Types of Alcoholism: The Disease Most People Would Rather Deny

Alcoholism isn't nearly as cut and dry as most people think. There are actually five different types of alcoholism. Alcoholics generally fall into one of these categories.

If you are an alcoholic, or you think you may be, this could be helpful information. Also, if you have a loved one whom you suspect is an alcoholic, this is important for you to know as well. Alcoholism is very dangerous, and the more you know about it, the better.

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Why are There Different Levels of Alcoholism?

There has been so much research done on the use of the world's most popular drug - alcohol. Not only are there different types of drinkers, but there are different types of alcoholism as well.

Alcoholism is complex. It is a problem that's difficult to define, and that has multiple facets. Still, with a little probing, you can uncover what some of the greatest minds in the world have uncovered.

The following information is the result of many decades of studying and research. You'll find that there are many classifications of drinkers because people are so different. Alcoholics respond to drinking in different ways. Therefore, many alcoholic types were needed in order to define them all.

E. Morton Jellinek’s Classification of Alcohol Use

A man by the name of Elvin Morton Jellinek dedicated his life to studying alcoholism. He actually died at his desk doing research in 1963. Jellinek was instrumental in accelerating research into medicalizing drunkenness and alcohol use. He came up with the phrase, the disease concept of alcoholism.

In 1960, he wrote a book that identified different stages of alcoholism. These stages were as follows:

As time went on, even more research would be done in this area. There was so much more to learn about alcohol use and the disease of alcoholism. His research gives incredible insight into how people progress as they continue to drink.

The Phases of Alcoholism

In addition to dictating the stages of alcoholism, Jellinek also came up with various stages of the disease.

The Pre-Alcoholic Phase

For those who are in the pre-alcoholic phase, their drinking is primarily socially motivated in the beginning. But it usually does not take long before they realize that they experience psychological relief from it. These individuals may be less equipped to cope with stress than others, or they may have higher amounts of stress. Either way, alcohol seems to have the answer for them.

Before long, the person will start to look for events and occasions in which to drink. At some point, they make a connection between drinking and stress relief. After that, alcohol use becomes a coping mechanism for them.

It is difficult to say how long someone may remain in this stage. It can last from a few months to two years or even longer. Over time, these people gradually develop an increase in their tolerance levels.

The Prodromal Phase

Alcoholism begins when drinking is no longer a social event, but it has become a way to escape psychological or physical pain. In the Prodromal Phase, it is still possible for the alcoholic to remain reasonably in control of their use. But there are some definite patterns in their behaviors that cannot be denied.

For example, people in this phase may:

  • Start to drink more often and more heavily than their friends or others around them.
  • They begin to get drunk as a habit, and it is something that happens all the time.
  • When they are drunk, they may take huge risks or boast about things that don’t make much sense. For instance, they may recklessly spend money, or tell others about accomplishments that might be real or imagined.
  • Experience blackouts on a regular basis. A blackout is much different from losing consciousness because the person is still capable of moving and communicating. They simply have no memory of the time they were impaired after the fact.
  • Sneak drinks and gulp them down as quickly as possible. They typically do this when no one is looking as a way to keep the level of their alcohol consumption a secret. They usually also try to avoid talking about drinking because of the guilt they carry around.
  • Suffer from hangovers on a regular basis. As time goes on, they become more and more physically and emotionally painful.

The Crucial Phase

Once a person has reached the Crucial Phase, they have been drinking regularly and heavily, but it isn’t always obvious. Up until they reach this point, they can generally stop drinking at any time they choose. They may suffer from some withdrawal symptoms, but willpower is usually all it takes to quit.

