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Are You a High-Functioning Alcoholic?

By Melissa Bienvenu
WebMD Feature

The classic picture of an alcoholic is someone who always drinks too much too often and whose life is falling apart because of it. But not all problem drinking fits that mold. Some people seem to be just fine while they abuse alcohol. Experts call these people “functional alcoholics” or “high-functioning alcoholics.”

You can still be an alcoholic even though you have a great “outside life,” with a job that pays well, home, family, and friendships and social bonds, says Sarah Allen Benton, a licensed mental health counselor and author of Understanding the High-Functioning Alcoholic.

A Different Kind of Alcoholic

A functional alcoholic might not act the way you would expect, Benton says. You might think he's responsible and productive because he works every day. He could even be high achieving or powerful. In fact, his success might lead people to overlook his drinking.

He could also be in denial about drinking. He might think, “‘I have a great job, pay my bills, and have lots of friends; therefore I am not an alcoholic,’” Benton says. Or he might make excuses like, “I only drink expensive wine” or “I haven’t lost everything or suffered setbacks because of drinking.”

But he isn’t doing fine, says Robert Huebner of the National Institute on Alcohol Abuse and Alcoholism. No one, he warns, “can drink heavily and maintain major responsibilities over long periods of time. If someone drinks heavily, it is going to catch up with them.”

What Are the Signs?

What is heavy drinking? Women who have more than three drinks a day or seven a week are “at-risk” drinkers. For men, the limit is four drinks a day or 14 a week. If you drink more than either the daily or weekly limit, you’re at risk. You’re not alone -- one in four people who drink this much already has a problem or is likely to have one soon. Overall, as many as 20% of alcoholics may be highly functional.

A drink count isn’t the only way to tell if you or someone you care about needs help. Here are some other red flags. Someone who needs help may:

  • Say he has a problem or joke about alcoholism
  • Miss work or school, get into fights, lose friendships, or have a DUI arrest
  • Need alcohol to relax or feel confident
  • Drink in the morning or when alone
  • Get drunk when he doesn’t intend to
  • Forget what he did while drinking
  • Deny drinking, hide alcohol, or get angry when confronted about drinking
  • Cause loved ones to worry about or make excuses for his drinking

Risky Behavior

Functional alcoholics may seem to be in control, Benton says, but they may put themselves or others in danger by drinking and driving, having risky sex, or blacking out.

Heavy drinking carries other risks. It can lead to liver disease, pancreatitis, some forms of cancer, brain damage, serious memory loss, and high blood pressure. Heavy drinkers have a higher chance of dying from car accidents, murder, and suicide. Any alcohol abuse raises the chances of domestic violence, child abuse and neglect, fetal alcohol syndrome, and car accidents.

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