The terms "functional alcoholic" or "high-functioning alcoholic" are commonly used to describe someone who is dependent on alcohol yet manage to maintain a relatively normal routine in their everyday life. These individuals are still able to function in society and carry out everyday responsibilities, such as going to work, provide care for their family, manage household obligations, and maintain social connections, despite their alcohol dependence.
The term "functioning alcoholic" is not a clinical diagnosis. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), the formal diagnosis for individuals struggling with alcohol dependence is alcohol use disorder. Regardless of its impact on their daily functioning, individuals who appear to manage their professional, social, emotional, and family lives may still meet the criteria for alcohol use disorder if they experience symptoms such as cravings, loss of control, persistent thoughts about their next drink and repeated unsuccessful attempts to quit.
Despite struggling with harmful alcohol use disorder, functional alcoholics often go unnoticed because they can function at or above an average level in their daily lives–meaning their symptoms typically do not lead to a breakdown in their professional, social, emotional, or family life, areas where the effects of alcoholism are usually most apparent. Often, on the outside, they appear to have everything under control: they are well-educated, middle-aged, well dressed and appear physically and mentally healthy. However, these external perceptions all mask the reality that they are actually struggling.
Signs of a high functioning alcoholic with Paul J. Rinaldi, Ph.D.
Howcast. (2020, July 23). Signs of a high-functioning alcoholic | Alcoholism
The concept of being a functional alcoholic can indeed seem contradictory at first glance, as the word "alcoholic" typically conjures images of someone whose life is falling apart due to their drinking. High-functioning alcoholics can be difficult to discern and deal with because they often falsely believe that if the world doesn't recognise their issue, it doesn't exist. They tend to struggle with admitting they have a problem, as their ability to maintain a façade of normalcy and keep up appearances conceals the true extent of their alcohol use.
Is it possible that you or someone you care about has an alcohol use disorder, even while continuing to function well? Could your drinking, or that of a loved one, have slowly increased to the point of alcohol dependence without either of you realising it?
Here are some of the most common signs and symptoms of a functional alcoholic that signal the need for help:
Increasingly turning to alcohol as a way to manage stress, anxiety, trauma, depression, and loss
Using alcohol to wind down or energise, and moderate emotions to hide negative ones
Drinking heavily and excessively
Impose limits on drinking, including time and amount, to convince themselves they are in control
Justify drinking as a reward, celebration, or social necessity
Socialise comfortably without drawing attention to their drinking problem by aligning drinking habits with the social norms of the crowd
After socialising, continue drinking once home
Get intoxicated when they don’t intend to
Surround themselves with people who drink on a regular basis
Engage in risky behaviour such as drinking while taking care of children, driving under the influence, getting into fights, or engaging in unprotected sex
Isolate themselves by drinking alone or secretly
Gradual withdrawal from hobbies or activities they used to enjoy in favour of drinking
Hide alcohol in a secret place
Use mealtime as excuse to drink or replace meals with a drink
No longer experience hangovers due to increasing tolerance to alcohol
Need to drink more to feel effects of alcohol
Failed attempts at quitting
Experiencing blackouts and poor memory
Lie when asked about drinking habits and lash back with angry outbursts
Irritability, mood swings, tiredness, and restless after abstaining from alcohol
Withdrawal symptoms when ceasing drinking, such as nausea, vomiting, shaking, fatigue, headaches, fevers, poor sleep, vivid dreams, nightmares, heart palpitations, anxiousness and nervousness
Alcohol addiction can severely impact a person's life, but the timeline for when it begins to affect their daily functioning can vary greatly from individual to individual. A functional alcoholic may downplay or deny their drinking problem because they don’t see alcohol as the root cause. Since drinking is so widely accepted in society, they might attribute their issues to other factors, such as their spouse or boss—anything except their alcohol use.
Additionally, because they are reluctant to part with their preferred drink, they may resist acknowledging that they have a problem. This denial can be difficult to break, making it challenging for them to admit the issue to themselves or for loved ones to reach them. They continue to convince themselves that their drinking isn't a problem, often justifying it with statements like:
“I only drink high-end spirits and wine, so it’s not a big deal”
“I’ve got a great job and I’m doing well—how could my drinking really be a problem?”
