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Most people think of an alcoholic as a stereotype: someone who blacks out, who can’t hold down a job, who slurs their words, or who stumbles when walking. While these stereotypes can be true in some cases, most people who struggle with alcohol abuse are functioning alcoholics. They can abuse alcohol but appear to be fine in many aspects of their lives. They can keep a job, maintain relationships with friends and family, and care for a home — all while abusing alcohol.

People functioning at this level while drinking heavily may not think they have a problem. But such a high level of drinking will eventually cause physical, emotional, mental, or relationship problems. Alcoholism, also known as alcohol use disorder (AUD), is a significant issue in the United States, affecting almost 15 million people, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

What is Excessive Alcohol Use?

More than a quarter of American adults reported binge drinking in 2019, with another 6.3% saying they engaged in heavy drinking, according to the 2019 National Survey on Drug Use and Health (NSDUH).

Excessive drinking includes binge, heavy, and alcohol use by underage people or pregnant women. The Centers for Disease Control and Prevention (CDC) define binge drinking as alcohol consumption on one occasion that puts a person’s blood alcohol concentration (BAC) level at 0.08% or more. This typically equals five or more drinks for men and four or more for women in a period of two hours.

The CDC views heavy drinking as having 15 or more drinks per week for a man and eight or more for a woman.

Signs of a High-Functioning Alcoholic

One of the most visible signs that indicate someone has an issue with alcohol, even if they seem to be managing their life, is the amount they drink per week. For instance, a woman with more than three drinks a day or seven drinks a week is at risk of AUD, while a man with four or more drinks a day or up to 14 a week is also at risk. Other signs of high-functioning alcoholism to look out for in a loved one or family member include:

  • Difficulty Maintaining responsibilities: High-functioning alcoholics may continue to fulfill their obligations at work, school, or home despite their alcohol consumption. They may excel in their careers or studies, and their accomplishments may disguise their alcohol problem.
  • Drinking to cope: Using alcohol to deal with stress, anxiety, or other emotional issues is common among high-functioning alcoholics. They may rely on alcohol to relax, unwind, or feel confident in social situations.
  • Hiding or minimizing alcohol consumption: High-functioning alcoholics often conceal the extent of their drinking habits from others. They may drink secretly, keep a stash of alcohol hidden away, or downplay the amount they consume when questioned.
  • High tolerance: Over time, high-functioning alcoholics tend to develop a tolerance for alcohol, meaning they must drink larger quantities to achieve the desired effects. They may appear less intoxicated than others despite consuming substantial amounts of alcohol.
  • Preoccupation with drinking: Constantly thinking about when they can have their next drink, planning activities around alcohol, or feeling restless when alcohol isn’t readily available are signs of an unhealthy relationship with alcohol.
  • Rationalizing or justifying drinking habits: High-functioning alcoholics may come up with various reasons to validate their drinking behavior, such as claiming they deserve it due to their success or stress levels. They may deny or downplay the negative consequences of their drinking.
  • Denial and defensiveness: When confronted about alcohol consumption, high-functioning alcoholics may become defensive, dismissive, or deny having a problem. They may insist that they have control over their drinking and that it doesn’t impact their lives negatively.
  • Isolation or secretive behavior: High-functioning alcoholics may withdraw from social activities that don’t involve alcohol or avoid situations where their drinking habits may be scrutinized. They may also distance themselves from friends or family members who express concerns about their drinking.

Effects of Functional Alcoholism

Someone who falls into the category of a functioning alcoholic can experience the same problems as a more stereotypical “alcoholic.” They run the risk of various health problems, from liver disease and pancreatitis to memory loss and high blood pressure, among other concerns.

They are also at a higher risk of being involved in a car accident or dying by suicide. Alcohol abuse also increases the chances of domestic violence, child abuse or neglect, and fetal alcohol syndrome.

Tolerance is another concern. The more regularly a person drinks, the more alcohol they need to consume to experience the same intoxicating effects. A functioning alcoholic may also, over time, learn how to perform specific tasks while inebriated without showing any signs of drunkenness. This happens slowly but can mean that a high-functioning alcoholic may be able to drink significantly at work or in social settings without being noticed.

Regular drinking over time can cause various health issues, even if the person’s life and work aren’t impacted. Potential physical problems include:

  • Weakened immune system
  • High blood pressure
  • Irregular heartbeat
  • Stroke
  • Cardiomyopathy (heart muscle disease)
  • Fatty liver
  • Fibrosis
  • Cirrhosis
  • Alcoholic hepatitis
  • Pancreatitis
  • Cancers of the head and neck, esophagus, liver, breast, and colon

What Happens When Functioning Alcoholics Try to Stop Drinking On Their Own?

If a functioning alcoholic does decide to stop or cut back on their drinking, they may also experience withdrawal symptoms. Common 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

How To Help a Functional Alcoholic

Like anyone with a drinking problem, a functioning alcoholic may be in denial about their problem. Luckily, helping a functioning alcoholic is no different than helping anyone with a substance abuse problem.

Start by learning about alcoholism. You’ll quickly understand that alcohol use disorder is a disease the individual cannot control.

Next, research rehab facilities and treatment options. It is important to have this information before taking the next step.

Find a time to talk with the person suffering from AUD. This conversation may need to happen several times before the functioning alcoholic is willing to admit that they have a problem.

Finally, when the person decides to seek treatment, ensure they have the support they need during and after their treatment. For example, they should consider joining a peer support group or a 12-step program like Alcoholics Anonymous. Family members and loved ones may also wish to consider joining their own support group, such as Al-Anon.

We Can Help, Too

We take a people-centered approach to alcohol addiction treatment. We’re conveniently located in Houston, Texas, and our treatment is led by experienced master’s level counselors and medical professionals. We also take the time to provide our clients with a personalized treatment plan. Let us help you help your family member or friend get their lives back on track. Contact us today to learn more.

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