Is There Such a Thing as a High-Functioning Alcoholic?

This post originally appeared in different form on the Ria Health Blog. Ria Health offers flexible treatment for alcohol use disorder from a smartphone app.

Businessperson carrying briefcase, looking sharp
Photo by Marten Bjork on Unsplash

To many people, the stereotypical alcoholic is someone often visibly drunk or hungover. This person struggles with jobs, finances, and relationships, and engages in risky behavior. It’s clear to most people they encounter that they have a problem.

But there have always been people who struggle with alcohol and don’t fit this stereotype. Some individuals are seemingly able to drink excessively while appearing sober or “normal” to others. They maintain jobs and relationships, and may even shine in these areas. Such a person is often termed a “high-functioning alcoholic.”

But are these “high-functioning” individuals really okay? Is it safe to be an alcoholic if you can keep everything together? Or, on the flipside, if this describes you, are you really an alcoholic at all?

The truth is, certain levels of drinking are going to cause harm sooner or later — if not to a person’s relationships, then to their physical health. And even those heavy drinkers who appear to function perfectly in daily life tend to struggle beneath the surface, or out of the public eye.

Here’s how to know if you or someone you love qualifies as a high-functioning alcoholic, and when it’s time to cut back, quit, or get help.

What is the Definition of a High-Functioning Alcoholic?

Three women socializing
Three women socializing
Photo by Priscilla Du Preez on Unsplash

A high-functioning alcoholic is someone who meets the criteria for an alcohol use disorder, but shows few outward signs of it. They are seemingly able to maintain their career, personal life, and health.

Close friends and family may suspect that they have a drinking problem, but most people will have no idea. And although they may experience some negative impacts from drinking alcohol, it isn’t yet disrupting their everyday life. For this reason, high-functioning alcoholics may deny there is any issue. They may believe they can “stop any time they want,” or control the amount of alcohol they drink.

Some of these individuals may drink moderately or steadily throughout the day. Others might remain sober during the day, then binge heavily on nights or weekends. But what all high-functioning alcoholics have in common is that they are drinking more than is safe for their health, and seemingly getting away with it.

10 Characteristics of a High-Functioning Alcoholic

Aside from drinking more than the average person, what are some signs that someone is a high-functioning alcoholic?

  1. They often have difficulty controlling the amount they drink.
  2. Drinking is a big part of their life; they may obsess over the next drink, or prefer social events involving alcohol.
  3. They sometimes joke about being an alcoholic or having a problem with drinking.
  4. Alternatively, they may lie to cover up how much they are actually drinking, or make frequent excuses.
  5. They drink when they are alone, in the morning, or throughout the day.
  6. They rely on alcohol to cope with stress, feel confident, or self-medicate feelings of anxiety or depression.
  7. They sometimes use drinking as a “reward.”
  8. Sometimes they engage in high-risk behaviors, such as binge drinking, driving under the influence, or practicing unsafe sex.
  9. They experience blackouts, or forget what they did while drinking.
  10. They experience symptoms of withdrawal when they cannot drink. These may include mood swings, shaking hands, appetite loss, difficulty sleeping, sweating, headaches, and nausea.

If someone has several of these symptoms, it’s possible they are a high-functioning alcoholic. And although their alcohol use may not appear dangerous yet, it can certainly become that way.

Read more: 8 Signs of Alcoholism — From a Former Alcoholic

Long-Term Consequences of “High-Functioning” Alcoholism

Unfortunately, even if a person drinks heavily and is able to keep their life together, there are certain biological factors at play.

Alcohol enters and impacts nearly every system in your body, putting particular stress on your liver, stomach, pancreas, and nervous system. Even if you’re genetically gifted with a bulletproof gut, for example, at least one of these other systems is likely to fail in the face of a multi-year, or multi-decade, barrage of ethanol.

And since the nervous system is one of the parts of your physical body that takes a hit, it’s likely that it will become harder and harder to prevent your drinking from affecting your mental health. Chronic alcohol use is linked to increased depression and anxiety, and greater stress sensitivity. Long-term, it can even lead to conditions like Wernicke-Korsakoff syndrome, also known as “wet brain.”

In other words, “high-functioning” alcoholics often don’t stay that way. Inevitably, the effects of heavy alcohol use on the body and mind take their toll. Although a person may be able to hold these consequences off for some time, sooner or later the crash will arrive — even if no one sees it coming.

“High Functioning” or “Currently Functioning”?

If you or someone you love drinks regularly, but seems to be able to do everything normally, it can be tempting to pass their habits off as harmless. And if they aren’t really drinking all that much, that may be the case; some people just like a glass of wine or two in the evening, which is generally safe.

However, if a person is having more than three or four drinks per day, or drinks to the point of blacking out every weekend, it’s worth being concerned about their long-term health. It’s also worth pointing out that not all types of problem drinking qualify as “alcoholism.” Someone who drinks 12 shots of whiskey every Friday with their friends may not be addicted. But it may still be doing a number on their liver, and giving them serious hangover anxiety all the way through Sunday.

In other words, all terminology aside, heavy drinking and your health is fairly straightforward. No matter how well you do your job, or how well you get along with everyone, alcohol undermines your physical and mental health. Heavy drinking is likely to catch up with you. And until that time comes, you’d still probably have a better time day-to-day if you did less of it.

You may be high-functioning. But it’s likely you’d be doing everything much better without too much alcohol.

Ria’s private, at-home program is for anyone who wants to drink less and live better. Learn more at riahealth.com