Alcohol & Health
Treatment
Helping Alcoholics
Medically Reviewed by Dr P. E. Pancoast, MD
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A functioning alcoholic, also known as a high-functioning alcoholic or functional alcoholic, is someone who is dependent on alcohol but still functions normally in society.
What makes them different from a "typical alcoholic" is they seem to have it all together. They appear physically and mentally healthy, even though they have a drinking problem.
A functional alcoholic is one of the five subtypes of alcoholism. The other types are:1
A functional alcoholic can also carry out daily activities like everyone else. They can manage different aspects of their life — be it their job, family, or home.
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Here are some signs that you may be a high-functioning alcoholic:
Drinking alcohol during the day is not bad. But if you do it regularly to cope with stress, anxiety, loneliness, and other negative emotions — you may be a functional alcoholic.
Day drinking to "numb" your feelings is a form of emotional drinking. It is an unhealthy coping mechanism that can lead to alcohol abuse.2
Even if you consume small amounts throughout the day, it will cause your alcohol tolerance to build up slowly.
There is nothing wrong with drinking alone. But if you do it to hide your drinking or drink excessively while alone, you may have a problem.
Signs of excessive drinking include:3
If you obsess over the next drink while still occupied with another activity, you may have alcohol dependence. High-functioning alcoholics who experience cravings or the physical urge to drink have physical alcohol dependence.
Psychological dependence is also a common trait of functional alcoholics. It’s when a substance (such as alcohol) becomes central to a person's thoughts, emotions, and activities.4 Many functional alcoholics have a psychological need to drink because it allows them to function.
If you stop drinking, withdrawal symptoms will develop 6 hours after your last drink.
Early alcohol withdrawal symptoms include:
Withdrawal peaks within 12 to 48 hours and lasts up to 72 hours. More severe symptoms, such as hallucinations and seizures, may appear.
Many functional alcoholics do not experience severe withdrawal or any symptoms at all. This is true for day drinkers and those who drink alcohol throughout the day. In these cases, alcohol withdrawal occurs if you stop drinking.
Day drinking and excessive drinking may cause you to develop a functional tolerance to alcohol. Despite having high blood alcohol levels, it allows you to perform activities without appearing intoxicated.
You feel more confident doing the same activity you repeatedly perform under the influence. However, you cannot apply this learned tolerance under different conditions.5
For instance, you can learn to drive while slightly intoxicated. But your driving may become impaired if you encounter something new on the road.
As a functional alcoholic, you may not realize you have a drinking problem. It's probably because you haven't encountered severe consequences from your drinking.
You may believe you're not doing anything wrong and are in control of your life. Many high-functioning alcoholics feel the same way until they experience the negative effects of their drinking.
Unfortunately, being in denial will only prevent you from getting early treatment for alcoholism.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), these 11 signs can help determine if someone has an alcohol use disorder (AUD).
The classic signs of alcoholism include:
A functioning alcoholic may not exhibit all symptoms. However, you can use these as a guide to finding out whether someone has alcoholism or not.
According to the National Institutes of Health (NIH), a high-functioning alcoholic usually has the following characteristics:1
These positive qualities make it difficult to tell who is at risk. However, studies show that nearly one-quarter of functional alcoholics experienced major depression at least once.
Almost half of functional alcoholics are smokers. One-third of them have a long family alcohol use disorder (AUD) history.1
Factors that increase your risk for alcoholism may also put you at risk for functional alcoholism. These include:
About 19.5% of U.S. alcoholics have functional alcoholism.1
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Functional alcoholism may not have any significant effects on a person's day-to-day life. However, this can change over time as their condition worsens.
Chronic alcohol use leads to long-term consequences on their physical and mental health. Eventually, this will affect their function and severely impact their lives and loved ones.
While there are different types of alcoholics, the damaging effects of long-term alcohol use are the same.
Here are some negative consequences of functional alcoholism:
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High-functioning alcoholism is a serious issue. Recognizing the signs of a functional alcoholic is crucial. It helps ensure they receive treatment before it’s too late.
You can also stage an intervention with close friends and family if you suspect someone you know is struggling with alcoholism.
An intervention is a carefully planned event in consultation with a doctor or addiction counselor. The goal is to help guide the addicted person to seek treatment in a controlled and effective way.
A few addiction treatment options are available for those struggling with alcohol abuse or alcohol addiction. Treatments include, but are not limited to:
Alcoholics Anonymous (AA) is an effective worldwide organization of peer-facilitated support groups that helps people recover from alcoholism. It does not necessarily "treat" AUD but can help people with AUD cope.
Inpatient treatment programs are also referred to as residential treatment programs. They are usually the first step in the recovery process and include medical detoxification.
This treatment is available on a short- and long-term basis. Patients will stay at a professional medical facility throughout treatment.
Outpatient treatment is more flexible than inpatient treatment and is typically best for those with mild cases of alcoholism. Patients do not live at the treatment facility; they return home at the end of the day.
It’s crucial that people attending outpatient treatment have a stable home/residential environment supportive of their efforts and can be alcohol-free during this period.
This treatment involves behavioral therapies, medical detox, alcohol counseling, and support groups.
High-functional alcoholism is a serious problem that can lead to severe physical and mental health complications. Recognizing the symptoms of high-functioning alcoholism is important because it allows you to get the help you need.
Some of these symptoms include:
There are different treatment options available depending on your situation.
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