Types of Alcoholics

Explore the diverse faces of alcoholism, from young adults to functional types. Understand the characteristics and treatment options for different alcoholics.

July 3, 2024

Understanding Alcohol Use Disorder

Alcohol Use Disorder (AUD) is a chronic condition characterized by the compulsive and excessive use of alcohol, despite the negative consequences it has on an individual's life. It is important to recognize and understand the different aspects of AUD in order to provide appropriate treatment and support for those affected.

Definition and Severity Levels

Alcoholism, or AUD, is one of the most prevalent forms of addiction in the United States. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), approximately 6% of American adults suffer from AUD, but only about 10% of those individuals seek professional treatment [1].

To diagnose AUD, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides a set of criteria which includes various symptoms associated with problematic alcohol use. The presence of at least 2 of these symptoms indicates the presence of AUD. The severity of AUD is classified into three levels: Mild (2-3 symptoms), Moderate (4-5 symptoms), and Severe (6 or more symptoms).

Diagnosis and Criteria

The DSM-5 criteria for AUD include both physical and behavioral symptoms. Some of the symptoms include:

  • Wanting to cut down or stop drinking but being unable to do so.
  • Spending a significant amount of time obtaining, using, or recovering from alcohol.
  • Cravings or a strong desire to drink.
  • Continued alcohol use despite it causing or contributing to social or interpersonal problems.
  • Giving up or reducing important activities or hobbies due to alcohol use.
  • Drinking in situations that are physically hazardous.
  • Developing tolerance and needing more alcohol to achieve the desired effect.
  • Experiencing withdrawal symptoms when alcohol use is stopped or reduced.

The DSM-5 introduced a new criterion, which asks whether a person has had a strong desire or urge to drink that they couldn't think of anything else. This addition reflects the compulsive nature of AUD and helps to identify individuals who may be struggling with the disorder.

Understanding the severity of AUD and accurately diagnosing it is crucial for developing effective treatment plans tailored to the individual. By identifying the specific symptoms and severity of the disorder, healthcare professionals can provide the necessary support and interventions to help individuals on their journey to recovery.

Types of Alcoholics

Alcoholism is a complex disorder that can manifest in various ways. Researchers have identified different subtypes of alcoholics based on factors such as family history, age of onset, symptom patterns, and co-occurring disorders. Understanding these subtypes can provide insights into the diverse nature of alcohol use disorder.

Young Adult Subtype

The Young Adult subtype accounts for approximately 31.5% of alcoholics in the United States. Individuals in this subtype are typically young adults who display low rates of co-occurring substance abuse and have a low family history of alcoholism. They often exhibit rare help-seeking behavior for their drinking issues.

Young Antisocial Subtype

The Young Antisocial subtype comprises around 21% of alcoholics in the United States. People in this subtype are usually in their mid-twenties and have an early onset of drinking. They have a higher rate of family history of alcoholism and are more likely to experience comorbid psychiatric conditions such as Antisocial Personality Disorder, major depression, bipolar disorder, and anxiety problems.

Functional Subtype

The Functional subtype represents approximately 19.5% of alcoholics in the United States. Individuals in this subtype are typically middle-aged, well-educated, and have stable jobs and families. One-third of them have a multigenerational family history of alcoholism. Despite their seemingly functional lives, they still struggle with alcohol use disorder.

It's important to note that these subtypes are not exhaustive and that there are other subtypes, such as Intermediate Familial and Chronic Severe, identified in the research conducted by the National Institutes of Health. These subtypes highlight the heterogeneity and complexity of alcoholism, emphasizing that it can affect individuals from various backgrounds and age groups.

Understanding the different subtypes of alcoholics can help in tailoring treatment approaches and interventions to address the specific needs and challenges faced by individuals within each subtype. It is crucial to recognize that each person's journey with alcohol use disorder is unique, and a personalized approach to treatment can greatly contribute to their recovery.

Characteristics of Alcoholics

Understanding the characteristics of alcoholics is crucial in recognizing and addressing alcohol use disorder. While individuals with alcohol addiction can exhibit a range of behaviors, there are some common traits that often emerge. This section will explore three prevalent characteristics: prioritizing alcohol, placing blame, and making excuses.

Prioritizing Alcohol

One of the key characteristics of an alcoholic is the prioritization of alcohol in their life. Individuals with a physical dependency on alcohol may demonstrate this by:

  • Choosing to skip events or social gatherings that do not involve alcohol.
  • Showing signs of irritability or restlessness when access to alcohol is delayed or restricted.
  • Displaying eagerness or anxiety to start drinking when going out or in social situations.

These behaviors highlight the strong hold that alcohol has on their thoughts and actions. Prioritizing alcohol above other aspects of life can have significant negative impacts on relationships, work, and overall well-being. It's important to recognize these signs and encourage individuals to seek help and support.

Placing Blame

Another common characteristic among alcoholics is the tendency to place blame on others for their drinking habits. Individuals with alcohol addiction may attribute their unhealthy behavior to external factors and may blame:

  • Coworkers, housemates, partners, or relatives for their inability to control their drinking.
  • Difficult aspects of their life, such as stress, relationship issues, or work-related problems.

By shifting responsibility onto others, alcoholics may avoid confronting their own behaviors and the consequences of their addiction. Recognizing this characteristic can be an important step in encouraging individuals to take ownership of their actions and seek professional help.

Making Excuses

Making frequent excuses to justify excessive drinking is another characteristic commonly observed among alcoholics. Individuals may provide various reasons to rationalize their drinking habits, such as:

  • A long and stressful week at work.
  • Relationship difficulties or personal problems.
  • Celebratory occasions or social events.

