High-Functioning Alcoholic: Symptoms, Risks & Treatment

The terms “functional alcoholic” or “functional alcoholism” aren’t official medical diagnoses. They are often used to describe people who can manage their daily responsibilities while consuming alcohol at concerning levels. People with functional alcoholism can maintain jobs, meet social commitments and have relationships. However, they also engage in excessive alcohol consumption that places them at risk for negative outcomes. 

What Is a High-Functioning Alcoholic?

A high-functioning alcoholic is someone who lives a pretty regular life while dealing with alcohol addiction. They can manage daily tasks even if they misuse alcohol.

“High-functioning alcoholism” isn’t a medical diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses “alcohol use disorder.” It includes various alcohol-related struggles, from mild to severe.

The severity of AUD depends on how many diagnostic criteria a person meets.

• Mild AUD means they have 2–3 symptoms
• Moderate has 4–5 criteria
• Severe has six or more

The criteria for alcohol use disorder include:

• Drinking a lot or for longer than intended
• Trying to control or reduce drinking without success
• Spending much time getting, using or recovering from alcohol
• Strong cravings for alcohol
• Failing to meet major duties due to drinking
• Continuing to drink despite social or relationship issues
• Giving up important social and job-related activities because of alcohol use
• Using alcohol in high-risk situations
• Drinking despite knowing it causes physical or mental problems
• Developing a tolerance
• Withdrawal symptoms occur when not drinking

Only a qualified healthcare professional can diagnose AUD.

What Is Functional Tolerance?

“Functional tolerance” means a person can do daily tasks even if they’ve built a tolerance to alcohol. Tolerance happens when the body becomes less responsive to alcohol’s effects. Someone may need more alcohol for the same effects but still seem normal in daily life.

Functional tolerance is not a formal medical term. It’s an informal description of someone who’s used to drinking more alcohol without obvious issues or disruptions.

Signs Your Loved One is a Functioning Alcoholic

Some key traits of high-functioning alcohol use disorder include:

• Appearing normal to others
• Denying or rationalizing drinking and its impact, often blaming stress
• Developing a tolerance for alcohol. Tolerance means the person can drink more without showing obvious signs of being intoxicated.
• Isolation to avoid judgment of drinking behaviors
• Health issues from drinking too much
• Getting defensive when asked about drinking behaviors
• Using alcohol to cope with tough feelings

Functional alcoholism and more severe alcohol use disorders share many similarities. A person should seek professional medical advice when they demonstrate concerning alcohol-related behaviors.

Why Early Intervention Is Worth It 

Early intervention is crucial in functional alcohol use disorder because it:

• Keeps it from getting worse: Alcohol use disorders tend to worsen over time. However, early intervention can stop it from turning into a more severe AUD.
• Improves treatment outcomes: Treatment success is often higher when alcohol issues are addressed early. Treatment plans can be carried out before alcohol misuse worsens.
• Reduces health risks: Drinking a lot can lead to health problems. These include mental health disorders, liver disease and heart problems. Early intervention can help prevent these conditions.
• Maintaining relationships and responsibilities: Functional alcoholics are often able to maintain their daily lives at first. However, it eventually can strain relationships and responsibilities. Early intervention can protect these important parts of a person’s life.
• Increased quality of life: Addressing functional alcoholism earlier on can help someone maintain or regain a positive quality of life.

Early intervention can also help you receive treatment at a lower level of care. For example, you could attend an outpatient program instead of an inpatient program. Outpatient programs allow you to remain, while inpatient programs require you to live on-site at a facility.

Primary care doctors are frontline healthcare providers. They are often the first point of contact for people with AUD. This is why they can spot early signs of this disease and offer next steps.

How to Help a High-Functioning Alcoholic

It can be challenging to help someone with high-functioning alcohol use disorder. Still, encouraging them to seek professional help can have a positive impact. Other ways you can help include: 

• Learning about AUD, its effects and available treatment options
• Avoid enabling behaviors while offering support
• Helping them research treatment options
• Going with them to appointments
• Exploring local support groups and resources (e.g., 12-step programs)
• Finding information about local treatment centers and mental health professionals

Treatment Options for High-Functioning Alcoholics

Many treatment options are available for high-functioning alcohol use disorder. They include:

• Inpatient treatment for those with more severe AUD
• Intensive outpatient programs (IOPs)
• Outpatient care for those with milder AUD. 
• Peer support groups like Alcoholics Anonymous (AA) and SMART Recovery

If you’d like to learn more about treatment options for someone struggling with alcohol use disorder, contact a Recovery Advocate today.