How to Recognize a Functional Alcoholic

While the term “alcoholic” was used in the past but is now viewed as outdated and stigmatizing. Today, healthcare professionals would say that a person has an alcohol use disorder (AUD).

A “functional alcoholic” (or “high-functioning alcoholic”) isn’t a formal medical diagnosis, but a term used colloquially to describe a person who is dependent upon alcohol but can still function in society. The term “currently-functioning” may be used since it’s not likely they will remain functional (and not misuse alcohol) indefinitely.

Drinking rarely causes them to miss work and other obligations (although it does happen occasionally). They are usually able to manage areas of life including jobs, homes, and families.

They often appear physically and mentally healthy. However, they are likely struggling with uncontrollable cravings, unsuccessful attempts at quitting, and obsessive thoughts about their next drink—all hallmarks of an alcohol use disorder.

Risk Factors for Functional Alcoholics

According to the National Institutes of Health, functional alcoholics are often “middle-aged, well-educated, with stable jobs and families.” Though the exact causes are unknown, several risk factors can increase the likelihood of developing an alcohol problem, including:

• Binge drinking more than 5 drinks per day
• High levels of stress
• Peer pressure to drink
• A parent or close relative with an alcohol use disorder
• A mental health problem, such as anxiety, depression, or schizophrenia
• Low self-esteem
• Consuming more than seven drinks per week for females or more than 14 drinks per week for males

Recap

Certain factors may increase your risk of developing an alcohol problem. Binge drinking, social pressures, family history, mental health issues, and excess alcohol use can all increase your risk of developing an alcohol use disorder.

Signs of a Functional Alcoholic

Could you have an alcohol use disorder even if you continue to function well in society? Has your drinking gradually increased to the point where you might be alcohol dependent without realizing it?

Here are some warning signs that you may need help:

• Being the first to go to the bar after work or pouring a drink as soon as you get home
• Feeling agitated, irritable, or anxious if something prevents you from having a drink
• Frequently drinking more or longer than you intended
• Joking about alcoholism, such as saying, “I’m a drunk, alcoholics go to meetings”
• Constantly talking about drinking or bragging about stockpiling liquor
• Using mealtime as an excuse to start drinking or “drinking” your meals
• Engaging in high-risk behaviors like binge drinking, driving under the influence, or drinking while caring for children
• Feeling angry or irritated if a loved one confronts you about your drinking
• Experiencing alcohol-related blackouts where you can’t remember parts of the night
• Facing relationship problems because of your drinking
• Hiding your alcohol consumption
• Experiencing withdrawal symptoms when you can’t drink

Denial

One of the main reasons people who misuse alcohol seek help is the negative consequences of their drinking. When the discomfort or embarrassment becomes overwhelming, it becomes harder to deny the need for change.

For functional alcoholics, denial is strong because they may not face significant negative outcomes. They go to work daily, haven’t experienced financial troubles, and have never been arrested.

They convince themselves there’s no problem. Common excuses include:

• “I have a great job and pay my bills, so I can’t have a problem with alcohol.”
• “I only drink expensive wine.”

Tolerance

A functional alcoholic often consumes as much alcohol as someone with an alcohol use disorder. However, they will not exhibit outward symptoms of intoxication.

This is because they have developed a tolerance for alcohol to the point that it takes more for them to feel the effects (including hangovers). Consequently, they must drink increasingly larger amounts to get the same “buzz” they want.

This slow build-up of alcohol tolerance means the functional alcoholic is drinking at dangerous levels that can result in:

• Alcohol dependence
• Alcohol-related organ damage
• Cognitive impairment

Chronic heavy drinkers can display a functional tolerance to the point they show few obvious signs of intoxication even at high blood alcohol concentrations, which in others would be incapacitating.

Withdrawal

Unfortunately, even when functional alcoholics begin to recognize that they have a drinking problem, they still resist reaching out for help. By the time they admit the problem, their withdrawal symptoms—which can begin within a few hours after their last drink—can become more and more severe.

