Addiction Alcohol Use What Is a Functional Alcoholic? By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on September 09, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print Thinkstock / Stockbyte / Getty Images Table of Contents View All Table of Contents What Is a Functional Alcoholic? Risk Factors Symptoms Impact Coping Getting Help 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. While the term "alcoholic" was used in the past but is now viewed as outdated and stigmatizing. Today, healthcare professionals would say that a person has an alcohol use disorder (AUD). What Is a Functional Alcoholic? A "functional alcoholic" (or "high-functioning alcoholic") isn't a formal medical diagnosis, but a term used colloquially to describe a person who is dependent upon alcohol but can still function in society. The term “currently-functioning" may be used since it’s not likely they will remain functional (and not misuse alcohol) indefinitely. Drinking rarely causes them to miss work and other obligations (although it does happen occasionally). They are usually able to manage areas of life including jobs, homes, and families. They often appear physically and mentally healthy. However, they are likely struggling with uncontrollable cravings, unsuccessful attempts at quitting, and obsessive thoughts about their next drink—all hallmarks of an alcohol use disorder. Risk Factors for Functional Alcoholics According to the National Institutes of Health, functional alcoholics are typically "middle-aged, well-educated, with stable jobs and families." While the causes are not known, there are risk factors that increase your chances of developing a problem with alcohol, including: Binge drinking (more than 5 drinks per day) Experiencing high levels of stress Exposure to peer pressure to drink Having a parent or close relative with an alcohol use disorder Having a mental health problem, such as anxiety, depression, or schizophrenia Having low self-esteem Having more than seven drinks (for females) or more than 14 drinks per week (for males) Recap Certain factors may increase your risk of developing an alcohol problem. Binge drinking, social pressures, family history, mental health issues, and excess alcohol use can all increase your risk of developing an alcohol use disorder. Signs of 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? Here are some red flags that signal you need help: Are you the first one at the bar after work, or do you pour yourself a drink when you come home? Do you get agitated, irritable, or nervous if a meeting or other occurrence prevents you from having a drink? Are there often times when you drink more or longer than you intended? Do you tend to joke about alcoholism? For example: "I'm a drunk, alcoholics go to meetings." Do you constantly talk about drinking or brag about stockpiling liquor so there's "enough" alcohol available? Do you “drink” your meals or use mealtime as an excuse to start drinking? Have you engaged in any high-risk behaviors (even if you never got caught), including binge drinking, driving under the influence, drinking while caring for your children, or practicing unsafe sex? Has a loved one ever confronted you about drinking? Did it make you feel angry or irritated? Have you ever experienced an alcohol-related blackout, during which you could not remember parts of the night or how you got home? Has your drinking caused any relationship problems? Have you ever hidden your alcohol consumption? Do you experience withdrawal symptoms when you're unable to drink alcohol? Self-Tests to Help Determine a Drinking Problem 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 significant 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.” Online Tests to Determine If You Have a Drinking Problem Tolerance A functional alcoholic often consumes as much alcohol as someone with an alcohol use disorder. However, they will not exhibit 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 dependenceAlcohol-related organ damageCognitive impairment 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. The Negative Effects of Alcohol Tolerance 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: Anxiousness or nervousness Appetite loss Depression Difficulty sleeping Dilated pupils Faster heart rate Fatigue or tiredness Headache Irritability Mood swings Nausea and/or vomiting Nightmares Not being able to think clearly Pale skin Shakiness Sweating Tremor They may try to quit independently, 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. What Helps With Alcohol Withdrawal? Impact of Being a Functional Alcoholic While a person who is high-functioning alcohol can still fulfill their obligations in many areas of life, that does not mean that their drinking does not take a toll on their health, relationships, career, and well-being. In the short term, alcohol use increases the risk for alcohol poisoning, fetal alcohol syndrome, accidents, injuries, violence, and risky sexual behavior. Alcohol intake also has long-term consequences, including an increased risk of: Alcohol dependence and alcohol use disordersCertain types of cancer, including breast, mouth, liver, colon, and throatMemory and learning problemsMental health conditions such as anxiety and depressionWeakened immunity In addition to the health effects of having an alcohol use disorder, it can also take a toll on relationships. Drinking doesn't just affect the individual; it affects the entire family unit. Family members may feel on edge and worried about their loved ones drinking. They may take steps to avoid the person while they are drinking, or they may experience feelings of guilt, shame, or self-blame. Coping With a Functional Alcoholic If you are concerned about your loved one's drinking, it can be helpful to join a support group such as Al-Anon. Such groups can offer valuable support, encouragement, advice, and information. While a functional alcoholic can still function in daily life, family members and loved ones are often aware and concerned about the individual's alcohol use. Some steps you can take to help include: Learn more about alcohol use disorders Joining a support group Talk to the person about your concerns in a calm and non-accusatory way Learn about community reinforcement and family training (CRAFT), which is a way that can help family members support a loved one's addiction recovery Learn how to stop enabling and co-dependent behaviors The National Institute of Health suggests that loved ones should start by talking about their concerns. Avoid accusing, blaming, or making threats. Instead, voice your concerns, share how their drinking is affecting others, and suggest ways that you can help them talk to a doctor or join a support group. Getting Help As a Functional Alcoholic 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. Press Play for Advice On Addiction Recovery Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring actor Richie Stephens, shares how to recover from alcohol addiction, manage cravings, and determine if AA is right for you. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts / Amazon Music 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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Community reinforcement and family training (CRAFT) - design of a cluster randomized controlled trial comparing individual, group and self-help interventions. BMC Public Health. 2019;19(1):307. doi:10.1186/s12889-019-6632-5 National Institute on Aging. How to help someone you know with a drinking problem. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.