High-Functioning Alcoholics: Signs and Treatment

Can you be an alcoholic and still perform well at work? Still maintain friendships? Look like youve got it all together from the outside? Yes, yes and yes. Its surprising given the stereotype of alcoholics being disheveled, slurring words and struggling to keep their life together, but thats also what makes alcohol use disorder (AUD) so dangerous for high-functioning alcoholics. Not only may they be in denial, their friends and family may also not even realize they have an alcohol problem. Heres what to look out for, as well as treatment options for high-functioning alcoholics.

AUD in the U.S.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines AUD as a chronic relapsing brain disease characterized by an impaired ability to stop or control alcohol use despite adverse social, occupational or health consequences. It can range from mild to severe; however recovery is possible regardless of severity.

The Substance Abuse and Mental Health Services Administrations 2018 National Survey on Drug Use and Health reports that 14.4 million adults ages 18 and older have AUD.

There are different subtypes within this disorder of which functional (high-functioning) is one. According to the NIAAA, 20 percent of those with AUD fall into this category, however that percentage could be much higher since high-functioning alcoholics can be difficult to recognize.

Identifying the Signs

The NIAAA states that high-functioning alcoholics are typically middle-aged, well-educated and have stable jobs and families. They look like any one of us, and thats what also makes this so scary.

One of the first red flags is heavy drinking. WebMD defines it as having more than three drinks a day or seven a week for women; and for men, heavy drinking is four or more drinks per day or 14 a week.

Other signs of a high-functioning alcoholic include:

  • Difficulty controlling how much alcohol they consume, even when they try to do so
  • Obsessing about the next drink, outing or event in which alcohol can be consumed
  • Acting drastically different when drunk than when sober
  • Periodic memory lapses or blackouts
  • Needing alcohol to de-stress, relax or feel confident and/or as a reward
  • Drink in the morning or when they’re alone
  • Periods of sobriety characterized by irritability, agitation and mood swings
  • Denying their drinking, joking about it, hiding alcohol or getting angry when confronted about drinking
  • Engaging in potentially hazardous behavior while drinking such as driving under the influence or risky sexual encounters

While they may be keeping up with most of their responsibilities and relationships now, over time alcohol will begin to have a negative effect on their ability to function normally. It will also impact their health by increasing the risk of liver disease, pancreatitis, some forms of cancer, high blood pressure and can even cause brain damage.

Help for High-Functioning Alcoholics

Treatment for high-functioning alcoholics is the same as for anyone with AUD. The first step is to admit that a problem exists. Family and/or friends may come to this realization first and decide on an intervention.

Its important to note that the National Alliance on Mental Illness (NAMI) reports that as many as one third of alcoholics may also suffer from a mental illness which complicates matters further. This is known as dual diagnosis.

For the best chance at long-term recovery and healing, the alcoholism and mental illness should be addressed simultaneously with an integrated treatment approach. With three licensed clinicians on our team along with a wealth of dual diagnosis experience, we specialize in getting those in our care to the appropriate facility for psychological evaluation and testing which is a critical component in the process.

We also include six months of case management after the intervention which allows us to support your family throughout the recovery journey with the guidance of our masters level clinical team as well as a trauma informed intervention protocol.

For more information on our treatment options for high-functioning alcoholics, call 800-219-0570 or email info@heatherhayes.com today.