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Updated on September 26, 2022

High-Functioning Alcoholics

There are many stereotypes about alcoholics.

You may think they're irresponsible people who can barely keep their lives together. But that's not always the case.

Alcohol use disorders (AUD) can manifest in many ways.

For example, some people with alcohol addiction are able to live successful lives. They may have a good job, a robust social life, and even a happy family at home.

What is a High-Functioning Alcoholic?

High-functioning alcoholics meet the criteria of having an alcohol use disorder (AUD).

They're still capable of maintaining their work and personal life. Also known as "functional" or "working" alcoholics, they look and act just like their peers.

On the outside, they appear healthy and successful. Most people won't realize that they have a problem.

In some cases, only their loved ones or people living with them will notice their drinking patterns.

11 Symptoms of Alcohol Use Disorder (AUD)

Alcohol use disorder (AUD) is the formal term for alcoholism or alcohol addiction. Here are the 11 main symptoms:

  1. You consume more and more alcohol (larger amounts or over a longer period of time)
  2. It's difficult to cut down on your excessive drinking
  3. You spend a lot of time getting, drinking, or recovering from alcohol
  4. You feel strong urges or cravings to drink
  5. Obligations and responsibilities like work, school, and relationships with friends and family members fall to the wayside
  6. You keep drinking alcohol despite alcohol-induced social or interpersonal issues caused by alcohol
  7. You stop or reduce important social, work, or recreational activities due to alcohol use
  8. You continue to use alcohol in risky situations that could cause you physical harm
  9. You continue to drink despite knowing it is causing you health problems or harming you psychologically or socially
  10. You've developed a high alcohol tolerance that requires you to drink more and more to achieve the same effect
  11. You've experienced alcohol withdrawal symptoms, including nausea, irritability, or tremors (delirium tremens)

The severity of AUD depends on the number of symptoms you have:

  • 2 to 3 is considered mild
  • 4 to 5 is considered moderate
  • 6 or more is considered severe

Functional alcoholics are often considered "successful" by their friends and society.

They tend to restrict their alcohol abuse to specific situations or times. This presents the illusion that they are in control of their alcohol use.

Many people are in denial about their high-functioning alcoholism. They may convince those around them that their drinking is not problematic.

Most functional alcoholics minimize the problems caused by their alcohol consumption. Many even believe the problems would exist for them with or without alcohol. But they still suffer from the effects of their substance abuse.

Functional alcoholics might have co-occurring mental health issues, such as depression or anxiety.

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Signs of High-Functioning Alcoholism

A functional alcoholic has yet to display most of the obvious effects of alcoholism. They likely experience negative consequences caused by alcohol abuse — but not to a noticeable extent.

Functional alcoholics will usually have a loved one cover for them. This typically happens when alcohol-related issues arise. For example, one’s spouse might call in sick when the functional alcoholic has a hangover.

Functional alcoholics might also isolate themselves from other people. They do this in order to spend time alone drinking.

High-functioning alcoholics tend to drink moderately consistently. They drink throughout the day without getting drunk.

This ongoing stream of alcohol into their system usually keeps cravings at bay and prevents withdrawal symptoms.

Some might binge drink, but it tends to be on the weekends or at night when it doesn’t affect their work.

A high-functioning alcoholic might also:

  • Deny or diminish the amount of alcohol he or she is drinking
  • Joke about having an alcohol problem
  • Justify alcohol misuse by drinking "top-shelf" or "celebrating" unimportant events
  • Drink a large amount of alcohol and not appear drunk
  • Drink at lunch time, or have an excessive number of drinks at dinner
  • Drink enough to cause a blackout
  • Get arrested for drinking while under the influence of alcohol
  • Miss school or work without a legitimate reason
  • Get confrontational or upset about inquiries into his or her alcohol consumption

A functional alcoholic will usually appear healthy. This is despite consuming a higher-than-healthy amount of alcohol.

Some may drink for years without experiencing health problems. Although eventually, their alcohol consumption will negatively affect their body.

Many high-functioning alcoholics only realize they had a long-term problem when they are older. By this time, their liver, heart, and brain health are already damaged.

It may seem that high-functioning alcoholism is not as severe as other types of alcoholism. They can maintain a job, family, social life, and appear “normal.” But they have an addiction to alcohol. It has just progressed differently, and they have learned how to manage it better.

Working with a High Functional Alcoholic

In the U.S., alcohol is one of the most used and abused substances. Therefore, it's not surprising to find high functioning alcoholics in the workplace.

Functional alcoholics can still operate effectively at work. They either hide their problem or deny it completely.

