Theo Nash
Alcohol consumption is a prevalent aspect of American culture, with drinking portrayed in various social settings. While it is legal for adults aged 21 and older, alcohol misuse is a significant concern, as evidenced by the high number of alcohol-related deaths and health issues. Understanding the different subtypes of alcoholics is crucial for effective treatment and management of alcoholism. In the United States, the largest percentage of alcoholics, approximately 31.5%, are young adults in their late teens or early 20s, often college students who engage in excessive social drinking. Another subtype, comprising around 19.5% of American alcoholics, is functional alcoholics, who lead double lives, maintaining success in various areas of life while struggling with alcohol abuse. Intermediate familial alcoholics make up 19% of the alcoholic population and are typically middle-aged individuals with a family history of multigenerational alcoholism. Additionally, young antisocial alcoholics, who often have co-occurring mental health disorders and substance abuse issues, represent a significant subtype. Recognizing these subtypes is essential for individuals to seek appropriate treatment and embark on a journey towards sobriety and recovery.
| Characteristics | Values |
|---|---|
| Number of Americans aged 12 and older who reported drinking alcohol at some point in their lifetime | 224.3 million (79.1% of this age group) |
| Number of males aged 12 and older who reported drinking alcohol at some point in their lifetime | 111.1 million (80.1% of this age group) |
| Number of females aged 12 and older who reported drinking alcohol at some point in their lifetime | 113.2 million (78.1% of this age group) |
| Number of youth aged 12 to 17 who reported drinking alcohol at some point in their lifetime | 5.6 million (21.6% of this age group) |
| Number of adults aged 18 and older who reported drinking alcohol at some point in their lifetime | 218.7 million (84.9% of this age group) |
| Number of people aged 12 and older who reported drinking alcohol in the past year | 177.3 million (62.5% of this age group) |
| Largest percentage of alcoholics in the United States | 31.5% (typically in their late teens or early 20s) |
| Percentage of functional alcoholics in the United States | 19.5% |
| Percentage of intermediate familial alcoholics in the United States | 19% |
| Number of Americans who die each year from advanced cirrhosis | 30,000 |
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What You'll Learn
Young adult alcoholics
Alcohol consumption is a prevalent issue in the United States, with over six in ten Americans reporting that they drink. While drinking is legal for adults aged 21 and older, alcohol use among young adults aged 18 to 25 is also significant. According to the 2023 National Survey on Drug Use and Health (NSDUH), 16.9 million young adults in this age group reported drinking alcohol in the past month, with a slightly higher proportion of females (50.8%) compared to males (48.4%). This equates to 49.6% of all young adults in this age bracket.
Binge drinking is also a concern within this demographic. The 2023 NSDUH revealed that 9.8 million young adults engaged in binge drinking in the past month, with a slightly higher prevalence among females (29.4%) compared to males (28.0%). This translates to 28.7% of the total young adult population aged 18 to 25. Furthermore, the same survey indicated that 2.4 million young adults, or 6.9% of this age group, reported heavy alcohol use in the past month, with a slightly higher prevalence among females (7.2%) compared to males (6.7%).
The Monitoring the Future (MTF) Panel Study of 2023 provides additional insights into high-intensity drinking among college students and non-college young adults. It found that 5.1% of full-time college students and 8.4% of non-college young adults engaged in high-intensity drinking (defined as consuming 10 or more drinks in a row) in the last two weeks. Alarmingly, alcohol is a contributing factor in the deaths of thousands of young people annually in the United States. The National Institute on Alcohol Abuse and Alcoholism estimates that 1,519 college students and 2,586 non-college individuals aged 18 to 24 die from alcohol-related unintentional injuries, including motor vehicle crashes.
Despite these concerning statistics, there is a positive trend indicating that young adults in the U.S. have become progressively less likely to use alcohol over the past two decades. This shift is attributed to various factors, including an increase in marijuana use among young adults, changing social norms, and a growing perception that drinking in moderation is unhealthy.
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Young antisocial alcoholics
This group is the second most common category of alcoholics, comprising 21% of the sample in one study. They are also more likely to seek treatment for their alcohol abuse, with almost 35% having done so. They tend to prefer self-help groups, alcohol detox programs, specialty treatment programs, and private healthcare providers.
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Functional alcoholics
In the United States, the term "alcoholic" is now considered outdated and stigmatizing. Healthcare professionals instead use the term "alcohol use disorder" (AUD). A "functional alcoholic" or "high-functioning alcoholic" is a colloquial term used to describe a person dependent on alcohol who can still function in society. Functional alcoholics typically appear physically and mentally healthy, but they may be struggling with uncontrollable cravings, failed attempts to quit, and obsessive thoughts about their next drink. They are often middle-aged, well-educated, with stable jobs and families.
The negative consequences of a functional alcoholic's drinking may be obscured by their outward successes. They may have good jobs and perform the expected tasks of daily life, giving the appearance of high functionality. However, they often live a double life, experiencing anxiety, depression, anger, and preoccupation with their next drink. The stress of maintaining this double life can drive them to drink even more.
Even when functional alcoholics recognize they have a drinking problem, they may resist seeking help due to the stigma associated with alcoholism and the fear of withdrawal symptoms. They may attempt to quit independently but find the withdrawal symptoms too severe, leading to a cycle of continued drinking to alleviate withdrawal symptoms. It is often only when the pain of withdrawal becomes less daunting than the toll of continued drinking that they will reach out for help.
