Functioning Alcoholics

What is a Functioning Alcoholic?

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

• Young adult alcoholics
• Intermediate family alcoholics
• Young antisocial alcoholics
• Chronic severe alcoholic

A functional alcoholic can also carry out daily activities like everyone else. They are able to manage different aspects of their life — be it their job, family, or home.

Risk Factors of High-Functioning Alcoholism

According to the National Institutes of Health (NIH), a high-functioning alcoholic usually has the following characteristics:¹

• Is middle-aged (around 41 years)
• Has good education
• Has a steady job
• Has stable relationships
• Maintains hobbies and interests

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 in their life.

Almost half of functional alcoholics are smokers. One-third of them have a long history of alcohol use disorder (AUD) in the family.¹

Other Risks for Functional Alcoholism

Factors that increase your risk for alcoholism may also put you at risk for functional alcoholism. These include:

• Drinking before the age of 15 (underage drinking)
• Drinking to feel good about yourself (emotional drinking)
• Being surrounded by friends, family, or peers who drink regularly
• Family history of mental health disorders (e.g., depression and anxiety)
• Experiencing a traumatic life event (e.g., death of a loved one)
• Feeling generally dissatisfied with life and having low self-esteem
• Being under a lot of stress and anxiety
• Consuming more than 4 to 5 drinks in 2 hours (binge drinking)
• Drinking at least 8 drinks per week in women and 15 drinks per week in men (heavy drinking)

About 19.5% of U.S. alcoholics have functional alcoholism.¹

What Are the Signs You Are a High-Functioning Alcoholic?

Here are some signs that you may be a high-functioning alcoholic:

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1. You Day Drink to Feel Good

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.

2. You Drink Excessively Alone

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

• Binge drinking: Drinking 4 or more drinks (in women) and 5 or more drinks (in men) in 2 hours.
• Heavy drinking: When you consume 8 or more drinks per week (in women) or 15 or more drinks per week (in men).

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3. You Have Alcohol Dependence

If you find yourself obsessing on 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 a physical dependence on alcohol.

Psychological dependence is also a common trait of functional alcoholics. It is 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.

4. You Have Alcohol Withdrawal

If you stop drinking, withdrawal symptoms will develop after 6 hours of your last drink.

Early alcohol withdrawal symptoms include:

• Headache
• Nausea and vomiting
• Sweating and trembling
• Anxiety
• Trouble sleeping

Withdrawal peaks within 12 to 48 hours and can last for 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.

5. You Have Functional Tolerance

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.

As you repeatedly perform tasks under the influence, you feel less impaired when doing the same activity. However, you cannot apply this learned tolerance under different conditions.⁵

For instance, you can learn to drive while slightly intoxicated. But if you encounter something new on the road, your driving may become impaired.

6. You're in Denial

As a functional alcoholic, you may not realize you have a drinking problem.

It's probably because you haven't encountered any severe consequences from your drinking. You may believe that you're not doing anything wrong and that you're in control of your life.

Many high-functioning alcoholics feel the same way until they start to experience the negative effects of their drinking.

Unfortunately, being in denial will only prevent you from getting early treatment for alcoholism.

Other Symptoms of Alcohol Use Disorder (AUD)

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are 11 signs that can help you determine if someone has an alcohol use disorder (AUD).

The classic signs of alcoholism include:

1. Consuming more and more alcohol over time
2. Finding it difficult to limit excessive alcohol intake
3. Spending time obtaining alcohol, drinking, or recovering from alcohol
4. Frequent and intense cravings for alcohol
5. Struggling to keep up with responsibilities, including relationships, work, and school 
6. Continuing to use alcohol despite interpersonal and social problems
7. Prioritizing alcohol over important work, recreation, and social activities 
8. Drinking in situations that can lead to physical harm
9. Drinking alcohol despite knowing its physical, psychological, or social harm
10. Developing a high tolerance for alcohol that requires drinking more to achieve the same effect
11. Experiencing alcohol withdrawal symptoms

A functioning alcoholic may not exhibit all symptoms. However, you can use them as a guide to find out whether someone has alcoholism or not.

Is Your Loved One a Functioning Alcoholic? (Know the Signs)

High-functioning alcoholism can be hard to spot, even in a loved one. But there are certain behaviors that you can watch out for.

For example, a functional alcoholic will:

• Avoid confrontation about their drinking habits
• Hide their alcohol use (e.g., how much and how often they drink)
• Store alcoholic drinks at home, in the office, or inside their car
• Continue to drink even if it is starting to cause problems
• Deny they have a drinking problem

Keep in mind that a functional alcoholic will not show outward signs of a typical alcoholic. They can be well-groomed and not look or act like they are intoxicated or that they have been drinking.

Consequences of High-Functioning Alcoholism

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 their 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:

• Health problems: Liver disease, cancer, and heart disease
• Damaged relationships: Such as with partners and family
• Career setbacks: Declining cognitive performance at work
• Legal issues: Drunk driving (DUI), violence, and assault
• Financial problems: Losing jobs and falling in debt
• Mental health issues: Depression and anxiety

Early Intervention: Why It Matters

The consequences of alcoholism can make it difficult for a "currently-functioning" alcoholic to remain functional over time. Early intervention prevents alcoholism from getting worse.

It reduces the health risks associated with long-term alcohol misuse. It also helps you transition into addiction treatment, so you can regain social function.

How to Help a High-Functioning Alcoholic (Best Treatment Options)

High-functioning alcoholism is a serious issue. Recognizing the signs of a functional alcoholic is crucial as it helps ensure they receive treatment before it is 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 that is usually done 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. There are a few addiction treatment options available for those struggling with alcohol abuse or alcohol addiction.

Treatments include, but are not limited to:

Alcoholics Anonymous (AA)

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

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

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 is crucial that people attending outpatient treatment have a stable home/residential environment that is supportive of their efforts and can be alcohol-free during this period.

This treatment typically involves behavioral therapies, medical detox, alcohol counseling, and support groups.