This stage is where everything changes. The symptoms of alcohol addiction begin to develop rapidly, and they include:

  • Losing control – This is the most common sign that someone’s drinking has moved from being only a psychological habit and is now a physical addiction. There may be times when they refuse a drink, but once they begin they cannot stop.
  • Feeling shame – When people lose control over their drinking, they immediately feel ashamed of themselves. They may spend time coming up with numerous reasons about why they are drinking. They hope that their rationalizations will justify their behaviors to the people who love them.
  • Drinking in the morning – Many in this stage will begin to feel the need to drink when they get up in the morning. They think of it as starting their day off right. Alcohol consumption in the morning is really only a way to calm their nerves and stave of the symptoms of withdrawal that have started to set in. They generally find it impossible to imagine taking on the day without alcohol.
  • Making changes – At this point, the alcoholic may recognize that there is a problem and try to make changes to rectify it. But those changes usually do not include stopping the use of alcohol altogether. Instead, they may switch the type of alcohol that they consume. A beer drinker may start drinking whiskey, or someone who drinks mixed drinks may start having wine. They do this to try and calm the pressure they are feeling from themselves and from those around them. Of course, none of this is effective because once alcohol is consumed, it will only start another chain reaction of continued use.
  • Becoming anti-social – Most alcoholics would rather either drink alone or with other people who have drinking problems. They come to believe that these are the only people who can understand them. Sometimes people can even become violent or destructive once they reach this phase.
  • Losing everything – Loss is something that alcoholics eventually become accustomed to. It is not uncommon for them to have a hard time coping with their jobs. Many will either quit or get fired before too much time has passed. Family members may feel so burdened that they abandon them. Friends may stop calling or stopping by for visits.
  • Seeking medical help – It is usually at this point where people start to seek out some type of medical help. This can come in the form of visiting a psychiatrist, going to the emergency room, or just going to see their doctor more regularly. Either way, they are not at the point where they are willing to admit the extent of their drinking. That means that they cannot get the type of help they really need. Even when the doctor does offer assistance, they are usually non-compliant.

The Chronic Phase

Up until this point, the alcoholic has always been able to make a choice to drink that first drink or not. Once the first one had been consumed, they lost control over how much they drank after that. The Chronic Phase represents the last stages of alcoholism. At this point, they have no choice. They must drink in order to be OK.

This stage is usually characterized by the following:

  • Binge drinking and benders – It is very common for people at this stage to get very drunk for days at a time. They are searching for that feeling of euphoria they once experienced, but it will not return. Everything is disregarded in their lives; including family, friends and even safe shelter.
  • Tremors – Alcoholics often grow accustomed to experiencing trembling in their hands on the mornings after they drink excessively. But at this point, they begin to experience the shakes when they cannot consume. The shakes is a serious condition of the central nervous system and it affects the entire body. Sometimes people even experience hallucinations at the same time. It is very common for people to swear off alcohol completely after they experience the shakes, but they usually always go back to drinking.
  • Maintaining supply – It is very important for people at this phase to have a supply of alcohol on-hand at all times. They will go to great lengths to get it; even selling their possessions or stealing if they have to. Once they have it, they will often hide bottles all over the house so that it will always be close to them when they need it.
  • Hostile behaviors – People in this phase of alcoholism will show hostility toward other people for a number of reasons. Some may be attempting to protect their supply of liquor at home or in their immediate possession. Many experts believe that this type of behavior is more likely the evidence of a subconscious desire for self-punishment.
  • Filled with fear and anxiety – Alcoholics might experience an overwhelming fear of impending doom or destruction. They may constantly worry about things they cannot control or describe in words. This only adds to their anxiety levels and fuels the need to drink even more. The fears they have will often show up in hallucinations that can be both visual and auditory.
  • The Realization of the truth – At this point, the alcoholic has started to realize that all of their reasons for drinking were only fabricated. They come to the point where they admit to themselves that there is no way to justify their behaviors. People at this time in this phase will need to admit that their alcohol consumption is beyond their control.
  • Surrendering – If an alcoholic is going to get help, this is the time when they usually do. They must realize that they have a disease, and any ideas of ever drinking again must be tossed aside. They have to be willing to seek and accept the help they need to recover. If they do not, they are sentencing themselves to a lifetime of psychological and physical pain, and eventually death.

