High-Functioning Alcoholic: Definition, Signs, & Treatment

What Is a High-Functioning Alcoholic?

The term “high-functioning alcoholic” refers to individuals who maintain a relatively normal or successful life while exhibiting alcohol addiction or dependence.¹ Many classic, outward, and apparent signs of alcoholism are unbeknownst to those other than the struggling individual. “Functioning alcoholic” is not an official diagnosis but describes people who can maintain their work, relational, and social responsibilities despite their alcohol abuse.

Characteristics of functioning alcoholics can vary, but they often display a high tolerance for alcohol, engage in secretive drinking, experience mood swings, and prioritize alcohol consumption over other aspects of their lives.¹ While they may appear in control of their lives, functioning alcoholics (one of the types of alcoholics) still face significant health risks and should seek help for their alcohol dependence. Unfortunately, the individual is sick, but they and others may not realize this until the consequences prove catastrophic.

What Is Functional Tolerance?

Functional tolerance, in the context of a high-functioning alcoholic, refers to an ability to maintain a certain level of performance or functioning despite consuming large amounts of alcohol. Over time, prolonged and excessive alcohol consumption can lead to the development of tolerance, where the body becomes accustomed to alcohol and requires higher quantities to achieve the same level of intoxication.

Functional tolerance allows high-functioning alcoholics to drink significant amounts of alcohol without displaying obvious signs of impairment.² They may carry out their daily responsibilities without others noticing the extent of their alcohol use. This ability to function at a seemingly normal level can make recognizing the severity of their alcohol problem challenging. Accordingly, functional awareness keeps the addiction out of conscious awareness, further complicating the condition.

12 Signs of a High-Functioning Alcoholic

Signs of a functioning alcoholic vary based on the individual. However, common alcoholic tendencies include not remembering what happened while drinking (blackouts), frequent episodes of binge drinking, or an inability to control drinking habits.^3,4 Functioning alcoholism can be hard to identify, but recognizing these behaviors can help.

Below are 12 signs of a high-functioning alcoholic:

1. Denial About Drinking Habits

A classic characteristic of alcoholism is denial, a common defense mechanism elicited to avoid the reality of a situation. When it comes to high-functioning alcoholics, denial means a person could say, “I’ll quit tomorrow,” “I only had one,” or, “It’s not that bad,” and 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.⁵

2. Drinking Alone or in Secret

A high-functioning alcoholic often drinks secretly, possibly before a special occasion or when home alone. For example, they may drink and pass out in front of the TV after the family has gone to bed.⁶ However, they may hide the evidence of their alcohol intake to avoid being reprimanded or discovered.

3. Drinking to Calm Down or Get Energized

A high-functioning alcoholic may drink alcohol to calm down or get energized, often reflecting alcohol use as a coping mechanism to manage stress, anxiety, or fatigue. High-functioning alcoholics may rely on alcohol to regulate emotions, and such traits of an alcoholic commonly align with severe alcoholism.⁷

4. Being Able to Drink Excessively Without Getting Drunk

Some people have a stereotypical image of a sloppy drunk who makes a fool of himself after drinking. However, this behavior is not characteristic of an alcoholic. A high-functioning alcoholic is more likely the opposite and can drink larger amounts without feeling the effects of alcohol due to their increased tolerance.⁸

5. Always Having a Reason to Drink

Always having a reason to drink is a common characteristic of functional alcoholism. Individuals often find justifications or excuses to consume alcohol regularly, even when doing so is inappropriate. They may use reasons such as celebrating achievements, coping with stress, socializing with others, or simply to relax and unwind. These explanations may appear valid, leaving others unaware of the extent of their alcohol dependence.

6. Being a Social Drinker

Being a social drinker is another camouflage for high-functioning alcoholics. They present themselves as individuals who only consume alcohol in social settings, often limiting their drinking to events, gatherings, or occasions where alcohol is expected or accepted. This behavior allows them to blend in with social norms, further concealing their alcoholism from others.

While appearing as social drinkers, high-functioning alcoholics may exhibit signs of alcoholism that remain unnoticed. These signs may include an increasing tolerance for alcohol, difficulty in controlling alcohol consumed, and continuing to drink despite negative consequences.⁷

7. Being Unable to Remember Events While Drinking

Blackout drinking is a concerning sign of high-functioning alcoholism. Individuals experience memory loss or complete gaps in their recollection of events that occurred while they were intoxicated.⁸ Despite functioning relatively well in other areas, high-functioning alcoholics may frequently experience such blackout episodes.

This phenomenon often relates to functional tolerance. However, blackout drinking indicates severe alcohol intoxication that can have serious consequences. Even though individuals may function adequately during these blackout episodes, they still risk engaging in unsafe behaviors or making poor decisions without recollection.

8. Being Unable to Stop Drinking Despite Attempts

A high-functioning alcoholic might quit for a week or a month, sometimes for Lent or “Dry January.” Early on, they may pause for a time. However, they may later discover a “really good reason” to drink, ending their attempt to maintain alcohol abstinence.⁹

9. Joking About Alcohol Use

Joking about alcohol use can be a defense mechanism high-functioning alcoholics use to downplay or normalize their drinking habits. This behavior allows them to make light of their actions and divert attention from the potential seriousness of their alcohol addiction.

10. Shame About Drinking Habits

Despite maintaining a seemingly successful or functional life, individuals struggling with alcohol addiction often harbor deep feelings of guilt, embarrassment, and self-blame about their drinking habits.¹⁰ They may not know the impact alcohol has on their lives and relationships, contributing to feelings of shame.

