Types of Alcoholics

Alcoholics can be grouped into five clinically recognized subtypes, as defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). This classification is based on a large-scale study involving 43,093 participants and considers factors such as age of onset, family history, personality traits, and co-occurring substance use. Below are the five main types of alcoholics, each with distinct characteristics:

• Young adult alcoholics: This is the most prevalent subtype. These individuals typically begin drinking in their late teens and develop alcohol dependence by their mid-20s, often without significant co-occurring mental health conditions.
• Young antisocial alcoholics: Characterized by early alcohol use and a high incidence of antisocial personality disorder, this group tends to begin drinking around age 15 and develop dependence by 18.
• Functional alcoholics: Despite their dependence, these individuals maintain stable jobs, relationships, and social appearances. Alcohol use often begins in adolescence, with dependence appearing later in adulthood.
• Intermediate familial alcoholics: These individuals often have a strong family history of alcoholism. They typically begin drinking in late adolescence and develop dependence by their early 30s.
• Chronic severe alcoholics: The rarest but most severe subtype, these individuals usually have multiple substance use issues and the highest rate of mental health challenges. Dependence often begins in their late 20s, following early initiation.

The classification of alcoholics into these five distinct categories was established by the NIAAA based on extensive data analysis. The study considered participants' family history, age of initial drinking, mental health traits, and patterns of substance use. Each subtype reveals how alcohol use disorder can manifest in different ways depending on life stage, psychological profile, and genetic background.

Young adult alcoholics represent the largest group. They often begin drinking around age 19 and typically develop alcohol dependence by 24. These individuals usually have fewer co-occurring mental health issues and may not seek treatment.

Young antisocial alcoholics tend to start drinking early, around age 15, and often meet criteria for antisocial personality disorder. Alcohol dependence in this group typically begins by age 18, and many have co-occurring drug use or behavioral problems.

Functional alcoholics appear outwardly successful, often holding steady jobs and maintaining relationships. They generally start drinking at 18 and do not become alcohol-dependent until around age 37. Despite their external stability, they often drink heavily and may not recognize their dependence.

Intermediate familial alcoholics have a notable family history of alcohol problems. They typically start drinking at 17 and develop dependence by 32. This group may also experience moderate levels of depression or anxiety.

Chronic severe alcoholics are the least common but experience the most intense consequences. They usually begin drinking around age 16 and become dependent by 29. This group has the highest rates of co-occurring substance use, mental health issues, and relationship breakdowns.

What is an alcoholic?

An alcoholic is defined as an individual who cannot stop drinking alcohol despite experiencing negative physical and mental effects. This term also describes someone who struggles to manage their drinking behavior and experiences intense urges when not consuming alcohol.

In recent times, however, the word “alcoholic” has gained a stigma, often leading to assumptions about those it describes. Because of this, medical and mental health professionals have moved away from this term, opting instead to use “individual with alcohol use disorder” when referring to people facing drinking-related issues.

What are the different types of alcoholics?

The types of alcoholics are often referenced to categorize different subgroups of people who experience alcohol use disorder (AUD). The following are the identified types of alcoholics.

1. The young adult subtype

This subtype consists of young adults, typically in their mid-twenties. Young adult alcoholics are more prone to engaging in risky drinking situations and, although they tend to drink less frequently than other groups, they are more likely to binge when they do consume alcohol.

Compared to other types, individuals in this category are less likely to have co-existing mental health issues and infrequently pursue treatment for alcoholism, as noted in a 2007 article, “Researchers Identify Alcoholism Subtypes” from the National Institutes of Health.

On average, members of this group start drinking at age 19 and develop dependence by 24. Research by Moss et al., published in December 2007 in Drug Alcohol Dependence, finds that males in this group outnumber females by 2.5 to 1.

According to more recent CDC data, binge drinking remains most common among adults aged 18–34. This subtype accounts for about 31.5% of all U.S. alcoholics. Personality traits may include impulsivity, risk-taking, and social thrill-seeking. The most common consequences involve alcohol poisoning, risky sexual behavior, car accidents, and strained relationships with parents or partners.

2. The functional subtype

Those classified as functional alcoholics are able to maintain steady employment or fulfill expected job roles, and typically have stable relationships within their families.

