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5 Tips For Recognizing The High-Functioning Alcoholic Or Addict

high functioning alcoholicIn the field of addiction treatment, some of the most tragic stories are those of high-functioning addicts. The friends, neighbors, relatives and co-workers you look up to – envy even – for their beautiful homes, loving children and successful careers may be dealing with a secret addiction that is destroying them from the inside out.

How long do you think it would take to identify the signs of addiction in someone close to you? Most people assume they’d perceive a problem rather quickly, keeping an eye out for major life consequences such as job loss or destroyed relationships. But according to a 2007 study by the National Institute on Alcohol Abuse and Alcoholism, only 9 percent of alcoholics fit this stereotype.

The majority of addicts are high-functioning – high-power executives, surgeons in the operating room, successful professionals, hard-working stay-at-home moms and others you may not suspect even if you know them intimately over a long period of time.

High-functioning addicts are masters of disguise whose struggles with drugs and alcohol may go unnoticed for years, often with increasingly severe consequences. Here are a few ways to unmask the high-functioning addict in your life:

#1 Beware of Denial

High-functioning addicts don’t fit the standard definition of an addict. They may not drink or use drugs every day; they may drink only the finest wines and liquors; and they may have avoided the serious consequences that befall other addicts and their families.

Because they don’t fit the stereotype, high-functioning addicts can spend years, even decades, in denial. If they manage a family and career and fulfill their daily responsibilities, they reason, there’s no way they could have a drug or alcohol problem. Even if they acknowledge that they drink or use drugs more than they should, they may feel entitled to indulge as a reward for their hard work.

The addict’s denial may be compounded by family and friends who fail to recognize or confront the problem. They may vow that they’ve never seen their loved one drunk or high (because the addict hides it well, has built a tolerance or uses drugs alone), or even pat the addict on the back for being able to “handle their liquor” so well. High-functioning addicts may not stand out in a crowd, often because they surround themselves with other heavy drinkers and drug users who fuel their denial.

#2 Observe Uncharacteristic Patterns of Behavior

Despite their best efforts at concealment, even the most functional addicts experience ramifications of their drug use. For some, it may be subtle changes in behavior that are uncharacteristic of their sober selves, such as skipping social events, a change in attitude or lack of focus. Or you may notice physical symptoms of addiction, such as insomnia, shakiness, paranoia or other health concerns. For others, it could be sloppiness at work, missing deadlines, frequently calling in sick, engaging in risky behavior or failing to fulfill family obligations.

#3 Don’t Accept Excuses

Often intelligent and charismatic by nature, high-functioning addicts have well-rehearsed excuses for every unusual behavior or slip-up. After a late night out with colleagues, they may explain they had to overindulge as part of the office culture. Or perhaps cocaine and prescription drugs boost their productivity at work, or a bottle of wine in the evening takes the edge off after a stressful day. Whatever the behavior, there’s a well-reasoned justification that sets everyone at ease and allows the addiction to continue.

#4 Watch for a Double Life

High-functioning addicts are adept at maintaining a double life. To the outside world, it may appear that the individual has it all. Inside, they may be plagued by uncontrollable cravings, unsuccessful attempts to quit, obsessive thoughts about their next drink or high, and other hallmarks of addiction. One moment, they may see clear signs that they have lost control; the next, they quickly intellectualize and rationalize the problem away. The lies and secrets begin to exact a heavy toll, leaving the addict exhausted, ashamed and alone.

Many high-functioning addicts are waiting for some sign – a “rock bottom” – to motivate them to seek treatment, which may not come for 10 to 20 years, if ever. Some gradually lose control of their drinking or drug use over a number of years, while others experience a dramatic event, such as a drunk driving arrest, job loss or divorce, that brings the severity of their problem to the forefront.

#5 Don’t Ignore the Signs

Someone who doesn’t fit the stereotype of an alcoholic or drug addict can still have a serious disease. A comfortable income and position of power at work or at home may cushion them from the consequences of their drug use, while a sense of self-importance or belief that they can resolve their own problems may prevent them from seeking treatment.

Even though they continue to function, high-functioning addicts pose a significant danger to themselves and others. High-functioning addicts are some of the most difficult individuals to help, but they are not hopeless. Since it’s likely that they will wait until they’ve lost it all before they acknowledge a problem, they rely on the people closest to them to intervene.

Treatment must be accessible and appealing for the high-functioning addict, and families and friends play an important role in this mission. If you recognize the signs of addiction in someone you care about, you’ve taken an important step by getting past your own denial. Next step: Put an end to enabling. Enlist the help of a professional interventionist to confront the addiction and help the addict into treatment.

Keep in mind that when questioned about their drug use, a high-functioning addict may vehemently deny that a problem exists and make greater efforts to hide their drug or alcohol use rather than agree to treatment. It often requires a series of attempts to break through the many layers of denial.

Alcoholic photo available from Shutterstock

5 Tips For Recognizing The High-Functioning Alcoholic Or Addict

David Sack, M.D.

Dr. David Sack is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CMO of Elements Behavioral Health, he oversees a nationwide network of treatment centers including drug and alcohol rehab programs at The Ranch in Tennessee and The Right Step in Texas.

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APA Reference
Sack, D. (2012). 5 Tips For Recognizing The High-Functioning Alcoholic Or Addict. Psych Central. Retrieved on November 28, 2020, from


Last updated: 3 Feb 2012
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