Functioning Alcoholic

Is My Partner a Functioning Alcoholic

What is Functional Alcoholism?

Functional alcoholism is a subtype of alcohol use disorder (AUD), in which individuals meet diagnostic criteria for AUD while still being able to maintain a job and relationships with others.1

Functional Alcoholism - An Introduction

It’s estimated that about 20% of individuals with alcohol use disorder are considered “functional alcoholics” or “high-functioning alcoholics.”2

These individuals maintain high levels of functioning while drinking in a way consistent with
alcohol use disorder. Functioning alcoholic symptoms are included in the diagnostic criteria for alcohol use disorder. An individual only needs two out of eleven criteria to have a disorder.

What Is a High-Functioning Alcoholic?

A high-functioning alcoholic is someone who is able to maintain a professional life, social life, and relationships while still consuming excessive amounts of alcohol. These individuals typically are older, educated, and have stable careers and family lives. The NIAAA, National Institute on alcohol abuse and alcoholism defines excessive drinking as follows:

  • More than 4 drinks per day, or more than 14 drinks per week for men.
  • More than 3 drinks per day, or more than 7 drinks per week for women. 

What is Binge Drinking?

Additionally, high-functioning alcoholics may struggle with binge drinking, or drinking to the point where blood alcohol content reaches .08 or higher. Binge drinking is different for men and women.

  • For men, drinking more than 5 alcoholic beverages on one occasion is considered binge drinking.
  • For women, drinking more than 4 alcoholic beverages on one occasion is considered binge drinking.3

Understanding Functional Alcoholism

Because functioning alcoholics succeed in various areas of life, these individuals often do not seek treatment.

How Can You Tell if Someone is a High-Functioning Alcoholic?

Unlike alcoholics who are lower functioning, high functioning alcoholics are less likely to get into legal trouble or struggle paying bills. Additionally, high-functioning alcoholics may not be as physically addicted and may not experience severe withdrawal symptoms.4

These individuals typically hide their drinking habits well. Signs of functional alcoholism include:

  • Avoiding conversations surrounding alcohol use
  • Short-term memory loss, or losing time from blackouts
  • Hiding alcohol consumption by drinking alone or disposing of evidence
  • Mood changes and irritability
  • Drinking at inappropriate times or in potentially dangerous situations 

Who is Most Likely to be a High-Functioning Alcoholic?

The National Institute of Health describes high-functioning alcoholics as typically being "middle-aged, well-educated, with stable jobs and families. However, anyone can be a high-functioning alcoholic.

Some risk factors for alcohol use disorder include: 

  • High levels of stress
  • Peer pressure
  • Familial history of substance abuse
  • Low self-esteem
  • Mental health conditions 

Why is High-Functioning Alcoholism a Problem?

One quarter of high-functioning alcoholics have experienced a major depressive episode. Alcohol use increases risk of depression and suicide. Approximately 20-35% of suicides are carried out by individuals with alcohol abuse disorder, and 5% of all individuals with alcohol use disorder die by suicide. 5

High functioning alcoholics can also be a danger to others. In a recent study of 200 patients diagnosed with alcohol use disorder, 21% of individuals reported that they had alcohol-related traffic incidents. Additionally, 30% of all crash fatalities are alcohol-related. 6

What Causes a Person to Become a High-Functioning Alcoholic?

Numerous factors increase the risk of developing alcohol use disorder; these risk factors will be detailed below.

Genetics

While there’s no one gene responsible, genetics play a role in development of alcohol use disorder. Genetics may be responsible for up to half of the risk for alcohol use disorder. 7

Family History

Alcohol use disorder tends to run in families. Parents' high levels of alcohol use in the home are associated with higher use in adolescents and young adults.

Home Life

A stressful and unsupportive home life can be a powerful avoidance strategy and trigger for drinking.

School or Work Environment

School or work environments play a role, especially for individuals who leave home and go to college. Environments that are stressful or permissive to drinking increase risk of AUD. 

Social Relationships

Drinking is often a social activity. A drink or two at dinner with a friend is standard, but situations where you feel pressured to drink can quickly develop into an alcohol use problem.8 

Exposure to Peer Alcohol Consumption

After age 15, family influence begins to dwindle, and peer support and influence take over. Once individuals leave home, drinking tends to increase. 

Cultural or Religious Views

Those within a culture permissive to drinking are more likely to start. For example, heavy drinking patterns may be related to a cultural concept of masculinity.

Individuals with higher religious commitment are 50% less likely to be drinkers than those with lower religious commitment.9

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What are the Signs of a High Functioning Alcoholic?

While functioning alcoholics may appear to ‘have it all together’ on the outside, that doesn't mean that they aren't struggling with alcohol use disease. Highly functioning alcoholic signs include:

Drinking to Cope With Stress

High-functioning alcoholics often drink to cope with stress. Unfortunately, because of alcohol's effects on the brain, it often worsens stress. Reaching for the bottle in times of stress is a sign you may be an alcoholic.

Drinking During the Day

One of the main signs of a functional alcoholic is day drinking. Functional alcoholics may also drink at inappropriate times, like at work.

