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What Is a High Functioning Alcoholic?

Published: March 2, 2021 Updated: March 22, 2023
Published: 03/02/2021 Updated: 03/22/2023
Headshot of Sandy Demopoulos, LCSWR, CASAC, SAP
Written by:

Sandy Demopoulos

LCSWR, CASAC, SAP
Headshot of Trishanna Sookdeo, MD, MPH, FAAFP
Reviewed by:

Trishanna Sookdeo

MD, MPH, FAAFP
  • Signs of a High Functioning AlcoholicSigns
  • What Are the Risks of Functional Alcoholism?Risks
  • How to Help a High-Functioning AlcoholicHow to Help
  • Treatments for High Functioning AlcoholismTreatments
  • Outlook for Someone Recovering From Functional AlcoholismOutlook
  • Additional ResourcesResources
Headshot of Sandy Demopoulos, LCSWR, CASAC, SAP
Written by:

Sandy Demopoulos

LCSWR, CASAC, SAP
Headshot of Trishanna Sookdeo, MD, MPH, FAAFP
Reviewed by:

Trishanna Sookdeo

MD, MPH, FAAFP

A high functioning alcoholic is someone whose life starts to become alcohol centered. Other people, even people close to them probably won’t be able to tell.1 They might spend a lot of time thinking about drinking in detail and anticipating the next drink. They probably don’t have withdrawal symptoms when they stop drinking due to having a high tolerance.

Tolerance means that after continued drinking, consumption of a constant amount of alcohol produces a lesser effect or increasing amounts of alcohol are necessary to produce the same effect.2 They may or may not remember what happened while drinking on occasion (blackouts),3 or they might have frequent episodes of binge drinking (five drinks in two hours for men and four drinks in two hours for women).4 Finally, there is a significant link between childhood trauma and problem drinking.5

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9 Signs of a High Functioning Alcoholic

Here are nine signs of functional alcoholism:

  1. Defensiveness: Someone might become offended or even enraged if you suggest they could have a drinking problem.6
  2. Drinking alone, or in secrecy: Drinking before an occasion where alcohol will be served, passing out after drinking in front of the TV or after the family has gone to bed, or drinking to fall asleep at bedtime.7
  3. Drinking to calm down or perk up: Or perhaps to reduce stress or feel happy. Drinking to change your mood in general.8
  4. Being able to drink everybody else under the table, and still not appear drunk: We may have a stereotype of a sloppy drunk who makes a fool of himself and has a foggy memory of what they did at the party the night before. This is likely someone who isn’t used to drinking and drank too much one night. A high functioning alcoholic is more likely the opposite. 9
  5. Always having a good reason to drink: These reasons might include peer pressure, accessibility, environment, social norms, stress, good experiences with it in the past.10 Someone might also use an excuse like, “it’s only one,” or, “everyone else is doing it.”
  6. Being a social drinker: Social drinkers don’t usually engage in drinking alone. The word social means there are other people to socialize with.12
  7. Social drinkers never have blackouts: A social drinker may forget where they parked the car in a big parking lot sometimes, but an alcoholic may not remember a whole evening. ”To an observer, a person typically appears to be awake and functioning during the blackout. In this time, a person may carry on conversations, drive, have sex and interact with people in other ways, only to find later they have no recollection of these events.”1
  8. Unlike alcoholics, social drinkers can stop drinking if alcohol seems to be problematic: It might sound something like, “I shouldn’t have had so much at the office party so I’ll stop drinking for a while or I won’t drink at office functions anymore”—and they don’t. They can stick to their plans. They are not fighting urges to drink. ”When problem drinkers are given sufficient reason to cut back on their drinking (i.e., have a negative drinking consequence, debilitating hangover, become a parent), they can self-correct and return to drinking in a low-risk manner.”13
  9. High functioning alcoholics try to control their drinking: They might quit for a week or a month. Sometimes for Lent or to have a “dry January.” Sometimes early on, they can pause for that length of time, but Alcoholism is progressive, so later on, there will be a “really good reason” to drink before the time period is up.14

What Are the Risks of Functional Alcoholism?

