As long as alcohol has been brewed, some percentage of the population has ruined their lives over it. The archetype of the alcoholic, who goes mad for spirits, losing house and home for an unquenchable thirst, has existed for a long time.
In recent decades, new information has emerged suggesting that there are at least five clearly identifiable subtypes of alcoholics, expanding our collective image of the alcoholic to include the marginal zones that may guide the entry into full-bore alcoholism.
This lens comes from a joint national clinical study by the National Institute Of Health (NIH), the National Institute On Alcohol Abuse And Alcoholism (NIAAA), and the National Epidemiological Survey On Alcohol And Related Conditions (NESARC). After conducting a wide survey of existing material, researchers grouped their findings into five subtypes of alcoholics:
- Functional subtype
- Young adult subtype
- Young antisocial subtype
- Intermediate familial subtype
- Chronic severe subtype
The criteria for sorting alcoholics into subtypes were: current age, age of starting drinking, age of becoming dependent on alcohol, family history, and co-occurring mental health disorders.
These subtypes are meant to assist in further examination and exploration of the social phenomenon of alcoholism, rather than for diagnostic purposes. In this post, we here at Villa Kali Ma will take a closer look at these proposed subtypes, for the purposes of raising consciousness and sparking discussion.
Functional Subtype
The phrase “functional alcoholic” is popularly used to describe people who have alcohol dependence, but do not encounter severe outer world life consequences for it. This subtype is estimated to make up almost 20% of current alcoholics. The age of this group is, on average, early 40s, comprised of people who started drinking after the age of 18, and whose dependence on alcohol appears in their late 30s.
Although the functional alcoholic is believed not to have consequences of use, that’s not exactly true, as they usually suffer from moderate levels of depression. This type may smoke cigarettes, but most probably don’t use other drugs. More male than female (60% male, 40% female), members of this group are among the more likely of alcoholics to be married.
The functional subtype is least likely of all alcoholics to have legal issues, and most likely have higher levels of education and income. On the outside, people in this subtype appear to be fine and their alcoholism may be hard to detect and diagnose due to the lack of dramatic life consequences.
People in this subtype are less likely to reach out for help, but when they do they tend to go to 12 Step and/or with a private therapist or mental health provider.
Young Adult Subtype
The largest subtype is made up of young adults, representing about 30% of alcoholics. This group begins drinking alcohol at around the age of 19, with alcohol dependence manifesting in their early 20s.
This group has lower rates of co-occurring mental illness, are moderately likely to have addiction to substances other than alcohol too, and are moderately likely to have family members who are also addicted to alcohol.
This subtype is the most likely of all alcoholics to be in college, unlikely to be employed full-time, and unlikely to be married.
Although this subtype drinks less frequently, when they do drink, it is excessive. There are 2.5 times more men than women in this subtype, and they are unlikely to seek treatment. If they do seek treatment, they are most likely to go to 12-step.
The young antisocial subtype represents about 20% of alcoholics. This group starts drinking at the youngest age of all subtypes, at around the age of 15 and develops dependence at the earliest age (around age 18).
About 50% of this subtype would meet criteria for a co-occurring mental health diagnosis of antisocial personality disorder (linked to criminalized behaviors). This group also has high incidences of social phobia, obsessive-compulsive disorder, bipolar disorder, and depression. This group is also most likely to have addiction to other substances in addition to alcohol, including meth, cocaine, opioids, marijuana, and tobacco. This subtype is more than 75% male.
This group has the lowest levels of higher education, employment, and income. This group is the highest likely to seek out substance abuse treatment and to go to 12-step.
Intermediate Familial Subtype
The intermediate familial subtype, a little less than 20% of alcoholics, starts drinking around age 17, developing alcohol dependence by their early 30s.
This subgroup has a high likelihood of co-occurring mental illness, including bipolar disorder, anxiety disorder, depression, or antisocial personality. This group has high rates of co-occurring addiction to cigarettes, marijuana, and cocaine. This group is likely (but not the most likely) to have immediate family members with alcoholism.
This subtype is estimated to be 64% male, with higher education than some subtypes but not as high as the functional subtype. This subtype tends to be employed, more so than other subtypes but is also likely to earn less than the functional subtype.