“I pay my bills, stay on top of things, and have lots of friends—everything’s fine”
“I haven’t had any major consequences in my life because of alcohol”
“Everyone drinks like I do—it’s just a normal way to unwind”
“I feel good that I don’t drink during the day like someone who really has a problem”
“If others had lived the way I have, they’d probably drink too”
For some people, the denial runs deep as they may not have encountered serious consequences yet—they go to work each day, haven't experienced financial hardship or serious health consequences, and have no legal issues. As a result, many functional alcoholics need support in recognising the damage their drinking is causing. Once they can accept that alcohol is an issue for them, half the job is done!
Addiction is a multifaceted condition, influenced by a combination of genetic, environmental, and social factors. Although there is no specific gene for functional alcoholism, certain risk factors can increase the likelihood of developing alcohol dependence. Most individuals who struggle with alcohol addiction may not outwardly appear to have a problem, as the signs are not always immediately visible. Some of these risk factors include but are not limited to:
Mental health challenges, such as anxiety, depression, or schizophrenia
High levels of stress at work or home without support
History of trauma
Low self-esteem
Family history of addiction
Peer pressure and the normalisation of heavy drinking within social circles
Living in an environment where alcohol is easily accessible
Binge drinking (more than 5 drinks per day)
Frequently exceeding the weekly recommended alcohol intake of 7 drinks for females and 14 drinks for males
Although functional alcoholics may feel like no one notices and believe they are getting away with their drinking, the reality is that it comes with significant consequences. Long-term, excessive alcohol consumption can lead to a range of serious health issues, including an increased risk of:
Liver damage including conditions like fatty liver, alcoholic hepatitis, fibrosis and cirrhosis, which may eventually progress to liver failure
Cardiovascular complications, including increased risk of high blood pressure, heart disease, stroke and cardiomyopathy
Neurological impacts including cognitive decline, neuropathy, brain shrinkage, memory problems and impaired judgment
Nutrient deficiencies due to issues with absorption
Digestive issues such as gastritis, ulcers, pancreatitis, and a higher risk of gastrointestinal cancers
Certain types of cancer, including breast, mouth, liver, colon, oesophagus and throat
Mental health challenges, including depression and anxiety, along with a heightened risk of suicide
Weakened immunity leaving the body more vulnerable to infections and illnesses
The combined effects of these risks can greatly diminish one's quality of life, lead to more frequent health issues, and shorten life expectancy. Alcohol use doesn't only harm the individual—it takes a toll on relationships and affects the entire family unit, further complicating the situation and making support for recovery even more important. It's crucial for functional alcoholics and their families to understand these long-term mental and physical health dangers in order to seek support and work towards recovery for a brighter and healthier future.
If you're concerned about a loved one’s relationship with alcohol, it’s important to approach the topic with compassion, in a non-judgmental and empathetic manner. Talking to someone you care about about their drinking can be really tough, especially when they seem to be managing okay on the outside. However, if you’re feeling like something isn’t right, it’s important to bring it up. Be mindful of the ways they may justify their drinking, as understanding these rationalisations can help you support them in recognising their problem. Here are some tips that may help to make that conversation a bit easier:
Pick the right moment–timing is everything: choose a time when things are calm and you’re both in a space where you can really talk. Avoid starting this conversation when they’ve been drinking or during a stressful moment. The goal is to have a real, honest chat
Speak from your heart: instead of saying, "You’re drinking too much," try something like, “I’ve been worried about how drinking seems to be affecting you lately.” This more connective approach keeps it focused on how you’re feeling, rather than making them feel like they’re being accused. When you speak from the heart, it’s easier for them to hear your concern
Show care, not judgment: it’s important to come at this from a place of love and concern, not judgment. Make it clear that you’re worried about their health and well-being, not criticising them as a person. You could say something like, “I care about you so much, and I just want to make sure you're doing okay”
Leave the labels out: this point cannot be emphasised enough! Avoid using labels like “alcoholic,” which can make someone feel defensive due to the stigma surrounding alcohol addiction. Instead, try talking about the behaviour and how it’s affecting their life, relationships, or health. This makes the conversation feel more supportive—like a team effort rather than an attack
Frame it around health and happiness: help them see that seeking treatment isn’t about fixing a problem—it’s about getting back to themselves and living a fuller, healthier life. You could mention things like, "Imagine feeling more energised" or "Think of how much better you’d feel and the more you could do if you weren’t worried about drinking.” It’s about showing them the positive side of seeking help