These excuses allow individuals to continue their excessive alcohol consumption without confronting the underlying issues driving their addiction. It's crucial to understand that these excuses are often a way for alcoholics to maintain their drinking habits and avoid facing the reality of their addiction.

Recognizing these characteristics can help individuals with alcohol addiction and those around them to understand the severity of the problem. It's essential to approach the situation with empathy and encourage individuals to seek professional support and treatment. Alcohol use disorder is a complex issue that requires comprehensive treatment and support to achieve recovery.

Impulsivity and Alcoholism

Impulsivity plays a significant role in alcohol use disorder (AUD) and is often associated with increased alcohol involvement and related problems. Understanding the relationship between impulsivity and alcoholism can provide insights into the development and treatment of AUD. This section explores the Five-Factor Traits and various theoretical models that shed light on this connection.

Five-Factor Traits

Research has shown that traits related to impulsivity and disinhibition demonstrate a robust and consistent relationship with alcohol involvement. However, all Five-Factor Traits, which include openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism, have been found to correspond to alcohol use and outcomes to varying degrees of consistency.

While impulsivity is often highlighted as a key trait associated with alcoholism, other personality dimensions, such as high levels of neuroticism and low levels of conscientiousness, can also contribute to problematic alcohol use. It is important to recognize that individuals with AUD may exhibit a variety of personality profiles, and the interaction between different traits can influence alcohol-related behaviors.

Theoretical Models

Numerous theoretical models have been posited to explain the causal effects of personality on alcohol use and related problems. These models aim to understand the underlying mechanisms that contribute to the relationship between impulsivity and alcoholism. Here are a few notable theoretical models:

  1. Deviance Proneness Model: This model suggests that problematic alcohol use is part of a broader pattern of deviant behaviors resulting from deficient socialization and genetic vulnerability. It proposes that deficits in socialization and genetic factors contribute to a range of problematic outcomes, including AUD.
  2. Genetic Diathesis Model: According to this model, the genetic correlation between personality traits and AUDs is mediated by genetic variance in behavioral undercontrol. This indicates that common genetic factors contribute to impulsive personality configurations and AUDs.
  3. Pharmacological Vulnerability Model: This model suggests that individuals have differential responses to the effects of alcohol. Some individuals may be more or less sensitive to the positive or negative reinforcement or the punishing effects of alcohol. The model emphasizes the role of individual differences in sensitivity to alcohol's effects in the development of AUD.

These theoretical models provide frameworks for understanding the complex interplay between personality traits and alcohol use. They help researchers and clinicians explore the underlying factors contributing to impulsivity and alcoholism, ultimately aiding in the development of targeted interventions and treatments.

By examining the Five-Factor Traits and theoretical models, researchers and practitioners can gain a deeper understanding of the relationship between impulsivity and alcoholism. This knowledge can inform prevention efforts, treatment approaches, and interventions that address the unique needs of individuals with AUD.

Treatment for Alcohol Use Disorder

When it comes to addressing alcohol use disorder (AUD), there are various treatment options available. These approaches aim to assist individuals in reducing or stopping their alcohol consumption and preventing relapse. The key treatment modalities for AUD include behavioral treatments, medications, and peer support through 12-step programs.

Behavioral Treatments

Behavioral treatments for AUD are designed to modify drinking behavior through counseling. These treatments are led by health professionals and have been supported by studies showing their effectiveness. Behavioral treatments may include:

  • Cognitive-behavioral therapy (CBT): This approach helps individuals identify and change their thoughts and behaviors related to alcohol use. It aims to develop coping strategies, enhance motivation, and prevent relapse.
  • Motivational enhancement therapy (MET): MET is a goal-oriented counseling approach that seeks to increase an individual's motivation to change their drinking behavior. It involves personalized feedback and guidance to enhance intrinsic motivation.
  • Contingency management: This approach provides incentives to reinforce positive behaviors, such as abstaining from alcohol or attending treatment sessions. It can be effective in promoting abstinence and adherence to treatment plans.

Behavioral treatments are often tailored to the individual's specific needs and can be delivered in individual or group settings.

Medications

Medications can be an integral part of the treatment plan for AUD. There are three medications currently approved in the United States to help people stop or reduce their drinking and prevent relapse. These medications are prescribed by healthcare professionals and may be used alone or in combination with counseling. The approved medications for AUD include:

  • Naltrexone: This medication helps reduce alcohol cravings and blocks the pleasurable effects of alcohol, making it less appealing.
  • Acamprosate: Acamprosate helps individuals maintain abstinence by reducing withdrawal symptoms and alcohol cravings.
  • Disulfiram: Disulfiram creates an unpleasant reaction when alcohol is consumed, acting as a deterrent to drinking.

These medications should be prescribed by a primary care physician or other healthcare professional experienced in treating AUD.

Peer Support and 12-Step Programs

Peer support and 12-step programs, such as Alcoholics Anonymous (AA), can provide valuable additional support for individuals seeking to quit or reduce their drinking. These programs offer a sense of community, understanding, and shared experiences with others who have faced similar challenges. When combined with treatment led by health professionals, mutual-support groups can be a crucial component of a comprehensive treatment plan [5].

Alcoholics Anonymous follows a 12-step approach that emphasizes personal responsibility, self-reflection, and support from peers who have achieved or are seeking sobriety. Other similar programs may also exist in local communities.

It's important to note that treatment for AUD should be personalized to the individual's needs and circumstances. A combination of behavioral treatments, medications, and peer support can provide a comprehensive and effective approach to help individuals overcome alcohol use disorder and achieve a healthier, alcohol-free life.

References

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