“Clinicians have long recognized diverse manifestations of alcoholism and researchers have tried to understand why some alcoholics improve with specific medications and psychotherapies while others do not. The classification system described in this study will have broad application in both clinical and research settings.”
~Ting-Kai Li, M.D., the Director of the National Institute on Alcohol Abuse and Alcoholism until 2008
What is Alcohol?
Alcohol is often seen as something people consume to relax or unwind. Alcohol is available almost everywhere, and drinking is very socially acceptable. It’s viewed as a treat that’s enjoyed on weekends, or even throughout the week. Very rarely is alcohol ever seen for what it really is – a drug.
Alcohol is actually classified as a depressant drug. It received this classification because of the way it slows down the central nervous system of the body. People who drink it will experience slurred speech, unsteady movements and other effects.
Alcohol can have different effects based on a few different factors. If it is consumed in smaller quantities, it can act as a stimulant in the body. If someone is drinking more than he or she should, its depressant effects start to kick in. They lack in judgment, may lose control, and may not be able to stop drinking.
There are many different types of alcohol, and these include beer, wine and spirits. “A drink” is largely dependent on the type of alcohol you’re consuming. For example, 12 ounces of beer is considered to be a drink, as is 1 ½ shot of spirits. Both contain the same amount of alcohol.
Alcohol abuse occurs when you misuse alcohol by drinking too much of it. This can occur one time, or it can occur repeatedly. Even so, there is a difference between alcohol abuse and alcohol addiction. This is the same principle as the difference between substance abuse and drug addiction.
Someone who is abusing alcohol may do so in a number of different ways. That person may drink excessively on occasion, or they may do it regularly. What’s missing is the compulsion to use alcohol. Someone who is participating in alcohol abuse does not feel the need to drink. That individual may enjoy having many drinks in one sitting, and then not touch alcohol for months.
Also, someone who abuses alcohol will not normally experience many of the chronic negative consequences of addiction. For example, they may not see many changes in their work or home life. When they aren’t drinking alcohol, they won’t go through alcohol withdrawal. This is what sets alcohol abuse apart from alcoholism, or alcohol addiction.
It is important to remember that alcohol abuse doesn’t always remain in this stage. Alcoholism can occur with repeated alcohol abuse, and for many people, it does. There is no way of knowing how long a person may “safely” abuse alcohol. Alcohol abuse can turn into alcoholism at any moment.
Alcoholism has also been called alcohol use disorder, or AUD. This is a term that refers to alcohol use that has gotten out of control. When someone is suffering from alcoholism, they are usually experiencing physical or mental health issues. This is as a result of consuming too much alcohol for too long.
Someone is thought to be an alcoholic when two or more of the following are present:
- Getting and drinking alcohol is very time consuming
- There is a strong desire for alcohol
- Drinking alcohol is done in large amounts
- Cutting down on the amount of alcohol consumed is not possible
- Drinking alcohol has resulted in physical health problems
- Consuming alcohol results in taking major risks
- Withdrawal symptoms are present when not drinking alcohol
- More alcohol needs to be consumed to get drunk
There are different types of alcoholism, and people generally fall into one of the types. We’ll go over what those are in just a moment. Even though there are different kinds of alcoholics, that doesn’t make one kind more preferable than another. No matter how you look at it, alcoholism is dangerous.
For many people who are alcoholics, they don’t realize they struggle with alcoholism. They may know that they drink too much, or too often, but they don’t see it as a problem. This is classically referred to as denial.
It’s possible that you are in denial as well. You need to know if you’re an alcoholic in need of treatment to recover. You can begin by taking an alcoholism quiz like this one. This quiz may answer many of your questions about alcoholism. You can also look for some of the signs of alcohol addiction in your own life. These might include:
- Lying about how much or how often you drink alcohol to others
- Hiding how much or how often you consume alcohol
- Experiencing blackouts because you drank too much
- Participating in regular binge drinking activities
- Not being able stop drinking when you want to
- Surpassing any alcohol consumption limits you may set for yourself
- Drinking alcohol in risky situations
- Showing some of the physical signs of alcohol abuse
- Focusing your life on your alcohol consumption
- Leaving behind favorite activities or hobbies because you’d rather drink
There are a number of risk factors that make someone more at risk of becoming an alcoholic. The amount of alcohol a person drinks is one risk factor. Men should not consume more than 15 alcoholic drinks per week. Women should not consume more than 12 alcoholic drinks per week. There are also other risk factors, such as:
- Having a parent with an alcohol use disorder
- Having a mental health issue, such as depression or anxiety
- Experiencing peer pressure from friends to drink alcohol
- Having a low self-esteem
- Being under a lot of stress
- Living in a community or culture where excessive alcohol use is accepted, common, and encouraged
Having one of these risk factors does not mean that you will automatically become an alcoholic. However, it does mean that your chances of becoming an alcoholic are greater.
