Functioning Alcoholics

What is a Functioning Alcoholic?

A functioning alcoholic, also known as a high-functioning alcoholic or functional alcoholic, refers to someone who is dependent on alcohol but can still function normally in society. This form of drinking is one of the five subtypes of alcoholism. The other four subtypes include young adult alcoholics, young antisocial alcoholics, intermediate familial alcoholics, and chronic severe alcoholics.

Although functioning alcoholism is not a formal medical diagnosis, it can significantly disrupt a person’s day-to-day life, mental health, and overall health. It is difficult to tell if someone is an alcoholic if they are “currently-functioning” in society. However, it is unlikely that they will remain functional, which is when the alcohol problem becomes obvious to others around them. 

According to the National Institutes of Health (NIH), the five most common characteristics of a high-functioning alcoholic include someone who:

• Is middle-aged (around 41 years of age)
• Has a steady job
• Is in a healthy relationship and/or has a family
• Has a family history of alcohol use disorder (AUD)

Risk Factors of High-Functioning Alcoholism

There are many risk factors associated with high-functioning alcoholism (and alcoholism in general). For example, a person is more likely to become a functioning alcoholic if they:

• Binge drink regularly (more than 5 standard alcoholic drinks per day)
• Typically drink more than 14 drinks per week (men) or 7 drink per week (women)
• Started drinking at an early age
• Are surrounded by friends, family members, or other peers who drink regularly 
• Are generally unsatisfied with life and have low self-esteem 
• Have had bariatric surgery (studies show that those who have had this surgery are more likely to develop alcohol use disorder)
• Have a mental health disorder (depression, generalized anxiety disorder, panic disorder, schizophrenia, bipolar disorder, etc.)
• Have high stress and/or anxiety levels 
• Have a family history of alcoholism 
• Have a family history of trauma 

In the U.S, functional alcoholics make up 19.5 percent of all alcoholics.

Are You a High-Functioning Alcoholic? (7 Warning Signs)

There are seven common signs that may indicate high-functioning alcoholism, including:

1. You Drink Alone Regularly

If you or someone you know is consuming alcohol while alone, there may be an issue. However, drinking alone doesn’t necessarily mean someone has an alcohol problem. Many people enjoy having a drink or two by themselves every once in a while.

If the individual is drinking heavily by themselves, or is drinking to self-medicate negative feelings, a more serious issue may be present. More specifically, if the following factors influence a person’s justification for drinking alone, alcoholism could be to blame:

• They drink alone due to “boredom”
• They can’t get through the day without wanting a drink (or more than one) after work
• They are drinking to self-medicate negative or unwanted emotions
• They get irritable or angry when they are not drinking
• They develop alcohol withdrawal symptoms when not drinking
• They often drink alone before social events to reduce anxiety

2. You Day Drink to Cope With Stress

If someone regularly makes jokes about how often they drink, or tries to hide their day drinking, they may have an alcohol use disorder. They may also have an alcohol problem if alcohol is being used to “numb” the feelings of daily life. For example, high-functioning alcoholics often drink during the day. This can include secretly drinking in the morning, at work, at lunch, or sneaking alcohol during social events to cope with anxiety. 

3. You Drink Heavily or Binge Drink Often

For men, heavy drinking is defined as consuming 15 or more alcoholic beverages per week. For women, heavy drinking is defined as consuming 8 or more alcoholic beverages per week. 

Binge drinking is when someone consumes 5 or more alcoholic beverages in about 2 hours. Women may only need to drink 4 alcoholic beverages in that same two-hour span (to reach a BAC of .08%) because they metabolize alcohol differently than men. Binge drinking is often linked to the inability to limit alcohol intake, frequent blackouts, and taking dangerous risks. Studies show that people who binge drink at a young age are three times more likely to develop an AUD in adulthood. 

4. You’ve Developed a Tolerance to Alcohol

Alcohol use triggers dopamine release in the brain, which makes you feel good. However, excessive and prolonged alcohol consumption leads to alcohol tolerance. This means you will need to drink more and more alcohol to achieve the same desirable effects. This is a sign of an alcohol use disorder. 