The consequences a high functioning alcoholic may experience could include legal problems, relationship and family problems, work or school problems, financial problems, and health problems. This stage can go on for many years.

In late stage alcoholism, people have many severe losses, including severe health issues.15 Functional Alcoholics can get diabetes, hepatitis C, pancreatitis, and many other issues due to neglect; simply because they have a tendency to avoid medical appointments.16

What Role Does Denial Play for a Functional Alcoholic?

Denial is a basic defense mechanism. It means that when a person says “I’ll quit tomorrow,” “I only had one,” or, “It’s not that bad,” they could pass a lie detector test. They are telling their version of the facts—the truth as they see it. ‘A drink’ could mean a six pack or a bottle. “I’ll be home soon” could mean tomorrow.1

Help For Reducing Drinking, Drying Out, And Staying Sober

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Get help breaking your addiction at a comfortable living facility. Treatment for alcohol, opioid, and heroin addiction. Rehab is often covered by insurance. To find out your insurance benefits call: (855) 236-2993.


Choosing Therapy partners with leading mental health companies and is compensated for marketing by Rehab.com and Sunnyside..

How to Help a High-Functioning Alcoholic

If somebody you love is in denial, attempts to control or limit their drinking by pouring it down the drain, giving them the silent treatment, or threats won’t help. Even when they promise never to do it again.17 What they need is your support and learning more appropriate ways on how to help an alcoholic.

Tell them what you observe in a calm voice: “Joe, I noticed you stumbling into the house, slurring your words, your breath smells like beer and there are empty beer cans in the car.” Or “When you drank too much and don’t remember breaking the glass last night I felt sad and angry.” These next words are key:I love you and I am worried for your safety and the impact your drinking is having on me. You have a drinking problem, and I am here to help you get treatment when you are ready.18

Remember that it’s not your fault. You didn’t cause it. You can’t control it or cure it, no matter how much you love that person or how hard or how long you try.19

Treatments for High Functioning Alcoholism

If or when your loved one is ready, have him call the local AA hotline and two people will come over to take them to a meeting.20 You can—and probably need to—go to Al-Anon, which is a free program for people who love alcoholics.21

You can call an interventionist, who is a person that can help you prepare the person you love to go into treatment, if AA is not enough. Other free mutual aid groups are Life Ring, Women for Sobriety, Smart Recovery, and Secular Organization for Sobriety.

If these groups are not providing enough support and professional treatment is needed, get a few recommendations from people you trust.

Alcoholics Anonymous

AA works well for many people, but it’s not the only option available. A functional alcoholic may need detox or inpatient treatment. If they can stop drinking while at home, a clinic or individual therapist will help keep them accountable.

AA meets more needs than helping people stop drinking alcohol. It provides social, emotional, psychological and spiritual help. Don’t be scared off by the word spiritual—your higher power can be anything that you believe in: The universe, nature, a deity, music, love, humanity, or even AA itself. AA doesn’t require you to believe in anything that you don’t want to; each step is a suggestion along the road to a sober life.”22

Detox

Detox helps people slowly withdraw from sedatives when there is a serious risk of seizure if they were to stop cold turkey. This is for the daily drinker.

Rehab

An alcoholic may need to get out of town for a month or so due to temptation to drink, high stress triggers, or need for medical attention. There are many well-run rehabs available that will treat him/her in groups, and introduce concepts around sobriety.

Intensive Outpatient Treatment

When they come home or if they stay home, a lower level of care is the intensive outpatient treatment program (IOP) These programs usually will offer individual and group therapy around the patient’s work schedule, perhaps three evenings per week.

Individual or Group Therapy

You may attend therapy sessions weekly or as-needed. Make sure to find a licensed therapist (social worker, psychologist, psychiatrist, licensed mental health counselor) who is familiar with or specializes in working with people who have substance use disorders, trauma (if there are underlying issues to work through), and relapse prevention. If they also have a credential in Alcohol and Substance Abuse Counseling, so much the better. Be careful to choose treatment by referral from someone you trust, like your primary care provider, or use a trusted online directory to find appropriate care.

