Understanding the High Functioning Alcoholic

Shlomo Hoffman
Medically Reviewed by
Dr. Jefferey A. Berman MD, DFASAM
Last Updated
August 10, 2022

Part of the complete guide to understanding addiction

Table of Contents
  1. The high functioning alcoholic
  2. What is a high functioning alcoholic?
  3. Signs and symptoms of a high functioning alcoholic
  4. Risk factors and causes
  5. Is your loved one a high functioning alcoholic?
  6. High functioning alcoholic quiz
  7. Getting help
  8. Sources

The high functioning alcoholic

The term alcoholic conjures up many images and assumptions of the individual who has been labeled with this diagnosis. Most of the general population imagines an individual living at or below poverty, difficulty finding or keeping a job, potentially unhygienic, and with strained or broken relationships. These are just a few of the thoughts that may run through a person’s mind when they hear this term.

Unlike common belief, alcoholism impacts a variety of people and is biased based on gender, age, or socio-economic status. An individual can be an alcoholic yet seemingly have their lives together. These individuals are known as functional alcoholics, or high functioning alcoholics as they are most often referred.

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What is a high functioning alcoholic?

The Diagnostic and Statistical manual of Mental Disorders (DSM-5) 1 classifies alcohol use disorder (AUD), alcoholism, as a psychological condition. The medical diagnosis alcoholism is an umbrella term that encompasses other forms of alcoholism mild, moderate, and severe. 2

A high functioning alcoholic is an individual who is dependent on alcohol but is otherwise able to function normally within society and their daily lives. They may be classified as having mild AUD based on the diagnostic criteria they meet. These individuals do not meet the diagnosis based on their alcohol use causing issues in their job or personal life, but other criteria are certainly met.

The DSM-5 poses 11 questions regarding your alcohol use in the last year and depending on the number of questions you answer yes to you are then placed in one of the three categories: mild, moderate, or severe. A high functioning alcoholic will answer yes to at least two of the questions making them mild.

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Signs and symptoms of a high functioning alcoholic

The signs and symptoms of a high functioning alcoholic can vary from person to person. A high functioning alcoholic generally refers to an individual that relies on alcohol as a means of coping, relaxing, or unwinding yet appears healthy physically and mentally.

Some red flags that indicate an induvial may be a high functioning alcoholic include having an alcoholic beverage right after work, drink longer than they intended, easily irritated if they are unable to drink, may hid their alcohol consumption, or focused on ensuring there is enough alcohol in their environment.

A high functioning alcoholic may have formed functional tolerance. This is the condition where the individual has consumed so much alcohol that their body has developed a tolerance to its effects. This requires the individual to drink more than others to achieve the same results. These individuals can often drink more alcohol than others yet not appear to be intoxicated at all.

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Risk factors and causes

Most high functioning alcoholics are consuming alcohol at such levels that they are potentially damaging organs and experiencing cognitive impairment. These individuals are also at a greater risk for becoming moderate to severe alcoholics due to their growing dependence and need for more. This slow progression into severe alcoholism is a dangerous one because it happens to gradually that the individual and loved ones may not realize it is happening.

Denial is another danger the high functioning alcoholic may face. To understand what it’s like to be a high functioning alcoholic you must understand that they genuinely believe they are okay. Because their lives seem unharmed by their alcohol consumption, they are more likely to deny they have an AUD and ultimately not seek help. While their alcohol consumption may not impact their lives, for long, their physical and mental health is still being put at risk.

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Is your loved one a high functioning alcoholic?

You might be wondering if your spouse or loved one is a high functioning alcoholic. You may see them consume large amounts of alcohol on a regular basis, which concerns you, yet your loved one is rarely intoxicated, and their lives are generally together. This can be confusing and may prevent you from providing the right support for the high functioning alcoholic, or worse, you may become a source of enabling. Therefore, it is a dire concern to understand the high functioning alcoholic, what it’s like to be a high functioning alcoholic, signs to look out for, and how to get them help.  

High Functioning Alcoholic Spouse

Those living with a high functioning alcoholic husband, wife or partner may not realize there is a problem until the condition has reached a dangerous point. The longer the condition goes undiagnosed and treated the harder it is for them to admit and get help.

This can place strain on a relationship as the high functioning alcoholic loved one may become irritated regarding their alcohol consumption. The loved one may not understand their compulsory need for alcohol based on a genuine medical condition and forego getting them help. 

Understanding the High Functioning Alcoholic

It is important to understand the high functioning alcoholic, how they have gotten to where they are and why it is difficult for them to realize they need help. Understanding what its like to be a high functioning alcoholic can help loved ones provide more support and empathy. Due to genetic and social factors often outside of their control, these individuals are at a higher risk for becoming dependent on alcohol. For whatever reason they can maintain their lives in a seemingly normal capacity, but their dependence on alcohol to function is still very genuine. In fact, genetic factors play a part in 50 percent of alcoholism. 3

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High functioning alcoholic quiz

If you or a loved one are concerned that you are a high functioning alcoholic there are many available high functioning alcoholic quizzes online. Our quiz below is based on the diagnostic questions in the DSM-5 and will help you determine if or where you fall in terms of an AUD diagnosis. The full list of questions can be found here.

Are you a high functioning alcoholic? Or are you even an alcoholic at all? Find out now with this quick and easy quiz.

1) Have you had times when you ended up drinking more, or longer, than you intended?
2) More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
3) Spent a lot of time drinking? Or being sick or getting over other after effects?
4) Have you ever wanted a drink so badly you couldn’t think of anything else?
5) Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
6) Continued to drink even though it was causing trouble with your family or friends?
7) Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
8) More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
9) Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
10) Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
11) Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

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Getting help

If you are concerned that you or a loved one is a high functioning alcoholic it is important to get help. Learn more about your treatment options and support near you through the Alcoholic Anonymous website. If reaching out to strangers feels difficult reach out to a friend or loved one for help.

A professional alcohol rehab facility is also a good option, reach out to Avenues Recovery trained addiction specialists today. We are standing by to help you get back your life.

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1 www.niaaa.nih.gov

2 www.niaaa.nih.gov

3 www.ncbi.nlm.nih.gov

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