Not all alcoholics fit the “typical” mold. There are some individuals who manage to hold down high-level professional positions and seem to have it all together, yet they also happen to have a moderate alcohol use disorder. They are able to conduct their usual daily tasks and juggle significant stressors without showing the usual signs of alcohol dependency or addiction. These individuals are referred to as high-functioning alcoholics.

A high-functioning alcoholic is someone who has been, at least on the outside, able to hide the fact that they have a problem with alcohol. They may not display the usual signs that are associated with alcoholism, somehow managing to continue functioning professionally, maintaining relationships, and showing no outward physical health effects of the addiction. 

Sometimes the signs of a high-functioning alcoholic means that there aren’t any overt signs! Meanwhile, the individual sustains a level of alcohol consumption that is just enough to stave off withdrawal symptoms at work while allowing them to show up at the job on time and perform their usual work functions. Others may remain sober during the workday but drink heavily at night or on the weekend, another tactic that can hide the truth, from coworkers at least.

Someone who is considered a high functioning alcoholic, also termed a functional alcoholic, may have a high tolerance for the effects of alcohol. This means their physiology permits them to consume high quantities of alcohol without succumbing to the usual symptoms associated with toxicity. This may be actually work against the individual, as the individual increases alcohol consumption while needed treatment for the disease of alcoholism is pushed off into the future. Meanwhile, alcohol is taking a toll on their health, even if the signs are not yet visible to others.

If someone has a compulsion to drink, even in spite of the inevitable consequences, they have likely acquired an alcohol use disorder. While the problem may be masked for the time being in a functional alcoholic, the fact remains that alcoholism is a chronic, relapsing, and fatal disease that will continue to escalate until the individual eventually stops consuming alcohol. For this reason it is essential that the individual seeks recovery with the guidance of a professional treatment program.

Denial and the High Functioning Alcoholic

A high-functioning alcoholic is committed to keeping their alcohol dependency hidden from family members and colleagues. Most likely, if someone approaches them to question whether there is a problem they will flatly deny it. They may believe that admitting they have a problem would potentially harm their reputation or career, so the reflexive response is usually denial.

Even if the individual has awareness of their alcohol use disorder, they may deny it because they feel admitting to the problem would be seen as a sign of weakness or lack of character. He or she may resist getting treatment for the alcohol problem using several tactics, including these telltale signs of a high-functioning alcohol:

• I am not hurting anyone. This is a common response that stems from the individual’s belief that it is their right to drink, and is only impacting their body and their life.
• Everyone drinks. The excuse that everyone drinks is based on their belief that they are no different than anyone else who enjoys alcoholic beverages, or that they don’t drink nearly as much as other people do.
• It is your problem, not mine. Denial wrapped up as an attempt to shift the blame to the concerned colleague or loved one as a means to disarm them, like gaslighting.
• I need to drink. Citing job stress or the demands of family to explain their need to relax by using alcohol, implying that the loved one should be more compassionate.
• I don’t have time for rehab. A classic excuse used by busy professionals who cite time constraints as the reason they are unable to get treatment.
• You knew this when you married me. The alcoholic claims their alcohol issue was always evident, and that the partner should accept him or her as they are. 
• I am not an alcoholic. The high functioning alcoholic will point out their ability to succeed at their profession, fulfill their parenting duties, maintain their friendships, etc., stating that they couldn’t do those things if they were alcoholic.
• I can quit whenever I want. Another common excuse is the claim that they have control over their drinking and can quit at will.
• Drinking is part of my job. When an alcoholic is confronted about their need for treatment, the thought of quitting is so frightening that they may state their livelihood depends on and must involve social drinking.
• There is nothing wrong with me. Denial of the physical toll that drinking is taking on them, the alcoholic will proclaim that all is well, ignoring the distended gut, puffy face, red-rimmed glassy eyes, and other physical signs of deterioration.

When a loved one puts up this much resistance, an intervention may be the appropriate next step toward obtaining help for them.

The Connection Between Stress and Alcoholism

While anyone in any profession can be a high-functioning alcoholic, there seems to be a correlation between those in high status executive positions and alcohol use disorder. These individuals take on high-pressure professional roles because they thrive on the challenges and have a passion for their work. Unfortunately, the stress levels are so unrelenting that the individual may begin to self-medicate with alcohol.

