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Alcohol use disorders (AUD) can manifest in many ways. While some struggle with their addiction, others can live successful lives.
These people have jobs, active social lives, or happy families at home. They are called high-functioning alcoholics.
Although they can live a perfectly normal life, they can still benefit from professional help. Without help, their AUD can worsen and cause long-term health and social problems.
What is a High-Functioning Alcoholic?
A high-functioning alcoholic will usually appear healthy despite consuming large amounts of alcohol. On the surface, they appear happy and successful.
Because of this appearance, their problem doesn’t seem as severe as other types of alcoholism. However, they usually meet the criteria of alcohol use disorder.
Most people won’t even realize they have a problem. Sometimes, only the people close to them will notice their problematic drinking patterns.
Signs of High-Functioning Alcoholism
Functional alcoholics will always try to find time to drink. They might also isolate themselves from other people to spend time drinking alone.
High-functioning alcoholics tend to drink consistently. Because they keep drinking, they don’t feel any withdrawal symptoms.
A high-functioning alcoholic also tends to:
- Lie about the amount they drink
- Joke about having an alcohol problem
- Justify alcohol misuse by drinking "top-shelf" or "celebrating" unimportant events
- Drink a large amount of alcohol without appearing drunk
- Day drink or drink at lunchtime
- Have an excessive number of drinks at dinner
- Get blackout drunk
- Get arrested while under the influence of alcohol
- Miss school or work without a legitimate reason
- Get confrontational when asked about their drinking habits
- Binge drink during off days or near the weekend
How to Recognize Alcohol Use Disorder (AUD)
High-functional alcoholism can lead to an alcohol use disorder. It could also be a sign that they already have an AUD.
To help recognize the signs of an AUD, here are 11 main symptoms:
- Consuming more alcohol for an extended period
- Difficult with cutting down on drinking
- Spend time drinking or recovering from drinking
- Intense alcohol cravings
- Failure to meet social obligations (school, work, family)
- Drinking alcohol despite causing social or interpersonal issues
- Abandon work or hobbies to drink
- Drinking, despite the physical hazards
- Drinking despite health risks
- A high alcohol tolerance
- Withdrawal symptoms
Dangers of High-Functioning Alcoholism
The main risk of high-functioning alcoholism is the potential for a worsening condition. Over time, you may struggle to maintain social and familial obligations and relationships.
There are also health risks to high-functioning alcoholism and AUD. These risks include:
- High blood pressure
- Liver disease and pancreas problems
- Memory loss
- Heart disease
- Mental health disorders
- Digestive problems
- Weakening immune system
- Chronic inflammation
How to Know if I’m a High-Functioning Alcoholic?
The signs and symptoms listed above should be a good indicator of high-functioning alcoholism. However, there are tests you can take to be certain.
These tests are provided by a healthcare professional and go in depth about your relationship with alcohol. The test helps give your doctor an idea of what treatment is best for you.
A test recommended by the National Institute for Health and Care Excellence (NICE) is the alcohol use disorders identification test (AUDIT).
How Does a Person Become a High-Functioning Alcoholic?
There are genetic and environmental factors that lead to high-functioning alcoholism. These factors include:
- Genetics or family history of AUD
- Early exposure to alcohol
- Home, school, or work-related stress
- Social relationships
- Peer pressure
- Cultural or religious views
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.
How to Treat High-Functioning Alcoholism
Although a person with high-functioning alcoholism may appear fine, they are not. Without treatment, their alcoholism can get progressively worse.
Treatment is the best way to get AUD under control. Unfortunately, many high-functioning alcoholics tend to believe they don’t need treatment.
Treatment options for high-functioning alcoholism include:
High-functioning alcoholism is defined by the alcohol’s ability to work or function normally. These people appear successful and healthy despite a possible underlying alcohol use disorder.
High-functioning alcoholics will do what they can to drink while appearing sober. They’ll binge drink on weekends to ensure they have no obligations the following day.
Genetic or environmental factors can cause high-functioning alcoholism. For example, a family history of alcoholism or a stressful environment.
Although they may appear to be healthy and functional, without treatment, their condition could get worse.
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- “Understanding alcohol use disorder.” National Institute on Alcohol Abuse and Alcoholism, 2020.
- Ossola et al. “Alcohol Use Disorders among Adult Children of Alcoholics (ACOAs): Gene-Environment Resilience Factors.” Progress in Neuro-Psychopharmacology and Biological Psychiatry, Elsevier, 2020.
- Office of the Surgeon General. “Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health.” Washington, DC: US Department of Health and Human Services, 2016.
- Witkiewitz 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, 2019.
- “Alcohol's Effects on the Body.” National Institute on Alcohol Abuse and Alcoholism, 2021.
- “Alcohol Use Disorder: A Comparison Between DSM–IV and DSM–5.” National Institute on Alcohol Abuse and Alcoholism, 2021.