Symptoms of alcohol withdrawal include:

• Anxiousness or nervousness
• Appetite loss
• Depression
• Difficulty sleeping
• Dilated pupils
• Faster heart rate
• Fatigue or tiredness
• Headache
• Irritability
• Mood swings
• Nausea and/or vomiting
• Nightmares
• Not being able to think clearly
• Pale skin
• Shakiness
• Sweating
• Tremor

They may try to quit independently, but the withdrawals are too unpleasant or severe. Therefore, they continue to drink to keep the withdrawals at bay, and the cycle continues.

Usually, it is only when their continued drinking becomes more painful than the prospect of going through the pain of alcohol withdrawal, will they finally reach out for help. But it doesn’t have to be that way. Help is available.

Impact of Being a Functional Alcoholic

While a person who is high-functioning alcohol can still fulfill their obligations in many areas of life, that does not mean that their drinking does not take a toll on their health, relationships, career, and well-being.

In the short term, alcohol use increases the risk for alcohol poisoning, fetal alcohol syndrome, accidents, injuries, violence, and risky sexual behavior.

Alcohol intake also has long-term consequences, including an increased risk of:

• Alcohol dependence and alcohol use disorders
• Certain types of cancer, including breast, mouth, liver, colon, and throat
• Memory and learning problems
• Mental health conditions such as anxiety and depression
• Weakened immunity

In addition to the health effects of having an alcohol use disorder, it can also take a toll on relationships. Drinking doesn’t just affect the individual; it affects the entire family unit.

Family members may feel on edge and worried about their loved ones drinking. They may take steps to avoid the person while they are drinking, or they may experience feelings of guilt, shame, or self-blame. 

Coping With a Functional Alcoholic

If you are concerned about your loved one’s drinking, it can be helpful to join a support group such as Al-Anon. Such groups can offer valuable support, encouragement, advice, and information.

While a functional alcoholic can still function in daily life, family members and loved ones are often aware and concerned about the individual’s alcohol use. Some steps you can take to help include:

• Learn more about alcohol use disorders
• Joining a support group
• Talk to the person about your concerns in a calm and non-accusatory way
• Learn about community reinforcement and family training (CRAFT), which is a way that can help family members support a loved one’s addiction recovery
• Learn how to stop enabling and co-dependent behaviors

The National Institute of Health suggests that loved ones should start by talking about their concerns. Avoid accusing, blaming, or making threats. Instead, voice your concerns, share how their drinking is affecting others, and suggest ways that you can help them talk to a doctor or join a support group.

Getting Help As a Functional Alcoholic

If you are having only mild to moderate withdrawal symptoms, your healthcare provider may recommend outpatient treatment, including medical detoxification that provides medication, vitamins, and diet to help ease the withdrawal process.

Your provider can also perform tests to see if you have developed any medical concerns from alcohol misuse and recommend counseling, rehabilitation, and support groups like Alcoholics Anonymous or SMART Recovery.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. National Institute on Alcohol Abuse and Alcoholism. When it comes to reducing alcohol-related stigma, word matter.

2. National Institute on Alcohol Abuse and Alcoholism. The cycle of alcohol addiction.

3. National Institute of Health. Researchers Identify Alcoholism Subtypes.

4. National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder.

5. National Institute on Alcohol Abuse and Alcoholism. Alcohol and tolerance. 1995; 28:356.

6. Mirijello A, D’Angelo C, Ferrulli A, et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-65. doi:10.1007/s40265-015-0358-1

7. Centers for Disease Control and Prevention. Alcohol use and your health.

8. National Institute on Alcohol Abuse and Alcoholism. Treatment for alcohol problems: Finding and getting help.

9. Hellum R, Nielsen AS, Bischof G, et al. Community reinforcement and family training (CRAFT) – design of a cluster randomized controlled trial comparing individual, group and self-help interventions. BMC Public Health. 2019;19(1):307. doi:10.1186/s12889-019-6632-5

10. National Institute on Aging. How to help someone you know with a drinking problem.

By Buddy T

Buddy T is a writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Because he is a member of a support group that stresses the importance of anonymity at the public level, he does not use his photograph or his real name on this website.

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