A “high-functioning alcoholic” may not exhibit some of the diagnostic criteria for an Alcohol Use Disorder – AUD, including an inability to control drinking even after it has caused problems at work or in their personal lives. They might, however, also satisfy additional requirements that result in an AUD diagnosis but generally don’t show any alcohol withdrawal symptoms.
An alcohol use disorder is a curable, chronic medical condition that alters the brain over time and makes it challenging to limit drinking without producing distress or impairment that is clinically significant. The term “alcoholic” is frequently used to describe someone who struggles with compulsive and excessive alcohol use. However, it is appropriate to refer to such a person as having an alcohol use disorder.
Alcohol use disorder symptoms can range in severity and appear differently in various persons. Some persons may exhibit AUD symptoms that manifest more quickly or severely than other people (and vice-versa). However, a medical specialist can only determine the diagnosis and severity of an AUD.
According to one study on alcohol use disorders, 20% of people who fulfil the diagnostic requirements for an alcohol use disorder appear to others to be highly functioning individuals who have completed educational programmes with success, have stable work, and earn well.
According to some experts and academics, between 50 and 75% of people with AUDs can perform well in a variety of fields of their lives.
The present dietary recommendations advise limiting alcoholic drinks. They also assert that if a person drinks at all, they should do so in moderation. The recommendations define moderation as no more than 1 drink per day for women and 2 drinks per day for males. The likelihood is that a functioning alcoholic consumes more than this recommended quantity or occasionally engages in binge drinking.
Detecting a Functioning Alcoholic
An alcoholic will frequently try to conceal their drinking issue. Learn the typical warning signs and symptoms of a functional alcoholic if you are worried about someone’s drinking.
It can be challenging to coexist with a functioning alcoholic. You are probably trying to get them to obtain professional care in addition to coping with the everyday impacts of their harmful drinking and the long-term implications of their alcohol consumption. We’ve also outlined (in this page) the best ways to approach the person about their drinking, and the addiction therapy that is provided at the rehab centres because talking to a functioning alcoholic about addiction and any form of rehabilitation can be challenging.
Functional Tolerance
One of the criteria for diagnosing an alcohol consumption problem is tolerance. Alcohol abusers frequently become tolerant of its effects. Alcohol tolerance occurs when a person needs to consume more alcohol to have the same impact because their body has adapted to deal with the disruption created by alcohol. Tolerance can, however, diminish or go away if you stop drinking for a while, just like other diagnostic criteria for alcohol use disorder.
Functional tolerance is the ability to consume large amounts of alcohol, either all at once or gradually over time, without showing signs of intoxication. An individual who has a functional tolerance to alcohol may be under the influence of alcohol without being aware of it, enabling them to engage in some activities of everyday life in a way that seems normal to others.
Warning signs and symptoms of a functioning alcoholic
Alcohol abuse can occasionally be muddled and challenging to identify. The individual might be successful at work, look great, and lead a full social life. Even while they might appear to be in good health to others, it’s possible that at home, warning signs and symptoms are developing.
The following are some of the most typical indications of a functioning alcoholic:
heavy and excessive drinking.
drinking by oneself and at erroneous hours of the day.
arguing that they are celebrating or rewarding themselves by drinking.
claiming they consume pricey alcohol as a way to “show” they don’t have an alcohol problem.
avoiding social situations without alcohol and being unable to socialise without it.
unable to recall previous nights or days due to excessive drinking.
making light of their heavy drinking or adopting a flippant attitude.
after drinking, becoming hostile, irritable, and impulsive.
keeping booze in unusual locations, like their car or garage.
if they are unable to drink for a day or two, they will start to get agitated and restless.
stay away from any criticism of the drinking habits.
drinking too much alcohol and passing out.
consuming alcohol covertly, such as drinking before or after a gathering or bringing alcohol into a gathering where it is not permitted.
consuming alcohol despite the fact that it has exacerbated or created physical or mental health issues.
denial of a drinking issue due to the absence of serious consequences, such as missing days of work or school or arriving late.
not being able to maintain a well-groomed appearance or otherwise fitting a stereotype of an alcoholic.
consuming large amounts of alcohol without showing signs of intoxication.
drinking during lunch at work.
drinking in potentially hazardous circumstances, such as just before a drive.
drinking to relax after a hard day’s work or to deal with pressure.
excessive drinking when not abstaining but nevertheless indulging on a regular basis, or justify it because the person can go for extended periods without consuming any alcohol.
desires, or a strong drive or need to drink, in particular circumstances
being inebriated or acting in ways that are inappropriate when under the influence of alcohol feeling guilty or humiliated after.
having a strong want to finish all drinks.
despite drinking being able to manage obligations successfully at home, school, and work.
consuming alcohol while keeping it a secret from co-workers, classmates, or family.
defending drinking as not harmful if it is done at upmarket events or with premium liquor.
lying about how much they’re drinking and how strong their drinks are to others.
use examples of people with worse drinking issues or catastrophic repercussions to demonstrate that your drinking isn’t that awful.
not considering excessive drinking, which can lead to psychological anguish, as a serious obstacle to going about daily responsibilities.
worrying about when they can get the next beverage.
attempting to limit their drinking.
maintaining a reputation for excellence in performance at work or at school despite binge drinking, which may or may not result in issues in other areas or mentally.
Another indication of alcoholism is if the person has previously made promises to reduce their excessive drinking but has failed to do so.
