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When does alcohol abuse start, and what are the various types of alcoholics?

As I continue on my journey of sobriety from alcohol, memories come flying from nowhere. Some are good memories, which seemed to be getting rarer for some time. The majority of these memories, unfortunately, are pretty negative. One lesson to be learned through recovery is confronting the uncomfortable, learning from the conflict, and at some point, helping others start their recovery journey.

When does the abuse of alcohol start? Indeed, some of this will be perception; if you are under 21 and consume alcohol, you are legally abusing alcohol. I feel it can begin as early as when you are a child and witness dramatic alcohol abuse. Ok, let’s get on track here. The first time I recall “getting drunk” was at a house party on New Year’s Eve of my freshman year of high school. If I remember correctly, it was Zima with some apple-flavored Jolly Rancher candies and Bud Light. Well, I can’t tell you if I enjoyed it or not. Still, I can say there were so many times over my “drinking life” that I would remember using the bathroom somewhere, anywhere, and looking in the mirror and saying to myself, “I’m not drunk; I don’t want to miss out on any of this party so keep control.” Something like that anyway, but the quotations make it more dramatic. I was pretty much always the “life of the party,” but that also stems from the typical “class clown” personality coping trait.

That ever-present fear of missing out attacks us all at some point, no matter the context! Call it pure pressure, keeping up with social interactions, or you are very extroverted. Nobody wants to see people having fun and not being part of it?! So this leads me to perhaps the most important story of this.

We jump to 2004, and two high school sweethearts, now 20-years-old, have just gotten married. They are packed up, jumping on a plane, and heading to Cancun for their honeymoon! Wow! What an experience to be grateful for, I’m sure it won’t be squandered, or anything negative will happen?!

This couple what a team…the husband helped….well…..drove to the airport, made some of the money to take on the trip and helped carry some of the bags. That implies the wife organized the itinerary for the trip, planned some of the activities with little positive remarks from the husband, budgeted and for a good reason, held the cash money, packed the bags with love and practicality, and well most of the responsible decisions to be made that weren’t considered manly the amazing wife handled with grace and a smile on her face. Wow!

Well, they made it, got all settled in, planned some fun, had some fun, had some laughs, drank, ate some excellent food, and, as most would want on a honeymoon, a special dinner date evening was planned. Oh, have I mentioned this resort was all-inclusive? For those who may be unaware, that means all your food within the resort property and booze is “free,” you know, part of the package.

Ok, so back to the planned dinner, the new bride, we can speculate, was quite excited to enjoy a dinner date night. Before that, however, the husband found himself at the all-inclusive bar and was one of the biggest Dallas Cowboys fans around, too, don’tcha know. Some “dudes” roll up to the bar and begin chatting with said husband. Drinks ensued, shots followed, more (free) shots and more drinks followed. It’s time for the dinner date, and the lovely newlyweds sit down for their romantic dinner. You can imagine the level of inebriation the newly married husband was exuding at the table.

With that in mind, he excused himself to the restroom, which was pretty much a saloon-style door, to enter the bathroom and stall with a small door. This poor husband, who we can assume abused the amount of alcohol he drank and got sick in this paper-thin walled bathroom. While in there loudly throwing up, this undeserving newly married wife sat alone at the table, listening to this happening and everyone else in the restaurant. Later he was told some people at a table looked at her with empathetic sadness on their faces and said sorry to her. He stumbles out of the bathroom and sits down to try and endure the spins and nausea. Unfortunately, to add more “salt to the wound,” the husband couldn’t handle it and had to return to the room immediately; the food had not yet arrived. She was told they do not allow guests to take food back to their room, but some might say this unique situation or sympathy allowed her to do so.

This story is one of many I have had to face head-on, and I understand that it was alcohol abuse. There are so many types of alcoholism; until I learned more about that through some happiness material I was learning, I may have never considered that I myself was an alcoholic.

I am happy to say this amazing wife never gave up, never stops trying to understand, and has outlived many of these stories. Today those high school sweethearts are happier and stronger than ever.

My journey is mine and everyone's will be different. As I have said before I don't share these stories for the attention value, but to potentially connect with someone who may be struggling or know someone who is strugglilng with addiction. It can show up many different ways. I was not a, what some might call a stereotypical alcoholic where I drank everyday. It was simply abuse of over indulgence, over and over again; which created a path of bad decisions, pain, and mental health issues. That can all change in an instant! Whatever triggers that person to seek help or even accept they have a problem, which we all know is the first "step,"starts them on the pathway to recovery. Recovery does not just mean you are sober, there is A LOT of additional mental work, pain, and healing. I'm still learning this but it's the best I have felt since in I am not sure how long. Don't give up!

