Understanding the Alcoholic Narcissist


An alcoholic narcissist is a person who suffers from alcohol use disorder (AUD) as well as narcissistic personality disorder (NPD). The two conditions feed into each other, creating a cycle of toxicity.

Communicating and interacting with an alcoholic narcissist can be difficult for family, friends, and colleagues. The self-destructive behaviors they might exhibit can also create issues for the people trying to help them, leading to resentment and broken ties.

Let’s take a look at what alcoholic narcissism is, the relationship between alcohol abuse and narcissism, and how both conditions affect patients and the people around them.

Alcohol Use Disorder (AUD)

AUD is alcohol abuse that causes physical dependence. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)— which doctors use to diagnose mental health conditions—it is described as the presence of two or more of the following symptoms within 12 months:

  • Poor control: Patients with AUD find it difficult to stop using alcohol. In addition, their desire to drink is so strong that they find themselves gradually increasing their alcohol intake. Poor control can also manifest as spending lots of time trying to obtain alcohol.
  • Social impairment: People with AUD distance themselves from friends and family. They let go of commitments and obligations at their workplace, school, or home. Despite these harmful social effects, there is no decrease in their consumption.
  • Risky use: AUD patients find themselves in hazardous situations while under the influence of alcohol. These situations can include driving while intoxicated, having unprotected sex with multiple partners, or engaging in violent behavior.
  • Tolerance: Tolerance is when a person needs to drink more alcohol to feel the same effects as before, or when the usual amount of alcohol produces weaker effects.
  • Withdrawal symptoms: AUD patients find it difficult to let go of alcohol because of withdrawal symptoms such as tremors, sweating, and nausea. These occur when someone quits cold turkey.

Narcissistic Personality Disorder (NPD)

NPD is a mental illness where patients exhibit a constant need for admiration from others. This behavior is persistent and accompanied by fantasies of success, power, and a false sense of grandiosity.

Note that simply having narcissistic traits does not necessarily mean that a person has NPD. In contrast to people with narcissistic traits, those with NPD have impaired functioning and poor relationships.

Here’s a deeper look at the three features of this mental health condition:

  1. Delusions of grandeur: People with NPD have an exaggerated sense of self-importance. They tend to falsely inflate their skills, talent, and abilities. And because of this false entitlement, they believe themselves to be superior to others. This can translate into manipulative behaviors, emotional abuse, and a disregard for others.
  2. Need for admiration: The need for admiration originates from the feeling of superiority. When denied praise or criticized, NPD individuals tend to get upset or angry.
  3. Lack of empathy: People with NPD fail to recognize the emotions of other people and may even exploit others for their own sake.

What’s the Relationship Between Alcohol and Narcissism?

Personality disorders (like NPD) often go hand in hand with addictive behaviors (such as alcohol addiction and substance abuse).

A study that looked at 350 college students found those with grandiose and vulnerable narcissism were more likely to consume alcohol.

Similarly, in a Canadian study of 210 young adults, researchers were able to predict alcohol-related problems in individuals who had a narcissistic personality.

Research has also shed some light on the relationship of alcohol consumption with certain types of narcissism.

For instance, a study involving 759 university students in the United States found that devaluing others is linked to a lack of control over alcohol intake or instances of heavy drinking.

How Does Alcoholic Narcissism Affect a Person?

From the disastrous health risks of heavy drinking to the deteriorating relationships caused by a narcissistic personality, alcohol narcissism poses many health, relationship, and career challenges for a person. They include:

Physical Health

According to the National Institute on Alcohol Abuse and Alcoholism, the safe daily consumption level of alcohol is two drinks for men and one drink for women. Any more than this amount can lead to various complications, such as:

  • Heart disease: including abnormal rhythm and heart failure
  • Stroke: which is when the blood supply to the brain is suddenly cut off
  • Nutrient deficiencies: including vitamins B1, B6, B9, and B12 deficiencies
  • Osteoporosis: which is when the bones become porous and more prone to fractures
  • Cirrhosis:the last stage of alcohol liver disease where the liver is irreversibly scarred
  • Pancreatitis: a life-threatening inflammation of the pancreas, the most common cause of which is alcohol consumption

Alcohol misuse is also linked to many cancers, including those of the liver, breast, intestines, head and neck, and esophagus.


Although alcoholic narcissists crave attention and admiration, their behavior causes the opposite effect. Manipulation and exploitation of others drive people away from them, leaving them socially isolated and more likely to misuse alcohol.


Alcohol narcissists encounter a number of career-related problems, such as:

  • Poor performance: Heavy drinking impairs cognitive function, which causes decreased performance at work. Alcoholic narcissists also prioritize drinking over their career-related obligations, which worsens their performance.
  • Unreliability: Alcoholism causes people to be absent from work and have difficulty following schedules. This makes them unreliable workers.
  • Conflicts: Because of their entitlement and feelings of grandiosity, alcoholic narcissists often find themselves in arguments and conflicts with their coworkers.
  • Legal issues: In highly regulated industries like healthcare, alcoholic narcissists may find themselves in trouble with the law due to their negligence and poor behavior.

