5 Signs Of A Functioning Alcoholic

Alcohol abuse or alcohol use disorder (AUD) is not always easy to spot. In fact, some forms of AUD, like functioning alcoholism, may go unnoticed because the person does not seem to experience the typical loss of those with an AUD.

According to SAMHSA’s 2023 National Survey on Drug Use and Health, approximately 29.5 million Americans aged 12 and older had alcohol use disorder in the past year. Yet, fewer than 1 in 10 received treatment. Many of those who don’t seek treatment are people whose AUD has not yet produced visible consequences.

Defining Functional Alcoholism

While ‘high-functioning alcoholic” is not a clinical diagnosis, it’s a term commonly used to describe people whose AUD may not yet be visibly disrupting their careers, finances, or relationships, but who still meet clinical criteria for AUD. Without treatment, high-functioning AUD typically progresses over time.

Many of these individuals have not had legal trouble or trouble with law enforcement. They could, however, have a family history of alcoholism, at least one major depressive episode, and could potentially have depression or a mood disorder.

There are some common traits shared by functioning alcoholics described below. A person with these symptoms may be suffering from an alcohol use disorder and needs help.

Day Drinking

Day drinking is not exclusively a symptom of an AUD. However, for a functioning alcoholic, it could indicate a bigger issue.

A high-functioning alcoholic might start drinking when they wake up. They may also start drinking at work and start sneaking drinks when others are not around. Day drinking can also relieve alcohol cravings that a functioning alcoholic develops over time.

Stress Drinking/Self-Medicating

Stress is very common in daily life. The functioning alcoholic may use stress as a way to convince themselves or others around them that they need to drink more often.

Stress from multiple areas of life, including work, family life, relationships, sudden loss of a job, or even divorce, could be a reason to drink for a functioning alcoholic.

There may be a problem if an individual’s prime stress reliever is alcohol. Excessive drinking due to stress can be considered self-medicating. Functioning alcoholics can also be struggling with a mood disorder or depression, and they are using alcohol to self-medicate.

Denial

People with high-functioning AUD often don’t recognize their drinking as a problem, particularly because their outward success seems to contradict the stereotype of someone with alcohol use disorder. This ambivalence can delay seeking help.

Motivational interviewing and other evidence-based approaches used in AUD treatment are specifically designed to help people work through this ambivalence without judgment.

Drinking Alone/Isolation

Functioning alcoholics have been known to drink alone. Possibly because they are hiding the amount of alcohol they consume, or because they have tried to moderate their drinking but are unsuccessful.

Individuals may even start drinking alone to escape judgment from others around them.

Binge Drinking/Heavy Recurrent Drinking

Functioning alcoholics may find themselves drinking more and more because they have built up a tolerance to alcohol. Alcohol tolerance is defined as a person needing more and more alcohol to produce the desired effects.

The NIAAA defines low-risk drinking as no more than 3 drinks on any single day and no more than 7 drinks per week for women, and no more than 4 drinks on any single day and no more than 14 per week for men. Drinking above these thresholds significantly increases the risk of developing AUD.

The standard size drink is 1.5oz of hard liquor, 5oz of wine, or 12oz of beer (around 5%). Functioning alcoholics may not drink every day, or only on weekends or specific days of the week. Drinking could be an issue if a person obsesses over the days that they drink.

Binge drinking is defined by the NIAAA as a pattern of drinking that brings blood alcohol concentration (BAC) to 0.08% or higher. That’s typically about 4 drinks for women or 5 drinks for men within roughly 2 hours.

Skipping meals to drink is also a clear indicator of alcohol use disorder.

Do Functioning Alcoholics Experience Withdrawal Symptoms?

Withdrawal symptoms will vary from person to person and may not always be prevalent in functioning alcoholics. Functioning alcoholics may miss work from time to time and could also avoid their responsibilities due to a hangover.

After an extended period of time, functioning alcoholics build up a tolerance, which could lead to severe withdrawal symptoms that are detrimental to their health and have proven to be fatal in some cases.

Symptoms of alcohol withdrawal are:

• not thinking clearly
• fatigue
• irritability
• mood swings
• confusion
• sweating
• increased heart rate
• anxiety
• depression
• tremors
• seizures

5 Types of Alcoholism

There are 5 subtypes of alcoholism. Functioning alcoholics may fit into more than one subtype.

Those subtypes are as follows:

• Young Adult – Young adults start drinking around the age of 20, have some compulsive behaviors, may not drink often but binge drink when they do.
• Young Antisocial – They have an antisocial personality disorder and start drinking in their adolescence, usually around the age of 15.
• Functional – above-average income, more educated, binge drinks often, and may drink every other day.
• Intermediate Familial – Roughly half of this subtype have a family who misuse alcohol, start drinking around 17 years old.
• Chronic Severe – Most are male, have a high divorce rate, and a high likelihood of having multiple substance use disorder issues.

Treatment For AUD – Functional Alcoholism

There are a variety of substance use disorder rehab facilities, including substance use disorder treatment for professionals. These facilities offer treatment for those who are unable to take time off work but can work remotely from a treatment facility.

A person attempting to manage a functioning alcohol addiction often struggles to manage their addiction alone.

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff