What is high-functioning alcoholism?

Like other forms of substance abuse, alcoholism can affect people of all genders and socioeconomic levels. Alcoholism doesn’t always mean a person can’t hold down a job or maintain a family life. This is the case for people who are considered high-functioning alcoholics.

In 2007, a report by the National Institutes of Health identified a different type of alcoholic that’s in conflict with most stereotypes: the functional alcoholic. The report found that nearly 20 percent of alcoholics were well-educated, held down stable jobs, and had families.

A high-functioning alcoholic is a person who is able to maintain what appears from the outside a successful, normal life.

A high-functioning alcoholic has usually achieved or overachieved in their lifetime. They’re less likely to think they need help or seek help. However, alcoholism is a disease. It often requires professional treatment to help a person overcome their condition.

Examples of symptoms associated with alcoholism include:

  • Resolving to drink less or just have “two drinks,” but never being able to control alcohol use.
  • Spending a significant time outside of work drinking, buying alcohol, or recovering from drinking alcohol.
  • Having strong cravings to drink when not drinking.
  • Giving up important responsibilities or activities you once enjoyed in order to go get drunk instead.
  • Developing a tolerance to alcohol so you have to drink more and more to feel “drunk.”
  • Experiencing withdrawal symptoms when you aren’t drinking. Examples include sweating, shaking, or feeling sick to your stomach.

Early on, a person will hide their drinking very well. Friends and family members don’t always realize that there’s an alcohol problem. Symptoms are also difficult to recognize in others. That’s because a high-functioning alcoholic doesn’t fit the “mold” of what people think of when they consider what an alcoholic is or looks like. However, some symptoms that a person may be abusing alcohol include:

  • using alcohol as a reward
  • telling others they drink often to relieve stress
  • choosing to drink instead of eating or saying they have no interest in eating
  • always having an explanation as to why they drink
  • hiding alcohol bottles or being dishonest about how many drinks they’ve had so others don’t know how much they drink

In the early stages of alcoholism, it’s easier to conceal a drinking problem from others. A person may deny that they even have a problem.

Alcoholism is a chronic and progressive disease. It doesn’t get “better” until someone is able to get the help they need to overcome the condition.

Many people who abuse alcohol may hesitate to get help because they fear judgment. It’s important to remember that doctors are medical professionals. Their job is to help you get better.

A doctor may diagnose alcoholism by asking about your health history and drinking patterns. They may also ask you how much you drink on a regular basis. If you give permission, they may speak to your family or loved ones regarding how much you drink.

If needed, they may also order blood tests to check your liver function and certain vitamins in your body. Drinking excessive amounts of alcohol can often rob the body of important nutritional components. A B12 vitamin deficiency is common in people who abuse alcohol.

Your doctor may also conduct imaging tests, if other laboratory studies come back abnormal. For example, a computed tomography (CT) scan tests for liver enlargement, which can occur after years of chronic drinking. Your doctor may order this test if your blood tests indicate abnormal liver functioning.

Treatment for alcohol use involves detoxing or stopping drinking. This lets your body cease its reliance on alcohol. Detoxing can cause harmful symptoms in longtime heavy drinkers. It’s recommended that you do this at a hospital or inpatient treatment facility. Withdrawing from alcohol can cause symptoms such as:

  • seizures
  • rapid heart rate
  • severe nausea
  • shaking
  • difficulty sleeping

Not everyone experiences the most severe symptoms, but they can happen. Your doctor can give you medication to help manage withdrawal symptoms.

Alcoholism is more than a physical dependence. It’s often used as a stress reliever or source of escape. This is why psychological counseling is important if you’re recovering from alcoholism. A person must learn new coping skills so they can turn to other behaviors instead of drinking in order to live a healthier life.

Both residential and day treatment programs are available for those in recovery. A number of resources can help you or a loved one get into recovery or continue your sobriety. These include:

You can also contact your primary care physician. They can refer you to an addiction treatment program.

People in the earliest stages of alcoholism may be able to maintain their jobs and family life. Eventually, though the complications associated with alcoholism will affect you. Prolonged excessive alcohol intake is associated with a number of health problems. Examples include:

  • bone damage, such as osteoporosis (bone thinning)
  • cirrhosis
  • increased risk for cancers, including breast, colon, liver, mouth, and throat cancers
  • liver disease
  • poor immune system
  • stomach problems, such as ulcers

Alcoholism also makes it more likely you’ll experience a motor vehicle accident. It can also ultimately lead to relationship difficulties as well as legal and financial problems.

High-functioning alcoholics are no less “sick” than alcoholics who have difficulty maintaining a job and relationships, or end up in legal trouble. Anyone who is an alcoholic can benefit from treatment and support. Alcoholism causes changes in the brain that can affect a person’s ability to quit on their own. This makes it important to find outside sources of medical support.