A ‘functioning alcoholic’ is someone who is dependent on alcohol but remains able to maintain an apparently ‘normal’ life.
The term is not a medically recognised one, yet it is a description many people are able to relate to.
Knowing the signs may be the difference between getting help for yourself or a loved one before you or they teeter into a place where the impact of alcohol is so great as to eliminate the ability to function anymore.
Early intervention can also greatly reduce the amount of time you or your loved one is exposed to increased risk of harm – the harm to health, relationships, finances and wellbeing alcohol can cause. Many functional alcoholics continue drinking in that way for years, even decades before they get help. Others never get help at all.
Public Health England estimates four out of five dependent drinkers are not in treatment. And each week that they are drinking to a damaging level takes its toll.
Not all heavy drinkers are alcoholics, but most alcoholics, functioning or otherwise, are heavy drinkers.
Alcoholism is difficult to define. Even Alcoholics Anonymous doesn’t have a formal definition – it’s a grey area, but it could be seen as the point where someone has become physically and emotionally reliant on alcohol. Having increased alcohol awareness is something that can benefit us all.
Increased risk drinking, as defined by the NHS, is anything over 14 units for men and women. Higher risk drinking is more than 50 units a week for men and more than 35 units a week for women.
How many units a drink contains depends on the strength of the specific brand and the size of the measure. Broadly speaking two bottles of wine may be equivalent to around 20 units (750 ml bottles, with a 13.5 ABV). A bottle of vodka may be around 28 units (700 ml, 40 ABV).
An alcoholic may well have developed a seemingly high tolerance to alcohol and not necessarily show the signs of being drunk despite having consumed a large amount.
A key characteristic of the functioning alcoholic is that they are exactly that i.e they are ‘functioning.’
They may be highly successful; they have a job, a life, relationships, a home.
It could be that their alcohol use has had an impact on one or more of these things either regularly or at times. There may have been the odd late start at work due to a heavy night, there could have been arguments with loved ones either when they’ve had a drink or about their level of consumption. But, equally, that may not be the case.
The fact that the functioning alcoholic is managing to continue with their life is actually a factor in adding to their own denial that they have a problem and may even lead those around them to remain in denial over it too.
Most recovering alcoholics will recognise denial as having been part of their problem.
A functioning alcoholic can slip deeply into denial due to their strong ‘justifications’ for why they can’t possibly be an alcoholic. They do not fit into the ‘stereotypical’ mold.
Sarah A Benton, who has been in recovery from alcoholism since 2004 and is author of ‘The High-Functioning Alcoholic’, wrote for Psychology Today: “My image of the alcoholic was always an individual who could not hold his or her life together, and I certainly did not fit that description.
“The denial that I experienced was so deeply rooted and was reinforced not only from my loved ones but from society as a whole.
“Alcoholism is a chronic, progressive and lifelong disease that needs to be treated whether the alcoholic is a lawyer or a homeless person. The face of the alcoholic needs to be changed and the walls of denial must be broken down in order that alcoholics everywhere can receive proper diagnosis and treatment.”
A functioning alcoholic may
joke about their drinking or be very open about it, feeling that in itself,
shows they don’t have a problem because alcoholics drink secretly, don’t they?
They may argue they only drink at certain times of the day, which they believe demonstrates their restrain and control over their drinking. Most recovering alcoholics will be able to look back on times when they too did that or switched to a different brand or type of drink because it was ‘less damaging.’
If confronted about their drinking, however, a functioning alcoholic may become defensive, angry or belligerent.
A functioning alcoholic may achieve taking a break from alcohol – many alcoholics who finally access treatment will have managed to give up for periods, but have then gone back to the drink.
A telling factor of how deep the problem lies may be if they suffer withdrawal symptoms when they stop drinking.
If a dependent drinker suddenly cuts down or stops, they may suffer hand tremors (the shakes), sweating, hallucinations, depression, anxiety or insomnia. The symptoms in themselves often lead an alcoholic to have a drink to help them cope and can become a vicious circle.
This is why a proper, managed detox, with medical help and rehabilitation, which seeks to address the reasons someone has come to rely on alcohol are so valuable.
If you are worried about your own drinking or the drinking of someone you know, the best thing to do is to talk to a professional.
Approach a GP, contact a reputable helpline or get in touch with us at Port of Call. A professional will be able to help you judge if your concerns are well founded and point you towards appropriate help.
Alex is our admissions team leader. Over the last 5 years he has spoken with more than 10,000 people via our helpline and has organised over 1,000 detox and rehabilitation placements.
We’re specialists in UK rehab options and can advise you on alcohol rehab in the North West, drug rehab in the North West and other addiction support services in the area.