Alcohol Addiction: Type A and Type B

Researcher Thomas F. Babor assigned two different types to alcoholics in the 1990s. He called them Type A and Type B. They have different levels of severity, and both types don't apply to men and women equally.

What is Type A?

Type A alcoholism is characterized by environmentally-based forms of the disease. This type becomes evident later in life. People with this type often have a weaker family history of alcoholism. They suffer from less co-occurring disorders, and have less negative consequences to their drinking habits.

Also, their level of dependence on alcohol tends to be much less than those with Type B. This may be due to the fact that they generally don't become alcoholics until they are much older.

What is Type B?

Type B alcoholism is much more severe than Type A. These individuals usually become alcoholics earlier on in their lives. Many of them may turn to alcohol during their young adult years, or even sooner. These individuals have a strong family history of alcoholism.

People with Type B tend to have had conduct problems as children. They may abuse multiple drugs and have multiple psychiatric disorders. Their level of dependence tends to be much higher than those with Type A.

Current Research on Drinking

The information we've gotten from past research on drinking has been quite helpful. However, it still left a lot of unanswered questions. It seemed as though there was so much more about this disease that still needed to be learned.

Dr. Howard Moss is a researcher from the National Institute on Alcohol Abuse and Alcoholism. He is also the associate director for clinical and translational research. Through his studies, he has determined that there are really 5 different subtypes of alcoholism.

The 9 Types of Drinkers

It's not always easy to understand the different types of alcoholism. If you're thinking about your own drinking patterns, you may wonder where you fall. This may be why the Department of Health in England has made different categories.

According to 9 different categories. Taking a look at these might help you get a better understanding of alcohol addiction.

Someone who is a depressed drinker typically is always dealing with stress or a crisis. They may have suffered from a divorce recently, or may be having money problems. For these individuals, alcohol is a way to find comfort. They use it to self-medicate and cope with their problems.

De-stress drinkers tend to have a great deal of stress in their lives. They may have stressful occupations, or they may have problems at home. They frequently feel out of control, and like they bear a lot of responsibilities. For them, alcohol helps them to relax and unwind. It gives them a sense of control when they feel as though they have none.

Re-bonding drinkers will often use alcohol as a way to reconnect with their friends and family. It serves as a social buffer for them. These types of drinkers are often out drinking because their social calendars are so full. They usually lose track of the time while they're consuming alcohol. Also, they may lose track of how much they drink.

Conformist drinkers are usually men who like to go out drinking on a nightly basis. They believe that drinking is what men do. When they're at a bar or a club, they see it as their well-deserved time for themselves. They feel as though they belong there, and they're accepted in these environments.

Community drinkers have large groups of friends they hang out and drink with. They love the sense of community they get to experience within their group. It feels safe to them to consume alcohol in such a large group of their peers. Their drinking group serves as their social network, and it helps them find meaning in their lives.

Boredom drinkers are usually women who have been recently divorced. They may also be single moms. They don't have much of a social life, and so, alcohol serves as their company. They may drink at the end of every day, or once they finish their housework for the day.

For the macho drinker, drinking alcohol is a sign of manhood. They carry a strong alpha male personality, and they're proud of their alcohol consumption. In reality, these individuals feel undervalued and unimportant in many areas of their lives. Drinking helps them feel powerful. It also helps them assert their masculinity to other people.

For hedonistic drinkers, alcohol is a way for them to release their inhibitions. They are typically divorced or single, and they may have adult children. For these individuals, drinking is a way for them to express their freedom and independence. When they're drinking, it makes them feel young again.

Border dependent drinkers are usually men who spend a lot of time in bars and clubs. They usually choose one in particular that makes them feel the most at home. They may be bored, and may feel a need to conform in society. They are usually depressed and feel down about themselves and their lives.

