long-term damage, including

  • Cancer 
  • Liver cirrhosis 
  • Heart disease 
  • Depression
  • Suicidal thoughts

Young Antisocial Subtype

The young antisocial subtype makes up 21% of alcoholics. This group consists of young adults in their mid-twenties who developed alcohol problems at an early age. Many have a family history of alcoholism and tend to use other substances in addition to alcohol. 

Over 50% are diagnosed with antisocial personality disorder. Other common co-occurring conditions affecting this group include depression, anxiety and bipolar disorders. 

More than one-third of this group seek treatment for alcohol use. Those who receive help usually gravitate towards groups, medical detox and treatment programs, or seek individual care from a private provider.

Functional Subtype

This subtype includes 19.5% of those who struggle with alcohol use but appear to be functioning. Those in the functional subtype drink excessively but compartmentalize alcohol to maintain appearances. They’re often middle-aged and educated and can maintain stable employment and relationships. Their loved ones either may not realize they’re dealing with addiction or may be in denial because they think the person is successful. 

These folks may not have experienced the negative impacts of alcoholism yet, such as job loss, strained relationships or criminal charges. You might see this type of alcoholism in industries where heavy drinking is normalized like entertainment or politics. 

Nearly one-third of those in this group have families with a history of alcoholism. About 25% have struggled with depression and 50% smoke cigarettes. Individuals in this subtype who seek help tend to attend 12-step groups or seek support from private healthcare providers.

Intermediate Familial Subtype

Folks within the intermediate familial subtype account for 19% of alcoholics. They often started drinking at a young age and have a family history of alcoholism. However, they didn’t start struggling with alcohol issues until middle age. 

Half of the people in this subtype have experienced depression, and 20% have bipolar disorder. Other common co-occurring mental health conditions include obsessive-compulsive disorder (OCD) and generalized anxiety disorder. Many people in this category also use tobacco, cocaine or marijuana. About 25% of this group seeks treatment for alcohol addiction. They tend to participate in groups, medical detox and treatment programs or receive help from a private healthcare provider.

Chronic Severe Subtype

Those within the chronic severe subtype are typically middle-aged but began drinking alcohol at an early age. Of this group, 80% have family histories of alcoholism, and many have antisocial personality disorder and engage in criminal behaviors. 

Compared to the other subtypes, this subtype has the highest rate of co-morbid mental health conditions, such as depression, anxiety and bipolar disorder. It’s also common for people within this subtype to have co-occurring substance use disorders with marijuana, cocaine and opioids. While they only account for 9% of those dealing with alcoholism, they’re the most common subtype you’d come across in treatment. 

Treatment for All Types of Alcoholism 

Successful treatment plans are unique to each person, and consider that recovery is a lifelong process. They will include short, medium and long-term support, goals and resources for the individual. Alcoholism treatment may include:

  • Individual, group or family therapy
  • Medications such as naltrexone and acamprosate
  • Support groups such as Alcoholics Anonymous (AA)
  • Medical treatment focused on co-occurring mental or physical health conditions
  • Psychoeducation regarding alcoholism and coping strategies
  • Medical detox programming

Seeking support for yourself or a loved one? The Recovery Village Atlanta provides robust treatment for those struggling with alcohol misuse. Our facility offers residential, partial hospitalization, intensive outpatient and medical detox programming. Reach out today and one of our Recovery Advocates can answer your questions and guide you through the admissions process.

Sources

Moss, H.B., Chen, C.M., Yi, H.Y. “Subtypes of Alcohol Dependence in a Nationally Representative Sample.” Drug Alcohol Dependence, December 1, 2007. Accessed April 26, 2023.

NI Direct.“Young people and risks of alcohol.” NI Direct, September 10, 2019. Accessed April 26, 2023.

NIAA. “Researchers Identify Alcoholism Subtypes.” National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health (NIH), June 28, 2007. Accessed April 26, 2023.

Substance Abuse and Mental Health Services Administration. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health.” Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, 2020. Accessed April 26, 2023.