The 17 Types of Alcoholism

There are many types of alcoholism that are defined by a large number of qualifying criteria. Here we'll show you what they are.
The 17 Types of Alcoholism
Samuel Antonio Sánchez Amador

Written and verified by el biólogo Samuel Antonio Sánchez Amador.

Last update: 15 July, 2023

Although it seems isolated and chronic, alcoholism is established in practically all societies. As indicated by the World Health Organization (WHO), each year, there are more than 3 million deaths due to the harmful use of this substance. Different types of alcoholism cause more than 200 different diseases and disorders, and 5.1% of the global disease burden is due to them.

In countries like the United States, more than 20 million people over 15 years of age have some type of substance use disorder, of which 15.7 million are alcoholics. The use of this drink is legal for those of legal age and its responsible consumption is possible, but it’s necessary to know the effects derived from its abuse to prevent long-term diseases.

What is alcoholism?

Before exploring the 17 types of alcoholism according to professional criteria, we find it interesting to define the term on its own. The Dictionary of the American Psychological Association (APA) defines alcoholism as “a syndrome of compulsive and dependent alcohol use.” The effects derived from excessive intake of this substance are both physical and psychological.

Alcoholism causes multi-organ damage, although it mainly affects the liver, brain, and pancreas. Cirrhosis of the liver (pathological scarring of the liver) is the most well-known secondary condition, but there are many more. For example, alcoholic hepatic encephalopathy (loss of brain function) occurs when toxins accumulate in the body from the abuse of this substance.

The appearance of this disorder is difficult to explain, however, it’s believed that the environment and genetics play an equally relevant role in its development (50-50%). Stress, other psychological problems (chronic anxiety, depression, and more), social isolation, and many disparate factors encourage human beings to experience alcoholism at some point in their life.

Diagnostic criteria

Being an alcoholic isn’t always equivalent to drinking a lot. From time to time, the APA (already named) publishes its Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the main reference for the diagnosis of disorders. The criteria in this manual, together with those postulated by the International Classification of Diseases, define alcoholism as a disease.

The DSM-5, published in 2013, cites the following symptoms as indicative of alcoholism:

  1. The patient consumes alcohol for a longer period than they intended.
  2. There’s an insistent desire to use the substance or futile attempts to quit.
  3. A significant percentage of the patient’s time is spent drinking, getting alcohol, and recovering from its effects.
  4. A very strong need or desire to drink.
  5. The use of alcohol leads to difficulties at school, work, or home (or a combination of all).
  6. Recurrent alcohol use despite persistent or recurrent psychosocial problems resulting from it.
  7. Social, recreational, and occupational activities are relegated or reduced due to substance abuse.
  8. The use of alcohol leads to delicate health situations.
  9. Alcohol use is continued even though the patient knows that they have a persistent or recurring physical or psychological problem that’s likely caused or aggravated by alcohol.
  10. Tolerance: Defined by 2 points. First, the need to drink more and more to achieve intoxication and, second, a diminished effect when using the same amounts of alcohol.
  11. Dependence or withdrawal: The patient feels a series of physical signs if they stop drinking and use alcohol (or other substances) in order to avoid them.

These symptoms are clear and obvious, but not all alcoholics suffer from the disorder (or show it) in the same way. Therefore, patients have been classified into different types of alcoholism in order to represent their disease in a more individualized way.

The 17 types of alcoholism

There are many types of alcoholic people according to the criteria used. Therefore, we’ll present them separately based on various ideas and theories. Keep reading!

1. Types of alcoholism based on DSM-5

Types of alcoholism are helpful for psychiatrists.
The classifications of alcoholism serve so that health professionals can propose the most effective treatments depending on each case.

We refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to show you the first types of alcoholism, which are based on the presence or absence of the 11 symptoms already mentioned:

  1. Mild alcoholism: The patient has 2 to 3 symptoms of those mentioned.
  2. Moderate: 4-5 symptoms are present.
  3. Severe: 6 or more symptoms are present.

Despite this classification, it should be noted that tolerance and dependence are the most important factors when diagnosing a person with alcoholism. As long as these 2 symptoms are present, the diagnosis can be confirmed.

