In 2007, a study using data from a national sample of almost 1,500 individuals meeting criteria for alcohol dependence and conducted by scientists at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) determined that there are five unique subtypes of alcoholism. People with these different types of alcoholism may be differentiated by their family histories of alcoholism, co-occurring mental disorders and substance abuse and treatment-seeking behaviors.
Young Adult Subtype
Approximately 31.5 percent of alcoholics fall into the young adult subtype. These individuals abuse alcohol but have relatively low rates of other substance abuse problems or co-occurring mental disorders. The rates of alcoholism in their families are also typically low. Young adult drinkers falling into this category rarely seek any sort of treatment or help for their drinking.
Young Antisocial Subtype
Individuals falling into the young antisocial subtype are typically in their mid-twenties with a history of alcohol problems and an early onset of regular drinking. Approximately 21 percent of alcoholics in the United States fall into this category, and more than one-third seek treatment for their drinking problems. Co-occurring mental disorders are especially common, with approximately half meeting criteria for a diagnosis of antisocial personality disorder and many having major depression, anxiety problems and/or bipolar disorder. At least 50 percent come from families in which other members also suffer from alcoholism. Simultaneous addictions to cocaine and opiates (pain killers or narcotics) are common, and more than 75 percent smoke cigarettes or marijuana.
Functional Subtype
The functional subtype--comprising roughly 19.5 percent of all alcoholics in the United States--is typically described as middle-aged, well-educated and stable in terms of career and family. Approximately 25 percent of these individuals have had at least one episode of major depression, and roughly one-third have alcoholic family members spanning multiple generations. Almost 50 percent of functional alcoholics are or have been regular smokers.
Intermediate Familial Subtype
The intermediate familial subtype comprises 19 percent of U.S. alcoholics. Individuals in this category are usually middle-aged with a strong likelihood (approximately 50 percent) of multigenerational alcoholism in their families. A history of mental disorders is relatively common, with almost 50 percent having suffered from clinical depression and 20 percent having bipolar disorder. Almost one in five people in the intermediate familial subgroup have had problems with cocaine or marijuana abuse, and most have smoked cigarettes. These individuals are not particularly likely to seek treatment, with only 25 percent ever getting help for their drinking.
Chronic Severe Subtype
Individuals in the chronic severe subtype comprise 9 percent of alcoholics in the United States and typically have the most extensive family histories and mental disorder and substance abuse comorbidities of all the alcoholism subtypes. Chronic severe alcoholics are usually middle-aged people with a history of early onset drinking and alcohol problems. Nearly 80 percent come from families characterized by multiple generations of alcoholism. These individuals have the highest rates of other psychiatric disorders such as depression, bipolar disorder and anxiety disorders, and they often have a history of antisocial personality disorder and criminal behavior. High rates of smoking and cocaine, opiate and marijuana dependence are common as well. These individuals are the most likely to be seen in treatment, with approximately two-thirds seeking help for their drinking problems.
References
- NIAAA: Researchers Identify Alcoholism Subtypes
- "Subtypes of Alcohol Dependence in a Nationally Representative Sample; HB Moss et al.; Drug and Alcohol Dependence, December 2007
