What Does High-Functioning Alcoholism Look Like & How Do You Know If Someone Is Hiding An Addiction?

What you will learn

• High-Functioning alcoholism is a colloquial term used to describe someone who drinks excessively but maintains their daily responsibilities.
• There are no criteria for a high-functioning alcoholic because it’s not a diagnosis.
• Just because someone’s life hasn’t fallen apart or they haven’t hit rock bottom doesn’t mean alcohol isn’t causing harm or that they don’t have an addiction.
• A lot of people with alcohol use disorder don’t seek help, possibly because they believe they have a handle on their alcohol use and still function day to day.

The term “high-functioning alcoholic” may sound like an oxymoron. It’s often used colloquially to describe people who can manage daily responsibilities, perform at work, and maintain healthy relationships despite excessive alcohol consumption.

However, the label can minimize the risks and negative consequences of alcohol addiction – alcohol use disorder (AUD) – and implies that functioning “well enough” means your life hasn’t been disrupted, you don’t really need professional help.

What is a Functioning Alcoholic? Does High-Functioning Alcoholism Really Exist?

The concept of a “high-functioning alcoholic” isn’t a clinical one – it’s a socially constructed label that describes people who drink excessively without a serious impact on their work, school, or home life. But just because someone’s life hasn’t fallen apart or they haven’t hit rock bottom doesn’t mean alcohol isn’t causing harm or that they don’t have an addiction.

How Alcohol Affects Daily Function

Alcohol affects every system of the body. Even moderate levels of alcohol use can inhibit concentration, memory, and decision-making abilities.[1] It also disrupts sleep and increases the risk of anxiety and depression, possibly leading to a cycle of self-medicating mental health symptoms and worsening alcohol tolerance and dependence.[2]

Long term, alcohol can cause liver disease, cardiovascular problems, and several types of cancer. Chronic alcohol use can lead to heart arrhythmia, blood pressure changes, gastrointestinal bleeding, erectile dysfunction, and peripheral neuropathy.[3] One of the hardest-hit organs is the liver, which can suffer hepatitis, fibrosis, and cirrhosis.[4]

In addition to the direct impact on the body and mind, alcohol is responsible for injuries and deaths indirectly. About one-third of annual alcohol-related deaths – roughly 61,000 – are caused by isolated incidents of excess drinking, such as car crashes, alcohol poisoning, alcohol-involved drug overdoses, and deaths by suicide.[5]

Whether alcohol use is “under control” or not, these risks are still present. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 28.9 million people ages 12 and older had AUD in 2022.[6] A lot of people don’t seek help, possibly because they believe they have a handle on their alcohol use and still function day to day.

What Does High-Functioning Alcoholism Look Like?

There are no criteria for a high-functioning alcoholic because it’s not a diagnosis. Generally, people refer to functional alcoholics as people who can hold down a full-time job or excel in their careers, maintain healthy relationships, appear responsible and productive, and don’t run into financial or legal consequences related to drinking.

Things aren’t always as they seem, though. A so-called functional alcoholic may engage in daily or excessive alcohol use, secretive behaviors, minimizing how much they drink, or using alcohol as a coping mechanism for stress or anxiety. They may deny that they have a drinking problem, specifically because they don’t have problems associated with it. Any health problems may be mild or absent, at least at first.

Warning Signs of Alcohol Use Disorder

If you or a loved one is functioning but engaging in unhealthy alcohol use patterns, you may notice symptoms of alcohol use disorder (AUD).[7] These signs of alcohol addiction include:

• Preoccupation with alcohol or planning activities around drinking
• Difficulty limiting the amount of alcohol consumed
• Experiencing cravings for alcohol
• Rationalizing drinking or blaming others for consequences related to alcohol use
• Developing a tolerance, or needing to drink more and more to feel the same effects
• Experiencing withdrawal symptoms when not drinking
• Secretive behaviors or subtle health problems
• Declining physical health or mental issues like depression, anxiety, or mood swings

Do Alcoholics Know They’re Alcoholics?

Not always. Denial is a big part of addiction, especially with a socially acceptable substance like alcohol.[8] Many people don’t realize they have a problem because they associate alcoholism with extremes – memory loss, DUIs, job loss, financial ruin, and homelessness. If their lives are going well, they assume there’s nothing to worry about.

Alcohol use disorder exists on a spectrum, though. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines criteria for alcohol use disorder that range from mild to severe.[9] If you fit some of the criteria, or you feel like you can’t control your alcohol use and it’s gotten worse, you could be dealing with alcohol addiction.

Alcohol use disorder isn’t a moral failing but a chronic, treatable disease. You don’t need to wait until you hit rock bottom with blackouts, when alcohol use damages your relationships, ruins your career, or takes a toll on your health, to get help. Taking the first step early with inpatient or outpatient rehab at a professional addiction treatment center can prevent some of the devastating effects of long-term, excessive alcohol use, such as liver damage or cognitive decline.

Get Treatment for Alcohol Addiction

Feeling like you’re “high functioning” despite consuming large amounts of alcohol or drinking daily isn’t a reason to avoid treatment. It’s a good reason to start before you experience the devastating consequences of chronic substance abuse. If you or someone you know is struggling with alcohol addiction, don’t wait to get help and live a healthier life.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more