What Is A High Functioning Alcoholic? | Definition And Signs

Medically Reviewed by Johnelle Smith, M.D on December 14, 2020

High functioning alcoholics are able to hide their alcoholic tendencies and maintain a relatively normal life. Recognizing a high functioning alcoholic can be difficult, but knowing the signs can help you get a loved one the treatment they need.

What Is A High Functioning Alcoholic?

High functioning alcoholics are not the easiest to spot amongst those struggling with alcoholism. Most people imagine an alcoholic as an individual who struggles with daily life due to alcohol addiction. Spotting a high functioning alcoholic isn’t as simple.

A high functioning alcoholic can appear normal. They seem to do well with their lives and may even excel. They can maintain good jobs, healthy relationships, and look in good overall health.

In fact, most high functioning alcoholics have never had any trouble with the criminal justice system.

Signs Of A High Functioning Alcoholic

Functioning alcoholics, although appearing to have their life in order, struggle with alcohol abuse or even alcohol use disorder (AUD). They can suffer withdrawal symptoms, miss work from being hungover, or avoid responsibilities.

A functional alcoholic typically is a heavy drinker or binge drinker. Heavy drinking in women is three or more drinks a day or seven per week. In men, heavy drinking is more than four drinks a day, or 14 weekly. Binge drinking is consuming about four to five alcoholic beverages in two hours.

Some additional, observable warning signs of a high functioning alcoholic are:

  • drinking alcohol to relax or relieve stress
  • drinking alone
  • justify drinking to others
  • jokes about alcoholism
  • planning events or day around drinking alcohol
  • day drinking
  • hiding drinking
  • drinking alcohol at work
  • drinking more than intended
  • blackouts or memory loss from drinking

Functioning Alcoholics And Denial

One of the main components of a functioning alcoholic is denial. Because functioning alcoholics have never suffered any severe consequences from drinking, many believe they don’t actually have a drinking problem.

Functioning alcoholics often justify their drinking as “normal” or won’t admit they have an alcohol problem because they are able to maintain good jobs and healthy relationships.

Some examples of what denial can look like in a functioning alcoholic:

  • say their drinking is just a bad habit or joke about their drinking
  • make excuses to drink alcohol (use alcohol as a reward)
  • believe drinking expensive alcohol means they do not have a drinking problem
  • compare their lives to other “known” alcoholics that have a worse problem
  • avoid any kind of help for their drinking
  • believe they don’t have a drinking problem because they can maintain successful lives
  • surround themselves with other individuals that drink, making themselves more comfortable to drink

Functioning Alcoholics And Tolerance

Alcohol tolerance is common with functioning alcoholics. Alcohol tolerance develops when an individual needs an increased amount of alcohol over time to feel the same effects of alcohol as before. Tolerance affects the brain and the liver.

When a person consumes alcohol, the liver produces enzymes to help break down alcohol. With more alcohol consumption, the liver produces more enzymes to break it down more rapidly. Because of this process, functioning alcoholics will generally drink more to feel the effects.

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In the brain, alcohol tolerance activates gamma-aminobutyric acid (GABA) receptors in the brain. GABA is responsible for inhibitory behaviors, so activating GABA with alcohol will result in lowered anxiety and alertness, while making the person feel sleepy and relaxed. Over time, the GABA receptors will need more alcohol to feel these effects.

Functioning alcoholics may be able to drink and function during the day. or even at work under the influence of alcohol as a result of alcohol tolerance. Developing an alcohol tolerance does not help them to realize they have an alcohol abuse problem.

Functioning Alcoholics And Withdrawal

As a functioning alcoholic’s tolerance increases so does their dependency. Once a person is dependent on alcohol, they will experience withdrawal symptoms after heavy alcohol abuse.

Some symptoms of alcohol withdrawal include:

  • sweating
  • mood swings
  • increased heart rate
  • depression
  • irritability
  • anxiety
  • seizures
  • tremors
  • fatigue
  • confusion

As symptoms present themselves, a person with high-functioning alcoholism may choose to drink in order to avoid the withdrawal symptoms. This may also contribute to why a functioning alcoholic continues to drink and cannot cut back on their alcohol use.

Treatment For High Functioning Alcoholics

Treatment programs for alcohol use disorders should include a treatment plan that is specific to the individual. Typically, an addiction treatment specialist and, in some cases, a treatment team, will work with the person to design and carry out the treatment plan.

The first step in treating most alcohol use disorders is a medically supervised detox. Severe alcohol withdrawal can be life-threatening, so being in a medically supervised environment allows a level of care that those struggling with alcohol addiction need.

Once a person completes detox, they may be ready for drug and alcohol treatment facilities. Depending on the treatment center, it may offer outpatient treatment, inpatient rehab programs, or access to support groups, such as Alcoholics Anonymous.

Reach out to us today, and we will help find substance abuse treatment options that are best suited for you or your loved one.

This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D on December 14, 2020
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