Let’s talk about these types :

Young Adult Alcoholics

The largest percentage of alcoholics fall into this group, as NIAAA publishes that 31.5 percent of all alcoholics in the United States fit this subtype. This group is typically in their late teens or early 20s, and either just of legal drinking age or slightly younger. Many young adult alcoholics are likely college students who are away from home for the first time, and who are surrounded by a culture that promotes and encourages excessive social drinking.

The Centers for Disease Control and Prevention (CDC) reports that underage drinkers between the ages of 12 and 20 regularly consume more alcohol at a time than older drinkers, and 90 percent of the alcohol consumed by this group is through binge drinking. Binge drinking is a pattern of drinking, often perpetuated by underage and young adult drinkers, where they bring their blood alcohol concentration (BAC) up to or above 0.08 g/dL, which often occurs in the span of two hours when a man has five drinks or a woman has four, NIAAA explains.

NIAAA reports on a national survey that found that 60 percent of college students between the ages of 18 and 22 drank alcohol in the past month, and nearly two out of every three of these students binge drank during that month. Binge drinking is a pattern of excessive alcohol use that increases the risk for developing tolerance and then physical dependence on alcohol that can then lead to addiction. According to NIAAA, around 20 percent of college students struggle with alcohol addiction.

The young adult alcoholic may not seek help for their problematic drinking, as drinking to excess at this age is often considered “normal” and part of a phase of life. Family members and adults may assume that the young adult will then “grow out of it” and do not see the drinking as a potential ongoing or long-lasting issue.

People who fall into the young adult alcoholic subtype also rarely have a family history of alcoholism. Alcoholism is considered to be a heritable disease, as NIAAA reports that genetics can account for about half of the risk for developing the disease. The flip side of this coin, however, is that environmental and other factors make up the other half of the risks for the onset of addiction. Drinking to excess on a regular basis, living in a pro-drinking environment, peer pressure, drinking before the brain is fully formed in early adulthood, and abusing other drugs with alcohol can all contribute to the onset of alcoholism, just as biology and genetics can.

Nearly one-third of all alcoholics fit into the young adult alcoholic subtype.

Young Antisocial Alcoholics

Alcohol impacts brain chemistry, and regular exposure to the mind-altering substance may actually change the way the brain’s circuitry works. An individual may then suffer from cravings and withdrawal symptoms when alcohol isn’t active in the bloodstream, encouraging the person to drink more to feel better.

Young brains do not have a fully developed prefrontal cortex, meaning that young people may have more difficulties controlling emotions and impulses, and are therefore more likely to take bigger risks without fear of consequences. Excessive drinking can be a particularly risky behavior, especially when undertaken by young people, as it may interfere with normal brain growth and development, and make the person more likely to struggle with substance abuse and addiction later in life, the National Institute on Drug Abuse (NIDA) warns. The CDC reports that consuming alcohol prior to age 15 increases the odds that a person will suffer from alcohol abuse or addiction later in life, up to six times more than a person who waits to drink until they are of the legal drinking age of 21.

More than half of young antisocial alcoholics have a family history of alcoholism, and around half also struggle with antisocial personality disorder. When a person suffers from a co-occurring mental health disorder, the risk for also developing alcoholism or problems with substance abuse are elevated. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that co-occurring mental health disorders and addiction are common, as about 8 million adults in America battled both in 2014.

Antisocial personality disorder commonly co-occurs with alcohol abuse, as alcohol can lower social inhibitions and anxiety, and make a person feel more relaxed. Drinking may then be used as a method of self-medicating the personality disorder symptoms. People who suffer from antisocial personality disorder also typically struggle with poor impulse control, which may then make them more vulnerable to participate in risky and problematic drinking, and other self-destructive behaviors.

Many people who fall into the young antisocial alcoholic subtype suffer from other mental health disorders as well, such as bipolar disorder, anxiety disorders, or depression. As many as three-fourths of this subset also smoke marijuana and/or cigarettes, and many also struggle with opioid or cocaine addictions as well. Polydrug abuse, and co-occurring disorders combined with alcohol abuse, increases the risk for addiction and can interfere with treatment measures. Around one-third of young antisocial alcoholics will seek treatment for problematic drinking.

Functional Alcoholics

This subtype of alcoholics is typically middle-aged, well-educated, and may seem to have it all “together” on the outside. They are likely have a steady job, a seemingly stable family life, and do not often fit into the traditional stereotype of an alcoholic.

