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What Characterizes A Functioning Alcoholic? 6 Signs To Look For

Last Medical Review On: February 10, 2025
Updated On: February 10, 2025
4 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

A functioning alcoholic is a common language term referring to someone who struggles with chronic alcohol use but still manages to navigate the responsibilities and obligations of daily life with some measure of success. It belies the stereotype (especially as depicted in Hollywood) that those with alcohol use disorder (AUD) can’t hold a job, have legal trouble related to their drinking, are economically underprivileged, and have volatile relationships.

Contrary to popular belief, the National Institutes of Health reports that nearly 20% of all alcohol use disorder sufferers are highly functional, well educated, and earn good incomes.[1] Additionally, 9% of U.S. adults who struggle with alcohol abuse could be categorized as chronic or severe. Many of the chronic or severe alcoholics presented an early onset of drinking and alcohol problems, and nearly 80% have a family history of alcohol use disorder.

What Is A Functioning Alcoholic?

Key Points

  • A functioning alcoholic is a common language term and subtype of alcohol use disorder that refers to someone who struggles with alcohol use but still manages stability at home, work, or school.
  • Six signs of a functioning alcoholic include maintaining responsibilities at work despite chronic drinking, relying on friends and family to enable their drinking patterns, relationship challenges, escalating adverse effects of drinking, denying the severity of drinking problems, and refusing help until a crisis occurs.
  • High-functioning alcoholics are outwardly successful and stable, appear consistent at work or school, have fewer psychological symptoms, are often in denial about the severity of alcohol use due to a perceived reduced impact, and approximately one-third have a family history of alcohol use disorder.
  • Comparatively, low-functioning alcoholics have a history of early-onset drinking, antisocial behavior, and polysubstance use (mixing alcohol with drugs or medications). Nearly 80% of low-functioning alcoholics have a family history of alcohol use disorder, and two-thirds seek help after hitting “rock bottom.”
  • Recommended treatment for functioning alcoholics includes medical detox, inpatient alcohol rehab, and ongoing medically-managed care.
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    What Is A Functioning Alcoholic?

    A functioning alcoholic is a common language term referring to someone who struggles with chronic alcohol use but still manages to navigate the responsibilities and obligations of daily life with some measure of success. It belies the stereotype (especially as depicted in Hollywood) that those with alcohol use disorder (AUD) can’t hold a job, have legal trouble related to their drinking, are economically underprivileged, and have volatile relationships.

    Contrary to popular belief, the National Institutes of Health reports that nearly 20% of all alcohol use disorder sufferers are highly functional, well educated, and earn good incomes.[1]  Additionally, 9% of U.S. adults who struggle with alcohol abuse could be categorized as chronic or severe. Many of the chronic or severe alcoholics presented an early onset of drinking and alcohol problems, and nearly 80% have a family history of alcohol use disorder.

    6 Lifestyle Signs That Characterize A Functioning Alcoholic

    Here are six lifestyle signs and patterns that may help you or a loved one identify what characterizes a functioning alcoholic:[2]

    • Maintaining Responsibilities At Work Despite Chronic Drinking

    Professional stability is a key marker of a functioning alcoholic, at least for a time. Their job is essential to maintain their drinking and, therefore, essential to keep. Over time, however, their behavioral and professional performance may also suffer due to the holistic impact of ongoing alcohol use.

    • Relying on Friends and Family To Enable Their Drinking Patterns

    Someone with chronic or severe alcohol use disorder will rely heavily on family members, friends, and coworkers to accommodate their habits, enable their behavior, or help them out of dangerous or compromising situations related to their alcohol use. This could mean ignoring their harmful patterns, helping them recover, or keeping them from driving or other potentially dangerous activities while intoxicated.

    • Relationship Challenges

    Any type of alcohol or substance use disorder can negatively impact relationships despite apparent performance at work or school. The families and children often face the brunt of any fallout, from mood changes and extensive recovery after drinking to aggression or violence.

    • Escalating Adverse Effects of Drinking

    With the pressure to continue performing at work and continue drinking, the stakes get increasingly higher, as well as the pressure along with it. Long-term alcohol use leads to significant health concerns, both physical and psychological, increasing the overall risk for someone who could identify as a functioning alcoholic.

    • Denying of The Severity of Drinking Problems

    A high-functioning alcoholic may not acknowledge the severity of their alcohol use simply because they can continue functioning at work, home, or school despite alcohol use. As long as they can continue to “show up,” they live in denial, telling themselves they’re fine. Additionally, managers or coworkers can ignore some of the signs of impairment or alcohol use disorder as long as job performance continues to meet satisfactory levels.

    • Refusing Help Until A Crisis Occurs

    If the individual does not believe alcohol patterns are harmful, it often takes something outside of themselves to trigger formal treatment or professional help. Many are coerced into treatment due to trouble at home, legal issues, or health concerns they cannot ignore.

    High-Functioning vs. Non-High-Functioning Alcoholism

    High Functioning vs. Non-Functioning Alcoholism

    One of the diagnosis criteria for alcohol use disorder is an inability to control or reduce alcohol consumption and a failure to fulfill major role obligations at work, home, or school.[3] However, we’ve already seen that a functioning alcoholic doesn’t necessarily meet that criteria despite heavy alcohol use.