This is not a subtype that is especially likely to seek treatment, but when people in this subtype do seek help, they go to 12-step, substance abuse treatment programs, including detox facilities, and to private health care.
Chronic Severe Subtype
The smallest percentage of alcoholics is represented by the chronic severe subtype, comprising around 10% of alcoholics. This subtype starts drinking at around age 15, becoming dependent around the age they turn 30. This group is most likely among subtypes to be addicted to a secondary substance like cocaine, opioids, marijuana, and cigarettes, alongside their alcohol dependence.
More than 75% of alcoholics in this group have close family members who are also alcoholics, making them the most likely of all subtypes to have alcoholism as a preexisting issue in the family.
Almost half of this subtype show symptoms and traits of antisocial personality disorder, second highest after the young antisocial subtype. This group is most likely of all subtypes to exhibit serious mental health problems, including major depression, bipolar disorder, generalized anxiety, social phobia, panic disorder, or dysthymia.
This group most closely resembles the known archetype of an alcoholic: 80-90% of people in this group are likely to make serious efforts to cut down, to experience withdrawals when they try to do so, to find it very difficult or impossible to stop drinking and to drink in spite of serious life consequences.
This group reduces their participation in activities due to their drinking, spends large amounts of time recovering from their alcohol use, and is most likely of all subtypes to have to go to the emergency room because of their drinking.
Rates of divorce and separation are highest amongst this subtype. Rates of education and employment are lowest. This group drinks most frequently of all subtypes, though their total intake is less than that of the young antisocial subtype.
More than 60% of this subtype have sought help for their alcoholism at least once, a rate of treatment-seeking which far exceeds any other subtype. When seeking treatment they go to 12-step, inpatient treatment (rehab), detox, and may also receive help from private physicians, psychiatrists, and social workers.
Villa Kali Ma’s Alcohol Addiction Treatment Program
The picture created by this research does not contradict what we see at Villa Kali Ma. We recognize these sub-archetypes as patterns overlaid on people we have known and loved, as well as people we have helped professionally.
We’ve worked with heartbreakingly vulnerable young women, coming to us from dangerous circumstances, who match the young antisocial description, all tough because they’ve had to be. We know these girls need healing, and a chance to be good.
We’ve also worked with college-age young women who want to stop their drinking because they don’t like how it feels to be losing their personal power to a substance. We see the light of their intelligence and help them have a chance to steer true and own themselves more fiercely.
We know well the secret pain of the functioning alcoholic, who seems ok on the outside but isn’t ok at all on the inside, where grief and anger simmer darkly. We know the searing family agony carried by the intermediate family subtype, who, whether they knew it or not, are here to get help not only for themselves but also for their kin.
Most of all we know the chronic severe cases, those tragic women meeting the wreckage that alcoholism eventually brings to all who don’t get out of its shadow in time.
If any of this resonates for you, or people you love, we want you to know that there are many, many success stories in every category. Gleaming, beautiful examples of unpredictably wonderful transformations, women who pulled themselves free, surrendered to a healing force and rose up stronger and brighter than anyone could have imagined.
Through hard work, yes, and the courage to give it all over, and through dedication that would impress a monk. But still, it is possible, and it is done, every day all over the world.
We also know this: no matter which subtype a woman might fall into, immediate intervention is the only known way to reduce the chance of greater heartache down the road.
If you are reading this blog for yourself, we encourage you to start your journey with that first step of reaching out and sharing out loud, that you know you have a problem.
Read more about how we help women, with our holistic alcohol treatment programs for women.
Villa Kali Ma can help women heal from alcoholism
At Villa Kali Ma, we specialize in healing women who are struggling with addiction.
We also treat mental illness and offer programs for addressing traumatization, one of the biggest causes of addiction in the first place.
Our signature approach to healing alcoholism, mental illness, and trauma is to blend evidence-based clinical approaches from the Western treatment model with ancient healing practices and modalities derived from yoga, Ayurveda, alternative medicine, and more.
Reach out to start a conversation about how we might help you find your path back to wholeness. Whether you relate to any of the subtypes of alcoholics described above, or none at all, we’re here to listen to what it’s like to be you.