This shame can stem from various factors, including the inability to control alcohol consumption, realizing the harm of drinking, or the fear of being judged by others. High-functioning alcoholics may go to great lengths to hide their drinking or make excuses, further intensifying these negative feelings. Unfortunately, shame is another significant barrier to seeking help and support.

11. Separating Their Drinking Life From Normal Life

High-functioning alcoholics work hard to maintain a facade of normalcy by compartmentalizing their alcohol consumption and keeping it separate from their everyday activities and responsibilities. They may appear to have their lives together while hiding or masking their drinking habits.

This separation serves as a coping mechanism that allows high-functioning alcoholics to avoid confronting the true extent of their alcohol addiction. They disconnect their alcohol-related behaviors from their overall identity by isolating their drinking life.

12. Becoming Defensive When Confronted About Drinking

Becoming defensive when confronted about drinking is a common response exhibited by high-functioning alcoholics. When their alcohol consumption is questioned or brought to their attention, they may react with defensiveness, denial, or even anger.

High-functioning alcoholics may feel threatened by the confrontation because this challenges their carefully constructed mask of control and normalcy. They may fear judgment, shame, or the potential consequences of acknowledging their alcoholism. Consequently, they may deflect blame, make excuses, or downplay the severity of their drinking habits to avoid fully confronting their addiction.

What Are the Risks of Functional Alcoholism?

High-functioning alcoholism may result in legal, relationship, work-related, and health issues. In late-stage alcoholism, many functional alcoholics can develop diabetes, hepatitis C, pancreatitis, and many other problems, possibly due to avoiding medical appointments.^11,12

Possible consequences of functional alcoholism include:

• Legal issues: Functional alcoholism can lead to legal problems, such as DUI (driving under the influence) charges, public intoxication, or engaging in illegal activities while under the influence of alcohol.
• Relationship problems: Relationship problems can arise due to the strain caused by alcohol abuse, including conflicts, communication breakdowns, trust issues, and a diminished emotional connection with loved ones.
• Domestic violence: Functional alcoholism can escalate to domestic violence, as excessive alcohol consumption can impair judgment, increase aggression, and contribute to volatile situations within the household.
• Health-related concerns: Health-related concerns associated with functional alcoholism include liver damage, cardiovascular problems, weakened immune system, increased risk of certain cancers, and a higher likelihood of developing alcohol-related diseases.¹³
• Memory loss: Memory loss is a potential consequence of functional alcoholism. Blackout episodes and impaired recollection of events are common and can negatively impact personal and professional relationships.⁷
• Increased risk of suicide: The risk of suicide increases among individuals struggling with functional alcoholism due to the detrimental effects of alcohol on mental health, depressive symptoms, and feelings of hopelessness.¹⁴
• Fetal alcohol syndrome (FAS): Functional alcoholism during pregnancy can result in FAS, a condition that can cause physical, cognitive, and behavioral impairments in an unborn child, highlighting the importance of abstaining from alcohol during pregnancy.

How to Help a High-Functioning Alcoholic

Acknowledging that someone is an alcoholic or is hiding an alcohol problem can be a heartbreaking experience. If you are dating or living with a functioning alcoholic, making threats won’t help. What they need is your support as they attempt to change. Let them know you are here to help, but remember their behavior is not your fault. You can’t control your loved one.¹⁵ However, you can offer guidance and patience as they navigate alcoholism treatment.

Treatments for High-Functioning Alcoholics

When your loved one is ready to seek treatment, many resources are available to provide support. An alcoholic can change if they desire to address their drinking habits and underlying stressors that may contribute to their behavior. If you believe you are struggling with an alcohol use disorder, consider reaching out for professional guidance.

Treatment options for functional alcoholism may include:

• Individual group therapy: A licensed therapist specializing in substance use disorders, trauma (if there are underlying issues to work through), and relapse prevention can help you as you recover from alcohol misuse.
• Alcoholics Anonymous: Alcoholics Anonymous (AA) meets more needs than helping people stop drinking alcohol. It provides social, emotional, psychological, and spiritual help. AA offers helpful suggestions along the road to a sober life.”¹⁶
• Detox: Detox helps people slowly withdraw from sedatives when there is a seizure risk if individuals were to stop drinking cold turkey. This treatment option may be beneficial for high-functioning alcoholics.
• Rehab: An alcoholic may need inpatient treatment due to a temptation to drink, high-stress triggers, or needing medical attention. Many well-run rehabs are available to introduce concepts around sobriety.
• Intensive outpatient treatment: Intensive outpatient treatment programs (IOP) usually offer individual and group therapy around work, school, and other schedules.

Outlook for Recovering From Functional Alcoholism

People can get better. Most people who give sobriety a solid try see drastic improvements in every area. It could be subtle at first. You may notice what is not happening, like fighting with your spouse or trouble concentrating at work. Things will begin to be smoother at home, at family events, and at work. You may start sleeping better and have more energy.

Relapse can happen, but you can reduce the risk by sticking with what works. If you do fall back into old habits, don’t give up. Just ask for help. There is no shame in relapse. Tell the people who love you the truth. Get back on course as soon as possible.

Final Thoughts

In conclusion, high-functioning alcoholism is a complex and often misunderstood condition characterized by individuals who maintain a seemingly average life while secretly battling alcohol addiction. Despite appearing to have control over their responsibilities, individuals should not ignore the signs of functional alcoholism. Recognizing these signs is crucial to provide appropriate support and intervention. Seeking professional treatment and support systems can help high-functioning alcoholics break free from the cycle of addiction, address underlying issues, and embark on a journey toward recovery, improved well-being, and a healthier relationship with alcohol, self, and others.