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Recognizing the Signs of High-Functioning Alcoholism

Written on June 24, 2021
Recognizing the Signs of High-Functioning Alcoholism

The cornerstone of any drug or alcohol addiction is the continued use of the substance despite its negative consequences. Some may believe that to truly be an alcoholic, these consequences must be so severe that the person’s life is completely falling apart: that they cannot keep a job, have become homeless, or their alcohol abuse has led to tragedy such as a serious or fatal accident. But the negative consequences in which we speak of in addiction treatment can be much more nuanced. Some people may look like they have their lives together on the outside, but their alcohol use prevents them from having meaningful connections or conflict resolution with their family members, for example. Perhaps they have a high-paying job but are unable to address mental health issues such as depression or anxiety because of their excessive drinking, or they feel as though they need alcohol to function in an array of of ways, such as with interacting with others.

Those who fall into these categories are often called “functional” or “high functioning” alcoholics. Their alcoholism may be overlooked by others and even by themselves because their lives look “normal” on the outside. There may be no DUIs or other legal problems due to drinking and they may excel at an array of tasks. Perhaps they check all the boxes of what others want their lives to be: good job, family, friends, success. It is common for the person with high-functioning alcoholism to believe that because they have their lives “together” in this way, their drinking habits don’t matter or aren’t problematic.

It is much more common for a person to be denial of their alcohol use disorder if they believe it to be invisible to others. Still, those who may fall into this category of “functional alcoholism” both need and deserve help to be free from their addiction. It is likely that their alcohol addiction is a maladaptive coping strategy for an underlying mental health issue or psychological trauma from which they will be unable to heal without first obtaining sobriety. Just because the damage to one’s body, mind, and spirit is not obvious to the outside world does not mean it is not there. Addiction takes a tremendous toll on a person’s ability to relate to the people they love, connect with the world in meaningful ways, and feel at peace in their own skin. There are also a wide array of physical health complications associated with alcohol use disorder, not to mention risks of endangerment of self and others due to the impairment of motor function while intoxicated.

The signs of high-functioning alcoholism include:

  • Shame or secrecy surrounding alcohol consumption
  • Heavy drinking (defined as more than 3 alcoholic beverages a day or 7 per week for women, 4 per day or 14 per week for men).
  • Inability to cut down on alcohol use
  • Withdrawal symptoms (anxiety, fatigue, irritability, shaking, confusion, sweating, mood swings, increased heart rate, seizures) when stopping or reducing drinking
  • Joking about having an alcohol problem
  • Having relationship problems or losing friends due to drinking alcohol, though continuing to drink anyway
  • Difficulty feeling confident or relaxed, especially in social situations, without alcohol
  • Drinking in the morning
  • Drinking while alone
  • Craving alcohol
  • “Black outs” or forgetting what happened when drinking
  • Drinking more than you originally intend
  • Getting angry, defensive, or lie when confronted about drinking
  • Engaging in risky behaviors, such as driving, while intoxicated

How to get help for high-functioning alcoholism

If you suspect that you may have alcohol use disorder, schedule an assessment with a qualified treatment provider to determine what level of care is best for you. It is important that before quitting alcohol, you allow an addictions professional to help you determine whether or not you may need medical detox. Medical detox is a medical setting where you can safely come off of alcohol while managing the risks associated with withdrawal symptoms. Alcohol is one of the very few substances that can cause death during withdrawal, so it is extremely important to avoid detoxing at home or without qualified medical supervision.

After detox, there are several options of addiction treatment available depending on your needs. Some programming, such as residential or partial-hospitalization with a structured sober living component offers twenty-four hour accountability and support while addressing your alcohol addiction and includes curricula to help with relapse prevention, developing healthy coping strategies, addressing underlying mental health or trauma issues, and building a sober community, among other things. A typical stay in this type of rehab setting is 30-90 days. Our mindfulness-based curricula includes experiential therapies such as meditation, yoga, hiking, art, and equine therapy as well as other evidence-based treatment modalities such as CBT, DBT, EMDR, MI, and ACT.

For those who need a lower level of care, intensive outpatient (IOP) can be a great option. IOP programming includes between 9-15 hours a week of group programming, plus individual counseling, and can accommodate the schedule of someone working or going to school without the need to take time off. IOP programming at Flatirons Recovery can be done virtually via Telehealth, in-person in our office just outside of Boulder, Colorado, or a combination of the two.