Around 19.5 percent of the alcoholic population in the United States falls into the functional alcoholic subtype. Someone who is considered a functional alcoholic may lead a kind of double life, compartmentalizing their drinking from the rest of their life. Unlike the typical alcoholic, a functional alcoholic will probably fulfill most of their regular obligations on a consistent basis, and family members may enable their drinking by making excuses for them when issues related to alcohol abuse do come up.

A functional alcoholic may not hit “rock bottom,” and they are often successful in relationships, employment, and life in general. Therefore, Psychology Today reports that they often deny they have a problem with alcohol and are less likely to seek professional help.

About half of this subtype of alcoholics smoke cigarettes, and one-third have a family history of alcoholism. Around one-quarter of the functional alcoholic demographic have had at least one major depressive episode in their lives as well. Depression and mood disorders commonly co-occur with alcohol abuse and can increase a person’s vulnerability to addiction. The functional alcoholic may be good at covering up emotional distress and issues with alcohol, and able to maintain outward appearances of success.

Intermediate Familial Alcoholics

Making up 19 percent of all American alcoholics, the intermediate familial alcoholic will typically be middle-aged and come from a family with multigenerational alcoholism about half of the time. Most intermediate familial alcoholics smoke cigarettes and close to one out of every five also struggles with marijuana and cocaine abuse. Abusing more than one substance at a time, such as alcohol and cocaine, increases all of the potential side effects and risk factors associated with each substance on its own, and also raises the risk that a person will then develop an addiction to one or both substances as well.

Nearly half of all intermediate familial alcoholics have struggled with clinical depression, and 20 percent have battled bipolar disorder. These disorders often co-occur with alcoholism. Alcohol may become a method of self-medicating the difficult emotional symptoms of depression and the mood swings associated with bipolar disorder. Essentially, alcohol changes brain chemistry and increases the presence of dopamine, which makes a person feel happy and relaxed.

Co-occurring disorders are optimally treated with an integrated program that can help to manage both disorders at the same time. Around one-quarter of intermediate familial alcoholics seek treatment for drinking-related problems.

Chronic Severe Alcoholics

Most likely what a person pictures when the term alcoholic is used, the chronic severe alcoholic subtype only accounts for about 9 percent of the entire US alcoholic population. A chronic severe alcoholic likely started drinking and struggling with alcohol-related issues and problematic drinking at a young age and is currently middle-aged. This subtype also battles antisocial personality disorder at high rates and regularly has issues with the law and therefore criminal or legal troubles as well.

Alcohol is often implicated in exacerbating aggression, and the National Council on Alcoholism and Drug Dependence (NCADD) publishes that 40 percent of all violent crimes cite alcohol as a contributing factor. Chronic severe alcoholics suffer from psychiatric disorders more often than other subtypes of alcoholics, including bipolar disorder, depression, and anxiety disorders.

Close to 80 percent of chronic severe alcoholics have a genetic and familial link to alcoholism, meaning that a close family member also suffered, or suffers, from alcoholism. Chronic severe alcoholics abuse other drugs at higher rates than the other subtypes of alcoholics as well.

Chronic severe alcoholics often smoke and may also suffer from cocaine, opioid, and/or marijuana dependence in addition to alcohol addiction. Chronic severe alcoholics often experience severe life problems related to their drinking, such as homelessness, loss of a job, dissolution of a relationship, legal problems, health issues, and other social, emotional, and behavioral concerns that may make them more likely to seek professional help. This subtype of alcoholics is the most likely to seek treatment and the most heavily represented type of alcoholic in a treatment program. About two-thirds of chronic severe alcoholics get help for their drinking.

Determining Your Alcoholic Type

Alcohol is the most common addictive substance abused in America today. NCADD reports than one out of every 12 adults struggles with alcohol abuse, dependence, or addiction. NIDA publishes the 11 signs of addiction that the Diagnostic and Statistical Manuel of Mental Disorders (DSM-5) lists as being indicators of the disease. These include:

1. Difficulties stopping drinking once you start and trouble controlling how often you drink

3. Experiencing cravings for alcohol

4. Spending a lot of time getting alcohol, consuming it, and recovering from its aftermath

5. Continuing to drink even though it damages relationships and social interactions

6. Drinking interfering with fulfilling regular life obligations

7. Giving up activities and recreational events for alcohol

8. Drinking alcohol in situations where it is physically dangerous or risky to do so

9. Continuing to drink even when you know that it will cause physical, emotional, social, or other issues

10. Tolerance to alcohol as indicated by the need to drink more to feel “normal”

The presence of any two symptoms within a one-year period can result in a diagnosis of alcohol addiction. As previously mentioned, however, there are multiple types of alcoholic subtypes. The following checklists for each type can help you determine which subtype you might fall into.

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