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What is a Functioning Alcoholic?
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What is a Functioning Alcoholic?

Alcohol addiction has different severities and unique timelines for each individual. It is common for those suffering from alcohol dependency not to display the stereotypical warning signs and/or symptoms of a “typical” alcoholic. Some of those with alcoholism are still productive and successful people; also known as high-functioning alcoholics (HFA). Many HFAs heavily abuse alcohol and can still maintain healthy romantic relationships, perform well at work, and be admired by others.

According to the National Institute of Health (NIH), there are over 17 million Americans who have Alcohol Abuse Disorder (AUD) and only 6.7% of them have received addiction treatment within the last year. Alcohol addiction occurs in incremental stages. When someone is in the beginning stages of AUD, they still might display behaviors similar to high-functioning members of society. However, it is only a matter of time before limited or occasional abuse can develop into a much more serious problem.


Four Stages of Alcohol Addiction


Usually, there are four stages of alcohol addiction: social drinking and/or binge drinking, using alcohol as a coping mechanism, facing serious consequences from problem drinking, and finally, the manifestation of physical and psychological changes stemming from alcohol abuse. Each stage of alcohol addiction has the potential to be deadly, but as time goes on, symptoms and consequences of AUD tend to get increasingly worse. Here are the four stages broken down:

  • Social Drinking and/or Binge Drinking: In the initial ‘experimentation phase’ with alcohol, many like to test their limits and drink with the sole intention of getting drunk. These alcohol abusers tend to look at themselves as high-functioning individuals because they aren’t drinking every day and are able to remain productive in other facets of their life (school, work, relationships, etc.).

Oftentimes drinkers in this stage will limit their alcohol intake only to the weekends. Although alcohol abuse has yet to completely engulf them at this stage, it can only take one drink before they lose control since they tend to feel a need to consume alcohol until becoming intoxicated.

  • Using alcohol as coping mechanism: Transitioning into the second stage occurs once someone begins using alcohol as a primary way for dealing with problems. This can cause one to infatuate about when they will have their next drink as alcohol starts to become the only solution for coping with stress.

Even though someone can still be highly functional in this stage, it can get increasingly more difficult for them to maintain relationships, perform well at work, and remain productive. One might also begin to feel depression, anxiety, and self-guilt at this time due to their excessive drinking.

  • Facing serious consequences from problem drinking: In the third stage, a user is forced to constantly undergo damage control in order to avoid the consequential repercussions resulting from their abuse of alcohol. Alcoholics in this stage will often attempt to make rules and set certain boundaries for themselves, but still continuously fail to keep their drinking under control. Friends and family members may also start to begin fearing for their safety.

Although someone might appear to be a functioning alcoholic at this point, it usually consists of them frequently having to change jobs, switch friend groups, or deal with other serious issues (e.g., depression, anxiety, legal problems, financial hardship, isolation, etc.).  

  • Manifestation of physical and psychological changes from alcohol abuse: The fourth and final stage is when an alcoholic begins to display significant physical ailments and changes (e.g., flushed skin, distended stomach, frequent heartburn, shaky hands, increased blood pressure, etc.).

Even at this stage, many alcoholics consider themselves as “functioning” because they are still able to go through the motions of working a job, taking care of a family, and having relationships with others. However, it is probable they are performing these tasks poorly.


Signs of a Functioning Alcoholic


Dr. Kevin Wandler, who is a Chief Medical Officer (CMO) for a well-known Recovery Center, defines a high-functioning alcoholic as “someone who meets enough criteria to have a substance use disorder and is still able to maintain their personal life, work life and health.”

When you think of an alcoholic, you probably picture someone who can barely keep a job and is utterly incapable of being a productive member of society. Albeit this is almost always the case when someone drinks for long enough, many of those with AUD can carry out their daily tasks and are oftentimes successful in doing so. Be that as it may, operating with AUD at a highly functional capacity is pretty much guaranteed only to be temporary.

