A breakthrough study by the National Institute on Alcohol Abuse and Alcoholism, published in the journal “Drug and Alcohol Dependence,” revealed distinct types of alcoholism. Previously, alcoholism was considered a single disorder with individual variations. The types described in the study differ in terms of age of onset, family history and functionality. The type of alcoholism can determine the type of treatment.
Alcoholism
The Mayo Clinic defines alcoholism as a dependence on alcohol. An alcoholic cannot control the amount he drinks and continues consuming alcohol even when his behavior disrupts his personal life. Alcoholics experience withdrawal symptoms when they abstain from drinking and develop a tolerance to the effects of alcohol. Other symptoms include blackouts, loss of interest in activities and becoming irritable when alcohol is not available.
Clusters
Howard B. Moss, the lead author of the study, and his colleagues identify five distinct clusters of alcoholism. The most common is Young Adult, in which 31.5 percent of the study population fell. People in this cluster tend be men with an average age of 24.5 years who develop alcohol dependence at an average age of 19.6 years. Twenty-one percent of the study group is identified as Young Antisocial. This cluster also tends to be men with an average age of 26.4 years. On average, they are 18.4 years old when they become dependent on alcohol. The Functional cluster, 19.5 percent of the group, consists mostly of older men, average 41 years of age, who are dependent on alcohol at an average age of 37. The fourth cluster is Intermediate Familial, with 19 percent of study respondents. The average age of this group is 38 years, with onset of alcohol dependence at an average age of 32. Lastly, the Chronic Severe cluster contains 9 percent of the study group. This group is 37.8 years old on average and develops alcohol dependence at an average age of 29 years.
Family History
Family history of alcoholism is generally uncommon except for the most severe clusters, Moss writes. In only two clusters--Young Antisocial and Chronic Severe--more than half of the group have a family history of alcohol dependence. This finding suggests genetics is an unlikely cause of alcoholism, Moss concludes.
Drinking Severity
Members of the Young Adult cluster tend to drink less often than those in other clusters, but they drink more on the days they do drink, Moss writes. The Functional and Intermediate Familial clusters as a whole drink less than the other clusters, whereas the Chronic Severe cluster tends to have the heaviest drinking patterns, drinking more often and consuming greater quantities than other groups.
Functionality
In general, the Functional and Young Adult clusters tend to have fewer antisocial behaviors than other groups as well as fewer concurrent psychiatric disorders, Moss says. People in these clusters also tend to be married with jobs. Those in the Chronic Severe and Young Antisocial categories tend to abuse other substances in addition to alcohol, have concurrent psychiatric disorder and are less likely to be married and employed.
Treatment Approaches
Despite the severity of their disorder, people in the Chronic Severe cluster are more likely than those in other clusters to seek help for their condition. Moss and colleagues also found people in the Young Adult cluster were the least likely to seek treatment help. People in the Young Antisocial cluster were more likely than others to seek individual treatment with private providers. Those in the Intermediate Familial and Functional clusters tend to find treatment with self-help groups.
