Am I a Functioning Alcoholic?

There’s a common perception of addiction as being completely debilitating.

It certainly can be. Many people with a dependency on alcohol or other drugs can struggle to function normally. A substance misuse problem can affect work, studies, relationships and every other aspect of day-to-day life.

Othe people can continue – outwardly at least – to function more or less normally despite their dependency. This does not mean that their alcohol consumption, drinking patterns and associated behaviours are not harmful to themselves and those around them. Excessive alcohol consumption can still impact physical and mental health and take a toll on personal relationships.

Being able to carry out daily tasks, hold down a job and even excel at work does not mean that there are no problems underneath the service. Being what is often referred to as a functioning alcoholic can lead to masking or denial of problematic drinking. It can prevent some people from seeking help or addressing their harmful drinking. Both the drinking and its potential consequences can worsen over time.

What Does “Functioning Alcoholic” Mean?

First of all, it’s important to understand that the term ‘functioning alcoholic’ is a colloquial term rather than an official diagnosis. In fact, ‘alcoholic’ itself is not used medically or officially, with terms such as alcohol use disorder generally being seen as more appropriate in medical or recovery settings.

The term ‘functioning alcoholic’ or ‘high-functioning alcoholic’ is useful, however, for understanding certain situations and patterns of behaviour. The term refers to those people who are dependent on alcohol but who seemingly manage their responsibilities and daily life. They may appear to thrive at work and have healthy relationships, but there are often cracks under the surface.

One older study that aimed to identify subtypes of alcohol addiction found that nearly a fifth (19.5%) of alcoholics in the US would fit the ‘functioning alcoholic’ description. Many of these were middle-aged and well-educated, with stable jobs and families. Around a third had a multigenerational family history of alcoholism.

Common Signs of a Functioning (High-Functioning) Alcoholic

There are no ‘official’ lists of symptoms defining a high-functioning alcoholic, as it is a very unofficial term.

There are some signs to look out for, though, which could indicate that someone fits the commonly held meaning of a functioning alcoholic.

These could include:

• Maintaining work, family or social responsibilities despite heavy or frequent drinking
• Feeling you need to drink to get through the day, or wind down afterwards
• Denying or minimising alcohol use and its impact; justifying or downplaying consumption
• Secret or hidden drinking, drinking alone, or drinking at unconventional times
• Developing a higher alcohol tolerance, needing to drink more for the same effect
• Experiencing withdrawal symptoms if you do not drink
• Loss of control, being unable to press the ‘off’ switch when you drink
• setting limits, and repeatedly breaking them
• Spending excessive time obtaining, using or recovering from alcohol
• Hidden emotional burdens; feelings of shame, guilt or isolation despite outward success

Functioning Doesn’t Mean Harmless

While functioning alcoholics may seem to have their lives and drinking under control, excessive alcohol consumption could still be having serious consequences.

This could include a toll on physical and mental health. According to charity Alcohol Change UK, alcohol is a causal factor in more than 200 diseases and health conditions, including high blood pressure, liver disease and various forms of cancer. In fact, alcohol is the biggest risk factor for death, ill-health and disability among 15-49-year-olds in the UK, and the fifth biggest risk factor across all ages.

These health risks remain the same even if you are getting up for work every day. One former regular drinker who told his story to the British Liver Trust recalled questioning whether he was a functioning alcoholic. Before he could address his drinking, he was diagnosed with cirrhosis and later with stomach and liver cancer that required a liver transplant.

Not everyone will experience such serious illness, but chronic drinking increases the risks of many health conditions, including mental health issues such as anxiety and depression. Many people say they drink to relax but excessive alcohol consumption can ultimately be counterproductive in this respect.

Drinking can also cause or widen fault lines in personal and professional relationships, even when life seems stable from the outside. Some people who seem to be functioning fine may experience a crash when they suddenly feel unable to cope, or a number of negative consequences appear at once. Being a functioning alcoholic can sometimes be more harmful as it can delay recognition of the problem, allowing harm to escalate over time.

How to Know If You Fit the Criteria of Alcohol Use Disorder (AUD)

Clinical conditions like alcohol use disorder (AUD) are assessed using standards set out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the US and the International Classification of Diseases (ICD-11) in the UK. There are many similarities in the two standards and some common criteria include:

• Frequently drinking more than intended
• Trying and failing to cut down
• Spending a lot of time and effort obtaining alcohol, using alcohol, and recovering from its effects
• Increased tolerance to alcohol
• Craving alcohol
• Withdrawal symptoms when you do not drink
• Avoiding situations where you cannot drink
• Using alcohol in inappropriate situations
• Putting yourself at risk of physical harm through drinking
• Continuing to drink despite negative consequences

There are other signs and symptoms and experiencing some of these sometimes does not necessarily mean you have an alcohol use disorder. If you recognise at least two of these signs though, a period of serious reflection and a formal assessment may be helpful.

What You Can Do Next

If you are worried that you might have a drinking problem including alcohol use disorder, you could try using screening tools like the Alcohol-Use Disorders Identification Test (AUDIT) or CAGE questionnaire as a starting points. Self-administered tests are not substitutes for medical diagnosis though and you should ideally seek a professional assessment—via GP or Addiction Specialist—for clarity and guidance.

Thankfully, alcohol addiction is increasingly well researched and understood and the former stigma surrounding problem drinking is on its way out, if not entirely gone. There are different treatment approaches available, including therapy, outpatient or residential rehab, and support groups like AA and SMART Recovery.

Alcohol Rehab Services London can help you find the treatment that’s right for you so if you think you or someone you know might have a problem, contact us to find out how we can help.