Signs of a Functional Alcoholic

Hands of man holding beer

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There are people who meet the criteria for a medical diagnosis for alcohol dependence who are highly functional in society and still have their jobs, homes, and families. This type of drinker is known as a functional alcoholic, high-functioning alcoholic, or “currently-functioning alcoholic,” since it’s not likely that you’ll remain functional (nor misuse alcohol) forever.

They rarely miss work and other obligations because of their drinking, although it does happen occasionally, and they usually excel at their jobs and careers. Typically, they are clever and witty individuals who are successful in many areas of their lives. To all but those who are closest to them, they give the outward appearance of being perfectly normal.

Risk Factors

While it’s unknown what causes someone to become a “high-functioning alcoholic,” there are risk factors that increase your chances of developing a problem with alcohol, including:

  • Having a parent or close relative with an alcohol use disorder
  • Having a mental health problem, such as anxiety, depression, or schizophrenia
  • Experiencing high levels of stress
  • Having low self-esteem
  • Having more than 12 drinks (for females) or more than 15 drinks per week (for males) 
  • Binge drinking (more than 5 drinks per day)
  • Exposure to peer pressure to drink

Denial

One of the main reasons that people who misuse alcohol seek help is the eventual negative consequences of their alcohol consumption. When the pain or embarrassment gets bad enough, they can no longer deny that their drinking needs to be addressed.

For the functional alcoholic, the denial runs deep, because they have yet to encounter outward negative consequences. They go to work every day. They haven't suffered financially. They have never been arrested. They tell themselves that don't have a problem. Listen for excuses: “I have a great job and pay my bills, so I can’t have a problem with alcohol.” “I only drink expensive wine.”

Tolerance

The functional alcoholic consumes as much alcohol as any individual with an alcohol use disorder, they just don't exhibit the outward symptoms of intoxication. This is because they have developed a tolerance for alcohol to the point that it takes more for them to feel the effects (including hangovers). Consequently, they must drink increasingly larger amounts to get the same "buzz" they want.

This slow build-up of alcohol tolerance means the functional alcoholic is drinking at dangerous levels that can result in alcohol-related organ damage, cognitive impairment, and alcohol dependence. Chronic heavy drinkers can display a functional tolerance to the point they show few obvious signs of intoxication even at high blood alcohol concentrations, which in others would be incapacitating.

Are You a Functional Alcoholic?

Could it be that you have an alcohol use disorder even though you continue to function well in society? Could your drinking have slowly increased to the point that you have become alcohol dependent without even knowing it? You should take the alcoholism screening quiz.

Below is a profile of typical functional alcoholic behavior. See if any of these actions seem familiar. This profile is a female, but the same behaviors are typical for males.

It's important to note that "functional alcoholic" is not a formal medical term or diagnosis.

She Drinks Like She Did in College

When she was in college, she was the first to arrive and the last to leave the party. She could drink everyone else "under the table." Most of her friends graduated, grew up, and stopped partying. Now in her mid-30s, she still drinks like a freshman away from home the first time.

She Can Hold Her Liquor

She can drink as much or more than anyone, but rarely appears intoxicated. She seldom staggers or slurs her speech. She is more than likely a "happy drunk," rarely getting unpleasant or belligerent when drinking.

First One at the Bar

She's highly functional at work, but as soon as the workday is over, she's the first one at the bar or she makes a drink as soon as she walks into her home to "unwind." She probably drinks the first two or three drinks very quickly. If for some reason she has to unexpectedly stay late at work, she can become agitated or irritable.

Drinking Is a Big Part of Her Life

She talks about drinking a lot and she is often the driving force behind office parties and drinking gatherings after work. She brags about her drinking bouts on her blog and most of the pictures in her photo albums were taken in barrooms. She tends to avoid events where no alcohol is available. She buys the economy sizes and always makes sure there is "enough" alcohol available.

Jokes About Drinking

She laughs about her alcohol consumption and drinking episodes with jokes like, "I'm a drunk, alcoholics go to meetings." The humor is an attempt to validate that her drinking is a choice. If confronted about the amount she drinks, however, she may get defensive, angry, or belligerent.

Friends Ignore the Symptoms

Because she is generally well-liked and fun-loving, or perhaps because she's in a position of authority, those around her also laugh off her drunken escapades. But secretly, they know she has a problem. They talk behind her back. But rarely is she confronted directly about her drinking.

She Begins Participating in High-Risk Behaviors

Although she might not get caught, she may begin engaging in high-risk behaviors including binge drinking, driving under the influence, drinking while caring for her children, or practicing unsafe sex.

She Begins to See the Effects

Although she continues to be functional, it begins to get more difficult to do. She begins to notice withdrawal symptoms when she's not drinking, such as the shakes or nervousness. She's having more frequent memory blanks. She needs more makeup to cover her flushed face, grayish pallor, or dark circles. Her drinking antics are becoming more extreme, dangerous, or embarrassing.

Symptoms of Withdrawal

Unfortunately, even when functional alcoholics begin to recognize that they have a drinking problem, they still resist reaching out for help. By the time they admit the problem, their withdrawal symptoms—which can begin within a few hours after their last drink—can become more and more severe.

Symptoms of alcohol withdrawal include:

  • Feeling anxious or nervous
  • Feeling irritable
  • Feeling depressed
  • Feeling wiped out and tired
  • Shakiness
  • Mood swings
  • Not being able to think clearly
  • Having nightmares
  • Dilated pupils
  • Sweating
  • Headache
  • Difficulty sleeping
  • Nausea and/or vomiting
  • Appetite loss
  • Faster heart rate
  • Pale skin
  • Tremor

They may try to quit on their own, but the withdrawals are too unpleasant or severe. Therefore, they continue to drink to keep the withdrawals at bay and the cycle continues.

Usually, it is only when their continued drinking becomes more painful than the prospect of going through the pain of alcohol withdrawal, will they finally reach out for help. But it doesn't have to be that way. Help is available.

Getting Help

If you are having only mild to moderate withdrawal symptoms, your healthcare provider may recommend outpatient treatment, including medical detoxification that provides medication, vitamins, and diet to help ease the withdrawal process.

Your provider can also perform tests to see if you have developed any medical concerns from alcohol misuse and recommend counseling, rehabilitation, and support groups like Alcoholics Anonymous or SMART Recovery.

If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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  1. National Institute on Alcohol Abuse and Alcoholism. Alcohol and tolerance. 1995; 28:356. Updated 2000.