Alcoholism can always be prevented, no matter what your circumstances are. Those with more than one risk factor may even want to consider never consuming alcohol at all.
Is Alcohol Addictive?
Alcohol is a drug that makes people feel good. It has a profound effect on the brain. The question is, why is it considered to be addictive? Some studies that were cited on WebMD may give us an indication about the addictive nature of alcohol.
According to research, brain images were taken of people who were deemed to be alcoholics. The reward centers of the brain respond favorably to alcohol for both light and heavy drinkers. For both groups, drinking alcohol resulted in the release of endorphins. Endorphins are opioids in the brain that are related to pleasure and feeling good. As you may guess, people in the heavy drinking group had a greater response. They also said they felt more intoxicated, even after drinking the same amount of alcohol.
This research suggests that when more opioids are released when alcohol is consumed, the risk of alcoholism is greater. These individuals have a much higher chance of becoming alcoholics.
Also, the brain normally releases these endorphins on its own in response to various stimuli. For example, when you eat a good meal, endorphins are released in your brain. For alcoholics, their brains will eventually stop making the endorphins on their own. Instead, they rely on alcohol to do that for them. This is why most alcoholics will claim that they don’t feel like themselves if they’re not drinking.
Alcoholism is a very personalized disease, manifesting differently in every person. Because the contributing factors, the family/personal history, the environment, and the severity of the disease can vary from person to person, Alcohol Use Disorder (AUD) treatment must also be adaptable to the individual.
Over the years, addiction researchers have been able to more distinctly distinguish what characterizes a person who suffers from a substance use disorder, commonly referred to as an addict or alcoholic and this clarification has made it possible to categorize the different sub-types of substance abusers.
In the case of Alcohol Use Disorder (AUD), the ability to identify the type of alcoholic a person is makes it that much easier for rehab professionals to create a personalized treatment plan for each individual that attacks the disease both at the source and in a matter that targets the specific manifestation.
Past efforts to categorize the individual subtypes of alcoholism primarily focused on those people who were either hospitalized or receiving some other professional treatment for their illness.
But recent reports from the NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditionsindicate that only about one-quarter of people with AUDs have ever had ANY treatment. This means that the largest percentage of alcoholics – and their individual sub-types – were not accurately represented in earlier studies.
The NESARC studies alcohol, drug, and mental disorders in the U.S. and is meant to be representative of the country as a whole. Around 1500 respondents from across America who met the standard for a clinical diagnosis for alcohol dependence participated – both individuals in rehab and those not yet seeking professional treatment.
Based upon several factors, researchers identified five distinct alcoholic sub-types. The factors included:
- Individuals’ family history of alcoholism
- Their age when habitual drinking began
- Their timeline of alcohol abuse/dependence
- Any co-occurring substance abuse or mental disorders
This sub-type accounts comprises roughly a fifth of all American alcoholics – 21%.
Typically, young antisocial alcoholics are in their mid-twenties and have a personal history that includes an early onset of alcohol problems. More than half have a history of alcoholism within the family, and approximately 50% have also been diagnosed with an Antisocial Personality Disorder (ADP). In addition, many suffer from major depression, anxiety, or bipolar disorder.
More than three-quarters smoke – both regular tobacco and marijuana – and many have an addiction to opiates or cocaine.
In contrast to “Young Adult” sub-types, over 33% of young antisocial alcoholics actually seek help for their AUD.
Functional alcoholics represent a smaller percentage of alcoholics – roughly 19%.
This sub-type is typically older than the others. They are usually middle-aged, well-educated, gainfully employed at stable jobs, and appear to have a “normal” family/home life.
