How to Support a High-Functioning Alcoholic

A “high-functioning alcoholic” is an informal term for someone who appears to maintain a successful professional and personal life, despite living with an alcohol use disorder.

The medical community discourages using the term “high-functioning alcoholic” because of the stigma associated with the label “alcoholic”. “Alcoholic” is a term with negative connotations that can discourage people from being open about their drinking problems and seeking alcohol treatment.

Instead, alcohol use disorder is the medical diagnosis for someone who has an impaired ability to stop or control their alcohol use, despite any negative consequences. Alcohol use disorders may be mild, moderate, or severe, and encompass a range of symptoms.

Many people with alcohol use disorders struggle in their social, work, and home lives. They may miss days of work, have dysfunctional and unstable relationships, or fail to fulfil family responsibilities. Often, these problems are evident to family, friends, and colleagues. High-functioning “alcoholics”, however, can lead relatively normal lives, and their alcohol use disorder may go unnoticed by those around them.

What Are the Signs and Symptoms of Someone With a High-Functioning Alcohol Use Disorder?

If someone is high-functioning, it can be harder to notice the signs of an alcohol use disorder, especially if they make efforts to hide their drinking habits. Here are some signs to look out for:

• avoiding open conversations about their drinking habits
• regularly blacking out after drinking alcohol
• mood swings
• hiding alcohol consumption, such as hiding empty bottles or drinking alone
• drinking large quantities of alcohol without appearing intoxicated
• drinking in inappropriate or dangerous contexts
• feeling ashamed after drinking sessions
• experiencing cravings for alcohol

What Are the Dangers of Alcohol Use Disorders?

Alcohol use disorders are damaging to everyone, even people who appear high functioning. Excessive alcohol use can cause serious health problems, leading to 8,794 deaths in the UK in 2020. Some of the dangers of alcohol misuse include:

• injuries or accidents while intoxicated
• engaging in risky behaviours, including drink driving
• high blood pressure, cardiovascular conditions, and digestive problems
• weakened immune system
• various cancers, including breast cancer, oral cancer, and liver cancer
• mental health issues such as depression and anxiety

The longer someone misuses alcohol, the more likely they are to develop serious health conditions – even if they appear high-functioning. Stopping or cutting down on drinking is the only way to reclaim a healthy and functioning life in the long term.

How Can You Support Someone With a High-Functioning Alcohol Use Disorder?

If you think a family member, friend, or other loved one may be living with an alcohol use disorder, you may feel worried, hopeless, or unsure how to help. Supporting someone with an alcohol use disorder can be difficult, especially if they are secretive or hostile about their drinking habits. It’s important to recognise your limits, set good boundaries, and be prepared to step back if necessary.

Some tips and advice for connecting with and supporting someone living with an alcohol use disorder include:

• Learning About Alcohol Use Disorders – One of the most important steps to take is to educate yourself on alcohol use disorders. This will help you to understand your loved one’s experience and behaviours, and know how best to offer support.
• Speak With a Mental Health Professional – You can speak with a therapist, substance abuse specialist, or another mental health professional for expert advice on how to reach out to and support your loved one.
• Have An Open Conversation – Have an open conversation with your loved one, making sure to listen to what they have to say without being judgemental. Express feelings and concerns about the impact of their drinking on themselves and others around them. Avoid making ultimatums or demands.
• Support Their Recovery Journey- You can support your loved one in accessing help by researching different treatment options or accompanying them to appointments. You could also adjust your drinking habits, for example, by quitting alcohol yourself.
• Look After Yourself – Supporting someone with an alcohol use disorder can be draining, and it’s essential that you look out for yourself in the process. Practise good self-care by eating well, exercising, and maintaining regular sleeping patterns. Reach out to friends for support and seek professional help if necessary.

How Effective Is Treatment?

Alcohol use disorder is a serious condition, but it is treatable. Decades of research have uncovered a range of treatment options proven to help individuals overcome their drinking problems and lead healthy, sober lives.

Individuals may access treatment through the NHS or privately. Treatment can be inpatient (involving a residential stay in a treatment centre) or outpatient (involving regular visits to a centre while continuing to live at home). Effective treatment programs usually offer a variety of different approaches, tailored to each individual’s needs.

Treatment options may include:

• Talk therapy such as cognitive-behavioural therapy helps identify the underlying causes of addictive behaviour and develop the skills to overcome them
• Medications that block the effects of alcohol or reduce cravings, making early recovery easier
• Complementary therapies such as meditation and mindfulness that support good overall wellbeing

No one treatment works for everyone, and your loved one may need to try a few options before finding the one that works for them. However, no matter how serious the problem may be, treatment can help anyone achieve and maintain recovery.

The Importance of Seeking Treatment

Seeking treatment is the first step to recovery from an alcohol use disorder. Unfortunately, many people do not access treatment – according to government estimations, 82% of people needing treatment are not receiving it. Supporting your loved one to recognize their drinking problem and seek treatment is the best way to ensure their recovery.