If you or someone you know may be struggling with functional alcoholism or AUD, it is important to seek professional help. This may include contacting the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline or consulting a doctor or mental health professional. Early intervention can help prevent further progression of the disease and the development of physical or mental health complications. Treatment interventions for AUDs can include behavioral therapy and medications. Additionally, support groups such as Al-Anon can provide valuable support and encouragement for family members of those struggling with AUD.
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Intermediate familial alcoholics
According to a study, 19% of 1,484 participants were classified as "intermediate familial alcoholic subtype". This subtype is predominantly composed of males, with 66% of the participants in this class being male. Many individuals in this group had first-degree or second-degree relatives with an alcohol dependence diagnosis. Many of these individuals started drinking alcohol in their teens, and about 20% abused either cannabis or cocaine products.
The research also found that nearly half of the intermediate familial alcoholic subtype group experienced significant depressive symptoms, and about 25% were diagnosed with bipolar disorder. About 25% of this group sought treatment for their alcohol use disorder. According to the research and formal diagnostic criteria, signs and symptoms to look out for include observations by relatives that someone's drinking behaviour is similar to a first-degree or second-degree relative with an alcohol abuse issue.
Individuals with a family history of substance use disorder are at an increased risk of developing a substance use disorder themselves. If an individual with a family history of substance abuse begins to question their own substance use, they should seek the advice of a mental health professional who specializes in addictive behaviours to determine the extent of any problems they may have.
The motivation behind research into different types of presentations of mental health conditions, such as substance use disorders, is to design specific intervention and assessment techniques to make the identification and treatment process more efficient.
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College students surrounded by excessive social drinking
College students in the US are particularly susceptible to excessive drinking and alcohol-related problems. Drinking has become a ritual that students see as integral to their college experience, and certain aspects of college life, such as unstructured time, widespread alcohol availability, inconsistent enforcement of drinking laws, and limited interactions with parents, can lead to problematic drinking behaviours. Students attending schools with strong Greek systems or prominent athletic programs tend to drink more than students at other schools. Furthermore, specific events and contexts, such as New Year's Eve, St. Patrick's Day, and athletic events, promote heavy drinking.
The social context of drinking plays a significant role in college student drinking cultures. Six distinct social contexts of drinking have been identified: social facilitation, peer acceptance, emotional pain, family drinking, sex seeking, and drinking in the context of motor vehicles. Drinking for social facilitation, or to enhance social experiences, is associated with drinking and driving and housing violations. Drinking in the context of motor vehicles is linked to alcohol abuse and dependence. Drinking to cope with emotional pain is associated with clinical depression.
The transition to college life can increase the likelihood of experiencing alcohol-related problems due to new freedoms and responsibilities. Identifying students prone to alcohol problems is essential for early intervention. College students who binge drink are more likely to face academic difficulties, such as missing classes and performing poorly on tests. Binge drinking is defined as consuming five drinks or more for males and four drinks or more for females on one occasion. Approximately 29.3% of full-time college students aged 18 to 25 engaged in binge drinking in the past month, according to the 2023 National Survey on Drug Use and Health (NSDUH). Additionally, around 14% of full-time college students aged 18 to 22 met the criteria for past-year alcohol use disorder.
To address harmful and underage drinking among college students, interventions targeting individual students, the student body, and the broader college community are necessary. Individual-level interventions aim to change student knowledge, attitudes, and behaviours related to alcohol to reduce drinking and mitigate harmful consequences. Environmental-level strategies, on the other hand, focus on changing the campus and community environments where student drinking occurs.
While college environments often encourage heavy drinking, some contextual factors can protect against binge drinking and negative consequences. For example, parental and religious disapproval of alcohol use can protect against binge drinking. Higher social capital, such as volunteering, and attending commuter schools or all-female colleges, is associated with lower rates of binge drinking. Additionally, drinking in locations that provide food and water or drinking with close friends who encourage safe drinking practices can help reduce the negative consequences of excessive drinking.
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Frequently asked questions
There are five types of alcoholics in the USA: young adult, young antisocial, functional, intermediate familial, and antisocial.
This subtype makes up the largest percentage of alcoholics in the USA. They are typically in their late teens or early 20s and are either just of legal drinking age or slightly younger. Many are college students who are away from home for the first time and are surrounded by a culture that promotes excessive social drinking.
Many people in this subtype suffer from other mental health disorders such as bipolar disorder, anxiety disorders, or depression. They also often struggle with polydrug abuse, with three-fourths of this subset also smoking marijuana and/or cigarettes, and abusing opioids or cocaine.
A functional alcoholic may lead a double life, compartmentalizing their drinking from the rest of their life. They will probably fulfill most of their regular obligations consistently and their family members may enable their drinking. They are often successful in relationships, employment, and life in general, and therefore often deny they have a problem with alcohol and are less likely to seek professional help.
This subtype makes up 19 percent of all American alcoholics and they are typically middle-aged and come from a family with multigenerational alcoholism about half of the time. Most smoke cigarettes and about one out of every five also struggles with marijuana and cocaine abuse.
