Are you concerned you may be living or in love with a functional alcoholic? In 2019, a study published by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that approximately twenty-five percent of adults reported binge drinking within the last month.1 If you believe your partner is struggling with alcoholism, it is critical to understand the warning signs and how to help your loved one.
Alcohol use disorder (AUD) or alcoholism is a behavioral health condition. This medical condition is diagnosed when an individual is unable to stop or control their drinking despite negative consequences. Potential consequences include damaged relationships, declining health, and being let go from a job. Alcoholism is technically classified as a brain disorder. People can receive a diagnosis of mild, moderate, or severe alcoholism.2
The Centers for Disease Control and Prevention (CDC) classify heavy drinking as eight or more drinks a week for women and fifteen or more drinks each week for men. Binge drinking is another common term used when discussing alcoholism. According to the CDC, binge drinking generally occurs when a person consumes four or more drinks within two hours.3
Are you wondering what is a functional alcoholic? Just because someone you know or care about appears to have it all together from the outside looking in does not mean they are not struggling internally. Some people can disguise the physical and emotional effects of their drinking for some time before incurring consequences.
Functional alcoholism is not a medical diagnosis. For a person to have an alcohol use disorder, there are particular clinical criteria. A few criteria for alcohol use disorder include negative consequences, failed attempts to reduce or stop using, and increased tolerance. Alcohol use disorder (AUD) is a chronic disease that requires treatment.3
High-functioning alcoholics (HFAs) generally do not fit into the stereotypical picture many people create in their heads of what an alcoholic should look like. For example, many people struggling with alcohol abuse still work every day, pay their bills, and support their families.
Although there is no formal definition for functional alcoholism, the NIAAA published a study showing that approximately twenty percent of alcoholics would be considered HFAs. What is a functional alcoholic? A functional alcoholic can maintain aspects of their life such as work, relationships, and friendships while drinking. Society is often hesitant to view these individuals as alcoholics because they appear to be doing well.4
There are many risk factors associated with functional alcoholism. Risk factors can include genetic disposition, low income, stress, loss of a loved one, divorce, depression, or other mental health disorders.4 The following sections will dive deeper into these risk factors and how they can increase the likelihood of an individual developing a drinking problem.
Stress is a trigger that can lead to excessive drinking. Life stressors such as financial hardship, unhealthy relationships, emotional stress from work, and parenting can result in a drinking problem. It can start as drinking just a few days a week for many people and then escalate into heavy daily alcohol use.
The statistics surrounding mental health and alcoholism are shocking. Individuals with mental health diagnoses such as major depressive disorder (MDD), post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), or schizophrenia are more likely to be diagnosed with an alcohol use disorder.
People with MDD in the general population are two to three times more likely to struggle with alcoholism. Approximately thirty-three percent of patients diagnosed with schizophrenia also meet clinical criteria for an alcohol use disorder.5
Self-esteem describes how one feels about themselves and their personal value. Low self-esteem leads people to constantly seek external validation from others and can also lead to feelings of self-loathing. Research has shown that people with poor self-esteem are more likely to misuse alcohol and develop functional alcoholism.6
When a person regularly drinks alcohol to the point of 0.08% BAC or higher, they are considered to be a binge drinker. Excessive drinking puts a person at greater risk of developing an alcohol use disorder.
Environmental influence can be broken down into three main categories, social network, community, and societal factors. Social network environmental influences include having parents with AUD, accessibility of alcohol, and how accepted alcoholism is within a person’s immediate family.
Community factors, like education and religious involvement, also predict how likely a person is to become a functional alcoholic. Lastly, societal factors such as economic circumstances, race, and ethnicity are environmental risk factors.7
Are you wondering what signs of alcoholism to look for in your partner? Here are a couple of questions to consider when determining if your spouse is a functional alcoholic:
If you answered yes to these questions, it might be time to seek professional medical help.
Changed behavior can be a sign of functional alcoholism. If a person is secretive, dishonest, depressed, or unusually angry, these may be symptoms of excessive drinking.
Additional signs of alcoholism include neglected home, work, school, and family responsibilities. For instance, if a person calls out of work regularly or skips school due to alcohol use. Someone struggling with alcohol use disorder may choose to stay at home and drink instead of attending a family event or activity.
Physical signs of alcoholism can be short-term and long-term. Functional alcoholism symptoms include withdrawal side effects such as nausea, sweating, trouble sleeping, and even seizures. In the long-term, functional alcoholics are more likely to experience deteriorating mental health and physical illnesses such as diabetes, obesity, and liver problems.
The three stages of functional alcoholism are denial, tolerance, and withdrawal. In the following few sections, we will discuss these concepts to learn how to support your loved one who is struggling with alcohol use.
Denial is very common among functional alcoholics. If a person is in denial, they might be ignoring or minimizing their drinking problem. People in denial frequently try to place blame on others instead of admitting they are struggling. Functional alcoholism symptoms include denial, guilt, and shame.8
Tolerance occurs when an individual needs more alcohol than before to achieve the same effects. For functional alcoholics, it could mean a person initially needed a six-pack to get drunk but now drinks a fifth of liquor daily. Tolerance looks different for everyone, but the concept stays the same.9
When a person becomes dependent on alcohol, their body will go through withdrawals if they stop drinking. Withdrawals can include both physical and mental symptoms. Alcohol withdrawals can be life-threatening, which is why it is critical to seek medical help when detoxing from alcohol.9
Medications, behavioral interventions, and sober support groups can be used to treat alcohol use disorder. Many people find that attending Alcoholics Anonymous and finding a sponsor make a considerable difference in their recovery journey.
Treatment for substance use disorder can be administered in various levels of care, ranging from outpatient to long-term inpatient. To determine the clinical level of care you or your partner needs, it is best to contact a licensed substance use professional to schedule an assessment. After the evaluation, you will receive a clinical recommendation informing you what type of treatment is medically appropriate for you or your partner.
For individuals that have become dependent on alcohol, medical detox is necessary to supervise and treat withdrawal symptoms. Detox provides a safe space for individuals to receive medical care while their body detoxes.10
The United States Food and Drug Administration (FDA) has approved three medications to address alcohol use and minimize the risk of relapse. These three medications are naltrexone, acamprosate, and disulfiram.
Behavioral treatments or talk therapy are highly effective tools for treating functional alcoholism. Relapse prevention, coping skills, mindfulness, and stress management are therapeutic interventions used to treat substance use disorders.
Many treatment centers use a combination of both group and individual therapy sessions to treat alcoholism. Some treatment agencies also offer single-gender groups to help participants relate to each other and share more comfortably. During individual counseling, substance abuse counselors may use cognitive-behavioral therapy (CBT), acceptance commitment therapy (ACT), and dialectical behavior therapy (DBT).
During therapy, alcoholics are supported by trained professionals as they learn how to live a happy and healthy life of sobriety.
If you or a loved one needs help, please call us at
(888) 744-9969 and our team at Blueprints For Recovery in Arizona will help.