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Addictions look different across every individual.
No two people will have the same symptoms, effects, or consequences as a result of their addiction.
Because of this, there are many stereotypes about addiction as a disease and how it affects individuals differently.
With an addiction to alcohol, the individual becomes physically dependent on the substance. Their brains will begin to be wired differently, with alcohol changing neural pathways in areas responsible for mood regulation and anxiety amongst other functions.
If the individual continues their addictive behaviours, not only is their physical and mental well-being at risk, but also other areas of their life such as their financial situation, their career, and their social life.
In some cases, this may not seem like the individual’s reality, but it can have long-lasting effects on individuals who do not receive treatment, leading to further issues in the future relating to all aspects of their life.
Especially in the UK, there is a strong drinking culture and going to the pub to meet with friends or colleagues is a relatively normal activity for most people.
For this reason, it can be difficult to tell whether or not someone is addicted to alcohol. It is even harder to tell if someone is a high-functioning alcoholic.
High-functioning alcoholics are individuals who maintain the factors mentioned above: their finances, their career, and their relationships, but are addicted, nonetheless. To most people, these individuals may not appear to have an addiction at all.
In some cases, these individuals may not even be diagnosed with an alcohol addiction using the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the qualities of their addiction are argued to require further definition. (1)
This differs from alcoholics who often find themselves in difficulties in one or more of the mentioned factors.
In most cases, high-functioning alcoholics are middle-aged and mature adults, maintain a steady job, pay bills on time, and not getting in trouble with the police, unlike some individuals who are diagnosed just with alcoholism.
Despite appearances and ability to maintain and balance many areas of their lives, high-functioning alcoholics are alcoholics, nonetheless.
This means that they are still at risk of many of the physical effects that alcohol can have on the body, as well as the dangers to the individual’s mental health.
Mental health effects include memory loss and an increased chance of developing or worsening depression. This is due to the fact that alcohol is a depressant: where it may feel good during the time of consumption, this can quickly decrease when no longer consuming the substance or during a hangover.
In addition, individuals who consider themselves to be high-functioning alcoholics may attempt to carry out behaviours that they should not such as driving or operating machinery at work whilst inebriated.
This carries a risk not only for the individual themselves but also for those around them.
As mentioned in the introduction, alcoholism and addiction in general can present themselves differently across every individual that it afflicts.
Because of this, telling whether or not someone – either yourself or someone you know – is struggling with addiction can be challenging.
There are several signs and symptoms that individuals can look out for, and these should be monitored carefully before making any sudden diagnoses.
Common signs to look for:
To high-functioning alcoholics, alcohol is of extreme importance. These individuals will often speak about, think about, and include alcohol in most of what they do.
This can be a key sign of when an individual may need support.
If you feel as though you may be a high-functioning alcoholic, or if you know someone who is a high-functioning alcoholic, then it is important to get help as soon as possible.
Alcoholism worsens quickly over time if the proper support is not provided. This is true even for those who may seem to have a grip on their situation – both their drinking habits and how this affects their life around them.
The first step is never to be confrontational. Walking up to someone you know and accusing them of being a high-functioning alcoholic is unlikely to help. In fact, it may worsen the situation as the individual becomes more secretive of their behaviour in an attempt to hide from any future accusations.
In all conversations, it is important to be understanding and receptive, listening to the individual and not pressuring them into speaking about anything they may not want to.
Being honest about how the individual’s alcoholism has affected you, as well as how you may feel it is affecting them is also a great way to help the individual understand how they may be affecting others, not just themselves.
In most cases of individuals struggling with high-functioning alcoholism, they are often in denial about their behaviour.
This is often due to the factors previously mentioned – their alcoholic behaviours may not be impacting their lives to a serious degree (at least in their opinion or to their knowledge).
If the individual knows that their alcoholism is not affecting those around them e.g., still being able to pay for bills and attend social events, then they may not see their addiction as an issue and be unprepared to undergo rehabilitation.
In some cases, the individuals may be unsure about their future as they have gone so long as a high-functioning alcoholic that it may seem strange to not have alcohol as part of their everyday life.
In all cases, it is important that the individual considers the physical health effects that an alcohol addiction may be having on their body. The effects may not always be visible, but they can have life-threatening consequences if not treated accordingly and in time.
Withdrawal is part of the detoxification process. Before beginning any future treatments or therapies, individuals must remove the substance they are addicted to from their bodies, as well as any harmful chemicals or toxins that have built up as a result of this.
In the case of alcohol – a physically addictive substance – it is important that this process is carried out in a safe and supported environment.
In most cases, it is recommended to go to a specialised detox clinic within a centre or separately. This allows for medical intervention should it be necessary.
This is especially recommended for individuals who have a long history of addiction or for those with more severe withdrawal symptoms.
During an alcohol withdrawal, it may be suitable to administer Librium – a drug used to combat the harmful physical effects of the withdrawal and make the individual’s detox safer and have a higher chance of success.
Benzodiazepines may also be prescribed in these cases, though they carry their own risks and are only suitable for individuals who may struggle to gain the benefits of Librium due to issues with their liver and/or metabolism. (2)
After an alcohol detox, it is always recommended to follow up with further treatments such as therapy which focus on the long-term mental health effects that an alcohol addiction may have.
As the first technique for rehabilitation, it may be suitable for individuals to take part in an intervention. This is especially suitable for those who may be in denial or unwilling to come to terms with the future of their rehabilitation.
With the help of a licensed interventionist or counsellor, the individual and those around them will also build on inviting new changes into their lives together, building relationships and improving communication.
This is most effective through modern approaches to interventions such as the Community Reinforcement and Family Training (CRAFT) approach. (3)
Other common treatments include partaking in counselling – common therapies such as cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT).
These are highly effective as they can be tailored to each individual and help them to create and build their own coping mechanisms to continue using in their long-term recovery.
To learn more about high-functioning alcoholism, its effects on individuals, and what the next steps for your rehab journey are, please do not hesitate to get in touch.
Rehab 4 Alcoholism’s free and confidential addiction advice service can be accessed 24/7 through our addiction support line on 0800 111 4108.
Get in contact today to see how we can help you.
 Benton, S.A., 2009. Understanding the high-functioning alcoholic: professional views and personal insights. Greenwood Publishing Group.
 Su, M., 2005. Alcohol withdrawal. In Harwood Nuss’ clinical practice of emergency medicine (pp. 1466-1470). Lippincott, Williams, and Wilkins, Philadelphia.
 Meyers, R.J., Miller, W.R., Hill, D.E. and Tonigan, J.S., 1998. Community reinforcement and family training (CRAFT): Engaging unmotivated drug users in treatment. Journal of Substance Abuse, 10(3), pp.291-308.