2. Types of alcoholism according to the addiction center

The Addiction Center presents us with a classification criterion that distinguishes 5 different types of alcoholism. These are defined according to the age of the patient, the moment in which they began to drink, the age at which the addiction developed, family history, the presence or absence of other disorders, and possible concomitant addictions. We’ll look at them separately in the following lines.

2.1 Young-adult subtype

It’s estimated that 31.5% of alcoholic patients fall into this category. Therefore, it’s the largest and most crucial group of all from a clinical point of view. People who are included in this pathological variant begin to drink early (before the age of 19) and also develop dependence at a very early stage (approximately 24 years of age).

Most of the representatives of this group have low rates of comorbidity with other mental disorders and their risk of presenting other addictions and a family history of alcoholism is moderate. They’re usually university students, single, and with a tendency to drink excessively in isolated episodes (but not constantly).

2.2 Functional subtype

This variant represents approximately 19.5% of alcoholics. Its members are middle-aged people (41 years on average), and they start to drink somewhat later than the previous group and develop dependence in a later life stage (about 37 years). They’re somewhat more prone to depression, but not other concurrent disorders.

The term functional is key. About half of the people in this group are married and report the highest levels of education and monetary income of all variants. In addition, they’re unlikely to have legal problems derived from their addiction. Although they appear to have a “normal” life, they still depend on alcohol to function.

Most people in this group don’t ask for help, as they don’t feel they need it.

2.3 Intermediate-familial subtype

The patients included in this group represent 18.8% of the total. They tend to start drinking early (17 years) and develop dependency earlier than the functional group but after young adults (32 years on average). As their general denominative indicates, they tend to have a family history of alcoholism. In addition, they’re also prone to one or more comorbidities.

At the same time, it should be noted that people belonging to this group abuse alcohol, but sometimes also marijuana, cocaine, and tobacco. They have an intermediate degree of education between that of functional and young-adult alcoholics and are the ones who are most likely to have a full-time job. Despite this, they tend to earn slightly less money than functional alcoholics.

It’s not a group very inclined to ask for professional help.

2.4 Young-antisocial subtype

These patients represent 21.1% of the alcoholic population. They start drinking before everyone else (about 15 years) and develop an addiction at the earliest possible stage (18 years). As the name itself suggests, about half of these people have antisocial tendencies, in addition to depression, social phobia, bipolar disorders, and other mental problems.

The youth-antisocial subtype is the one that most mixes alcohol with other drugs, such as tobacco, marijuana, methamphetamine, and opioids (including heroin). In addition, they report the lowest level of education, employability, and money. Due to their delicate situation, people in this category are more likely to ask for help than the rest.

2.5 Chronic-severe subtype

We come to the last of the types of alcoholism according to the classification proposed. The chronic-severe subtype is the least common of all and represents only 9.2% of patients with this addiction. They begin to drink early (15 years), although they don’t develop addiction until well into their life trajectory (29 years).

The vast majority of these people (more than 70%) have relatives with alcoholism and almost half have antisocial tendencies, only surpassed in this area by the young-antisocial variant. On the other hand, it represents the group most likely to suffer from depression, anxiety, panic disorders, and bipolarity.

People with chronic-severe alcoholism have a very low level of education, very little money, and a critical employment situation. They divorce in almost all cases and drink more than any other group in terms of assiduity but in smaller amounts than in other variants. It’s the most obvious degree of alcoholism and, therefore, the most serious.

3. Types of alcoholism according to the theory of EM Jellinek (part one)

In 1941, psychiatrist Karl Bowman and biometrist EM Jellinek published a paper that went into detail when describing the mechanisms and treatments of this disorder. This first publication recognized the following types of alcoholism, as indicated by Alcohol Health and Research World:

  1. Primary or true alcoholics: Representatives of this group are characterized by their immediate taste for the effects of alcohol, the rapid development of an uncontrollable need for this substance, and their inability to abstain.
  2. Constant endogenous symptomatic alcoholics: In this case, it’s suggested that alcoholism is derived from other underlying psychiatric problems. Schizophrenia and schizotypal disorders are the most common triggers in this group.
  3. Intermittent endogenous symptomatic drinkers: These are patients similar to those of the previous group, but in this case, they drink during intermittent and periodic cycles. People with manic-depressive tendencies fall into this category.
  4. Stammtisch drinkers: Those patients who develop alcoholism from exogenous causes. This category is perfectly exemplified by people who drink in order to improve their social skills.

