Around one in five alcoholics don’t look how we expect: they turn up to work, even excel there; have loving families and beautiful homes; earn good money; and appear happy and successful—all while drinking heavily. While they’re currently functioning, these alcoholics and their loved ones are quietly suffering and they’re just one slip-up away from a disaster such as a DUI, a terrible diagnosis, a job loss, an arrest, or a divorce.
- Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have identified five distinct subtypes of alcoholics by examining responses to epidemiological surveys as part of an effort to better understand the disease and target treatment.
- Functioning alcoholics are often deeply in denial about their addiction, assuming they can’t have a problem because they have a high-flying career, live in a beautiful home, appear healthy, etc.
- In a study of alcoholic subtypes; one-quarter of functional alcoholics have a college degree, equivalent, or higher while another third completed some college. Among functional alcoholics, the total family income averages $59,576/year, higher than any other type of alcoholic.
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What is a functioning alcoholic?
A functioning alcoholic, also called a high-functioning alcoholic, is a colloquial term for someone who drinks excessively but still manages to fulfill their daily responsibilities. They go to work, pay their bills, have nice homes, seem healthy, turn up to their kid’s soccer games, and keep up appearances. In short, they don’t look like our stereotype of an alcoholic.
The five subtypes of alcoholic
Alcohol use disorder often doesn’t look how we imagine. Researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA) have identified five distinct subtypes of alcoholics by examining responses to epidemiological surveys as part of an effort to better understand the disease and target treatment.
The five types are:
- Functional subtype (19.5%): well-educated, with stable jobs and families. However, one-third have a multi-generational history of alcohol use disorder, and one in four has experienced major depression sometime in their life. Only 17% have ever sought treatment for their addiction, the lowest of any subtype except young adults.
- Young adult subtype (31.5%): unlikely to abuse other substances but also unlikely to seek help for their drinking.
- Young antisocial subtype (21.5%): in their mid-20s with an early onset of drinking. More than half are from families with alcoholism and around half are diagnosed with antisocial personality disorder.
- Intermediate familial subtype (19%): middle-aged with around half from families with multigenerational alcoholism.
- Chronic severe subtype (9%): middle-aged individuals with an early onset of drinking, high rates of concurrent substance abuse, criminality, antisocial personality disorder, and other psychiatric diagnoses. This is the most common type of alcoholic in treatment.[1]
Sarah Allen Benton, author of Understanding the High-Functioning Alcoholic and herself a recovered alcoholic, estimates that as many as half of all alcoholics are high-functioning and flying under the radar.[2]
“Currently functioning alcoholics”
Just as many family members, friends, and co-workers may not identify them as alcoholics, many functioning alcoholics themselves don't realize they have a problem. They often believe they can’t have an addiction because they still carry out their duties.
However, no one can drink heavily for long without consequences. Eventually, functional alcoholics strain their relationships, miss days of work due to benders and withdrawals, run into legal difficulties (often DUIs), develop health issues, and stop being able to hide their addiction.
That’s why functioning alcoholics are sometimes called “currently functioning alcoholics” in treatment circles. Eventually, if they don’t get treatment, alcohol wins.
What are the signs of a functioning alcoholic?
Functioning alcoholics may believe that no one, from their partners to their bosses, knows they drink as heavily as they do. Often their “functioning” is contingent on this invisibility. They wouldn’t have the job they do and the relationships they do if others knew how frequently they’re drunk.
But even the highest functioning alcoholics display signs of their disease, especially as it starts to spiral out of control.
Someone might be a functioning alcoholic if:
- They can drink large amounts of alcohol without appearing drunk.
- They black out and don’t remember events from the night before.
- They’re deceptive about the amount of alcohol they consume. They may drink before an event where alcohol won’t be served, secretly put alcohol into other beverages and their containers, and hide bottles around the house.
- They drink at work or on their lunch breaks.
- They drink to deal with stress or to reward themselves for accomplishments.
- They respond with denial, anger, or aggression when confronted about their drinking habits.
- They mention other people they define as alcoholics whose drinking is supposedly worse than theirs.
- They’re regularly hungover or experience withdrawal symptoms, including shaking hands, sweating, nausea, and vomiting.
- They’re unable to drink just a single beer or glass of wine. Every occasion becomes a bender.
- They prioritize their drinking over everything and become irritated if they can’t drink.
- They’re reluctant to attend social events or restaurants where they can’t drink.
- They experience health consequences from their drinking.
- They buy expensive wine and liquor and insist that alcoholics only drink the cheap stuff.
- They joke about alcoholism.
- They become overly drunk and embarrass themselves at social events.
Read here for more warning signs and symptoms of alcoholism.
How do I know if I’m a functioning alcoholic?
Functioning alcoholics are often deeply in denial about their addiction, assuming they can’t have a problem because they have a high-flying career, live in a beautiful home, appear healthy, etc. But years of drinking will slowly erode their control, leaving them at risk of losing everything.
Here’s how to tell if you’re a high-functioning alcoholic before you reach rock bottom:
- You can’t just have one drink.
