Almost 90 percent of all American adults (aged 18 and older) report consuming alcohol at some time in their lives, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports based on data collected in 2014. And alcohol is the most widely used addictive substance in America, the National Council on Drug Abuse and Drug Dependence (NCADD) publishes. For most people, alcohol does not constitute a problem; however, more than 16 million people, or nearly 7 percent of the American adult population, battled an addiction involving alcohol in 2014, NIAAA reports.

Functioning Alcoholic: When to Seek Treatment?

What Is a High-Functioning Alcoholic?

Addiction generally invades all aspects of a person’s life, disrupting social circles, interpersonal relationships, families, the workplace, and bringing financial and even legal ramifications. For some, however, alcohol addiction may manifest differently and individuals may appear, to the outside world at least, to have it all together and be functioning normally in spite of their alcohol consumption and problem drinking episodes. These individuals are often referred to as “high-functioning alcoholics.” The New York Times publishes information from surveys that indicate as many as 50 percent of all the people who struggle with an addiction involving alcohol may be high-functioning alcoholics.

A functioning alcoholic may lead a kind of double life, holding down a high-powered job, being financially secure, attending and doing well in school, and seeming to be taking care of all familial and expected obligations during the day, and then drinking excessively at night.

Spotting a Functioning Alcoholic

Functional alcoholics are often successful, well-educated people with respected careers who, unlike most people struggling with addiction, are able to be at work on time and continue to perform at high levels without a noticeable decline in production. Many careers may even blur the lines between social drinking and work, thus facilitating problematic drinking. For example, many jobs encourage or even promote martini lunches or cocktail hours during the day. A functional alcoholic may thrive in this environment.

Many of the regular signs of addiction may not apply to a functional alcoholic, as they may continue to take care of themselves physically, keep up with responsibilities, retain social circles and relationships, and maintain financially stability. There are several things to watch for that may signify a potential high-functioning alcoholic, however, including the following:

  • High tolerance levels and the potential lack of a hangover: Those who drink regularly build up a tolerance to certain levels of alcohol and will need more and more to get the desired results from drinking. When someone who is an occasional drinker overdoes it, hangovers may be brutal the following day, but in someone who is tolerant to these levels of alcohol, these aftereffects may be negligible.
  • An inability to have just one drink: Individuals who are high-functioning alcoholics may impose personal limits on drinking before starting and then be unable to meet these goals, drinking more than intended in a sitting.
  • Personality changes while drinking: Impulsivity, risk-taking behaviors, increased sociability, and aggression may be common side effects of alcohol intoxication.
  • Blackouts: Although individuals may not seem intoxicated, they may not remember events that occurred while drinking.
  • Always a good reason for the drinking: Whether drinking to assuage stress or to celebrate, a functional alcoholic will almost always be able to rationalize drinking on any occasion or in most circumstances, and the reasons may seem perfectly logical at the time.
  • An obsession with drinking and thoughts of drinking: A person’s thoughts may constantly seem to revolve around alcohol, and they may talk and joke about it incessantly. They are likely unable to go more than a day without drinking.
  • Alcohol cravings and an inability to feel “normal” without it: Alcohol changes the way a person responds to pleasure and interferes with the normal production and absorption of some of the brain’s chemical messengers like dopamine, GABA, and glutamate. Chronic drinking can lead to a disruption in the parts of the brain that are involved in helping to regulate emotions, willpower, short-term memory formation, and decision-making. Withdrawal symptoms are common when alcohol is not present and may include anxiety, agitation, insomnia, depression, restlessness, irritability, and physical symptoms that may even be dangerous without proper treatment (e.g., irregular heart rate, respiration levels, and blood pressure, and the potential for seizures).
  • Drinking alcohol in place of meals: Alcohol may regularly replace food for a functional alcoholic who may see mealtime as an excuse to drink.
  • Denial: A high-functioning alcoholic may refuse to admit that their drinking is problematic and may become resentful, angry, aggressive, and hostile if it is suggested that alcohol may be a source of concern.

When and How to Get Help

Excessive alcohol use can shorten a person’s lifespan. It was responsible for 88,000 deaths each year between 2006 and 2010, the Centers for Disease Control and Prevention (CDC) warns. The World Health Organization (WHO) further extrapolates that alcohol abuse plays a role in more than 200 injury and disease conditions globally.

Alcohol may not seem to be impacting the everyday life of a high-functioning alcoholic just yet, but it will catch up to them at some point. Functioning alcoholics may not want to seek treatment for their alcohol abuse until problems start to crop up. Data published by Psychology Today indicates that only about a quarter of those who need treatment for alcohol abuse actually get the help they need. It often takes an external push to get these individuals into the treatment they need, be it a spouse issuing an ultimatum, the loss of a driver’s license, or the exposure of problematic drinking at work. It is best to try and get help before a major disaster occurs, however. Whenever someone feels the need to hide their drinking, is unable to control how much and how often they drink, or cannot stop thinking about drinking and their next drink, it is time to get professional help.

Family members and loved ones may either inadvertently, or overtly, be adding to the problem by making excuses for a high-functioning alcoholic and allowing the problematic behavior to continue. When an addiction involving alcohol is suspected, regardless of how functional the person seems to be, treatment is necessary. Medical, mental health, and substance abuse professionals, as well as trained interventionists, are able to offer advice and help family members begin the conversation to get their loved one into a treatment program.