This categorization is somewhat more rudimentary than those shown in previous lines, but you must bear in mind that it laid the foundations for many of the applications we manage today. In addition, it gave way to another somewhat more useful criterion that’s still used today, which we’ll see below.

4. Types of alcoholism according to the theory of EM Jellinek (part 2)

Despite its usefulness, the first EM Jellinek classification received very little attention from the scientific and psychiatric community. For this reason, in the sixties, this author set out to perfect it with his writing of The Disease Concept of Alcoholism. We’ll show you the types of alcoholism that he suggested in this work (which are still used today).

4.1 ALPHA Alcoholic

This type of alcoholic represents the earliest stage of the disorder and manifests a purely psychological continuous dependence on the effects of alcohol to alleviate bodily or emotional pain. There’s no withdrawal syndrome and the consumer maintains control over the consumption of the substance but doesn’t stop abusing it, as they report well-being in some sense.

  • Psychological vulnerability: High
  • Physiological vulnerability: Low
  • Sociocultural influences: Low-moderate
  • Economic influences: Low-moderate

4.2 BETA alcoholic

The types of alcoholism according to their effect on health.
When alcoholism persists long enough, the liver may begin to undergo irreversible changes leading to cirrhosis.

This represents a regular heavy drinker, but still without physiological or physical dependence. These patients do begin to perceive organic problems, such as polyneuropathy or liver cirrhosis. Although they don’t appear to have a “psychiatric illness”, they drink practically every day.

  • Psychological vulnerability: Low
  • Physiological vulnerability: Low
  • Sociocultural influences: Low-moderate
  • Economic influences: Low-moderate

4.3 GAMMA alcoholic

This category is the first to involve tolerance, dependency, and loss of self-control. Individuals are clearly “hooked” on a physical level, but also on a psychological level (and of great importance). These are alcoholics who are already ill in every sense.

  • Psychological vulnerability: High
  • Physiological vulnerability: High
  • Sociocultural influences: Low-moderate
  • Economic influences: Low-moderate

4.4 DELTA alcoholic

This is a slowly progressive profile that’s very similar to GAMMA. Unlike the latter, these individuals have a marked inability to give up alcohol, although they have a lower burden of loss of control.

  • Psychological vulnerability: Low
  • Physical vulnerability: High
  • Sociocultural influences: High
  • Economic influences: High

4.5 EPSILON alcoholic

Finally, we come to the last of the types of alcoholism according to this classification. It’s the final stage of the disease and it appears with dipsomania, a term that has been used historically to refer to alcohol abuse disorder of a periodic nature. According to EM Jellinek, it’s the most serious stage.

Types of alcoholism and their effects

Alcoholism may sound like something distant and pathological, but it should be noted that 5.1% of the world population over 15 years of age (about 380 million people) have some type of disorder derived from the abuse of this substance. The statistics don’t end here, as it’s estimated that up to 8.8 out of every 100 000 inhabitants of some European countries (Estonia) die from alcohol consumption.

These data are shocking, but they’re necessary to establish a critical conclusion: It’s very likely that every reader knows an alcoholic in their life or suffers from this addiction in their own flesh. It’s not something to be ashamed of, but be aware that this problem requires treatment and clinical management just like any other disease.

If you have seen yourself reflected in any of these lines, we recommend that you call the Addiction Prevention Service in your country or go to the nearest trained center. It’s possible to combat alcoholism, but it requires external help and both physical and psychological therapy. It’s never too late to regain control of life.

Este texto se ofrece únicamente con propósitos informativos y no reemplaza la consulta con un profesional. Ante dudas, consulta a tu especialista.