    Some other differentiators between the subtypes for high-functioning alcoholics and low-functioning alcoholics include:[4]

    High-Functioning Subtype

    • Outwardly successful and stable
    • Consistent at work or school
    • Fewer psychological symptoms
    • Often in denial about the severity of alcohol use due to a perceived reduced impact
    • One-third have a family history of alcohol use disorder.

    Low-Functioning Subtype

    • Early onset drinking
    • Antisocial behavior
    • Polysubstance use (mixing alcohol with drugs or medications)
    • Nearly 80% have a family history of alcohol use disorder
    • Two-thirds seek help after hitting “rock bottom”

    Physical and Mental Health Symptoms of a Functioning Alcoholic

    Alcohol consumption leaves a mark on your body and your mind. These symptoms can be present while drinking, after drinking, or if drinking is stopped and withdrawal symptoms begin. Someone battling long-term or severe alcohol addiction may experience some or all of the following symptoms:[5]

    • Mood changes
    • Poor judgement
    • Inappropriate behavior
    • Slurred speech
    • Poor memory
    • Lack of coordination
    • Blackouts
    • Coma
    • Agitation
    • Brain damage
    • Alcohol withdrawal
    • Cravings
    • Insomnia
    • Sweating
    • Rapid heart rate
    • Tremors
    • Hallucinations
    • Anxiety
    • Seizures
    • Overdose

    Health Risks of Long-Term Alcohol Use Disorder

    Over time, alcohol consumption breaks down your body and your brain. If one has developed physical alcohol dependence, it alters the natural baseline for how your body functions. Alcohol interferes with the natural communication pathways in the brain and chemically alters how the brain functions, compromising memory, speech, balance, and judgment.[6]

    Other long-term health problems associated with heavy drinking include:[7]

    • Increased risk of cancer (More than 20,000 people in the U.S. are estimated to die each year from alcohol-related cancers.)
    • Heart disease
    • Increased risk of mental health concerns like depression or anxiety
    • Liver disease
    • Increased risk of stroke
    • Immune system compromise
    • Digestive issues
    • Increased risk of dementia and memory loss

    Treating Alcohol Use Disorder

    If you or a loved one are struggling with alcohol use disorder, binge drinking, or the adverse effects of alcohol use, there is help available. Treating someone with a high tolerance or a long history of drinking alcohol requires targeted support from medical professionals, behavioral therapy, and patient-centered alcohol addiction treatment. Here’s what you can expect during the treatment process:

    • Alcohol Detox: Detox is a short-term phase of treatment that allows the body to safely eliminate harmful substances and begin to reestablish a natural baseline. With medication-based treatment options for managing withdrawal symptoms and 24/7 healthcare, you or your loved one can begin treatment safely and with confidence.
    • Inpatient Residential Rehab: An inpatient treatment facility offers dedicated care where one can focus solely on recovery without any distractions of daily life. Patients will participate in group therapy, individual therapy, and physical health interventions and get help to address any underlying mental health issues to support a productive and healthy life when they leave.
    • Medically Managed Care: Medically managed care helps patients establish and maintain balance in their physical and mental health to support lasting recovery during and after inpatient care.

    Get The Help You Need

    If you or a loved one are struggling with alcohol use that is either out of control or hiding under a high-functioning mask, there is help for you. Reach out today to get the answers and support you need to overcome.

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    Frequently Asked Questions About Functioning Alcoholic

    01

    Can a functioning alcoholic stop drinking?

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    With the right treatment and support, a functioning alcoholic can overcome alcohol use disorder and be equipped with healthy, safe ways to navigate stress and daily life. One consideration for overcoming alcohol use is filling the time that was once dedicated to drinking and recovery. With support groups and 12-step programs like Alcoholics Anonymous, there are so many resources available to help anyone stay the course and maintain sobriety.

    01

    How Long Does Inpatient Rehab Take?

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    The timeline for inpatient rehab will vary for each person. Every patient will be assigned a fully customized treatment plan designed to address their unique needs and provide the best possible solutions for recovery. On average, inpatient alcohol rehab lasts approximately 30 to 90 days.

    Sources
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    [01]

    [1][4]U.S. Department of Health and Human Services. (2015, September 29). Researchers identify alcoholism subtypes. National Institutes of Health. https://www.nih.gov/news-events/news-releases/researchers-identify-alcoholism-subtypes

    [2]Glauser, W. (2014, January 7). “high-functioning addicts”: Intervening before trouble hits. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne. https://pmc.ncbi.nlm.nih.gov/articles/PMC3883816/

    [3]Office of the Surgeon General (US). (1970, January 1). Appendix B: DSM-IV-TR diagnostic criteria for alcohol abuse and dependence. The Surgeon General’s Call to Action To Prevent and Reduce Underage Drinking. https://www.ncbi.nlm.nih.gov/books/NBK44358/

    [5]hMayo Foundation for Medical Education and Research. (2022, May 18). Alcohol use disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243

    [6]U.S. Department of Health and Human Services. (n.d.-a). Alcohol and the brain: An overview. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/alcohol-and-brain-overview

    [7]Centers for Disease Control and Prevention. (n.d.-a). Alcohol use and your health. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/about-alcohol-use/index.html

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