Investigation Identifies Five Subtypes of Alcoholic
> 7/3/2007 4:17:37 PM

There are thousands of AA groups in America, all focused on treating "the alcoholic." If there is only one type of alcohol addiction, then there can exist one method best suited for helping all addicts. However, clinical evidence and experiences over time have proven that not all forms of alcohol abuse are alike. There have been a number of attempts to identify distinct subtypes, but these were primarily done by examining populations that had already come in for treatment.

A new study, led by Dr. Howard Moss from the National Institute on Alcohol Abuse and Alcoholism, looked not at those self-selected few who came for official treatment, but rather at results from the more general National Epidemiological Survey on Alcohol and Related Conditions. Dr. Moss sifted through the 1,484 respondents who met diagnostic criteria for alcohol dependence and tried to determine if there are any lines that divide meaningfully different categories. He found that the distribution of behaviors and backgrounds can be sorted into five subtypes.

Here is an outline of each subtype, from most prevalent to least:

Young Adult (31.5%): The plurality of alcohol addicts are young drinkers without a family history of alcoholism or coeval drug addictions. This should help undermine the myth that most drinkers are formed through the genes or behavior of alcoholic relatives. Because young drinkers rarely seek treatment, they make up an inordinately large portion of those left out of previous studies questioning only those working on their problem.

Young Antisocial (21%): Those around their mid-twenties who have a variety of other abuse problems as well as symptoms of Antisocial Personality Disorder. More than half from this group had alcohol problems in their families and many suffered additional mental illnesses like anxiety and depression.

Functional Subtype (19.5%): This group subverts the stereotype of the alcoholic failure unable to cope with life because of addiction. The subtype is generally well-educated, and manages to maintain successful professional and familial relationships. 1/4 have experienced serious depression, 1/3 have a family history, and 1/2 smoke cigarettes. Their addiction is often hard to detect, and they have less motivation to seek treatment than those faced with clear external evidence of alcohol's detrimental effects.

Intermediate Familial (19%): Equivalent in number to the functional subtype, this group has a far higher prevalence of complicating disorders and family history. 1/2 have depression and family alcoholism, but only 1/4 seek treatment.

Chronic Severe (9%): The most crippling but also least prevalent subtype. Members have an extremely high rate of mental illness and additional addictions. 4/5 had family members with alcoholism. A full 2/3 seek help, ensuring that a survey of treatment centers would bias the image of the alcoholic towards the extreme outliers.

If these adroitly constructed subtypes cannot encompass all alcoholics, the categories still point to the larger issue of how alcohol dependence can take on many shapes and forms. These subtypes can then serve as helpful tools in the discussion about addressing alcohol abuse. They allow us to appreciate the many varieties of addiction while understanding that there are some commonalities that can be used to form general, yet effective treatment strategies.

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