What is a Functioning Alcoholic

March 28th, 2022

In the early years of substance abuse counseling the term Alcoholic was birthed. This is a term used in the rehabilitation community to identify a person with an inability to control their drinking. Over the years this term has been replaced with the acronym AUD, or Alcohol Use Disorder. Typically, you can identify these individuals by a slew of common traits they share; the inability to hold down a job, money problems, homelessness, and the list goes on. More than 6% of adults in the U.S. have an alcohol use disorder. Recently we have seen the rise of a new class of people with AUD, the Functioning Alcoholic or High-Functioning Alcoholic.  

What is a Functioning Alcoholic? 

So, what is a functioning Alcoholic, what sets them aside from someone who suffers from AUD? Isn’t an alcoholic just and alcoholic? You might tend to think so, however the separation of the two terms comes from the evolution of the disease. Yes, this disease has evolved into something that may be a little harder to detect. Like bacteria may evolve to become resistant to a medication, this disease has evolved to co-exist with everyday life.  

The term Functioning Alcoholic is not a diagnosis, rather an unofficial term used to describe someone who is dependent on alcohol but can still function in society. Simply put, the Functioning Alcoholic is a person that suffers from AUD, but may not demonstrate the criteria to diagnose AUD.  

The Functioning Alcoholics drinking may not impact their lives as significantly as others. Typically, these individuals will have a job, hold down a proper household, raise children, pay bills and the like. Although they may not exhibit benchmark AUD traits, there are still signs.  

What are the signs my loved one may be a Functioning Alcoholic? 

Can someone have an alcohol dependency problem even if they function well within society? The answer is a resounding, yes. In the paragraphs above we discussed the signs of someone that suffers from AUD and spoke about the difficulty in diagnosing AUD in certain people who can function well in society all-the-while suffering on the inside. The struggle is real, but there are signs we can use to identify a Functioning Alcoholic. We may hear or see these: 

  • Making Jokes about alcoholism, “Rehab is for quitters”, “I drink my dinner”. 
  • Drinking more than intended, or “blacking out” 
  • Needing a “night-cap” to sleep? 
  • Taking unnecessary risks, driving while intoxicated, risqué sexual habits, drinking despite health concerns. 
  • Extreme cravings 
  • Failed attempts to cut back. 
  • Hiding your alcohol consumption. 
  • Has drinking taken place of other activities you previously engaged in? 
  • Drinking to cover or mask depression or anxiety. 
  • Experiencing symptoms of withdrawal, nausea, trouble sleeping, sweating, restlessness? 
  • Or even going as far as talking about other people’s drinking problems, while avoiding their own. 

One major sign of a Functioning Alcoholic is denial. Denial is an important factor here as it drives the disease deep within the subconscious. This denial can keep someone sick for a very long time and allows the induvial to rationalize their drinking problem. You might hear. 

  • “I only drink to get relaxed.” 
  • “I have a stressful job, so I need a drink every now and then.” 
  • “As long as I can still pay my bills.” 

Risk Factors: What if this goes untreated? 

The CDC has outlined some short-term and long-term risk factors of an ongoing and untreated AUD. According to cdc.gov there are chronic and immediate risk factors.  

Chronic health effects. More common are the effects on learning, memory, and mental health. Other long-term effects are. 

  • Heart Disease 
  • Hypertension (High Blood Pressure) 
  • Stroke 
  • Liver Disease 
  • Cancer 

Immediate health effects. 

  • Injuries 
  • Violence 
  • Poisonings 
  • Sexually Transmitted Infections 
  • Unintended pregnancy  
  • Or worse, poor pregnancy outcomes like fetal alcohol syndrome 

Getting help and Intervention. 

So, what can you do?  

There are a couple different ways to approach this.  

One, visit with your medical provider. If you aren’t showing signs of a sever withdrawal your provider may offer an outpatient treatment program, medical detox, and other forms of help.  

Two, for those showing signs of sever withdrawal. Your medical provider might offer an inpatient treatment program.  

Three, for those in a stage of denial- an intervention may need to be implemented.  

Regardless of the route you take, there are many different rehabilitation centers out there, counseling services, and support groups like Alcoholics Anonymous or SMART Recovery to help you through your fight. And it is a fight.  

Look, I’ll be real with you. There’s no shame in the game. There are ex-military combat veterans out there suffering from this disease. Some of the toughest people on our planet are in the fight. So, is rehab for quitters? Or for the strong willed? Head up, shoulders high- help is out there.  

Coach Out.