It’s incredibly easy for anyone to develop an alcohol use disorder (AUD) or become what is known as a “high functioning alcoholic” or “functional alcoholic.”
Regular alcohol use, even when it teeters on abuse, is a socially accepted part of American life.
Consider how many events people regularly attend that include alcohol, such as work conferences, holiday office parties, sporting events, and concerts. Add to that the many family or social gatherings that are centered around drinking.
Excessive alcohol use or “heavy drinking” is considered to be 15 drinks or more a week for men and eight or more drinks a week for women, according to the Centers for Disease Control and Prevention (CDC).
Binge drinking is the act of consuming five or more drinks in one sitting for men and four for women.
Society normalizes the use alcohol in many settings so becoming a functional alcoholic does not have the same stigma attached to it as most forms of drug use.
What Does it Mean to be a High Functioning or Functional Alcoholic?
Though it’s not an official diagnostic term, a high functioning or functional alcoholic is a person with a moderate to severe alcohol addiction that “seems” to be able to manage without serious personal, social, professional, or legal consequences. At least for the time being.
The National Institutes of Health (NIH) suggest that nearly 20 percent of those with an alcohol use disorder are what they term the “functional alcoholic subtype.”
According to the NIH, a functional alcoholic is generally a person who is a well-educated, middle-aged adult with a stable family and career.
Some people with an alcohol use disorder spiral out of control, either quickly or over time, suffering incredibly severe consequences from substance abuse.
These individuals often face the stigma associated with the stereotypical “down and out alcoholic” and might be incorrectly considered a lost cause.
Those who fall into the category of a functional alcoholic appear on the surface to lead a regular life.
They may seem physically healthy, be able to balance family matters and friendships, and even excel in their careers.
Despite the lack of overt negative consequences, functional alcoholics are very often suffering an alcohol use disorder that affects their decision-making process and behavior nearly as much as those with a more apparent alcohol addiction problem.
Typical Symptoms or Functional Alcoholic Signs
Life as a functional alcoholic can actually be very insidious because people living with the disorder are much less likely to seek help.
This is primarily due to the fact that they feel things are under control. As is often the case, they are in complete denial that they have a drinking problem to begin with.
High functioning alcoholics and relationships can be problematic, especially if one person is sober. Alcoholism can put a strain on a marriage and regular drinking leads to a breakdown in communication.
Apart from regular, excessive alcohol consumption, there are other factors that can put a person at risk of becoming a functional alcoholic.
People struggling with anxiety, depression, past trauma, or other mental health issues may use alcohol as a way to self-medicate or cope with the symptoms of these and other conditions.
Genetics and a family history can also play a role. If a parent or member of an individual’s extended family had alcohol use disorder, it can increase the chances of developing the same issues.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), research shows that genetics is responsible for about 50% of the risk for developing an alcohol use disorder.
Other signs of a functioning alcoholic can include some of the following:
- Very high tolerance to alcohol as a result of excessive drinking
- Moderate to severe alcohol withdrawal symptoms after a short period of abstinence
- Habitually schedule social or professional engagements around the ability to drink alcohol
- Agitation or irritability when the regular drinking schedule is disrupted by work, family or other situations
- Lack of hobbies, interests or friends that don’t revolve around alcohol
- Casual jokes about “drinking too much” or “too often”
- Regularly consuming alcohol before, during, and after dinner
- Frequently drinking alone or preferring to drink alone
- Getting blackout drunk makes it difficult to remember parts of or all of the previous evening
- Engaging in risky behaviors like drinking and driving, drinking while at work, or sexual promiscuity while intoxicated
- Seemingly unable to understand there might be a problem even when confronted by family members, friends or other loved ones, a symptom known as denial
- Anhedonia or not being able to enjoy activities that were once enjoyable
Denial is a particularly difficult challenge for a functioning alcoholic because they can point to their successful jobs, relationships, and lack of alcohol-related problems. However, overcoming denial is not impossible.
How to Deal with the Denial of a Functional Alcoholic
The short term effects of alcohol may not pose a serious problem, but over the long-term, functional alcoholics will experience more serious negative physical and mental consequences.
Chronic alcohol abuse takes a heavy toll on the body, leading to all sorts of health issues. It also disrupts a person’s brain chemistry, making them more susceptible to mental health issues.
It’s not always easy, especially in the early stages, to convince a functional alcoholic that their choices are unhealthy, damaging, and dangerous.
Whether or not a person can break through their denial ultimately depends on them. But constructively expressing concern, a willingness to listen, and offering nonjudgmental support can be effective.
Always be supportive and never confrontational when pointing out your concern about another person’s drinking habits.
It is also meaningful to set clear boundaries about how drinking is subtly affecting their home life, relationships and any other consequences that may or may not seem substantial to them.
Finally, loved ones can send a clear message that they do not support their drinking, distance themselves with love and urge an individual to seek addiction treatment.
Treatment for Functional Alcoholics
It’s important to state right at the top that recovery from alcohol use disorder, whether it be a functional issue or not, is very achievable.
Treatment for functional alcoholism will vary based on a person’s individual situation and needs.
Some people might respond well to the independence of an outpatient program program. This offers patients the opportunity to continue their life mostly uninterrupted while still receiving the necessary therapy for recovery.
Outpatient treatment might be a good option for high functioning alcoholics because they seem to be in control of their life enough to continue working while in recovery.
For others who might have a co-occurring mental health issue like depression they’re dealing with as well, a dual diagnosis treatment program that provides a safe, supportive and healing atmosphere away from their normal daily stressors is preferred.
Though it may be difficult for people to understand in the beginning, living a life in recovery from alcohol misuse can be far more rewarding than ever imagined.
Even though a person may be coping as a functional alcoholic, there is a chance that it will develop into something more serious could cause extreme health or social problems in the future. Getting it under control early is a key to successful recovery.