Dealing With High-Functioning Alcoholism

Not everyone who’s battling addiction has hit rock bottom and is unable to perform daily tasks. Many can hold down jobs and keep up with family obligations. They may seem to manage life just fine.

The New York Times reports that about half of all people struggling with alcoholism can be classified as high-functioning. 

With high-functioning alcoholism, denial is often an issue, and the problem can go undetected for a long time. Families and friends may help to cover up effects related to alcohol abuse and enable the behavior.

High-functioning alcoholism can have significant consequences, however. It often leads to crisis eventually. 

Alcohol Use

Alcohol is socially acceptable, readily available, and a common factor in many settings. In 2016, more than 15 million people in the United States had an addiction involving alcohol, the National Survey on Drug Use and Health (NSDUH) publishes.

Alcohol is one of the most commonly used addictive substances in America.

Signs of High-Functioning Alcoholism

Addiction often involves drastic changes in personality, a decline in personal hygiene, social isolation, and an inability to keep up with everyday tasks, such as those related to work, school, and home life.

High-functioning alcoholism is different. Individuals are often educated, have good jobs, can keep up with work obligations, have seemingly stable home and family lives, are productive, and don’t suffer from legal or criminal charges or issues related to alcohol abuse. Until a major event like a DUI or other alcohol-related issue occurs, high-functioning alcoholism can fly under the radar.

Family members and friends are the best candidates for recognizing when a problem exists. The following signs may indicate high-functioning alcoholism:

• High tolerance for alcohol — drinking more without seeming impaired
• Engaging in and often planning events, even work outings, that involve drinking, such as happy hour meetings and martini lunches
• Drinking more in a sitting than initially intended
• Needing to drink to relax
• Making excuses for drinking and passing it off as “no big deal”
• Drinking in secret and potentially hiding alcohol in easy-to-reach locations, such as a desk drawer at work
• Drinking alcohol as a replacement for meals
• Talking a lot about alcohol and making many jokes involving alcohol or drinking
• Drinking in private and seeming to function in public, living a sort of double life
• Being unable to stop drinking even if the desire to do so is there
• Acting completely differently when under the influence of alcohol
• Blacking out frequently and being unable to remember what happened while drinking

Nearly 3 million people die annually in the United States from alcohol-related causes. Alcoholism can create a wide range of social, emotional, physical, and mental health issues. High-functioning alcoholism doesn’t mean a person is safe from these consequences.

Staging an Intervention

Families and close loved ones are often the first to recognize that a problem with alcohol exists. They are generally the ones who will need to step in and help the person recognize that alcoholism can benefit from a comprehensive treatment program. This often starts with a conversation.

Individuals who have high-functioning alcoholism are commonly resistant to accepting that there is a problem, so a more structured approach may be helpful. An intervention is a pre-planned and structured meeting with loved ones. The goal is to help the person decide to enter an addiction treatment program.

Interventions should always be planned in advance. The intervention team will be made up of people who are affected by alcohol abuse, such as family members, coworkers, neighbors,

Often, team members will write letters ahead of time that detail how alcohol abuse has impacted them directly. This is an effort to show the person how their use of alcohol is negatively affecting the people around them.

There are many options when it comes to alcohol addiction treatment. Families should research these ahead of time and present them during the intervention.

The National Institute on Drug Abuse (NIDA) reports that treatment should be immediately accessible so that it can be helpful to already have space reserved at the treatment facility.

The messages presented at the intervention should be loving and nonjudgmental. A professional interventionist can help to facilitate this.

Tips for Managing High-Functioning Alcoholism

Typically, a diagnosis of alcoholism is not made until alcohol abuse causes harm or negative consequences, per the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Even though someone struggling with high-functioning alcoholism may not have hit rock bottom, it is still optimal to seek treatment now. You may be able to step in before a traumatic life event occurs.

One of the biggest things that family members and loved ones can do when alcohol abuse becomes an issue is to stop enabling the person.

Enabling behaviors can include:

• Making excuses when they are late or don’t show up to work or other events.
• Cleaning up their messes.
• Letting them off the hook when things don’t get done.
• Ignoring the denial and secrecy involving alcohol use.
• Not calling out potentially risky or hazardous behaviors related to alcohol abuse.
• Putting the other person’s needs above your own.
• Placing the blame for alcohol abuse on situations or other people instead of where it belongs — on the person misusing alcohol.
• Diffusing situations, often out of fear, instead of being honest about what is going on.
• Continuing to provide financial and emotional support after treatment is refused.

When you seek to “help” your loved one in these ways instead of forcing them to take responsibility for their own actions, you are basically giving them a free pass and engaging in enabling behaviors, Psychology Today explains. This allows them to continue with their destructive behavior instead of eliciting positive change.

Enabling ultimately causes more harm than good. Start putting yourself first, and expect your loved one to be accountable for their own actions. This may motivate them to get help.

Taking Action

Continue to show love and compassion for your loved one. Let them know that alcohol abuse is an issue, and you support them if they choose to make a positive lifestyle change and seek professional help through a complete addiction treatment program.

An intervention can often be the catalyst that helps someone suffering from high-functioning alcoholism to realize that their drinking presents a problem. Even though they might seem to have it all together, high-functioning alcoholism often reaches a tipping point. The consequences of long-term alcohol abuse generally present themselves through health issues, employment problems, damaged relationships, and legal concerns.

Sources

(September 2017) Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm

(May 2009) High Functioning, But Still Alcoholics. New York Times. from https://www.nytimes.com/2009/05/05/health/05brod.html?_r=0

(August 2018) Alcohol Leading Cause of Death, Disease Worldwide, Study Says. USA Today. from https://www.usatoday.com/story/news/nation-now/2018/08/24/alcohol-death-disease-study-beer-wine/1082443002/

(July 2015) Intervention- Tips and Guidelines. National Council on Alcoholism and Drug Dependence. from https://www.ncadd.org/index.php/family-friends/there-is-help/intervention-tips-and-guidelines

What are Symptoms of an Alcohol Use Disorder? National Institute on Alcohol Abuse and Alcoholism. from https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Whats-the-harm/What-Are-Symptoms-Of-Alcohol-Use-Disorder.aspx

(July 2012) Are You Empowering or Enabling? Psychology Today. from https://www.psychologytoday.com/us/blog/the-anatomy-addiction/201207/are-you-empowering-or-enabling

(January 2018) Principles of Effective Treatment. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment