Highly Functioning Alcoholic

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Based on reports by the CDC, about 1 in 30 adults in the US are dependent on alcohol. 19.5 percent of US alcoholics are highly functioning with families and stable jobs. But even though they may look like they have everything together, this isn’t necessarily the case.

This page will look at the signs of a highly functioning alcoholic, risk factors, and how they may deny claims that they have a problem.

Signs of a Highly Functioning Alcoholic

It’s difficult to detect when a person has a drinking problem, especially if they appear to be looking after all their responsibilities. One of the most common signs is that they drink more than the recommended CDC guidelines, but this may be difficult to spot in the case of a high functioning alcoholic. Therefore, other signs include:

  • Drinking alone at odd times
  • Experiencing lapses in memory when they can’t remember what happened
  • Being dismissive about their drinking
  • Justifying their drinking using a celebration or event
  • Keeping alcohol in secret places where only they can access it
  • Experiencing withdrawal symptoms like fatigue, headaches, and nausea when they stop drinking

Functional Tolerance

People who regularly abuse alcohol tend to develop a tolerance to its effects. Tolerance develops when the body adapts to compensate for the effects of alcohol, and requires a greater dosage to create the same effect. It’s a criteria used for diagnosing an alcohol use disorder, but it can reduce or disappear entirely if you stop drinking for long periods of time.

Functional tolerance refers to when a person can consume large amounts of alcohol (slowly or at once) and not seem intoxicated. People with a functional tolerance may be under the influence, except that it won’t be noticeable. This allows them to participate in daily tasks in a way that seems normal.

Denial of Highly Functioning Alcoholics

Usually, people who suffer from alcohol use disorder fail to recognize that they’re dependent on the substance. This is especially true of highly functioning alcoholics. Compared to the chronic severe subtype or the young antisocial subtype, they don’t see the consequences of their drinking habits. That’s because their lived haven’t faced considerable damage due to their drinking. They may rationalize their drinking behaviour through statements about how they:

  • Have a stable job and are successful
  • Only drink expensive alcohol
  • Pay their bills and haven’t hit rock bottom

Major Risks and Why It’s a Problem

Even though it may seem like high functioning alcoholics don’t face any problems due to their drinking behavior, they still do. Some of the long-term risks of continued alcohol abuse are as follows.

  • Liver Damage: Excessive alcohol consumption puts added strain on the liver and reduces its ability to regenerate. With time, the cells are replaced with scar tissue, which can eventually lead to liver cirrhosis.
  • Brain Damage: Prolonged alcohol abuse can have negative effects on a person’s mental well-being and brain health.
  • Legal Issues: Although high functioning alcoholics are able to evade any consequences for problems they cause while intoxicated, such issues eventually catch up to them. Whether it’s driving under the influence or alcohol-induced aggression, even high functioning alcoholics may run into legal problems due to their drinking behavior.
  • Loss of Relationship: Regardless of how well high functioning alcoholics hide their drinking, it’s impossible to hide the effects of it from the people closest to you. Over time, the family and partners of high functioning alcoholics may grow tired of their excuses and making excuses on their behalf. This can lead to the loss of a relationship.
  • Depression: Over time, excessive alcohol consumption causes long-term changes in areas of the brain that regulate mood. Alcohol also alters the brain’s neurotransmitter levels, which can potentially cause depressive disorders.

Confronting a High Functioning Alcoholic

It’s not easy to acknowledge that a loved one has a drinking problem and is dealing with addiction. Nevertheless, it’s crucial that you approach them about their behavior by staging an intervention. It’s important to do so when they’re sober, and be assertive while explaining how their drinking negatively impacted you or other members of their family.

Ensure that you don’t sound judgmental or make accusations when convincing them to seek treatment. Reiterate that they risk facing worse consequences if they don’t take control of their drinking behaviors. If they try to attack you, deny what you say, or make excuses, be calm and respond honestly. With time, they may come to realize that they have a problem and agree to try addiction rehabilitation.


Once you’ve acknowledged that you need to seek treatment, your healthcare provider will recommend approaching a rehab clinic to undergo a complete treatment process. Drinking alcohol affects the part of your brain that controls speech, memory, judgment, and balance. Over the long term, heavy drinking alters neurons and reduces their size. But, recovery of the grey matter in your brain can happen as quickly as one week after you stop drinking alcohol. The legal drinking age in the United States is 21 years or older, but there are laws against driving under the influence (DUI) of alcohol.


In most cases, treatment starts with a detox program to eliminate your body’s dependency on alcohol. It involves getting rid of any traces of alcohol in the body using medically-assisted detox techniques. Doing so under medical supervision can help you manage potentially harmful and damaging withdrawal symptoms so you can entirely focus on recovering.


In the event that you’re having trouble managing withdrawal symptoms, you may be prescribed specific medication for them. These include benzodiazepines like diazepam and lorazepam. Similarly, naltrexone can help reduce cravings, and disulfiram discourages drinking by causing adverse reactions when it comes into contact with alcohol.


Effective recovery plans for alcohol use disorder involve helping a person deal with underlying feelings and processing their feelings. Therapy with a certified mental health professional can help you identify stimuli that trigger the behavior, and coping strategies to manage cravings. Therapy can be one-on-one with a counselor, with a group, or with your family.

Risk Factors of Highly Functioning Alcoholics

Compared to other subtypes of alcoholics, the highly functioning subtype develops a dependence on alcohol later. And while they may be described as being well-educated with a good income, certain factors increase their risk for developing alcohol use disorder.

  • They have a relative who also suffered from alcohol use disorder, putting them at a higher risk of developing it as well.
  • They suffer from a depressive disorder. As alcohol consumption is linked to depressive feelings, a person’s depressive disorder is a major predictor of an impending alcohol problem.
  • They face high levels of stress at home or work, or have mental health struggles that they have yet to get support for.