What Is the Best Way to Help a Functioning Alcoholic?
Many alcoholics with mild or moderate alcohol use disorder (AUD) are not aware they have a drinking problem, as they may be able to successfully maintain their jobs, careers, and family lives despite misusing alcohol. Some people with AUD may deny they have a drinking problem due to their ability to fulfill these important obligations and, therefore, deny the need for help or treatment.
In this article:
Know the Signs
Alcohol addiction is characterized by a set of diagnostic criteria defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).1 However, a high-functioning alcoholic may not meet most or all of these diagnostic criteria if they can successfully maintain certain aspects of their lives. For example, the DSM-5 criteria state, “recurrent use of the substance results in a failure to fulfill major role obligations at work, school, or home.”1 But that may not apply to a functioning alcoholic who continues to excel and succeed at work.
An estimated 19.5% of alcoholics in the United States are classified as functional alcoholics. Most of these people are middle-aged, well-educated, and have stable jobs and families.2
The signs of a high-functioning alcoholic may be more subtle and less obvious than those associated with other alcoholics. Individuals who appear “functional” when misusing alcohol may look for reasons to justify their alcohol use, such as the need to unwind after a day at work. They may also use alcohol to reward themselves, such as after getting a promotion or bonus at work or getting good grades in school or college.
Review the signs and diagnostic criteria of alcohol use disorder and determine whether some of these criteria apply to your loved one’s situation. These criteria are:1
- Using alcohol in larger amounts or over a longer period than intended
- Trying, but being unsuccessful, at reducing or controlling alcohol use
- Spending a great deal of time obtaining alcohol, using alcohol, and recovering from the effects of using alcohol
- Experiencing strong cravings or urges to use alcohol
- Recurring alcohol use is causing problems at work, school, or home
- Continuing to use alcohol when it causes persistent social or interpersonal problems
- Giving up or engaging less often in important social, occupational, and recreational activities due to persistent alcohol use
- Using alcohol in situations where it is physically hazardous to do so
- Continuing to use alcohol despite knowing it is causing or worsening physical and psychological problems
- Having a high tolerance for alcohol
- Experiencing alcohol withdrawal symptoms when not drinking
Alcohol contributes to a wide range of health problems, some of which may already be affecting a functioning alcoholic. Many of these health problems progress gradually and may not be obvious during the early stages of addiction.
Alcohol can cause the following health problems:3
- Weakened immunity
- High blood pressure
- Irregular heart rate
- Fatty liver disease
- Alcoholic hepatitis (inflammation of the liver caused by heavy alcohol use)
- Fibrosis (buildup of scar tissue in the liver)
- Cirrhosis (chronic liver damage)
- Weight gain and obesity
- Pancreatitis (inflammation of the pancreas)
- Certain cancers
- Co-occurring mental health disorders, including depression and bipolar disorder
Take note of whether your loved one is suffering from signs of any of the above alcohol-related health problems. For example, a weakened immune system may cause them to become sick more frequently. If you’re starting to notice any physical, mental, or emotional changes in your loved one, mention these changes to them, and point out the correlation between alcohol use and the developing conditions.
Choose the Right Time to Talk
Plan to talk to your loved one at a time when you know they will be sober. Talking to the person about their alcohol use when they are intoxicated will likely not be productive or effective. The disinhibiting effects of alcohol can encourage negative reactions such as dismissiveness and aggression, as well as affect an individual’s memory of the conversation and their ability to make meaningful decisions based on what is discussed.4
Think about when your loved one may be most receptive. For example, try talking to them first thing in the morning on the weekend when there are no work-related pressures or during a family outing when you are feeling close and already speaking about intimate, personal family matters.
Alcohol addiction is a chronic, complex brain disorder and mental illness.1 It cannot be fixed overnight and often requires a series of medical interventions and treatments in order for an individual to achieve and maintain meaningful recovery. Understand that AUD is a disease.
As you attempt to help your loved one, focus on being non-judgmental and supportive in the way you speak and act. You may feel complex emotions, including anger and betrayal. Try to express these emotions to friends, family members, or a licensed therapist. Being confrontational can encourage your loved one to withdraw or react with their own negative emotions.
A high-functioning alcoholic may be hesitant to get help at first, especially if they don’t want treatment taking valuable time away from work and other important obligations they have been managing up to now. However, your compassion, patience, and understanding may motivate them to make positive changes.
A functioning alcoholic may not be aware that their alcohol misuse is affecting your relationship, just as they may not have personally acknowledged that they have a problem. Take time to explain how their drinking affects your relationship or their relationships with others.
When speaking with your loved one, speak from your own perspective using “I” statements. Explain your personal experience of your loved one’s drinking, using specific examples of how the person did something that damaged your relationship. For example, if the person is your spouse and you have children together, explain how you and your children feel to see your spouse spend more time acquiring and using alcohol than playing with your children.
Explaining to someone how their addiction directly affects you can offer them a new perspective, motivating them seek help.
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You may hesitate to speak up about your loved one’s addiction in consideration of the negative consequences doing so may have. For example, a high-functioning alcoholic who is the primary provider in your household may claim that they need to use alcohol to feel relaxed and refreshed after work and that they will stop being successful at work if they stop using alcohol.
Acknowledge that some negative emotions and situations are likely to arise during the process of addressing your loved one’s addiction, such as your loved one experiencing discomfort when they do not use alcohol, which may affect their mood. You can work toward changing how alcohol is used in your household by establishing boundaries. For example, stop buying alcohol and providing excuses for your loved one when they are drunk or hungover.
However, if you feel uncertain or unsafe confronting your loved one or making rules about alcohol use in your household, consider doing so with the assistance of a mediating medical or behavioral health professional.
Consider Staging an Intervention
If your attempts to talk to and help a functioning alcoholic do not work, consider hiring a professional interventionist who can help you stage an intervention. An interventionist can help you communicate with your loved one about the need to seek treatment. An intervention presents an opportunity to express the risks to your loved one’s interpersonal relationships, hobbies and commitments, career, and health.5
Evidence suggests that up to 90% of interventions successfully connect an addicted person with professional treatment.5 An interventionist can help you form an intervention team composed of close friends, relatives, coworkers, and other people who may be affected by your loved one’s addiction. During the intervention, each of these individuals will have the opportunity to tell the person how their drinking problem has personally affected them. Afterward, the interventionist can play a role in transporting your loved one to a nearby treatment facility or follow up with you to see whether your loved one decided to seek treatment.5
Alcohol addiction can be effectively treated with a combination of medications, behavioral therapy, and 12-step support group fellowships such as Alcoholics Anonymous.6 Many alcohol rehab centers develop personalized treatment plans for high-functioning alcoholics. Functioning alcohols may have the option to attend an outpatient treatment program so they can continue working or going to school while getting the help they need.
Call 800-839-1686Who Answers? to speak to a treatment specialist about nearby alcohol rehab centers if you need help choosing the best facility for yourself or a loved one. Our specialists can answer questions you may have about addiction and available treatments, and help you find a nearby rehab center.
- National Institute on Drug Abuse. (2018). The Science of Drug Use and Addiction: The Basics.
- National Institutes of Health. (2007, June 28). Researchers Identify Alcoholism Subtypes.
- National Institute on Alcohol Abuse and Alcoholism. Alcohol’s Effects on the Body
- National Institute on Drug Abuse. Alcohol.
- Association of Intervention Specialists. Learn About Intervention.
- National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help.