Most individuals in this group work full-time, possess higher education, and have the highest earnings among the subtypes. They also display moderate rates of smoking and are the least likely to face legal issues.

Functional alcoholics generally begin drinking at age 18 but do not become dependent until around 37, according to a piece by Michael Bayba, medically reviewed by Annamarie Coy for Alcohol Rehab Help. Sixty percent of this group are men, while forty percent are women. Someone regarded as a functional alcoholic can sustain both personal and professional achievements, despite secretly struggling with powerful alcohol cravings.

This group represents roughly 19.5% of all people with AUD in the U.S. They often show traits of perfectionism, denial, and high achievement orientation. Over time, the worst effects may include liver disease, emotional detachment in close relationships, hidden depression, and sudden health emergencies due to underreported consumption.

3. The intermediate familial subtype

This subtype encompasses those with a family background of alcoholism. These individuals have a heightened risk of being diagnosed with major depression, antisocial personality disorder (ASPD), bipolar disorder, and obsessive-compulsive personality disorder.

They are also more susceptible to cannabis or cocaine use disorder. This group generally takes their first drink at 17 and develops alcohol dependence by 32.

According to a 2007 study published in Drug Alcohol Dependence, about 64% of this group are male and 36% are female. An example is someone raised in an environment where heavy drinking is common and adopts these behaviors in adulthood.

This subtype makes up about 18.8% of U.S. alcoholics. Common personality features include emotional instability, family enmeshment, and high reactivity to stress. Effects often include strained family dynamics, co-occurring substance use, and worsening psychiatric symptoms without intervention.

4. The young antisocial subtype

People in this classification have the highest likelihood of antisocial personality disorder among the subtypes. They also experience high rates of accompanying mental health problems, including depression, bipolar disorder, and social phobia.

Additionally, young antisocial alcoholics are likely to have other substance use disorders involving marijuana, tobacco, or opioids. A 2023 article, “Understanding Alcoholism: 5 Different Types of Alcoholics” by Alcohol Rehab Help, reports that this group starts drinking at 15, with an average current age of 26, and alcohol dependence typically develops by 18.

Approximately 76% are male and 24% are female. An example is an individual who had conduct disorder symptoms before age 15, such as skipping school, lying, engaging in fights, or stealing.

This group represents about 21.1% of people with AUD and shows traits such as aggression, impulsivity, and low empathy. Side effects can be severe, including incarceration, violent behavior, accidental injury, homelessness, and untreated mental illness.

5. The chronic severe subtype

This category includes individuals who drink heavily nearly every day—about 248 days a year. Those belonging to the chronic severe subtype are most likely to have a genetic predisposition, with the highest rates of alcoholism among close relatives, as detailed in a 2007 feature, “Clinical Features Point to Five Alcoholic Subtypes,” published in PsychiatryOnline.

They also have the greatest frequency of alcohol-related emergency room visits and spend substantial time recovering from drinking episodes. The usual age for starting to drink in this group is 16, with dependence developing by 29.

About 65% are male and 35% are female. A typical example is someone consuming alcohol at hazardous amounts that severely disrupts many aspects of life. Such individuals are often unemployed, isolated from family or friends, and have experienced repeated failed attempts to reduce their drinking.

This is the rarest group, making up about 9.2% of alcoholics, but it presents the most acute health and social consequences. Common traits include severe dependence, co-occurring drug addiction, and low resilience to stress. Consequences often include liver failure, cognitive decline, hospitalization, job loss, incarceration, and long-term social withdrawal.

How do professionals classify alcoholics?

Professionals identified and grouped alcoholics according to several criteria, including their age, the age when they first used alcohol and developed dependence, family history of alcoholism, co-existing psychological disorders, and the presence of other substance use issues.

Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a division of the National Institutes of Health, utilized these factors to analyze people with alcohol dependence, leading to the identification of five distinct types of alcoholics.

What are the key factors to consider when categorizing various types of alcoholics?

The criteria for identifying various types of alcoholics detail the specific aspects and characteristics that experts and researchers evaluate when classifying individuals with alcohol-related issues. Recognizing subtypes of alcoholism has played a significant role in reducing the negative stigma associated with the condition. The following are the primary factors considered when grouping different types of alcoholics.

