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March 3, 2023

What Is a High-Functioning Alcoholic?

TV shows and movies often portray people with drinking problems as confused, disheveled, and incapable of getting through the day without embarrassing themselves and their loved ones. While some people sadly conform to this unfortunate stereotype, others are able to hide the evidence of their alcohol abuse and live what appears to be a productive and satisfying life. These individuals are often referred to as high-functioning alcoholics.

What Is a High-Functioning Alcoholic?

Before we delve into this topic, it is important to clarify that “high-functioning alcoholic” is not a clinical term. It is a casual way to describe someone who appears to have avoided the more devastating effects of alcohol addiction.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes 11 criteria for alcohol use disorder (which is how mental and behavioral health professionals refer to alcoholism). However, in order to be accurately diagnosed with this condition, a person only has to meet two of these criteria during a 12-month period.

The diagnosis of alcohol use disorder can be subdivided into three categories based on how many DSM-5 criteria a person meets:

  • Mild: Two or three criteria
  • Moderate: Four or five criteria
  • Severe: Six or more criteria

If a person has a mild or moderate alcohol use disorder, they may be able to retain some semblance of control over their lives even as they struggle with the compulsion to drink more (and more frequently) than is healthy. 

A high-functioning alcoholic may perform well in school, make steady progress in their career, and otherwise give the outward appearance of being a happy and successful person. Unbeknownst to others, though, these individuals may be putting their livelihoods (and their lives) at risk every day due to an uncontrollable urge to drink.

Signs of High-Functioning Alcoholism

The very nature of this condition makes it difficult to detect if someone is a high-functioning alcoholic. 

  • In typical cases of alcoholism, people exhibit signs such as slurred speech, impaired coordination, diminished cognition, frequent absenteeism from school or work, failure to meet personal or occupational responsibilities, and a clear inability to stop drinking.
  • In the case of a high-functioning alcoholic, they either don’t have some of the more obvious symptoms of alcohol use disorder or they have become skilled at hiding these symptoms from friends, family members, colleagues, and others with whom they regularly come into contact. 

However, this doesn’t mean that it is impossible to determine if someone that you know is a high-functioning alcoholic. Here are a few key indicators to keep an eye out for:

  • When they are socializing, they often have multiple drinks in a short period of time. 
  • They rarely or never have an alcohol-free lunch or dinner.
  • They have no hesitation about driving after they have been drinking.
  • They often “pregame,” or drink at home (alone or with others) before going to a bar, club, or event where they will continue to consume alcohol.
  • They claim that having a drink or two “loosens them up” or allows them to function more effectively.
  • They keep alcohol in their desk at work, in the glove box in their car, or in other places where this substance is not typically found.
  • They often exhibit sudden changes in mood, attitude, and energy.
  • They become agitated, irritated, or even angry when they are in situations where they cannot drink.
  • You suspect that they have been lying to you or others about how they spend their time and who they associate with.

Effects of High-Functioning Alcoholism

Outwardly, a high-functioning alcoholic may appear to be in control of their life. But regardless of what level of academic achievement, career advancement, or financial success they have attained, they remain at risk for negative effects such as the following:

  • Damage to the heart, liver, and kidneys
  • Cognitive deficits
  • Malnutrition
  • Conflicts in their relationships
  • Physical injuries due to slips, falls, automobile accidents, or violent outbursts
  • Legal problems such as being arrest for driving while intoxicated
  • Elevated risk for certain cancers
  • Development of anxiety, depression, or another co-occurring mental health concern
  • Polysubstance abuse
  • Job loss and long-term unemployment
  • Financial problems
  • Accidental death
  • Suicidal ideation

High-functioning alcoholics may drink as a means of numbing themselves to emotional pain that is related to poor stress management capabilities, self-doubt, a history of untreated trauma, or myriad other influences. The desire to keep their alcohol abuse a secret may prevent a person from getting help to address their addictive behaviors. This, in turn, means that they are also unlikely to seek treatment for their mental or emotional concerns.

It is not difficult to see how this can lead to a downward spiral of worsening mental health and increasingly more severe alcohol abuse. In the absence of effective professional treatment, a high-functioning alcoholic remains in perpetual jeopardy for devastating physical, emotional, and socioeconomic outcomes.

Begin Treatment for Alcohol Addiction in Atlanta

If you have been struggling with alcohol addiction, or if you believe that someone that you care about is a high-functioning alcoholic, please know that help is available. At Inner Voyage Recovery Center in Atlanta, Georgia, adults receive the personalized care they need to end their alcohol abuse and begin their journey toward successful recovery. 

Features of treatment at our center include detoxification, multiple outpatient programs, a variety of effective therapies, and unwavering support. When you’re ready to start living a healthier and more hopeful life, the Inner Voyage Recovery Center team is here for you. Visit our admissions page or call us today to learn more.

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Author

  • Emily Rowe, LMSW

    Emily Rowe is the Clinical Director at Inner Voyage Recovery Center. She is a Licensed Master of Social Work with 8 years of experience in clinical settings covering one on one sessions, family sessions, group sessions, crisis interventions and suicidal prevention. Recognized by leadership and colleagues as forward thinking, creative, empathetic, active listener and effective.

    Rowe, LMSW Emily