Be ready for pushback: they may not be ready to hear it right away—and that’s okay and expected. People often resist change, especially when it comes to something like alcohol. Don’t take it personally if they get defensive. Just let them know you’re there when they’re ready to talk
Offer help, but don’t push, respect their space: gently suggest treatment options, whether it’s therapy, support groups, residential treatment, or even just talking to a doctor. Let them know there are resources available and that you’re there to support them in whatever way they need. However, be sure not to pressure them into a decision they’re not ready for. Ultimately, the decision to seek help is theirs to make, and it’s important to respect their journey. Be patient and make it clear that the door is always open for more conversations, but don’t force it if they’re not ready to take that step yet
Let them know you’re in their corner: offer your support. Let them know that if they do decide to take the first step, you’ll be right there with them. Whatever seeking help may look like, it’s important they know they don’t have to face this alone
Be there for the long haul: there’s no truer saying than "change doesn’t happen overnight," and it’s important to remember that this is a marathon, not a sprint. Keep offering support and be there for them, even if it takes time for them to make the decision to seek treatment. Importantly, don’t forget to consider getting support yourself as well—it can help you stay strong through the journey, set boundaries and be the best support you can be for them
The key point is to make sure the conversation feels like a caring, supportive exchange, not a lecture. You want them to feel understood, not judged. Starting the conversation is the first step, and even if it doesn’t go perfectly, it’s still a step in the right direction. Because alcohol addiction is surrounded by stigma and assumptions, it can make it especially difficult for those affected to admit they have a problem. Many individuals who misuse alcohol seek help only when the negative consequences of their drinking become too overwhelming to deny. This may be the point when the pain or embarrassment reaches a level where they can no longer ignore their psychological dependence on alcohol and the need for change. The previous support of a loved one—offering consistent understanding and encouragement—can play a crucial role as they take the next steps toward recovery.
There is no shame in acknowledging the need for help with alcohol addiction, in fact it demonstrates significant strength, courage and wisdom! If you feel ready, consider reaching out to a trusted friend or family member. They can provide the care and encouragement you need moving forward. If you'd rather get professional guidance, talking to your GP is a good place to start. They can evaluate your situation and suggest possible next steps, whether that means treatment or other forms of support. If you're considering a more comprehensive, residential treatment option, reaching out to Noosa Confidential can be a great next step. Their compassionate team offers personalised support to help you on your recovery journey, providing the environment and resources needed to truly heal and make lasting change.
Becoming proactive and pursuing residential alcohol treatment can support you in overcoming alcohol dependence safe and effectively, leading you toward a healthier, more fulfilling future. Some of the benefits of residential inpatient care at Noosa Confidential include:
Efforts are made to minimise the discomfort of withdrawal by ensuring the guest is safe and comfortable throughout the detox process. Medically supervised alcohol detox helps cleanse the body of alcohol while managing withdrawal symptoms. This process incorporates medication, supplements, a balanced diet, wellness activities, and exercise, all working together to stabilise your physical health and prepare you for further treatment
All therapies and treatments are delivered exclusively on a one-on-one basis by a highly qualified team. Set in a non-clinical environment, each guest has their own private room and bathroom, ensuring comfort and privacy. Support is available 24 hours a day, with ongoing aftercare provided for up to 12 months. Therapy focuses on addressing underlying emotional issues while teaching effective ways to manage emotions through psychoeducation. It helps you gain self-awareness, identify triggers, and build coping strategies to overcome cravings. Sessions can be tailored to individual needs and may include family involvement when necessary
The addition of 12 months of aftercare creates a soft landing and ensures ongoing support to help you manage triggers, avoid relapse, and reinforce what you learned in treatment
Recovery from functional alcoholism is a lifelong journey. Gaining a deeper understanding of the complexities of alcohol use disorder empowers one to make informed choices and adopt effective strategies to help create improved well-being and lasting change. If you or someone you care about is struggling with alcohol use and its consequences, Noosa Confidential is here to offer support. Our approach combines advanced therapeutic methods with the latest scientific research, delivering personalised and compassionate care. Reach out today to explore the treatment options available to you.