How to talk to a functioning alcoholic in denial
Despite exhibiting the clear signs and symptoms of a functional alcoholic, the person you live with might not want to acknowledge a problem or could think their drinking is under control.
Following are some tactics you can employ when beginning a new conversation with someone if your previous attempts to speak with them have been received with hostility, denial, or irritability:
Talk about their drinking when they are not drunk. So that they can think clearly and remember what you’re saying, speak to them when they are experiencing and comprehending the psychological and physical effects of their drinking.
Tell them how their drinking is harming you and your family or household as a whole. Instead of concentrating on the individual, highlight how their drinking affects other people, including yourself. Saying their drinking is scaring you and the kids in the house, for instance, and explaining why it would be appropriate to search for help.
Speak compassionately. It makes sense to feel anxious or even angry. Confronting someone will most likely only make them furious or defensive. Try to be sympathetic, but keep in mind that even if they don’t express it, the person is probably ashamed, scared, and disoriented.
Share your expertise. Share the warning signs and symptoms of a functional alcoholic with them because they might not recognise they have a drinking problem, or they might be in denial.
Never accept justifications or assurances. They could offer justifications for their behaviour or make commitments to cut back or stop. Don’t let this happen, please. Promises made by someone who is dependent on alcohol may be swiftly forgotten when they feel the need to drink again.
You can always talk to someone else at a later time. If the conversation does turn tense, leave. You are sowing the seed for the person to eventually realise they do have a problem if you start talking about your worries and the impact their drinking is having on them.
Recognise that despite trying their best to manage their drinking, the individual likely finds it difficult—and occasionally impossible—to do so. Instead of ordering them to stop, offer that they consult with a qualified expert who can see the situation from their point of view.
Early Intervention: Why it Matters
Early intervention to identify and then receive treatment for an alcohol use problem can aid someone in halting the further deterioration of their condition. Additional alcohol-related physical or mental health problems may be avoided with early intervention.
Instead of an inpatient or residential facility, substance use therapy for a mild alcohol use problem is frequently delivered through your general care physician and can be minimally demanding.
Medication and behavioural therapy are two treatment options for AUDs. Primary care doctors are increasingly screening patients for AUD and offering these early measures for therapy. Primary care doctors are also promoting earlier patient education regarding AUDs, assisting patients in efficiently managing urges, finding better methods to deal with stress, and preventing relapse to harmful alcohol use. A primary care physician may refer a patient to more extensive forms of treatment if they believe a higher level of care is necessary.
Living with a high-functioning alcoholic may make it easier for you to observe their ostensibly harmless drinking habits than if you were living somewhere else. To persuade your loved one to speak with a counsellor or their primary care physician about their alcohol consumption, think about having an honest conversation with them about it.
Your loved one may contest that they have a drinking problem, pointing out that they go about their everyday lives normally and haven’t suffered the harmful effects of alcohol addiction.
You can get more information about alcoholism and advice on how to approach your loved one from your doctor, a mental health professional, or call us to speak with one of our addiction specialists.
Seeking addiction treatment for a functioning alcoholic
Professional treatment is available to assist someone in quitting drinking if they realise they have a problem and need support.
You or the person can call Compare Rehab UK for a free initial assessment, during which an expert will guide and support to decide what level of care is most suitable. Additionally, it gives you both the chance to learn more about the addiction and the facility that is closest to you.
We can assist in assessing every situation and can offer a residential treatment programme that gives the patient space and time to begin their rehabilitation away from their regular life. Individuals receive the chance to learn about the causes and effects of their drinking and create strategies for staying alcohol-free in the future through group and one-on-one therapy, seminars, workshops, and important individual working time.
If necessary, day and outpatient treatment programmes are also offered.
What to do about a loved one
Getting someone to acknowledge they have a problem and need assistance is the first step to take if you are worried that they are a functioning alcoholic. We offer the following advice for persuading a functioning alcoholic who has previously been resistant to receive care:
Set up a time to speak with them when they don’t have any plans and are sober enough to hear you out, such as before they start drinking significantly.
Speaking to a functioning alcoholic about their alcoholism after they have recently had a negative result due to their drinking can often be highly beneficial since they may feel sorry.
No matter how they react emotionally, try to maintain your composure and avoid arguing with them. Try an empathic strategy instead, one that demonstrates care and support.
Tell them how their drinking is harming your family as a whole. Give specific instances where their drinking affected you and others, raised concerns, or otherwise made you feel uncomfortable.
Encourage them by letting them know that alcoholism is curable.
Tell the person:
the clear indications and symptoms of a drinking addict
that alcoholism is recognised by medicine as a degenerative disease with both a mental and physical component
that a person does not absolutely have to lose everything before they are given an alcoholic diagnosis
that as alcoholism worsens, many bad effects, including breakups of relationships and jobs, criminal charges, and mental and physical decline, frequently occur
that people shouldn’t feel guilty about having a condition
that there are others who suffer similarly to them and that the disease they have is perhaps more common than they realise
that individuals who struggle with an alcohol use disorder rarely recover on their own
In the event that the person admits they have a problem and need assistance throughout the talk, it is crucial to take immediate action without holding back.
This is referred to as “a window of opportunity,” but it rarely lasts for very long until denial returns.
Last Edited: September 14th, 2022
Clinically Reviewed: July 4, 2022
Clinical Reviewer
Michael
BACP accredited psychotherapist with 16 years experience working in mental health specialising in psychodynamic person-centred therapies treating those with a range of mental health disorders including anxiety, depression, OCD and Addiction.
