Are There Different Types of Alcoholics?

The disease of alcoholism, officially diagnosed as an alcohol use disorder, can manifest differently from person to person. Some alcoholics may be able to hide their drinking fairly well and appear to be on the ball at work and at home. Others may experience some of the more devastating potential consequences of compulsive drinking such as serious medical problems, a decline in job performance or job loss, and ruined relationships. In short, alcohol addiction and the course of the disease depends on a large variety of factors.

This spectrum of addiction might make it more challenging to group people into even theoretical categories, though for diagnostic and other purposes, researchers and treatment professionals may try.

Studies can definitely identify trends among people of similar age subsets, family history of alcoholism, other concurrent substance abuse and/or psychiatric disorders, and socioeconomic status, while texts like the Diagnostic and Statistical Manual of Mental Disorders provide criteria for identifying different levels of severity of problem drinking to help guide a treatment path.

Read on to learn more about:

  • How clinical and medical professionals define alcohol use disorder.
  • Some different theoretical subclassifications of alcohol addiction.
  • How some identify different subtypes of alcoholics.
  • Treatment options for those with an alcohol use disorder.

What is an Alcohol Use Disorder?

About 14 million adults 18 and older were diagnosed with an alcohol use disorder in 2019.1 But what is an alcohol use disorder (AUD)? It’s a condition characterized by a person’s inability to control their alcohol use, even if they are suffering from consequences in their relationships, work, or health because of it.2

AUDs are thought to develop in association with certain brain changes that result from chronic alcohol misuse. These changes help explain why AUDs are persistent conditions and why people with AUD are vulnerable to relapse.2

Previous versions of the Diagnostic and Statistical Manual of Mental Disorders, the comprehensive diagnostic handbook used by treatment professionals to diagnose mental health issues for mental health disorders, outlined two distinct alcohol disorder diagnoses: alcohol abuse and alcohol dependence.3

The most recent version, the DSM-5, defines alcohol use disorder as one condition with subclassifications of severity based on the number of symptoms a person exhibits.3

Symptoms of Alcohol Addiction

There are 11 criteria that treatment professionals use to diagnose an alcohol use disorder. These are:4

Subcategories of Alcohol Use Disorder

A medical or clinical professional may diagnose a person with an alcohol use disorder if they meet any 2 of the above criteria within a single year.4

A mild alcohol use disorder is when a person displays 2 to 3 symptoms within a 12-month period. A moderate AUD diagnosis is made when 4 to 5 of the criteria from the DSM are met. When a person meets 6 or more symptoms, they are considered to have a severe alcohol use disorder.4

Subtypes of Alcoholics

Published in the journal Drug and Alcohol Dependence, a  2007 National Institutes of Health study on epidemiologic survey data identified 5 different subtypes of alcoholism. This breakdown brought into focus a more diverse sample pool of people suffering from alcohol abuse than before, as previous studies largely focused on people who had been hospitalized for or received treatment for their alcoholism. At the time of the study, roughly only one quarter of people with alcoholism had ever undergone treatment for it.5

Unlike the DSM subcategories, which are used to denote levels of AUD severity based on the number of met diagnostic criteria, these 5 subtypes provide a fuller, more diverse picture of who is abusing alcohol in the United States. The different subtypes include:6

Treatment for Alcohol Use Disorder

The good news is that treatment for functioning alcoholism or chronic alcoholism, or any subclassification of alcohol use disorder, can lead to long-term sobriety and recovery. Medically-supervised withdrawal, evidence-based treatment, behavioral therapy, support groups, and plans for life after treatment can all aid a person who is looking to recover from alcohol addiction.

 

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