Living With an Alcoholic Narcissist

Living with an alcoholic narcissist is a big challenge. Here are six reasons why:

  1. Emotional abuse: Alcoholic narcissists have no empathy for others, which is why emotional abuse is often a main feature of their relationships. This can take the form of verbal abuse, constant criticism, and belittlement which can be mentally taxing for friends and family.
  2. Manipulation: Because alcoholic narcissists believe they are superior to others, they blackmail, gaslight, or deceive others to have their way.
  3. Unpredictable behavior: Relationships with alcoholic narcissists carry a lot of uncertainty (and anxiety as a result). Alcohol triggers impulsivity and mood swings, because of which family and friends are unable to predict how an alcoholic narcissist will respond or act in a certain situation.
  4. Helplessness: Interacting with an alcoholic narcissist can leave people with a sense of helplessness. You have to bear constant emotional stress that shows no signs of resolving. Being unable to change the behavior of an alcoholic narcissist makes people lose hope and feel emotionally drained.
  5. Financial instability: Alcoholic narcissists tend to spend recklessly, which can drain family finances. They may spend unnecessarily on alcohol to fuel their addiction or other expenses to satisfy their grandiose delusions. This can be particularly concerning for their partners who are unable to control their behavior.
    Alcoholic narcissists have unstable careers because of poor performance at work, which worsens financial instability. Moreover, in times of financial hardship, they may have no one to bring them out of economic ruin.
  6. A cycle of dysfunction: Partners of alcoholic narcissists find themselves repeatedly abused and exploited. Despite small intervals of normal behavior, this pattern repeats. Only external help in the form of support or therapy can break this cycle.

How to Cure Alcoholic Narcissism?

The best way to treat alcoholic narcissism is to simultaneously use methods that address both alcoholism and NPD.

Note that alcoholic narcissism persists even if symptoms temporarily resolve. That’s why multiple studies support long-term treatment that allows gradual recovery.

Let’s explore the treatment options available for alcoholic narcissists:

Alcohol Addiction Treatment

Alcohol detox not only reduces alcohol health complications but also helps treatments for NPD work better. It includes:

  • Medicines: Drugs like disulfiram and naltrexone can reduce the euphoric effects of alcohol or cause unpleasant effects upon consumption. This deters people from drinking.
  • Counseling: Counseling or behavioral treatments such as cognitive behavioral therapy (CBT) and motivational enhancement therapy are conducted as one-on-one or small group sessions. They work through the identification of triggers associated with drinking, the formation of therapeutic plans, and equipping people with the skills needed to abstain from alcohol.
  • Support groups: Support groups like Alcoholics Anonymous can be a great way to address alcohol addiction. Led by healthcare professionals, these groups connect people with alcohol addiction with individuals who face similar challenges. This provides a safe space where AUD patients can speak about their condition without the fear of judgment. They can also learn from their peers who overcame their alcohol addiction.

NPD Treatment

There are multiple ways to treat NPD, such as:

  • Cognitive behavioral therapy: CBT helps alcoholic narcissists identify their narcissist traits and thought processes. It also teaches them mental techniques to conquer these negative thoughts of grandiosity and entitlement. This helps people curb harmful behavioral patterns that stem from deranged thought processes.
  • Schema-focused therapy (SFT): SFT is a newer form of psychotherapy. It builds upon CBT through techniques such as empathic confrontation, where mental health professionals explore why the narcissist developed their traits while remaining empathetic towards them.
  • Family therapy: This aims to teach family members the skills to communicate and interact with an alcohol narcissist. It addresses flaws in existing family dynamics, helps identify and establish boundaries in relationships, and promotes family support towards the alcoholic narcissist.
  • Medications: While there are no FDA-approved medications for NPD, many patients benefit from selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and risperidone. These modulate the biochemical pathways in the brain to address symptoms of personality disorders as well as other mental disorders.

How Curednation Can Help

Even talking to an alcoholic narcissist about treatment can lead to a rage reaction, let alone taking to a physical treatment center.

That’s where Curednation comes in. We offer telemedicine addiction treatment services, so patients can recover where they feel the safest—home.

If you, or someone you know, is struggling with the difficulties of alcoholic narcissism, get in touch with us today and learn how we can help you fit back into society with our evidence-based therapy and support services.

Frequently Asked Questions

Are Most Alcoholics Narcissistic?

No, most alcoholics are not narcissistic. But 53% of the people struggling with alcohol and drug abuse in a study had personality disorders, which suggests alcoholism and narcissism are highly linked.

What Other Personality Disorders Are Associated With Alcoholism?

Antisocial personality disorder and borderline personality disorder are also linked to alcoholism in addition to narcissism.


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