A high-functioning alcoholic may be better described as a person with a mild-moderate alcohol use disorder (AUD) who functions satisfactorily in many aspects of their life. Although people on the outside may not see many of the effects of the person’s drinking habits, those close to them—such as spouses, children, and family members—get a first-hand look at the potential consequences of living with a chronic, heavy drinker.
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What is a High-Functioning Alcoholic?
The National Institute on Alcohol Abuse and Alcoholism has identified functional alcoholics as a subtype of people who are alcohol-dependent. According to their description, this subtype represents 19.5% of alcoholics in the United States. They are typically middle-aged, have job and family stability, and may be well-educated and high achievers. Many have a family history of alcoholism, suffer from depression, and are current or former smokers. (1)
A high-functioning alcoholic can usually attend to most familial obligations and maintain a livelihood despite regular alcohol misuse. Because of how well the person can manage their responsibilities, they are unlikely to be exposed to the societal stigma severe alcoholics face. They also tend to have little acceptance of their condition or how difficult circumstances could potentially become.
As a result, they may not grasp the full extent of their problems until they encounter severe repercussions, such as family dysfunction, job loss, legal trouble, financial hardships, or health issues. Furthermore, they are also likely to be the last to recognize that their drinking habits continue to worsen. As long as they feel they’re in relative control of their situation, they will probably be experiencing at least some amount of denial. There are many behaviors of functional alcoholics that loved ones may notice in a family member. (2)
Common Drinking Behaviors of a Functional Alcoholic Include:
- Consuming alcohol regularly above moderate levels as defined by dietary guidelines. (3)
- Being unable to control drinking once started.
- Going on binges that last several days before recovering and returning to life as usual.
- Needing to drink to relax, relieve stress, be social, feel confident, or as a coping mechanism.
- Drinking after waking up, early in the day, or when alone.
- Occasionally missing events or neglecting responsibilities due to drinking or being hungover.
- Engaging in risky or impulsive behavior while drinking, such as driving, doing stunts, or fighting.
Defensive Mechanisms of a Functional Alcoholic Include:
- Denying, minimizing, or concealing the problem’s severity.
- Failing to accept a problem exists despite being confronted by loved ones.
- Rationalizing drinking alcohol as a reward after a stressful day.
- Blaming others for their drinking or alcohol-related behaviors.
- Joking about their alcohol misuse to re-frame the problem as being trivial.
Alcoholics Who “Function” Still Have Alcohol Use Disorder
It’s important to understand that functional alcoholics do meet the diagnostic criteria for an alcohol use disorder. (4) As such, they, like all alcoholics, will use almost any excuse to drink when they want to drink. Stress, depression, enjoyment, relaxation, boredom, social occasions, etc., are all potential reasons for drinking. Functional alcoholics are not just social drinkers who use alcohol to fit in and stop when they feel like it. They have a significant problem that can rapidly evolve into a more severe alcohol use disorder and damaging effects.
According to NIAAA, AUD “is a medical condition characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational, or health consequences.” It encompasses conditions commonly referred to as alcohol misuse, alcohol dependence, and alcoholism. (5)
Unhealthy alcohol use is further defined as such that it “includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems.” (6)
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Challenges of Dealing With a Functional Alcoholic: Denial & Excuses
Denial among heavy drinkers is pervasive due to the nature of their disease, and it may be even more pronounced among high-functioning alcoholics. (PSYCH) People able to maintain relationships and careers and manage to avoid health, legal, and financial issues have reasons to deny that their drinking is problematic and needs to be addressed. Unfortunately, denial is a significant barrier to people who misuse alcohol because if they admit a problem exists, there will be an expectation to change.
People in denial will also insert excuses and reasons into their arguments defending their drinking habits. They might underestimate the severity of their alcohol use or the impact the problem has had on their lives and those of loved ones. Once confronted with reality, such as being arrested for drinking and driving, they take this sign they need to change. However, others will continue to downplay the gravity of their actions and attempt to evade the realities of their situation.
Denial and excuses will likely progress to consistent deception and social avoidance. Moreover, you might expect the person to do everything they can to avoid detection, including drinking secretly, missing important events, and concealing alcohol.
Why Consider an Intervention?
Talking to a loved one about their drinking habits can be challenging. You may be met with many defensive mechanisms, such as those listed above, to deflect your attempts. Moreover, you might expect to encounter denial, deception, justifications, apprehension, anxiety, and anger. Finally, they may leave the situation altogether, and nothing gets accomplished. For these reasons, staging an intervention may be more likely to yield a more favorable outcome.
A professional intervention is an organized meeting of family and friends, typically held by an interventionist or addiction specialist. It is a systematic process that allows participants to convey their feelings and concerns clearly and effectively, so the loved one understands the full scope of their problem. The interventionist’s ultimate goal is to convince the person of focus to seek treatment.
Before the intervention, a pre-arranged treatment plan will be outlined with steps, goals, and guidelines and readied to be presented to the individual. During the process, loved ones will be asked to provide specific examples of unhealthy or destructive behaviors and how each has affected them and the family. An addiction treatment provider, such as a recovery center, will have already been alerted of their possible admission and have a space ready for them to stay.
The intervention plan will spell out what each participant will do if the loved one refuses to accept treatment. Interventions led by an interventionist tend to be more successful than those staged by family members. Still, even these are not always successful—at least not initially. Sometimes multiple interventions spaced out over time are required to achieve the desired result.
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High-functioning alcoholics, despite an outward appearance of relative normality, still face the same risks as more severe drinkers. These include adverse health complications, damaged relationships, financial and legal issues, and reduced professional or academic performance. High-functioning alcoholics are not immune to the consequence of heavy drinking and are urged to seek treatment, such as detox and long-term inpatient or outpatient treatment.
At Guardian Recovery, we offer an integrated, holistic approach to substance misuse treatment, encompassing a wide array of evidence-based practices. Our recovery programs feature evidence-based methods, including individualized therapy, 12-step immersion, and medication-assisted treatment, which provide our clients with the tools they need to be successful in recovery.
Contact us today to speak to a skilled Treatment Advisor to learn more about our comprehensive programs and streamlined admission process. We can also provide you or your loved one with a free, no-obligation assessment and health insurance benefits check. We are dedicated to helping individuals struggling with alcohol use disorder and their families overcome alcohol addiction and nurture healthier, happier lives.
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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.