As we are now in the Covid era, all the self-help/mutual aid groups are offered online. Treatment programs vary in terms of offering virtual or in person services. The website In the Rooms has a multitude of anonymous meetings to offer. Most individual and group therapists are operating remotely. The idea is to start with the lowest level of care needed and then step down to lower levels of care throughout the process. The length of each person’s process varies. Insurance may play a part in deciding which services are covered.

Outlook for Someone Recovering From Functional Alcoholism

People can get better. Most people who give sobriety a good solid try, (maybe four to six months sober) see drastic improvements in every area. It could be subtle at first. Maybe you will notice what is not happening, like fighting with your spouse, or trouble concentrating at work. Probably, things will begin to be smoother at home, at family events, and projects are getting done at work. You may start sleeping better and have more energy. Maybe you decided to go back to school after all, move to a better place, or have a baby. Life gets bigger. Be careful to protect your sobriety to avoid relapse.23

Relapse

It can happen but does not have to happen if you stick close to and keep doing what worked in the beginning. If it happens, don’t give up. Just ask for help. There is no shame in relapse, it’s just a setback. Tell the people who love you the truth. Get back on course as soon as possible.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Drinking Moderation

Sunnyside – Want to drink less? Sunnyside helps you ease into mindful drinking at your own pace. Think lifestyle change, not a fad diet. Develop new daily routines, so you maintain your new habits for life. Take a 3 Minute Quiz.

Find A Rehab Center (Free & Confidential) – Call (855) 236-2993

Get help breaking your addiction at a comfortable living facility. Treatment for alcohol, opioid, heroin, and behavioral addictions including eating disorders. Most rehab centers work with multiple insurers. To find out your benefits call: (855) 236-2993

Opioid Use Treatment

Bicycle Health – Offers medication-assisted treatment with Suboxone to help patients stop their opioid use. No office visits required. 95% of patients report no withdrawal symptoms at 7 days. See the doctor online. Most insurance is accepted. Visit Bicycle Health

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Talk Therapy

Online-Therapy – Online-Therapy.com provides a weekly live video session, unlimited text messaging, and self-guided activities like journaling. Starting at $64 per week, this is one of the most affordable options for CBT therapy. Try Online-Therapy

Choosing Therapy partners with leading mental health companies and is compensated for marketing by Rehab.com, Sunnyside, Online-Therapy, and Bicycle Health.

For Further Reading

If you or a loved one is struggling with an alcohol use problem, or you simply want more information, these resources can help:

  • 15 Best Books on Alcoholism
  • WeConnect Recovery App Review
  • National Institute on Alcohol Abuse and Alcoholism
  • National Institute of Health – Rethinking Drinking
  • National Council on Alcoholism and Drug Dependence
  • Office of Addiction Services and Supports of New York (formerly Office of Alcoholism and Substance Abuse Services)
  • Alcoholics Anonymous – Find a Meeting
23 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Chris Elkins, MA. (February 2020). What Is a High-Functioning Alcoholic? DrugRehab.com. Retrieved from: https://www.drugrehab.com/addiction/alcohol/high-functioning-alcoholics/

  • National Institute on Alcohol Abuse and Alcoholism No. 28 PH 356 April 1995. (October 2000). Retrieved from:
    https://pubs.niaaa.nih.gov/publications/aa28.htm

  • Blackout Drinking: Impaired Judgement, Memory Loss, and Other Harmful Effects. (February 2020). American Addiction Centers. Retrieved from: https://americanaddictioncenters.org/alcoholism-treatment/blackout

  • Binge Drinking: Nationwide Problems, Local Solutions. (January 2012). Center for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/vitalsigns/bingedrinking/index.html

  • Patock-Peckham, J. A., Belton, D. A., D’Ardenne, K., Tein, J. Y., Bauman, D. C., Infurna, F. J., Sanabria, F., Curtis, J., Morgan-Lopez, A. A., & McClure, S. M. (2020). Dimensions of childhood trauma and their direct and indirect links to PTSD, impaired control over drinking, and alcohol-related-problems. Addictive behaviors reports, 12, 100304. https://doi.org/10.1016/j.abrep.2020.100304