How Does the DSM-5 View Alcohol Problems?

The DSM-5 defines severe alcohol problems as being an alcohol use disorder.

According to this manual, you may be an alcoholic if you:

  • Have had times when you drank more or longer than you meant to
  • Have tried to cut down or stop drinking more than once unsuccessfully
  • Spend a lot of time drinking
  • Were unable to think of anything else but drinking
  • Found that drinking interfered with your daily life, including relationships, responsibilities, work, and/or school
  • Continued to drink even though it was causing problems within your personal relationships
  • Given up on activities that you once found important in favor of drinking
  • Gotten into situations after drinking that increased the risk of injury
  • Continued drinking even after it made you feel depressed or anxious
  • Had to drink much more than usual to get the desired effects of the alcohol
  • Had withdrawal symptoms when the effects of the alcohol had worn off

All of the above are signs of alcoholism. The DSM-5 is very clear that alcoholics typically experience many of these signs. If you are as well, you are probably an alcoholic.

Questions You May Have About Drinking

Here at Northpoint Seattle, it is our hope that we've answered a lot of your questions. However, we know that alcohol is a very complex subject. You may have even more questions, such as:

When you have an alcohol tolerance, it means that it takes more alcohol for you to feel the effects. You may need to drink more than you once did in order to get drunk.

Increasing tolerance levels are typical among alcoholics. They often need to increase their intake to dangerous levels after they've been drinking a long time.

Yes, chronic alcohol use can, and often is, a cause of death. Alcohol is a drug, and it's not as safe as most people think it is. The longer you drink, the higher your risk is for an alcohol-related illness or disease.

Some examples of alcohol-related diseases include:

Alcohol use is also a leading cause of accidents and injuries. It is a very dangerous drug that should never be misused, or used excessively.

This is a very difficult question to answer. End stage alcoholism can last for a short time, or it can last for years. People who are facing this stage are often suffering from:

Basically, end stage alcoholism is the culmination of the effects of alcohol on the body for years. Everyone is different, so there's no way to tell how long it will last. Doctors may be able to give their medical opinions on individual cases.

Men and women are very different, and because of these differences, women can drink less and become alcoholics faster. On average, men weigh more than women do. Men’s bodies have higher water contents, and alcohol disperses in water. If a man and a woman have the same amount of alcohol, the woman’s BAC level will be higher. This puts her at a greater risk of harm.

But it is important to note that this fact does not mean that men are safe from becoming alcoholics. Statistics from the CDC state that:

  • Around 59% of men have reported drinking within the last 30 days.
  • This is much higher than the number of women.
  • 23% of men report binge drinking around five times a month.
  • Men are almost two times more likely to participate in binge drinking than women.
  • Among those who met the diagnostic criteria for alcohol dependence, 4.5% of them were men and 2.5% of them were women.

It is never a good idea to attempt to quit drinking on your own if you are an alcoholic. You need to go through a solid alcohol detox program that can help you begin the process.

Detoxing can help you avoid potentially dangerous withdrawal symptoms and conditions such as delirium tremens. It can also make the process of recovering much easier on you both physically and mentally.

Once you do that, you will be ready to enter into an alcoholism treatment program. It is essential for you to understand what led to your addiction so that you can get the help you need to make changes in your life.

How Can You Get Help if You're an Alcoholic?

If you have an alcohol addiction, you need to get immediate help. Alcoholism isn't something you can ignore, and you shouldn't just stop drinking on your own.

Trying to quit alcohol cold turkey can be devastating for you. It can cause serious alcohol withdrawal symptoms that may even be life threatening. Professional treatment is recommended for anyone with an alcohol addiction. An IOP program might be the best place for you to start. This offers a flexible way to get your treatment that also intensive and effective.

Do you have more questions about the different types of alcoholism? We'd love to answer them for you. Please contact us to learn more about alcohol addiction and your treatment options.