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Archive for July, 2007

It’s time to change the label

Posted by Roberta Jewell
Categories: Medications and research

labelLabeling someone is usually not politically correct, but occasionally it can help debunk an old stereotype. Take alcoholics for example. Until now, conventional treatment for alcohol dependence has been centered around 12-step programs, in-patient care, or a drug that makes you throw up. These strategies have been considered the most effective in helping the typical alcoholic — that middle aged, late stage drinker — in overcoming his or her battle with the bottle. Problem is: most alcoholics don’t fit that mold.

New research from the National Institute on Alcohol Abuse and Alcoholism has identified five alcoholic subtypes. It turns out chronic, late stage alcoholics represent less than ten percent of the overall alcoholic population. In a nutshell, here’s what researchers found:

“The young adult subtype accounts for about 32 percent of U.S. alcoholics. They’re young adults who rarely seek help for alcohol dependence. About 24 years old, they became alcoholics by age 20, on average. They drink less frequently than other alcoholics, but they tend to binge drink when they drink. This is the largest subtype.

The young antisocial subtype comprises 21 percent of U.S. alcoholics. They are 26 years old, on average. More than half have antisocial personality disorder. They tended to start drinking at 15 and became alcoholics by 18 — earlier than other subtypes. They are more likely to smoke tobacco and pot. The young antisocial subtype and the young adult subtype don’t overlap, Moss tells WebMD.

The functional subtype accounts for about 19 percent of U.S. alcoholics. They’re generally middle-aged, working adults who tend to have stable relationships, more education, and higher incomes than other alcoholics. They tend to drink every other day, often consuming five or more drinks on drinking days.

The intermediate familial subtype makes up nearly 19 percent of U.S. alcoholics. Nearly half have close relatives who are alcoholics. Alcoholics in this subtype typically began drinking by 17 and became alcoholics in their early 30s.

The chronic severe subtype is the rarest subtype, accounting for about 9 percent of U.S. alcoholics. This subtype mainly includes men, has the highest divorce rate, and frequently includes users of illicit drugs.”

Study author Howard Moss, M.D., agrees that in all cases, “alcohol dependence must be viewed as a severe disease with a significant adverse impact on health and well-being.”

We’re glad to see these distinctions identified so appropriate care can be provided. Many young adult, middle age, and highly functional alcoholics visit our website and join our program. As a general rule, they have refused conventional treatment because they don’t feel they fit the stereotype of a traditional alcoholic. Many categorically reject existing options which force them to quit drinking completely or attend meetings that offend their sensibilities. So the downward spiral continues.

Interestingly, once those same individuals begin a course of customized therapy, many ultimately decide they want to eliminate alcohol from their lives forever. They gain control, insight, and support on their path to health. Some even follow up with fellowship based meetings in addition to the free online support we provide. But they’ve begun a program of healing with a therapy tailored to their needs. No more cookie cutter assumptions about what defines an alcoholic or how best to treat them.