Here are some red flags to watch out for that might be signals pointing toward a functioning alcoholic:

  • Using alcohol as a coping mechanism
  • Nearly every situation requires alcohol
  • Drinking alone
  • Heavy amounts of alcohol in a single sitting
  • Increased alcohol tolerance
  • Physical and psychological withdrawal symptoms
  • Missing school or work for unspecified reasons
  • Making jokes about their drinking problem
  • Confrontation about their drinking problem makes them angry


How Long Does It Take To Detox From Alcohol?


When someone thinks of detoxing from drugs, heroin and other hard narcotics might come to mind, but it’s rare for people to associate detoxing with alcohol. The truth is, alcohol detox and its withdrawal symptoms can be physically painful, mentally taxing, and implicitly dangerous. Alcohol is a depressant that affects the central nervous system, which can slow down the brain and cause nerves to work overtime just to communicate back and forth with each other.

Once the body is deprived of alcohol, the brain continues to maintain a chaotic state, which casually brings about symptoms of alcohol withdrawal. Symptoms range from mild to severe and generally get worse as time passes. Alcohol withdrawal ordinarily starts six hours after the last drink and can last for over 72 hours.

Within the first six hours of alcohol detoxification, milder symptoms may start to emerge such as anxiety, nausea, and vomiting. Much more serious problems can surface 24-48 hours after having the last drink, ranging from hallucinations to seizures. In 5% of alcohol withdrawal cases, one can experience delirium tremens (DTs), which usually materializes with heavy sweating, vivid hallucinations, along with delusions. In even rarer cases, some people have died while going through alcohol withdrawal.


Why Do Some People Become Functioning Alcoholics?


Although alcoholism is a progressive disease, some can get addicted to it much quicker than others. With that said, it can take several years before someone fully develops the disease over time. A diverse medley of cultural, genetic, and environmental factors can all play important roles when classifying someone as a functioning alcoholic.

Here are key elements to consider:

  • Life at home
  • Environment at work
  • Stress exposure
  • Genetics and hereditary factors
  • Romantic relationships
  • Peer pressure from friends or family
  • Cultural views and religious beliefs
  • Mental health issues

Determining why some people become more addicted to alcohol at noticeably faster rates than others can be impossible to fully ascertain. Functioning alcoholics can get by for years or even decades before they truly feel the health and social impacts from their alcohol abuse, but they can just as well be in an equally dangerous situation as their alcoholic counterparts who are completely unable to function.


Treatment for Functioning Alcoholics


Sometimes it is harder for a functioning alcoholic to ask for help, but there are plenty of resources and facilities available for them as well: whether it be centers that perform medically supervised detoxes, inpatient/outpatient rehabilitation programs available on nights and over weekends for working professionals, or various support groups and other like-minded places that truly have a desire to help.

Regardless of which stage of alcoholism someone is going through, there are several outlets where one can seek treatment. Alcoholism can be extremely difficult to overcome, but it is by all means achievable with the right amount of willpower and a solid support system put in place. If you or someone you know suffers from AUD or alcoholism, we highly recommend discussing it with a medical professional and seeking help immediately.


Wrapping it Up


Alcoholism doesn’t always consist of financial difficulties, broken relationships, problems holding down a job, or health issues. Nearly a fifth of the 17 million American adults classified with AUD may not display characteristics of this stereotype. Since functioning alcoholics can be so challenging to discern, this estimative figure could be even higher.

Many functioning alcoholics can also limit their drinking to certain days of the week and might not feel the effects of a hangover as much as a normal alcoholic, so it can create a situation where it is unreasonable for them to seek treatment. But to reiterate, it is likely only a matter of time before their drinking catches up to them, whether it is through DUIs, getting fired from a job, ruining a relationship, or much worse.

Functioning alcoholics with a strong support system might be able to rehabilitate themselves through outpatient programs, educational training, and therapy or counseling. Others might benefit from a more intensive inpatient program, especially if factors like mental illness are involved. Although someone is able to function as an alcoholic, the problems they are facing should never be taken less seriously than those alcoholics who are unable to function.