  • Denial as a Symptom of Alcoholism: As alcoholism progresses, so does the denial. (May 2020). VeryWellMind. Retrieved from:https://www.verywellmind.com/denial-a-symptom-of-alcoholism-63296

  • High Functioning Alcoholic: Six Signs that You Are One. Ashwood Recovery. Retrieved from: https://www.ashwoodrecovery.com/blog/wp-content/uploads/2019/05/six-signs-that-you-are-a-high-functioning-alcoholic-01.png

  • Kristeen Cherney. (September 2019). Healthline. Retrieved from: https://www.healthline.com/health/alcohol-and-anxiety

  • Alcohol and Tolerance”. National Institute on Alcohol Abuse and Alcoholism (NIAAA), Alcohol Alert (28). April 1995. Retrieved from: https://pubs.niaaa.nih.gov/publications/aa28.htm

  • Why Do People Drink Alcohol? Alcohol and You. Retrieved from: https://www.alcoholandyouni.com/people-drink-alcohol/

  • Why Do We Drink Alone? (April 2020). Ria Health. Retrieved from: https://riahealth.com/2020/04/21/why-do-we-drink-alone/

  • Alcohol-Induced Blackouts. (August 2019). Vertava Health. Retrieved from: https://vertavahealth.com/alcohol/blackouts/

  • Sarah A. Benton MS, LMHC, LPC, AADC. (April 2009).Social Drinkers, Problem Drinkers and Alcoholics. Psychology Today. Retrieved from: https://www.psychologytoday.com/us/blog/the-high-functioning-alcoholic/200904/social-drinkers-problem-drinkers-and-alcoholics

  • Methods Alcoholics Use to Try Controlling Their Drinking. (January 2019). Magnolia Ranch Recovery. Retrieved from: https://magnoliaranchrecovery.com/methods-alcoholics-use-try-controlling-drinking

  • Short- & Long-Term Effects of Alcohol – Negative Side Effects on the Body.  Drug-Free World, Retrieved from: https://www.drugfreeworld.org/drugfacts/alcohol/short-term-long-term-effects.html

  • Drinking too much alcohol can harm your health. Learn the facts. (January 20201). CDC. Retrieved from: https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

  • How do I help my Alcoholic Family Member or Friend? Al-Anon Family Groups. Retrieved from: https://al-anon.org/newcomers/how-can-i-help-my/

  • Steve Davis. (January 2014).Transformation Through CareFrontation. facilitatoru. Retrieved from: https://facilitatoru.com/facilitation/transformation-through-carefrontation/

  • The Three C’s of Al-Anon and Real Change. (May 2015). Serenity Vista. Retrieved from: https://serenityvista.com/the-three-cs-of-al-anon/

  • Need Help With a Drinking Problem? Alcoholics Anonymous. Retrieved from: https://aa.org/pages/en_US/need-help-with-a-drinking-problem

  • Al-Anon Family Groups. al-anon.org. Retrieved from: https://al-anon.org/

  • Step 2 AA | Believe in a Higher Power. recovery.org. Retrieved from: https://www.recovery.org/alcoholics-anonymous/step-2/

  • Timothy J. Legg, Ph.D., CRNP. (January 2020). Relapse Prevention Plan: Techniques to Help You Stay on Track. Healthline. Retrieved from: https://www.healthline.com/health/opioid-withdrawal/relapse-prevention-plan

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Headshot of Sandy Demopoulos, LCSWR, CASAC, SAP
Written by:

Sandy Demopoulos

LCSWR, CASAC, SAP
Headshot of Trishanna Sookdeo, MD, MPH, FAAFP
Reviewed by:

Trishanna Sookdeo

MD, MPH, FAAFP
  • Signs of a High Functioning AlcoholicSigns
  • What Are the Risks of Functional Alcoholism?Risks
  • How to Help a High-Functioning AlcoholicHow to Help
  • Treatments for High Functioning AlcoholismTreatments
  • Outlook for Someone Recovering From Functional AlcoholismOutlook
  • Additional ResourcesResources
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