These behaviors may indicate that a co-worker might be a functioning alcoholic:

  • They drink whenever they are given the chance
  • A sudden change in behavior after a few drinks
  • Exhibiting blackouts which causes them to not remember their actions and words
  • Messing up responsibilities
  • Frequent sick days
  • Unexplained tardiness and absences
  • Personal instability
  • Strained relationships with co-workers
  • Being grumpy and having a negative attitude

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What Causes a Person to Become a High-Functioning Alcoholic?

An alcohol use disorder can develop quickly or progressively. The earlier a person begins drinking, the more likely they are to develop an alcohol addiction.

Environmental and genetic factors affect a person’s risk of developing alcohol use disorder. These include:

  • Genetics
  • Family history of alcohol use disorder
  • Home life
  • School or work environment
  • Stress and stress management ability
  • Social relationships
  • Exposure to peer alcohol consumption
  • Cultural or religious views

Whether or not a person can function in response to alcohol use disorder is unpredictable.

Some people develop an addiction and have obvious problems shortly after. Still, others can abuse alcohol for decades without major problems.

Is Treatment Necessary for High-Functioning Alcoholics?

Alcohol use disorder is progressive. It might develop quickly or gradually.

But without treatment, it will get worse. This is why everyone with alcohol use disorder needs treatment. Without it, a high-functioning alcoholic can soon become non-functioning.

High-functioning alcoholics tend to believe they do not need treatment. In rare cases, this type of alcoholic might passively seek support. Yet because of their ability to function, they never receive a diagnosis.

This is unfortunate because treatment is the best way to get AUD under control. Treatment also makes it possible to avoid long-term risks. These risks are something all alcoholics eventually develop.

In addition, functional alcoholics often require corroboration from loved ones to engage in their behavior. Some sources refer to these types of relationships as codependent.

This is not a formal diagnosis but more of a descriptive term that is used to identify patterns of interaction that occur in individuals with dysfunctional relationships.

Even functioning alcoholics who never experience major problems are not living their best life. Some people compare it to living with untreated depression or anxiety.

Life goes on, but it’s always less than it could be and the person never feels their best.

With treatment, high-functioning alcoholics can better manage their disorder and reach their full potential.

Health Problems Caused by Alcoholism

There are numerous health problems caused by unhealthy drinking behaviors and alcohol dependence.

Short-term effects

The following are the short-term effects of alcoholism:

  • Alcohol poisoning
  • Injuries such as falls, motor vehicle accidents, and burns
  • Violence such as fighting, sexual assault, or domestic violence
  • Risky sexual behavior such as unprotected sex
  • Miscarriages among pregnant women

Many functioning alcoholics won't experience these short-term effects.

In some cases, this increases their level of denial. They may be convinced that their drinking is not an issue because they don't engage in binge drinking.

Long-term effects

The long-term health risks associated with alcoholism are:

  • High blood pressure
  • Heart disease
  • Liver damage
  • Cancer
  • Brain problems
  • Mental health disorders
  • Seizures
  • Weak immune system
  • Digestive issues
  • Chronic inflammation
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Resources

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    Robert C. McMahon, et al. International Journal of the Addictions, 1986 Psychological Correlates and Treatment Outcomes for High and Low Social Functioning Alcoholics, 21:7, 819-835.
  1. Cognitive Impairment and Recovery From Alcoholism.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, July 2001.
  2. Horner, Michael David, et al. "The Relationship of Cognitive Functioning to Amount of Recent and Lifetime Alcohol Consumption in Outpatient Alcoholics." 14 May 1999.
  3. Liepman, Michael R., et al. “Family Functioning of Male Alcoholics and Their Female Partners during Periods of Drinking and Abstinence.” Wiley Online Library, John Wiley & Sons, Ltd, 3 Aug. 2004.
  4. Ossola, Paolo, et al. “Alcohol Use Disorders among Adult Children of Alcoholics (ACOAs): Gene-Environment Resilience Factors.” Progress in Neuro-Psychopharmacology and Biological Psychiatry, Elsevier, 7 Nov. 2020.
  5. Varela, Maria, et al. “Neuropsychological Characteristics in Children of Alcoholics: Familial Density.” Journal of Studies on Alcohol, Alcohol Research Documentation, 1999.
  6. Witkiewitz, Katie, et al. “Profiles of Recovery from Alcohol Use Disorder at Three Years Following Treatment: Can the Definition of Recovery Be Extended to Include High Functioning Heavy Drinkers?” Addiction (Abingdon, England), U.S. National Library of Medicine, Jan. 2019.

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