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What Is a High-Functioning Alcoholic?

Written by
Chris Elkins, M.A.
Edited by
Kim Borwick, M.A.
Medically Reviewed By
Ashraf Ali, M.D.
This page features
6 Cited Research Articles

High-functioning alcoholics are people who appear to function normally despite being addicted to alcohol. Many high-functioning alcoholics seem to keep their lives together while drinking in secret, but chronic alcohol abuse always leads to negative consequences. Many high-functioning alcoholics experience emotional problems that others can’t see.

People suffering from alcohol addiction don’t always hit rock bottom. Many people keep their addiction secret and believe they control how much they consume.

They may never get fired for being hungover, have a falling-out with friends or get pulled over for driving under the influence. The side effects might not catch up to them until old age, when chronic alcohol abuse takes its toll on their liver, heart and brain.

These people are commonly referred to as high-functioning alcoholics or working alcoholics. A high-functioning alcoholic might drink moderately throughout the day — never enough to get drunk but always enough to curb cravings and stave off withdrawal. Or they may remain sober throughout the day but binge drink at night or on weekends.

But they have an addiction as real as those of the people who get in car accidents, show up to work drunk or lose their family and friends.

Functioning alcoholic at a party

The term high-functioning alcoholic can be defined as a person who suffers from alcoholism but has yet to experience noticeable side effects of their addiction to alcohol. They likely experience negative consequences caused by alcohol abuse, but those consequences do not appear to prevent them from functioning in everyday life.

The American Psychiatric Association classifies substances use disorders as mild, moderate or severe. The severe cases are obvious. They’re highlighted on TV and in the news. But mild and moderate cases may be more common, affecting millions across the U.S.

In 2007, Columbia University researchers found that 4 percent of Americans had an alcohol use disorder.

In 2007, Columbia University researchers analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions. They found that 4 percent of Americans had an alcohol use disorder. Among the 4 percent, 3 percent — about 9 million people — were considered functionally dependent.

Alcoholics have a stereotype, so friends, family members and co-workers might not recognize high-functioning alcoholics.

The term high-functioning is misleading, though. Some experts prefer the term “currently-functioning alcoholic” because odds are such people aren’t going to be high-functioning forever. They might not even continue to abuse alcohol forever.

The Columbia researchers found that about 72 percent of people who become dependent on alcohol overcome the disease, with or without treatment, within three or four years and do not relapse. The prognosis for the other 28 percent isn’t as encouraging. They relapse an average of five times and must work to remain sober for the rest of their lives.

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Signs & Symptoms of a High-Functioning Alcoholic

People with alcohol use disorders don’t fall into either a highly functional or dysfunctional category. In fact, every person experiences different symptoms and side effects of the disease. Researchers from the National Institute on Alcohol Abuse and Alcoholism developed five general subtypes of alcoholism.

“Our findings should help dispel the popular notion of the ‘typical alcoholic,’” said Dr. Howard Moss, NIAAA associate director for clinical and translational research, in a news release. “We find that young adults comprise the largest group of alcoholics in this country, and nearly 20 percent of alcoholics are highly functional and well-educated with good incomes.”

High-functioning alcoholics are difficult to recognize because they try to keep their addiction a secret. They may be in denial about their addiction, so they’re unwilling to accept help or admit they need help. Often, only a select few friends, family members or spouses are close enough to recognize the signs.

Signs that someone is a high-functioning alcoholic include:

High-functioning alcoholics are more likely to participate in high-risk behavior, but they may be better at not getting caught than others.

Examples of high-risk behaviors include:

One of the misconceptions about high-functioning alcoholics is that they never experience problems. Alcoholism never occurs without consequences. Some alcoholics may be highly functional at work, in school or in social situations, but the negative effects of the disease will eventually show up somewhere.

People with alcohol use disorders, including those with mild types, often isolate themselves to hide how much they drink. They may experience legal problems, usually in the form of a DUI or after an accident involving drinking. Chronic alcohol consumption often leads to mental health problems such as depression or other health issues such as high blood pressure, liver problems or heart problems.

You can get help for yourself or your loved one before hitting rock bottom, but you have to start by finding out if you or your loved one are a high-functioning alcoholic. A short quiz for high-functioning alcoholics can help you determine the severity of you or your loved ones addiction to alcohol.

AM I AN ALCOHOLIC?

Take our 11-question quiz to find out now.

How Do People Become High-Functioning Alcoholics?

Some people become addicted to alcohol quickly, and others develop the disease over time. People who drink alcohol when they’re underage are more likely to become addicted because the developing brain is more vulnerable to the effects of the substance.

A variety of genetic and environmental factors affect a person’s chances of becoming addicted. The same factors also affect how severely a person will get addicted.

Factors that may affect whether a person becomes a high-functioning alcoholic include:

It’s impossible to determine why one person becomes more severely addicted than another. Some people have genetic and environmental factors that allow them to be addicted to alcohol for a long time before they experience major health or social problems. Others have a high number of risk factors and are never able to appear functional.

Do Functioning Alcoholics Need Treatment?

High-functioning alcoholics don’t remain highly functional forever. If you think you or someone you know is a high-functioning alcoholic, even someone with a mild alcohol use disorder, don’t wait until problems occur to seek treatment for alcoholism. DUIs, trouble at work and family drama can be avoided by seeking help before the disease progresses.

Research suggests that some high-functioning alcoholics never experience major problems, but they also never live life to their full potential.

“Although their lives do not fall apart, their excessive drinking may be a matter of significant concern for them and their loved ones,” said Dr. Moss of the NIAAA. “In this way, people with functional alcohol use disorders resemble others with major depression or anxiety disorders who are able to function but at a suboptimal level and with a significant level of distress.”

Family members of high-functioning alcoholics need to be careful not to become codependent on their loved one. Codependence refers to helping another person to an extent that you experience health or social problems. People who are codependent on a high-functioning alcoholic may miss work or time with their family because they’re preoccupied with hiding the fact that their loved one is an alcoholic.

There is nothing shameful about suffering from alcoholism. But if you don’t want others to know you’re in recovery, you can attend outpatient treatment or attend anonymous support group meetings. Recovery from alcoholism is possible with dedication and perseverance.

Editor
Kim Borwick, M.A.
Kim Borwick, M.A., Editor, DrugRehab.com
Medical Reviewer
Ashraf Ali
Psychiatrist, Los Angeles County Department of Mental Health

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