Frequently Drinking Alone

Individuals may drink to beat boredom or loneliness. Drinking in high quantities can also increase these feelings. Additionally, functional alcoholics may choose to drink alone to hide their drinking habits from others.

Heavy And Frequent Drinking

While functional alcoholics may be able to appear ‘sober’ after drinking, they still are subject to the effects of alcohol. Heavy drinking is considered more than 14 drinks per week for men and more than 7 for women.

Functional alcoholics may also be binge drinkers, another form of heavy drinking. Binge drinking more than five times a month is considered heavy and indicative of an alcohol use disorder.

Denial Or Avoidance

Alcoholics are often in denial of the fact that they have an alcohol use disorder and avoid conversations about their use. Families and employers may also be as well. However, alcoholism has serious effects that can’t be avoided long term.

What are the Consequences Of Functional Alcoholism?

Functional alcoholism and alcohol use disorder have many consequences. The short-term effects can be often seen immediately, while the effects on health tend to be more long-term.10

Short-Term Effects

Short-term effects regarding functional alcoholism are often related to high risk behavior. Effects and risks of alcohol misuse in the short term include:

  • Injuries and accidents, such as motor vehicle incidents or falls
  • Violence due to mood changes
  • Risky sexual behavior, increasing chances of transmission of sexually transmitted diseases
  • For pregnant women, miscarriage or fetal abnormalities such as fetal alcohol syndrome.
  • Hangover and short term memory loss

Long-Term Effects

Alcohol use disorder has disastrous effects on the body as well and the individual's life in general. There are many diseases linked to alcohol abuse, both mental and physical. Complications related to long-term alcohol abuse include:

  • Heart disease, increased blood pressure, stroke, liver disease, and digestive issues
  • Cancers of the mouth and throat, breast, liver, colon, and rectum
  • Weakened immune system
  • Mental health problems like depression and anxiety
  • Insomnia, sleep apnea, and other sleep issues
  • Cognitive changes such as memory loss, confusion, and dementia
  • Social effects on relationships, employment, and family
  • Death

What are the Treatments For Alcoholism Today?

If you think that someone you may know is a functional alcoholic, or if you are wondering if you yourself could be categorized as such, know that there is hope in treatment. There are many treatment options available for alcohol addiction.

Alcohol Detoxification

Often the first step in addiction treatment is alcohol detoxification. Individuals with alcohol use disorder are likely to experience withdrawal symptoms when quitting drinking.
Severity of withdrawal symptoms depends on history of drinking and current use. Symptoms of withdrawal can begin within just 6 hours of ceasing drinking.11

These symptoms include:

  • Anxiety
  • Shaking
  • Nausea
  • Insomnia
  • Sweating
  • Seizures
  • Hallucinations

Residential Alcohol Addiction Treatment

Changing your environment can be key in treating alcohol addiction. Often it is very difficult to get sober on your own, especially if you primarily drank at home. Spending time in a residential facility allows you to explore your relationship through the guidance of trained professionals.

Therapy

Working with a therapist will allow you to learn the “why” behind your drinking, as well as holding you accountable to your sobriety. A therapist works as a mental health guide and can give you alternatives for coping with stress.

Aftercare and Secondary Care

Many individuals join support groups such as SMART recovery, or a twelve-step alcoholics anonymous program. Individuals who use alcohol as a way to cope with underlying mental health issues may benefit from working with a psychiatrist to find medications to manage their underlying issues.

Addiction Treatment Programs

There are four basic types of addiction treatment programs, varying in intensity. The level of treatment you may need will depend on several factors including severity of the alcohol use, drinking patterns, and individual needs.12

The four basic types of addiction treatment programs will be discussed below.

Outpatient

This lower-intensity option involves regular checkups, therapy, and medication. An individual will continue to live at home and schedule appointments with professionals.

Intensive Outpatient or Partial Hospitalization

This option works for individuals who have complex needs. Some individuals only need to be hospitalized for a portion of their treatment.

Residential

This type of treatment can be low or high intensity depending on the facility. This option allows for 24 hour care and support.

Intensive Inpatient

Individuals with severe alcohol use disorder may benefit from a heavily supervised medication managed treatment. This type of treatment is useful for managing severe withdrawal symptoms and cravings.

Get Help for Alcoholism

Functional alcoholics may be high performers in certain areas of their life, but the reality of the situation is much grimmer. It is estimated that approximately twenty percent of individuals with alcohol use disorder are functional alcoholics. If your ability to manage stress on your own is low, you may turn to alcohol to cope.

Don’t beat yourself up over a potential alcohol problem, because treatment options are available. Explore our
mental health guide for functional alcoholism and treatment, and get help today.

Functioning Alcoholic

Contact Ripple Ranch

Because alcohol detoxification and withdrawal can be dangerous, it is best to do it under a health professional's supervision. Checking into a residential alcohol addiction treatment facility will give you the structure and tools you need to quit drinking alcohol for good.

Ripple Ranch offers many treatment options for alcohol use disorder. Whatever you decide, know that help is available and recovery is always possible. Start your journey to sobriety with us today.

Ripple Ranch Recovery