Dispelling the myth of the typical alcoholic, researchers have identified five subtypes of alcoholics from a study of 1,484 people who met diagnostic criteria for alcohol dependence. The surprising finding of the study is that young adults with no family history of alcoholism make up the largest group of alcoholics, while the chronic severe alcohoics are the smallest group.

The study found that the largest group of alcoholics in the U.S. are young adults. Twenty percent are highly functional and more than half do not have a family history of alcoholism. The study was conducted by Howard B. Moss, M.D., NIAAA associate director for clinical and translational research, and a team of researchers. The study drew from responses to the National Epidemiological Survey on Alcohol and Related Conditions, a representative epidemiological study of alcohol, drug, and mental disorders in the United States.

Types of Alcoholics

The NIAAA researchers defined five subtypes of alcoholics by the following specific characteristics. They also listed the percentage of each type that composes the total number of U.S. alcoholics:

Young Adult Alcoholics

• 31.5 percent.
• Young adult drinkers, with relatively low rates of co-occurring substance abuse and mental disorders.
• Low rates of family alcoholism.
• Rarely seek any kind of help for their drinking.

Young Antisocial Alcoholics

• 21 percent.
• Most are in their mid-20s and had early onset of regular drinking and early onset alcohol problems.
• More than half come from families with alcoholism, and about half have a psychiatric diagnosis of antisocial personality disorder.
• Many have major depression, bipolar disorder, and anxiety problems.
• More than 75 percent smoke cigarettes and marijuana, and many also have cocaine and opiate addictions.
• More than one-third seek help for their drinking.

Functional Alcoholics

• 19.5 percent.
• Typically middle-aged, well-educated, with stable jobs and families.
• About one-third have a multigenerational family history of alcoholism.
• One-quarter had major depressive illness at some time in their lives.
• Nearly 50 percent are smokers.

Intermediate Familial Alcoholics

• 19 percent.
• Middle-aged with about half from families with multigenerational alcoholism.
• Almost half have had clinical depression, and 20 percent have had bipolar disorder.
• Most smoke cigarettes, and nearly one in five report cocaine and marijuana use.
• About 25 percent ever seek treatment for their problem drinking.

Chronic Severe Alcoholics

• 9 percent.
• Mostly middle-aged individuals who had early onset of drinking and alcohol problems.
• High rates of antisocial personality disorder and criminality.
• Almost 80 percent come from families with multigenerational alcoholism.
• They have the highest rates of other psychiatric disorders including depression, bipolar disorder, and anxiety disorders.
• This group has high rates of smoking, and marijuana, cocaine, and opiate dependence.
• Two-thirds seek help for their drinking problems, making them the most prevalent type of alcoholic in treatment.

Previous studies which tried to identify alcoholism subtypes were conducted with people who were in treatment for their alcoholism. Therefore, a large percentage of alcoholics were left out of those studies, because only about one-fourth of alcoholics ever seek treatment.