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Why It's So Difficult To Identify High-Functioning Alcoholics

Here's how to recognize the signs that your loved one may be a high-functioning alcoholic, what happens when alcohol dependency goes untreated, and how you can help.

Alcohol dependency, or the inability to stop or control drinking, can cause noticeable problems for people at home, school, and work. But sometimes the signs are less obvious. People whose excessive alcohol use doesn't impact their lives as significantly are often referred to as functioning or high-functioning alcoholics.

“A high-functioning person dealing with an Alcohol Use Disorder (AUD) typically still works daily, has maintained relationships, and has experienced moderate to very little consequence related to their alcohol use,” Brittany E. Bryant, D.S.W., and Lindsay M. Squeglia, Ph.D., from the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina told WebMD Connect to Care in an email. “Despite experiencing fewer consequences, a high-functioning individual suffering from AUD still tends to rely on alcohol to complete daily tasks and has a dependence on, tolerance to, and intense cravings for alcohol that interferes with their health and wellbeing.”

While it can be especially challenging to recognize problem drinking in functioning alcoholics, here are some signs to looks for.

Signs Your Loved One Is A High-Functioning Alcoholic

You’re loved one may be struggling with alcohol dependency if:

  • They are unable to control or stop drinking alcohol
  • They have had legal problems related to drinking, like a DUI
  • They drink alone, hide drinking from others, or need alcohol before attending social events
  • They become angry or defensive when others question their drinking habits
  • They experience blackouts, or lapses in memory when drinking
  • They use alcohol to cope with stress or negative emotions
  • They experience withdrawal symptoms—shakiness, irritability, restlessness, trouble sleeping, and nausea—when they’re not drinking

“In general, while they are still able to keep up with many responsibilities, they may not be optimally functioning or may be failing in some realms, despite seeming to have it together,” according to Bryant and Squeglia.

What Happens When High-Functioning Alcoholism Goes Untreated?

There are several short- and long-term consequences of leaving alcoholism untreated, according to the CDC.

Short-term

  • Dangers in pregnant women, including miscarriage, stillbirth, and fetal alcohol syndrome
  • Risky behaviors, including unsafe sex
  • Legal problems, like DUI arrests
  • Injuries from violent altercations, falls, and drownings
  • Alcohol poisoning

Long-term

  • Liver disease
  • Heart disease
  • Certain types of cancers
  • Changes to the brain
  • Death

How To Help a High-Functioning Alcoholic

Because a high-functioning person with alcohol use disorder may not be experiencing severe levels of impairment at work, school, or home, they may not recognize they have a problem. Early intervention is key in preventing serious health effects.

Bryant and Squeglia say the best way to help someone who might be struggling with alcoholism is to discuss your concerns with them: “Encourage your loved ones to talk with their primary care provider about the amount of drinking they are doing and request appropriate tests be run to ensure that your loved one is still healthy. Sometimes objective tests can help the person see that they do have an issue with their drinking, as it is affecting their health.”