Understanding High Functioning Alcoholism

Alcohol misuse is a serious issue throughout the UK. An estimated 24% of adults in England and Scotland regularly drink over the Chief Medical Officer’s low-risk guidelines and there are an estimated 600,000 dependent drinkers in England alone. Of these, only 18% are receiving treatment for their alcoholism.

Alcohol addiction – commonly known as alcoholism – can have detrimental effects on the drinker’s physical and mental health, as well as other aspects of their lives. There’s a common perception of alcoholics as being out of control with chaotic lifestyles. This can certainly be the case for many people, but others can still largely maintain control of their daily lives while being dependent on alcohol.

It is easy for people with high-functioning alcoholism to slip through the cracks when it comes to getting help, or they may be in denial about having a problem in the first place. But what is a high functioning alcoholic and how can you get help for high functioning alcoholism?

What is High Functioning Alcoholism?

What is a functional alcoholic? Simply put, it is someone who is addicted to alcohol but manages to carry on with their everyday life. This is different to many other people whose alcohol intake and associated behaviours can cause more disruption. Their work may suffer, they may miss classes if in education or work coach meetings if on certain benefits. Their drinking may disrupt family life and relationships, with some people becoming violent or abusive when drinking. They may struggle to pay bills and maintain a home, descending into a spiral that could lead to crime, street drinking and even homelessness.

With functional alcoholism, there may seem to be minimal disruption from the outside, but they will still be putting themselves at risk and their physical and mental health may be suffering. Some people may just be better than others at hiding their problems such as financial instability and some people who seem to be functional alcoholics could find their situation deteriorate in the future.

It is also an unfortunate fact that high-functioning alcoholics are less likely to seek or be referred to treatment, or to self-identify as being dependent on alcohol, so reliable data on the prevalence of functional alcoholism is quite scarce.

High Functioning Alcoholism vs. Other Alcohol Use Disorders

People who struggle with alcohol addiction will often struggle with many other areas of their life. In the UK the diagnosis of an Alcohol Use Disorder (AUD) is generally made using two screening tools, questionnaires known as AUDIT (Alcohol Use Disorders Identification Test) to establish whether the disorder is present and the Severity of Alcohol Dependence Questionnaire (SADQ) to try to gauge the severity of any problem. There are no easy biological markers or blood tests to establish alcohol use disorders so, while it is not perfect, diagnoses largely rely on self-reported information.

Some of the questions explore things such as how often and how much you typically drink, how you feel in the morning and whether you have felt unable to stop drinking once you had started. Some of the questions consider other impacts of your drinking on yourself and those around you, however.

The AUDIT questionnaire includes such questions as:

• How often during the last year have you failed to do what was normally expected from you because of your drinking?
• Have you or somebody else been injured as a result of your drinking?
• Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

While functional alcoholics might drink heavily and regularly, feel unable to stop, experience cravings and suffer the morning after drinking, they might answer no to the questions above.

It’s worth noting that in the UK, high-functioning alcoholism is a commonly used or colloquial term, but it is not a medical diagnosis. People with what is termed high-functioning alcoholism will still be considered to have alcohol use disorder (AUD), although they might not meet some of the diagnostic criteria.

Signs of High Functioning Alcoholism

Many of the other markers for alcohol dependency will still apply and a high-functioning alcoholic will display certain alcoholic traits.

Some of the signs and symptoms of high functioning alcoholism could include:

• Drinking regularly or heavily
• Binge drinking
• Being unable to cut back or quit drinking
• Being unable to stop drinking once you have started (no ‘off switch’)
• Needing an alcoholic drink the next day after drinking
• Being unable to remember periods when drinking
• Experiencing withdrawal symptoms the day after drinking – this could include shaking, sweating, craving a drink or ‘affective withdrawal’ such as feeling frightened when you wake up

The National Institute for Health and Care Excellence (NICE) says that alcohol dependence is characterised by craving, tolerance, a preoccupation with alcohol and continued drinking in spite of harmful consequences. All these can apply in a high-functioning alcoholic.

What Causes High Functioning Alcoholism?

The causes of high-functioning alcoholism are the same for any other form of alcohol addiction, although the way it exhibits can be different. Drinking alcohol can change the way your brain works over time, affecting areas involved with pleasure, reward and impulse control. You can also build up a tolerance, meaning you need to drink more for the same effect. As you system adjusts to the presence of alcohol, you might experience a range of physical and psychological withdrawal symptoms when you don’t drink.

There may be other genetic, social and environmental factors that can increase your risk of developing high-functioning alcoholism, but anyone can develop an alcohol problem.

How to Help a High Functioning Alcoholic

If you’re wondering how to help a high functioning alcoholic, there are certainly things you can do. Talking to them or offering a non-judgemental shoulder if they want to talk can be valuable. You can research possible treatments and ways forward if they do decide to seek help.

Professional help is also available and we can offer confidential advice if you are worried about your own drinking or that of a loved one and believe they may be a high functioning alcoholic. Learn more about alcohol rehab treatment here, fill out our contact form, or phone us today on 0151 268 6992.

Posted on Friday, August 11th, 2023 at 3:38 pm in Alcoholism, Latest News.