What is a High Functioning Alcoholic? (Signs, Treatment, Warnings)

Updated: May 4

If you have ever heard of a functional alcoholic, then you might be left wondering what it means. We think of an alcoholic as someone who has totally lost control of their life

they've probably lost their job or family members. So how can we have a term

that calls an alcoholic functional? What an oxymoron, right?

Most people know that an alcoholic is a person that has a physical need to consume alcohol, even when it is negatively impacting their life, but there are also different types of

alcoholics...

One of these types is a functioning alcoholic, which is a term that is used to describe an alcoholic that still functions in society.


What Is a Functional Alcoholic?


A functional alcoholic, or high functioning alcoholic, is not a formal medical diagnosis, but it is a term that is often used to describe a person that is dependent upon alcohol

but is still able to function in society.

The term "currently functioning" is also sometimes used to describe such a person, as it is

not likely that they will remain functional indefinitely.

For functional alcoholics, drinking is something that rarely causes them to miss work and other obligations, although it does happen on occasion.

They are usually able to manage areas of their life like their job and they also often appear to be both physically and mentally healthy.

However, a functional alcoholic is also likely to be struggling with uncontrollable cravings,

unsuccessful attempts at quitting, and obsessive thoughts about their next

drink as well as underlying health problems. These are all signs of an

alcohol disorder.


Even though the term alcoholic has been used in the past, it is often now viewed as outdated and stigmatizing.

Today, healthcare professionals would typically refer to a person as having an alcohol use disorder, or AUD.


Risk Factors for Functional Alcoholics


According to the National Institutes of Health, functional alcoholics are typically middle-aged and well-educated, with stable jobs and families.

The exact causes of alcoholism are not known, but there are risk factors that will increase your chances of developing alcohol problems. Some of these risk factors are:

Binge

  • drinking (more than 5 drinks per day)

Experiencing

  • high levels of stress

Exposure

  • to peer pressure to drink

Having

  • a parent or close relative with an alcohol use disorder

Having

  • a mental illness, such as anxiety, major depression, or schizophrenia

Having

  • low self-esteem

Having

more than seven drinks (for females) or more than 14 drinks per week (for

  • males)


Denial


One of the main reasons that people who misuse alcohol seek help is the eventual negative

consequences that arise from excessive alcohol consumption.

If the pain or embarrassment eventually gets bad enough, they can no longer deny that their

drinking needs to be addressed. There are those who never ask for help

and continue to drink until their bodies can no longer handle it.

For a functional alcoholic, denial is something that runs deep, as they have yet to come across significant negative

consequences.

If they are still going to work, they will not suffer financially. If they are not incohesive, they have likely not been arrested. Due to all of this, they are more likely to

convince themselves that they do not have a problem.


Secretive Behaviour


Something else that is quite common for a functional alcoholic is secretive behaviors. You might have noticed that they have become more secretive about where they are going or

their drinking habits. They might try to hide their drinking from you and lie

about where they have been. It is also possible for them to start storing

alcohol in weird places, like in their car or outside to try and stop you from

finding it and realizing how much they are drinking or when they are drinking.


Alcohol Tolerance


A functional alcoholic will often consume just as much alcohol as someone that has an alcohol use disorder. However, they will not typically show signs of intoxication. This is because they have developed a tolerance for alcohol to the point where they need

much more for them to feel the effects of it, including hangovers. This means

that a functioning alcoholic will need to drink in larger amounts to get the

buzz that they are seeking.

This slow build-up of alcohol tolerance means the functional alcoholic is drinking at dangerous levels that can lead to things like:

Alcohol

  • dependence2

Alcohol-related

  • organ damage

Cognitive

  • impairment


Withdrawal


Unfortunately, even when functioning alcoholics do start to realize that they have a problem drinking, they will still resist reaching out for help.

Something that can happen to those that have been relying on alcohol for a long time is withdrawal, which can begin just a few hours after their last drink.

It will only become more severe as time goes on. Some symptoms of alcohol withdrawal include:

Anxiousness

  • or nervousness

Appetite

  • loss

  • Depression

Difficulty

  • sleeping

Dilated

  • pupils


Faster

  • heart rate

Fatigue

  • or tiredness

  • Headache

  • Irritability

Mood

  • swings

Nausea

  • and/or vomiting

  • Nightmares

Not

  • being able to think clearly

Pale

  • skin

  • Shakiness

  • Sweating

  • Tremor

Sometimes, functioning alcoholics will try to quit on their own, but the withdrawals can be very unpleasant and have severe consequences, leading to them continuing to

drink to solve the problem of withdrawal.

The cycle then continues.

A lot of the time, it isn’t until their continued drinking becomes more painful than withdrawal would be that they reach out for help. However, it doesn’t always have to be this

way.

The Challenge of Functional Alcoholism

One of the biggest challenges is reflected in the book 12 and 12, where it talks about rock bottom, this book says on page 23,

Many less desperate alcoholics tried A.A. but did not succeed because they could not make the admission of hopelessness.

It goes on to talk about how this changed and says that

Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism.

It then talks about having had to “raise the bottom” to the point where it would hit others that were not down and out. This is the biggest challenge for the functional alcoholic, but one that is necessary before they can take the first step required by Alcoholics Anonymous.

For many, it will be their partner leaving or their children not wanting to hug them. The damage to personal relationships and the change to normal life are often enough provided the functional alcoholic is willing to make the connection between their alcohol abuse and the negative effects that it has on their personal life.

I wrote in a post on the first step that

Rock bottom is that moment when we find we can no longer hide the truth of our problems from ourselves. Rock bottom is the moment of our lowest emotional point, the moment when there is a sub-conscious realization that we have defects of character that need to be dealt with and that we needed a new way of living if we wanted a life of sobriety.

Rock bottom is the moment we have to admit to ourselves that we are powerless over our alcohol abuse disorder.

For all the trappings of success, I feel more anguish for the functional alcoholic than the stereotypical alcoholic as it is far harder for them to reach the step where

We admitted we were powerless over alcohol—that our lives had become unmanageable.

Without being able to do this the effects on our physical health and on any mental health issues will deteriorate under influence of alcohol, contributing to liver disease, high blood pressure, and brain damage.


Changing it Up

It is necessary for functional alcoholics to ask hard questions of themselves. Ask questions such as whether we are truly satisfied with our daily life, whether we like the trajectory of our lives and if the answers are no, then decide whether it is our alcohol consumption that contributes to this state. Ask then whether you are able to control your drinking problem.

This is more difficult than it sounds because alcoholics are specialists in denial and none more so than one who has a successful career. If you can admit that alcohol is to blame for the issues and that you are powerless over it, you have taken the first step.

Getting Help

If you or someone you know are having mild to moderate withdrawal symptoms or has admitted to a problem then medical professionals may recommend outpatient treatment options, involving medical detox that provides medication, vitamins, and diet to help

ease the alcohol withdrawal process.

There are lots of different ways in which people can help if they are suffering, including through counseling, rehabilitation, and support groups. This can include programs such

as A.A., cognitive behavioral therapy, and treatment programs.

Conclusion

Not being on skid row does not mean someone is not an alcoholic. It does mean that recognizing the substance abuse disorder is more difficult. It is a matter of time before it gets worse. Make the smart decision and make the choice you need to.


Note: All quotes are from the book Alcoholics Anonymous, also known as the Big Book.