• Current age of the individual: Age serves as a key demographic element to determine whether specific age groups have a higher association with alcoholism, and it also represents a significant risk factor for developing alcohol dependence.
• Age at drinking onset: The age when a person first consumes alcohol is an important risk marker, as starting to drink earlier can heighten the severity of dependence and increase the likelihood of alcohol-related health problems.
• When alcohol dependence began: Identifying the age at which someone became dependent on alcohol is vital in organizing the national data sample analyzed by NIAAA researchers.
• Family history of alcoholism: Similar to other forms of addiction, alcohol use disorder often shows a genetic or familial pattern. Having relatives with alcoholism may raise an individual’s likelihood of developing dependence.
• Presence of co-occurring mental health disorders: Determining whether mental health conditions exist alongside alcoholism can inform more effective treatment strategies for those affected.
• Presence of other substance use disorders: Assessing if individuals with alcoholism also struggle with additional substance use disorders provides essential information for tailoring appropriate treatment interventions.

What types of alcoholics are conscious of their addiction?

The functional subtype and young antisocial subtype are the categories of alcoholics with a greater likelihood of recognizing their own alcoholism. While those classified as functional alcoholics are generally not inclined to pursue treatment, they are also the least likely to acknowledge alcohol-related issues compared to other subtypes.

As a result, people within the functional subtype are the least prone to experiencing legal repercussions from alcohol misuse. In contrast, young antisocial alcoholics are more apt to recognize their condition, as research by Moss et al. (2007) in Drug Alcohol Dependence indicates this group has the highest rate of seeking treatment among all subtypes.

What type of alcoholic is the most dangerous?

The most dangerous type of alcoholic is the chronic severe subtype. This group exhibits the highest levels of physical dependence, psychiatric comorbidities, and co-occurring substance use disorders. They drink heavily almost every day, approximately 248 days per year, and experience the most severe withdrawal symptoms, including hallucinations, seizures, and delirium tremens. According to the NIAAA, this subtype has the highest rate of emergency room visits, unemployment, legal problems, and family estrangement. Their drinking typically begins early (around age 16), and dependence develops by age 29, leading to long-term damage across multiple areas of life. The combination of medical, psychological, and social risks makes this the most life-threatening form of alcoholism.

What is the most common type of alcoholic?

The most common type of alcoholic is the young adult subtype, accounting for about 31.5% of individuals with alcohol use disorder in the United States. These individuals often start drinking at age 19 and develop dependence by age 24. While they do not usually drink daily, they engage in high-risk binge drinking behaviors, which increase the likelihood of alcohol poisoning, accidents, and impaired decision-making. They are also the least likely to seek treatment, which contributes to underdiagnosis. Despite having fewer co-occurring mental health disorders than other subtypes, their sheer prevalence and risky patterns of consumption make them a major focus for public health interventions.

What type of alcoholic is the hardest to quit?

The functional subtype is often the hardest type of alcoholism to quit. These individuals maintain employment, stable relationships, and often have higher education and income levels, which allows them to hide their addiction from others, and sometimes from themselves. Because they appear successful on the surface, they are less likely to recognize their drinking as problematic. Their dependence tends to develop later in life (around age 37), after years of socially acceptable alcohol use. This long-standing pattern, coupled with high denial and low perceived need for help, makes initiating and sustaining treatment more difficult for this group.

Does the treatment approach vary for different types of alcoholics?

The treatment approach for typical alcoholics is comparable to that used for individuals identified with the various subtypes of alcoholism. People from different subgroups often turn to self-help groups, 12-step programs, and professional care from healthcare providers as part of their treatment strategies. These methods are commonly applied to anyone living with alcohol use disorder.

In general, however, the most effective treatments for alcohol use disorder are medically supervised detox and withdrawal, cognitive behavioral therapy (CBT), or a combination of these approaches.

Are there distinctions in treatment methods for different types of alcoholics?

Yes, treatment can vary depending on the type of alcoholic. Findings from the NIAAA study indicate that those in the young adult and functional subtypes are more inclined to participate in 12-step programs for support.

Conversely, people classified as intermediate familial, young antisocial, and chronic severe alcoholics are more likely to pursue self-help groups, detoxification services, and specialized alcohol withdrawal treatment programs as part of their recovery process.