An epidemiological study by the National Institute on Alcohol abuse and Alcoholism, that evaluated data on almost 1500 people who met the criteria for alcohol dependence, has subdivided the different types of alcoholics into 5 distinct subgroups. By better understanding the different types of alcoholism and how it afflicts diverse groups of people, interventions and treatments can hopefully be designed better suited to the needs of individual alcoholics.
The study reveals that more than half of all people that meet the criteria for alcohol dependence have no familial history of alcoholism, and that those most likely to ever seek out treatment were the most antisocial and most dependent of drinkers. Only about 25% of all alcoholics ever seek any form of treatment for their drinking, and much fewer than even that number succeeds in successfully conquering the disease.
What we know is that only a fraction of people with alcoholism are ever getting better; and while this may seem a very pessimistic view for the future, the fact that 75% of alcoholics avoid treatment for life means that we have a great opportunity to effect change by designing interventions and better treatments to get those people never treated into treatment, and onto the road to sobriety.
The five sub groups of alcoholics as classified by the NIAA are:
The Young Adult Alcoholics 31.5%
These people have a very low percentage history of family drinking, and a low rate of other substance use or dependency. These people are very unlikely to seek out treatment for their alcoholism.
The Anti Social Young Alcoholic
This group representing 21.5% of alcoholics started drinking heavily early, more than half have a family history of alcohol abuse, and more than half present with some form of co present psychiatric disorder (often anti social personality disorder). This group is very likely using other drugs with alcohol and about 33% of these people will seek out help for their drinking
The Functional Alcoholic
This group of alcoholics represents 19.5% of the sample, and these people are normally well educated and professionally and stably employed. About half of these people will have experienced a major psychiatric disorder at some point, and these people are unlikely to seek help for their drinking.
Intermediate Familial Alcoholics
Representing 19% of alcoholics, these people are not as successful as the functional group. About half come from families with a multigenerational history of alcohol abuse, and more than half will have suffered from a depressive disorder. About 25% of these people will ever seek out treatment.
Chronic Severe Alcoholics
This last group, representing 9% of drinkers, are mostly middle aged, and have a long history of alcoholism, normally starting out in adolescence. 80% of these people have a multigenerational history of alcoholism and also present with a high degree of criminality and other substance abuse. This group of people is the most commonly seen group in alcohol treatment, with more than 75% of these people initiating alcohol treatment at some point.
How does this information help?
Examining the classification data, we can see that very few people are ever seeking out treatment help, and that the two groups most likely to ever seek out treatment are the two group displaying the most severe alcoholism and criminality. We know that the earlier treatment is attempted the better the eventual outlook, but it seems that the vast majority of treatment is only ever initiated on people with very severe and long lasting histories of alcohol abuse and dependency.
Those people who do suffer from alcoholism but do manage to hold down jobs, and lead more "normal" lives, are the most likely to benefit from treatment, are the largest group of alcoholics by the numbers, and are also by far the least likely to ever seek or receive appropriate interventions and treatment.
Because alcoholism is a progressive and destructive disease, we need to effect better change in the people most likely to benefit from treatment, and at the earliest possible opportunity. Young adult and functional alcoholics very rarely get the treatment that they need, and interventions and outreach need to do a better job at convincing these reluctant addicts of the need and the benefits of rehab or other appropriate treatment opportunities.
The fact that we are only treating a quarter of alcoholics over their lifetimes can be presented as a great opportunity to better treatment participation percentages, and to enact real positive change for a group of people that are very likely to benefit from these offered treatments.
Families, employers, clergymen, friends and co workers, we all need to do a better job at intervening in the lives of those people that desperately need treatment, but who are statistically so very unlikely to ever initiate it. We hate to stick our noses where they don’t belong, but the benefits of intervention far outweigh a perception of interference, and we have a great opportunity to do some real good.
Be nosy, interfere, and do some real good amongst groups of people that could really benefit from available therapies.