Functional Alcoholism: How to Tell if Alcohol Abuse Is Happening

The term "functional alcoholic" is heavily debated in the addiction community, but it's part of the social vernacular so it's valuable to discuss the common misconceptions. Just because someone with an alcohol use disorder (the medical term for an alcoholic) is functioning doesn't mean they're functioning well or functioning in each aspect of their lives. Keep that idea in mind while you approach the topic of alcohol abuse and addiction.

What Is a High-Functioning Alcoholic?

A high-functioning alcoholic is someone who appears to have their drinking and behavior relatively under control. They might drink too much or too often, but they seem to be doing fairly well in various areas despite possible substance abuse. People often look at social standards of success, found below, and mistakenly believe that a person is "functioning" or doesn't truly have an alcohol use disorder if they have:

• A good job
• A nice house
• A steady relationship and a happy family
• Creative outlets or hobbies

But that may be an illusion. In reality, a high-functioning alcoholic may be experiencing a great deal of stress while they maintain their drinking and all the dressings of a socially accepted lifestyle. So the appearance of functioning may be carefully manufactured to keep their alcohol use disorder (alcoholism) unchecked and unaddressed. So it becomes difficult to ascertain the true relationship that they have with alcohol.

How to Tell If You or a Loved One Is a High-Functioning Alcoholic

Because "functional alcoholism" is a fluid and informal term, and because the consequences vary from person to person, there is no single deciding factor that can determine whether a person is a high-functioning alcoholic. Again, someone who is "functioning" with their alcoholism still has an alcohol use disorder. But you can ask questions regarding the relationship they have to alcohol to help determine whether a substance use disorder exists. Here are a few questions to consider:

• Has your relationship to the person ever been strained by their use of alcohol?
• Have they given up on any goals or dreams perhaps due to alcohol?
• Do they ever get defensive about their use of alcohol?
• Do they have dedicated or protected time for drinking?
• Whether they drink once a day or once a month, do they lose control?
• Have they seen any legal consequences as a result of their drinking?

Look at the relationship they have to alcohol. While the appearance of their drinking may seem functional, there might be hidden consequences as a result of their alcohol use disorder. Although some well-known signs of addiction may not be present, for example a DUI or a lost job, those outcomes may yet happen. And there are other less obvious warning signals you can look for that indicate an alcohol use disorder.

What Would a High-Functioning Alcoholic's Drinking Look Like?

The drinking patterns and consequences are not different for a functional alcoholic than they are for anyone else with an alcohol use disorder. What separates the two are social concepts of success. There's a stigma still attached to addiction: those with substance use disorders must be unemployed or homeless or have lower economic status. But those beliefs are simply not true. Addiction affects all people. When it comes to alcohol use disorders, the pattern of use and the relationship to drinking are what matter, not the social ideas of success that tie into the concept of functional alcoholism.

With that said, here are some common patterns of use and consequences that people with alcohol use disorders experience, functional or otherwise:

• They experience frequent performance issues at work or other functions
• When they drink, they lose control
• They set a high priority on their drinking and become frustrated or upset when something interferes with it
• They make reoccurring commitments to moderation or abstinence
• They drink alone at home
• They experience health problems as a result of their drinking

What Are the Signs That an Alcoholic Is No Longer Functioning?

It's possible for someone to transition from a state of functioning to non-functioning. This suggests a loss of control and a growing dependence on alcohol, which is a common sign of substance use disorders. Additionally, continued use despite severe consequences is a common red flag for alcohol use disorders. Some examples follow:

• They repeatedly get very intoxicated or completely lose control
• There exists a series of embarrassing situations that become more regular
• They begin to have cravings for alcohol
• They cannot stay sober despite severe consequences like a DUI or health issue
• They begin to experience withdrawal symptoms when they're sober
• They go to great lengths to hide their use, like drinking alcohol from non-alcoholic containers
• Their tolerance is growing, meaning they have to drink more to achieve the same level of inebriation

If cravings and withdrawal have become severe, it's important to consult medical professionals. Alcohol withdrawal can produce a withdrawal effect known as delirium tremens that can prove life-threatening. Detox under medical supervision is a safer and more effective option than attempting to detox without help. Find a detox center to get started.

How Does an Alcoholic or Other Substance Abuse Affect the Household?

Addiction can create noticeable effects on the family and household. Indirectly, the functional alcoholic sets the terms for how people engage with them and how people behave around them. Here are a few examples of the ways in which addiction could affect your home and signs that the functional alcoholic is dictating the rules of engagement, often subconsciously:

• A child may stop bringing friends over
• Family members may constantly be on edge
• The mood and temperament of the functioning alcoholic affects everyone else's
• The family begins to internalize the functioning alcoholic's lashing out
• As a result, family members believe they are flawed in some way

Any Tips on How to Live with an Alcoholic?

For anyone who's concerned about a loved one's drinking, please find a community of support like Al-Anon. Whether your loved one agrees or not, their actions affect you and you deserve outside support. Other alternatives include group or individualized therapy, consulting educational resources and books, or attending online support groups.

You are never alone: many are experiencing the same issues, and just as many are here to support you. Hazelden Betty Ford's resources for families of alcoholics can help get your family on the path to healing, forgiveness and reconnection.

Is it Possible to Effect Change When a Loved One Has an Addiction?

Whether you can effect change in your loved one depends on the person. If they are open to hearing your concerns, express them using "I" language and be assertive:

"I feel (sad, lonely, afraid) when I see (the action) because…"

And then share how their behavior affects you. Express an openness to talk about their drinking, provide support and establish boundaries. Make it clear to him that you will not support their drinking or unhealthy behaviors, and you will not share in the consequences. Then detach with love and utilize all of your support networks.

If they are open and willing, they might enter into an inpatient rehab and begin a new chapter in life. If they are in denial, you will have to hold fast to your boundaries. But your value is not dictated by your loved one and their addiction. You matter.