5. You're in Denial 

Functioning alcoholics typically experience a different kind of denial than regular alcoholics. This is because peers likely don’t notice that they have a problem. The functional alcoholic won’t face any of the normal consequences, such as people trying to get them to seek help, failed relationships, and work problems. 

Also, functional alcoholics often feel like they have control over this aspect of their life, which keeps them from dealing with the truth. In other words, they don’t have a reason to stop drinking because they don’t see it as a problem—yet.

Over time, though, the individual will not be able to hide their alcoholism anymore, which is when the consequences begin to surface. 

6. You Think About Drinking Often

If you notice yourself obsessing about the next drink, you may be developing a dependency on alcohol. For example, you may find yourself thinking about alcohol at work or while attending to daily responsibilities. Mood swings, such as anxiety, irritability, and depression symptoms, may also emerge when you cannot drink. These can all be signs that your alcohol use is turning into a more serious problem, such as alcohol use disorder (AUD). 

7. You’ve Developed Alcohol Withdrawal 

One of the most obvious signs of alcohol use disorder is withdrawal. Early alcohol withdrawal symptoms will begin after six to 24 hours of the person’s last drink. Day-drinking is often the way functioning alcoholics prevent these withdrawal symptoms, so they likely won’t notice they have a drinking problem. Common withdrawal symptoms include irritability, tremors, and nausea.

Other Symptoms of Alcohol Use Disorder (AUD)

If you suspect you or someone you know is a high-functioning alcoholic, there are other signs to look out for. In the beginning stages of alcoholism, the problem may not be obvious. As the person begins to develop a deeper addiction to alcohol, they will likely not function as “normally.” 

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

1. Continuing to consume more and more alcohol (larger amounts or over a longer period)
2. It is challenging to limit excessive alcohol intake
3. A lot of time is spent trying to obtain, drink, or recover from alcohol
4. Frequent and intense cravings for alcohol
5. It is difficult to keep up with responsibilities, including relationships, work, and school 
6. Alcohol use continues despite interpersonal issues or alcohol-induced social problems
7. Alcohol use is the priority over important work, recreational, and social activities 
8. Continuing to use alcohol in situations that can lead to physical harm
9. Continuing to drink alcohol despite knowing the physical, psychological, or social harm it causes
10. Developing a high tolerance for alcohol that requires drinking more to achieve the same effect
11. Experiencing alcohol withdrawal symptoms

Consequences of High-Functioning Alcoholism

There are many social and health consequences associated with high-functioning alcoholism. Even though these alcoholics do not experience the social consequences of alcoholism right away, they are still harming their bodies. And, over time, their drinking will begin to affect their lives and their loved ones. 

Some negative consequences of high-functioning alcoholism include:

• Health problems such as liver disease, digestive issues, increased risk of cancer, stroke, high blood pressure, elevated heart rate, cirrhosis, and heart disease
• Damaged relationships with spouses, partners, family members, and coworkers
• Career setbacks and declining cognitive performance at work
• Legal issues due to drunk driving (DUI), violence, and injuries
• Financial problems due to losing jobs and not being able to perform well at work
• Mental health issues caused by excessive alcohol use (which changes your brain chemistry and can cause brain damage)

Help for Functioning Alcoholics (Best Treatment Options)

High-functioning alcoholism is a serious issue, and recognizing the signs of a functional alcoholic is crucial to 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 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. These include, but are not limited to:

Alcoholics Anonymous (AA)

Alcoholics Anonymous (AA) is not necessarily a treatment option for alcohol use disorder. It is an effective worldwide organization of peer-facilitated support groups that helps people recover from alcoholism.

Inpatient Treatment

Inpatient treatment programs are also referred to as medical detoxification and are usually the first step in the recovery process. Inpatient 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. Outpatient treatment typically involves behavioral therapies, medical detox, alcohol counseling, and support groups.