High Functioning Alcoholic is a phrase still widely used by the general public, although the medical and treatment community refer to it as alcohol use disorder instead, which is the diagnostic term to describe a person with an alcohol addiction. According to the CDC, 25 percent of adults had at least one day in the past year of heavy drinking. Many people drink alcohol somewhat regularly without any negative consequences. Others have been drinking to extreme levels for years and have suffered with health problems because of it. Somewhere in between these two groups is a category identified as a functioning alcoholic that appears on the surface to be able to handle drinking, only because it hasn’t impacted them yet.
What is a Functioning Alcoholic?
Though the phrase is not a diagnostic term, high functioning alcoholic is often used to describe a person whose dependency to alcohol has not yet caused problems in most areas of their social, professional, and personal life. At the “functioning” stage of their alcohol use, a person rarely misses work, though they may experience a dip in productivity as a result feeling hung over on a regular basis. Likewise, he or she has usually been able to maintain seemingly good relationships with family and friends. Despite an outward appearance of health and stability, a functional alcoholic is likely dealing with intense cravings for alcohol, multiple failed attempts to cut back on their drinking, or to quit drinking all together. In many cases, a person with an alcohol use disorder will eventually lose the ability to stay in a so called functioning stage of alcohol dependency because the disease of addiction tends to escalate, especially when left unaddressed and untreated.
Signs of a High Functioning Alcoholic
Recognizing the signs of a functional alcoholic, or more precisely someone with an alcohol use disorder, is important for getting help in the early stages of an alcohol addiction or being able to point out potential problems to a loved one or a friend. It can be difficult for a functional alcoholic to admit he or she has a problem, which is known as denial. This is especially true when a person hasn’t yet suffered with any serious drinking-related consequences. Still, there are some relatively clear signals that a person may be dealing with an alcohol use disorder.
Signs of a functional alcoholic can include some of the following:
- Attempting to hide the frequency or amount of alcohol and individual drinks – sometimes referred to as a closet drinker
- An incredibly high tolerance to alcohol
- A lifestyle, schedule, or social circle built around the consumption of alcohol
- Blacking out or not being able to remember what happened after a period of drinking the evening or day before
- Engaging in risky behavior, such as driving while intoxicated, practicing unsafe sex while inebriated, or drinking while caring for young children
- Becoming irritated when confronted about drinking behavior
- Feeling anxious or agitated when situations change and being unable to drink as planned
- Drinking more than a person originally intended
- Having social media posts that show most leisure time is spent drinking alcohol
- Constantly having discussions about drinking
What’s important to remember is that there is no shame struggling with an alcohol use disorder. While it may feel like something that’s embarrassing or needs to be hidden, because of the societal stigma often attached, it is a very treatable condition.
Consequences of Functional Alcoholism
Many people battling functional alcoholism are often dealing with undiagnosed or untreated mental health issues, such as depression, anxiety, post-traumatic stress disorder, or other issues. Regular or excessive alcohol consumption is one way many people unwittingly self-medicate the symptoms of these problems. Left untreated, the problems faced by a functioning alcoholic may increase because long-term alcohol use makes the symptoms of mental illness worse, causing a cycle of drinking more to feel better. For some people who begin drinking without any mental health issues, excessive or long-term alcohol use changes the function and structure of the brain as addiction occurs. These brain changes can lead to depression, anxiety, or other mental illness conditions that were absent before regular alcohol use. The combination of addiction and mental illness combined is known as a co-occurring disorder and requires dual diagnosis treatment for recovery from both conditions.
Other Functioning Alcoholic Negative Consequences
As the cycle continues, real-life drinking-related problems, such as DUIs, losing employment, or having relationship issues will begin to manifest very quickly, making life even more chaotic and unmanageable. Excessive drinking over time, even if it seems manageable and under control can lead to negative health issues such as liver damage, wet brain, cancer, heart disease and others. Many times, physical and mental health conditions from alcohol use may develop slowly, so a person doesn’t know they are happening until the issue becomes serious, and then it may be too late to correct. Seeking treatment for functional alcoholism should begin before any negative health symptoms appear.
Functioning Alcoholic Treatment
A residential alcohol treatment program may be necessary to address many of the challenges faced by a functioning alcoholic in the same manner as those with a more serious alcohol use disorder. Treatment for functional alcoholism usually needs to start with alcohol detox in a safe, medically monitored facility that can help individuals move through withdrawal symptoms in the most comfortable manner possible. For most individuals, alcohol detox will generally last for 7 to 10 days depending on the severity, and may only take 3 to 5 days for some people. An inpatient, supervised detox will ensure the patient is safe and comfortable, and fully completes the detox process instead of quitting if things become too difficult, and begin drinking again. Detoxing from alcohol should never be done at home alone because withdrawal can be dangerous. The most serious form of alcohol withdrawal is known as Delirium Tremens (DTs), and can cause seizures or even be fatal. After detox is completed, a formal treatment program tailored to a person’s specific needs will address the underlying causes and drivers of alcohol addiction, including any issues with depression, anxiety, or other mental health problems. Alcohol addiction treatment usually includes one-on-one counseling, group sessions, and family counseling. All of these are incredibly useful for understanding the reasons a person has been drinking and to help them fully engage in the recovery process. Therapeutic approaches like Cognitive Behavioral Therapy (CBT) help people develop skills that address and change negative thought patterns and behaviors. Others such as Relapse Prevention Therapy teach ways to avoid triggers and cravings that can derail sobriety and cause a person to begin drinking again. Though it can be difficult for those considered to be a functional alcoholic to envision life without drinking alcohol regularly, many others before them have recovered successfully. It is challenging to seek help and work through the program, but it is worth the reward of living a happy, healthy, and productive life in recovery from an alcohol use disorder.