It is understandable how stress and alcoholism are linked. Alcohol is a depressant, directly impacting the central nervous system. Alcohol not only reduces stress but also providing a mild sense of euphoria. For someone trying to manage the impact of unrelenting stress, reaching for a drink or two seems logical. In reality, however, alcohol misuse will eventually catch up to the person. As tolerance increases, so does the level of consumption. The impact on the brain’s reward system and pathways will set in motion the route to alcohol dependency.

14 Signs of a High-Functioning Alcoholic

Although the functional alcoholic is ready with excuse after excuse to deflect the problem, there are some clear warning signs that the individual indeed has an alcohol use disorder. The signs of a high-functioning alcoholic include:

1. They use alcohol in increasing quantities as a tool to manage stress or as a reward after a hard day at work
2. They often lie about how much alcohol they actually consume, even hiding it around the house, car, or office
3. They use alcohol to boost their confidence
4. They experience blackouts
5. They are in denial about their drinking problem, deflects with jokes or becomes angry
6. They may neglect their diet, preferring alcohol to a healthy meal
7. They are often told they seem to have a high tolerance for alcohol
8. They may isolate themselves, retreating to a location where they can drink alone
9. They may forget important dates or events
10. They may drink in the morning
11. They have been arrested for a DUI or multiple DUIs
12. They rely on enabling from others to perpetuate their guise of having it all together
13. They seem to place limitations on their drinking, such as imbibing only after work or on the weekends
14. They may be using alcohol to manage a co-occurring mental health condition, such as anxiety or depression

Recovery Programs for the High-Functioning Alcoholic

Treatment for the high-functioning alcoholic is available in outpatient or residential settings. The outpatient setting allows the individual to continue to participate in their work roles to some extent while receiving treatment. Professional demands and time constraints may dictate the outpatient option, which provides the executive with ample freedom. The residential setting is best for individuals with a moderate to severe alcohol use disorder, as it will provide a more intensive, customized treatment plan with 24 hour monitoring and support.

Detox first

When approaching treatment for alcoholism it is important to understand that the first step in recovery is detox and withdrawal. This process should be completed under the supervision of a trained medical detox team. Attempting to detox on one’s own can present serious, even life-threatening, health risks, including the seizures and coma associated with the delirium tremens (DTs). Alcohol withdrawal symptoms will vary in severity depending on such factors as the length of time abusing alcohol, the level of alcohol consumption, the presence of a coexisting mood disorder, additional substance issues, and the general health status and age of the individual.

Withdrawal symptoms begin within 6-12 hours of alcohol secession and might include:

• Nausea and vomiting
• Sweating
• Shaking
• Hand tremors
• Racing heart
• Fever
• Elevated blood pressure
• Headache
• Irritability
• Agitation
• Insomnia
• Anxiety
• Disorientation, mental confusion
• Psychosis
• Seizures
• Coma

Treatment

A comprehensive alcohol treatment program will involve the following interventions:

Individual therapy. Through intensive psychotherapy the individual will examine any unhealthy behavior patterns that perpetuate the alcohol addiction, and then reshape those thoughts and behaviors.

Group therapy. Group therapy offers an opportunity for peers in recovery to share about their personal experiences and challenges, resulting in a sense of mutual support.

Family therapy. Family groups help the whole family unit heal and move forward together as their loved one enters recovery. Couples therapy is also offered at some residential rehab programs to assist partners in navigating the recovery journey.

Medication. Medication-assisted treatment is sometimes appropriate for helping someone stabilize in recovery. Naltrexone is a non-narcotic medication that helps reduce cravings and relapse risk.

Psychosocial education. Teaches recovery skills to access as needed, including relapse prevention planning, stress management, conflict resolution, and improved communication skills.

Holistic. Rehab programs now routinely integrate experiential and holistic activities that help enhance relaxation and the spiritual aspects of the recovery process.

Solutions 4 Recovery Provides Comprehensive Alcohol Recovery Treatment

Solutions 4 Recovery is a residential dual diagnosis addiction rehab program located in Southern California. If you witness the signs of high-functioning alcoholism in yourself or a loved one, our expert clinical team is here to provide the most effective treatment available. Don’t hesitate to take your life back. Call our compassionate team today at (888) 417-1874.