Around a third of alcoholics in this sub-type have a family history of problem drinking that goes back multiple generations. Additionally, 25% have a personal history of major depression. Half smoke cigarettes.
Intermediate familial alcoholics make up a fifth of American alcoholics – 19%.
This sub-type is typically made up of people who started drinking in their teens, but became alcoholics in their mid-30’s. 50% of the people within this sub-type have family histories with multi-generational alcoholism.
Approximately half meet the criteria for a clinical diagnosis of depression, while around one-fifth struggle with a bipolar disorder. Most intermediate familial alcoholics smoke cigarettes, and about 20% have abused cocaine or marijuana.
Only about one out of every four intermediate familial alcoholics have ever actively sought alcohol abuse treatment.
Accounting for only about 9% of American alcoholics, this is the smallest sub-type.
Chronic severe alcoholics demonstrate the role played by genetics and an early onset of drinking problems, and how other co-occurring mental/personality disorders and alcoholism can present simultaneously.
Most chronic severe alcoholics are middle-aged men with a personal history that includes an early onset of problem drinking. Four out of every five alcoholics within this sub-type come from families with multi-generational alcoholism.
Chronic severe alcoholics suffer from the highest rates of mental/psychiatric disorders, including Antisocial Personality Disorder (APD), depression, anxiety, and bipolar disorder. Among the alcoholic types, they also have the highest divorce rate.
A large percentage of chronic severe alcoholics smoke, and many also abuse marijuana, cocaine, and opiates.
This type of alcoholic is the most common sub-type found in alcohol rehab – approximately 67% seek professional help for their AUD.
Because alcoholism has been medically-labeled as a disease, being able to determine the precise manifestation and severity of that disease as it presents in a person gives addiction professionals an invaluable tool that can create more individualized and effective treatment plans.
Even more, when a person fully grasps the concept that they have a disease – instead of a moral weakness – a proper classification can help an alcoholic in recovery gain a better understanding of how their disease is affected by everything else.
- Family history (genetics)
- Other abused substances (contributing environment/personal history)
- Any diagnosed mental problems (co-occurring disorders)
These classifications are also helpful because they show the alcoholic that he or she is not alone– there have been others with the same disease who were able to recover their sobriety.
Classification can also convince the alcoholic to accept help via a professional treatment program, when they see that AUD treatment is practiced like any other branch of medicine.
Alcoholism Treatment Recommendations
For someone with any one of the different types of alcoholism, specific treatment guidelines should be followed. It will be necessary to go through a period of alcohol detox. This is done for the individual’s safety because of the dangerous nature of stopping alcohol abruptly. When someone stops drinking cold turkey, that person is at risk of delirium tremens, and other dangerous symptoms. Alcohol withdrawal can be life threatening, and detoxification can help to prevent it from becoming fatal.
Once alcohol detox is completed, alcohol rehab is recommended. It’s not enough to simply take care of the physical part of the addiction. In order for recovery to be successful, the psychological part needs to be treated as well. Most people find that staying at an inpatient alcohol rehab center is the best route. That way, they are able to get professional help and support around the clock.
Afterwards, ongoing treatment will be recommended. This may come in the form of outpatient alcohol rehab, AA meetings, or a combination of both.
Finding Alcohol Treatment Near You
You may be suffering from one of the types of alcoholism. It’s possible that you feel as though you’re stuck. You may feel like there’s no way for you to escape being an alcoholic. We want you to know that this simply is not true. Being an alcoholic may seem like a lifetime sentence to you. However, that doesn’t mean you need to continue on in active alcoholism. With the right treatment, you can begin the healing process and work toward your recovery.
NorthPoint Recovery specializes in alcohol detoxification and residential rehab. The program offered is evidence-based and wellness-focused, and attacks the disease of addiction on multiple levels. This approach gives people in recovery their best chance at a successful return to sobriety.
Here at NorthPoint Recovery, we want you to know that we care about you and your recovery. We want you to experience the sober life you long to live. We know that it’s possible, and we’re determined to help you throughout the process. It is possible for you to embrace sobriety, no matter what type of alcoholic you are.
Do you have questions about the different types of alcoholics, or about alcoholism recovery? If you do, please contact us so that we can assist you.