If you have ever heard of a functional alcoholic, then you might be left wondering what it means. We think of an alcoholic as someone who has totally lost control of their life. They’ve probably lost their job or family members. So, how can we have a term that calls an alcoholic functional? What an oxymoron, right?
Most people know that an alcoholic is a person who has a physical need to consume alcohol, even when it is negatively impacting their life, but there are also different types of alcoholics…
One of these types is a functioning alcoholic, which is a term that is used to describe an alcoholic who still functions in society.
What Is a Functional Alcoholic?
A functional alcoholic, or high-functioning alcoholic, is not a formal medical diagnosis. However, it is a term that is often used to describe a person who is dependent upon alcohol but is still able to function in society.
The term “currently functioning” is also sometimes used to describe such a person, as it is not likely that they will remain functional indefinitely.
For functional alcoholics, drinking is something that rarely causes them to miss work and other obligations, although it does happen on occasion.
They are usually able to manage areas of their life like their job and appear to be physically and mentally healthy.
However, a functional alcoholic is also likely to be struggling with uncontrollable cravings,
unsuccessful attempts at quitting, and obsessive thoughts about their next drink as well as underlying health problems. These are all signs of an alcohol disorder.
Even though the term alcoholic has been used in the past, it is often now viewed as outdated and stigmatizing.
Today, healthcare professionals would typically refer to a person as having an alcohol use disorder, or AUD.
Risk Factors for Functional Alcoholics
According to the National Institutes of Health, functional alcoholics are typically middle-aged and well-educated, with stable jobs and families.
The exact causes of alcoholism are not known, but there are risk factors that will increase your chances of developing alcohol problems. Some of these risk factors are:
- Binge drinking (more than 5 drinks per day)
- Experiencing high levels of stress
- Exposure to peer pressure to drink
- Having a parent or close relative with an alcohol use disorder
- Having a mental illness, such as anxiety, major depression, or schizophrenia
- Having low self-esteem
- Having more than seven drinks (for females) or more than 14 drinks per week (for males)
Denial
One of the main reasons that people who misuse alcohol seek help is the eventual negative consequences that arise from excessive alcohol consumption.
If the pain or embarrassment eventually gets bad enough, they can no longer deny that their drinking needs to be addressed. There are those who never ask for help and continue to drink until their bodies can no longer handle it.
For a functional alcoholic, denial is something that runs deep, as they have yet to come across significant negative consequences.
If they are still going to work, they will not suffer financially. If they are not incohesive, they have likely not been arrested. Due to all of this, they are more likely to convince themselves that they do not have a problem.
Secretive Behavior
Something else that is quite common for a functional alcoholic is secretive behavior. You might have noticed that they have become more secretive about where they are going or their drinking habits. They might try to hide their drinking from you and lie about where they have been. It is also possible for them to start storing alcohol in weird places, like in their car or outside, to try and stop you from finding it and realizing how much they are drinking or when they are drinking.
Alcohol Tolerance
A functional alcoholic will often consume just as much alcohol as someone who has an alcohol use disorder. However, they will not typically show signs of intoxication. This is because they have developed a tolerance for alcohol to the point where they need much more for them to feel the effects of it, including hangovers. This means that a functioning alcoholic will need to drink in larger amounts to get the buzz that they are seeking.
This slow build-up of alcohol tolerance means the functional alcoholic is drinking at dangerous levels that can lead to things like:
- Alcohol dependence
- Alcohol-related organ damage
- Cognitive impairment
Withdrawal
Unfortunately, even when functioning alcoholics do start to realize that they have a problem drinking, they will still resist reaching out for help.
Something that can happen to those who have been relying on alcohol for a long time is withdrawal, which can begin just a few hours after their last drink.
It will only become more severe as time goes on. Some symptoms of alcohol withdrawal include:
- Anxiousness or nervousness
- Appetite loss
- Depression
- Difficulty sleeping
- Dilated pupils
- Faster heart rate
- Fatigue or tiredness
- Headache
- Irritability
- Mood swings
- Nausea and/or vomiting
- Nightmares
- Not being able to think clearly
- Pale skin
- Shakiness
- Sweating
- Tremor
Sometimes, functioning alcoholics will try to quit on their own, but the withdrawals can be very unpleasant and have severe consequences, leading to them continuing to drink to solve the problem of withdrawal.
The cycle then continues.
A lot of the time, it isn’t until their continued drinking becomes more painful than withdrawal would be that they reach out for help. However, it doesn’t always have to be this way.
The Challenge of Functional Alcoholism
One of the biggest challenges is reflected in the AA book 12 x 12, where it talks about rock bottom. This book says on page 23,
Many less desperate alcoholics tried A.A. but did not succeed because they could not make the admission of hopelessness.
It goes on to talk about how this changed and says that
Alcoholics who still had their health, their families, their jobs, and even two cars in the garage, began to recognize their alcoholism.
It then talks about having had to “raise the bottom” to the point where it would hit others who were not down and out. This is the biggest challenge for the functional alcoholic, but one that is necessary before they can take the first step required by Alcoholics Anonymous.
For many, it will be their partner leaving or their children not wanting to hug them. The damage to personal relationships and the change to normal life are often enough, provided the functional alcoholic is willing to make the connection between their alcohol abuse and the negative effects that it has on their personal life.
I wrote in a post on the first step that
Rock bottom is when we find we can no longer hide the truth of our problems from ourselves. Rock bottom is the moment of our lowest emotional point, when there is a subconscious realization that we have defects of character that need to be dealt with and that we need a new way of living if we want a life of sobriety.
Rock bottom is the moment we have to admit to ourselves that we are powerless over our alcohol abuse disorder.
For all the trappings of success, I feel more anguish for the functional alcoholic than the stereotypical alcoholic, as it is far harder for them to reach the step where
We admitted we were powerless over alcohol—that our lives had become unmanageable.
Without being able to do this, the effects on our physical health and any mental health issues will deteriorate under the influence of alcohol, contributing to liver disease, high blood pressure, and brain damage.
Changing it Up
It is necessary for functional alcoholics to ask hard questions of themselves. Ask questions such as whether we are truly satisfied with our daily lives, whether we like the trajectory of our lives, and if the answers are no, then decide whether it is our alcohol consumption that contributes to this state. Ask them whether you can control your drinking problem.
This is more difficult than it sounds because alcoholics are specialists in denial, and none more so than one who has a successful career. If you can admit that alcohol is to blame for the issues and that you are powerless over it, you have taken the first step.
Getting Help
If you or someone you know are having mild to moderate withdrawal symptoms or has admitted to a problem, then medical professionals may recommend outpatient treatment options involving medical detox that provides medication, vitamins, and diet to help
ease the alcohol withdrawal process.
There are many different ways in which people can help if they are suffering, including through counseling, rehabilitation, and support groups. This can include programs such
as A.A., cognitive behavioral therapy, and treatment programs.
Conclusion
Not being on skid row does not mean someone is not an alcoholic. It does mean that recognizing the substance abuse disorder is more difficult. It is a matter of time before it gets worse. Make the smart decision and make the choice you need to.
Note: All quotes are from the book Alcoholics Anonymous, also known as the Big Book.