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The 5 Subtypes of Alcohol Dependence

A 2007 study by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Health (NIH), and the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) analyzed data from a national survey and found that people who struggle with alcohol dependence fall into 5 different clusters or alcohol “subtypes.”1

Alcohol dependence can develop when the body and brain adapt to repeated alcohol exposure and can only function in the presence of alcohol.2 Researchers determined the 5 subtypes of alcohol dependence by looking at several factors, including family history, the age a person developed dependence, and the presence of co-occurring disorders.1

The Five Alcohol Subtypes

According to the study, the five different alcohol subtypes include:

  • Young Adult Subtype
  • Young Antisocial Subtype
  • Functional Subtype
  • Intermediate Familial Subtype
  • Chronic Severe Subtype

The 5 subtypes are intended to further our understanding of alcohol dependence. They are not intended to be used to diagnose whether a person has an alcohol use disorder (AUD). If you think that you or someone you care about may have a problem with alcohol, it’s best to speak with your primary care physician or another medical professional. You can also call our alcohol helpline at to learn more about addiction and treatment.

1. Young Adult Subtype

Researchers found that the young adult subtype is the most common subtype of alcohol addiction, with 31.5% falling into this category and an average age of 24.5 years old. The young adult cluster is relatively young when they develop alcohol dependence, at an average age of 19.6 years old, and they have lower probabilities of co-existing mental health concerns or legal problems.1

Males are far more common in the young adult subtype, and around 75% of this group have never married. While they drink alcohol less often than other clusters, they do drink more at a time—73% of their drinking days are 5 or more drinks. Alcohol addiction in young adults and binge drinking can be dangerous, but only 8.7% of this group have ever sought help for dependence.1

2. Young Antisocial Subtype

The young antisocial subtype includes 21.1% of the study’s respondents and is relatively young, with an average age of 26.4 years old. This subtype of alcohol use disorder has the earliest age of first drinking, at 15.5 years old, and the earliest age of alcohol dependence, at 18.4 years old on average.1

There are more antisocial behaviors and a higher level of mental health diagnoses in this group, including major depression, bipolar disorder, social phobia, and obsessive-compulsive disorder.1 This cluster also has the highest probability of using other substances, including regularly smoking (77%), cannabis dependence (66%), cocaine use disorder (29%), and opioid use disorder (22%).1

This AUD subtype includes more males (76%) than females (24%), and they average 201 drinking days in the last 12 months, consuming 5 or more drinks on 80% of those drinking days. Around 35% of this group reports seeking treatment.1

3. Functional Subtype

The functional subtype included 19.4% of those in the study. The average age they started drinking was 18.5 years old, and the average age of alcohol dependence was 37 years old.1

This cluster has a moderate likelihood of major depression (24%) and being regular smokers (43%), but a low likelihood of using other substances or having legal problems. The functional subtype had 60% men and 40% women; almost half were married, and 62% worked full-time. This group reported 181 drinking days per year and have 5 or more drinks on 54% of these days. Of these “functional alcoholics,” as they have been called, 17% had sought help and tended to seek help through 12-step programs or private doctors.1

4. Intermediate Familial Subtype

The intermediate familial subtype was characterized by an older average age at the time of the study (38 years old).1 This group is more likely (47% of respondents) to have first or second-degree family members with alcohol dependence.1

This cluster has a higher likelihood of struggling with smoking cigarettes, mental health diagnoses, and cannabis and/or cocaine use disorder.1 Men make up 64% of this group, and women 36%.1

This alcohol subtype reported drinking 172 days in the last year and consumed 5 or more drinks on 54% of those days. Almost 27% have sought help for drinking, and they tend to go to self-help groups, specialty programs, and private healthcare providers.1

5. Chronic Severe Subtype

The chronic severe subtype represented only 9.2% of those in the study. The average age of respondents was 37.8 years old, and they started drinking at an average age of 15.9 years old, with alcohol dependence setting in at around age 29.1

This group exceeds all other clusters in the likelihood of first and second-degree family members with alcohol dependence, the likelihood of major mental health diagnoses, and the prevalence of cannabis and/or cocaine use disorder.1

This subtype of AUD was 65% men and 35% women and reported drinking 247.5 days in the last year, with 69% of days being 5 or more drinks. This group also is the most likely to seek help (66%) and may look for self-help groups, rehab programs, and inpatient treatment.1

Getting Help for Yourself or Someone You Care About

If you or someone you care about are struggling with alcohol misuse or addiction, you don’t have to go through it alone. Addiction is treatable and there are several evidence-based treatment approaches available for alcohol use disorder.3 Alcohol addiction treatment can help break the cycle of addiction. You can take the first step by calling American Addiction Centers (AAC) or using our rehab directory to find help near you today.

 

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