- You try and fail to stop or curb your drinking.
- You experience cravings for alcohol.
- You drink alone at home.
- You lie to family members about the amount you drink.
- You don’t want to go anywhere if you can’t drink.
- You drink before going out with friends so they don’t know how much you’re consuming.
- You hide bottles of alcohol around the house.
- You spike drinks with alcohol and drink alcohol out of the containers for non-alcoholic drinks (eg. water bottles and soda cans).
- You need alcohol to feel relaxed or confident or to manage stress.
- You celebrate every event with alcohol.
- You're constantly thinking about when you can next drink.
If you are worried about your or a loved one's alcohol consumption, then take our alcohol addiction self-assessment to see if you require further treatment.
Which professions have the most functioning alcoholics?
The researchers who illuminated the five subtypes of alcoholics found that functioning alcoholics are usually employed. Around 62% work full-time, another 13% work part-time, and 5% are already retired.
They’re also highly educated: one quarter has a college degree, equivalent, or higher while another third completed some college. Their total family income averages $59,576/year, higher than any other type of alcoholic.[3]
There are functioning alcoholics in every workplace. But Benton says that they’re over-represented in positions of power: chief executives, managers, doctors, lawyers, and politicians. People in these professions aren’t directly supervised at work and have their own offices. Their positions of power mean that people with suspicions about their drinking are reluctant to challenge them. They also earn enough money to escape the financial consequences of heavy drinking. They often justify their drinking as a reward for their hard work and accomplishments.
Research by the Substance Abuse and Mental Health Services Administration (SAMHSA) found the highest rates of heavy drinking among the following professions:
- mining: 17.5%
- construction: 16.5%
- accommodations and food service: 11.8%
But it also found high rates of drinking in prestige professions with high salaries and education requirements, including:
- management: 9.9%
- professional, scientific, and technical services: 7.7%
- finance and insurance: 7.4%
- public administration: 6.6%
- education: 4.7%
- health care and social assistance: 4.4%[4]
Famous functioning alcoholics include:
- astronaut Buzz Aldrin
- writer Stephen King
- First Lady Betty Ford
- actor Leonard Nimoy
- actress Mary Tyler Moore
- football player Joe Namath
Early intervention for functioning alcoholics
High-functioning alcoholics are often so good at masking their addiction and keeping plates spinning that they can covertly drink for decades. They're among the least likely to seek treatment for alcoholism: just 17% do, compared to two-thirds of those in the chronic severe subtype and one-third of those in the young antisocial subtype.
But they can’t keep drinking and functioning indefinitely. The truth comes out eventually, often revealed by a crisis. The alcoholic is arrested for drunk driving, their long-suffering spouse files for divorce, their work performance starts to slide and they’re disciplined or fired. At that point, some are finally propelled into treatment in order to preserve their relationships and careers.
You don’t have to wait until you hit rock bottom to confront your addiction and seek help. Early treatment can protect your health, safeguard your relationships, and improve your career. As well as you think you’re coping, you’d cope better and be happier if you weren’t battling cravings and withdrawals, lying to your partner, bluffing your way through work, driving drunk, and prioritizing the bottle.
How to help a high-functioning alcoholic
High-functioning alcoholics often become defensive and argumentative when confronted about their drinking. They deploy excuses: they’re not an alcoholic because they’re a successful lawyer. They’re not an alcoholic because they own a beautiful home. They’re not an alcoholic; they just collect wine. They deny they have a problem, even to themselves.
But if you’ve spotted the signs of alcohol addiction in someone in your life, you shouldn’t be convinced by their denials. You don’t have to wait until their drinking spirals completely out of control to urge them to get help.
You can help a functioning alcoholic by:
- Starting a conversation about their drinking: Wait until they’re sober or trying to cut back and gently but firmly tell them that their drinking is worrying you. Don’t be judgmental, condescending, or seek to settle scores. Instead, be empathetic and make sure they know you’re speaking from a place of concern and will be by their side as they work toward recovery.
- Encouraging them to get professional help: Many people can’t stop drinking on their own. Many have already tried to do so and have been unsuccessful. You should point the functioning alcoholic in your life toward professionals who can help them get and stay sober. For some people, the most appropriate treatment is an inpatient rehab or detox program. Others with less severe problems may be able to speak to a therapist or their family doctor. High-functioning alcoholics are most likely to turn to private healthcare professionals and 12-step programs when seeking sobriety. Offer to accompany or drive them to appointments and meetings and to participate in family sessions. Don’t assume all of their responsibilities but let them know that you’re there to support them while they focus on recovery.
- Don’t blame yourself: You’re not responsible for either their addiction or their recovery. The alcoholic must themselves decide to pursue sobriety and undertake the hard work to get there. The most you can do is to support them.
Getting help for an alcohol use disorder
Are you just barely functioning with a drinking problem? Are you concerned your drinking will soon cost you your family, career, and health? Help is available. To learn more about treatment options near you, click here.
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