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A functioning alcoholic is someone with a dependence on alcohol who manages to maintain a high level of function. This is not an official medical term and is in use by laypeople to describe alcoholics who do not fit the stereotypes associated with alcoholism. Functional alcoholics, as they are also called, are dependent on alcohol but mask it with their professional and personal successes. Often, it is not until a crisis situation occurs that the alcoholic is diagnosed and receives treatment.
When someone is a functioning alcoholic, the person consumes a high volume of alcohol on a regular basis and can experience medical problems associated with alcohol dependence like liver damage, general malaise, and malnutrition. Obsessive thoughts about alcohol are common, and the alcoholic may count down the time until the next drink, refuse to attend events where drink is not served, and experience blackouts.
However, the functioning alcoholic may also hold down a job, often a high powered and stressful one. Functioning alcoholics can be active with their families, contribute to their communities, and appear, on the surface, to be healthy, well-balanced individuals. Their alcohol consumption may be noted, but not addressed, because people believe it is not an issue, since the person's life does not seem to be in a state of disruption as a result of alcohol dependence.
With no one to comment about alcohol consumption, a functioning alcoholic can remain in a state of denial and will generally not seek treatment for alcohol dependence or abuse, as the person doesn't think there is a problem. An event like a drunk driving citation, a mistake at work while drunk, or a similar crisis precipitates a reevaluation of the person's life and may reveal the alcohol problem. The crisis can lead to treatment, but not in all cases; excuses are often made for functioning alcoholics and the event may be attributed to a one-time lapse in judgment.
It is not uncommon for functioning alcoholics to be very bright, driven, and motivated individuals. They may be reluctant to seek treatment because they don't want to show weakness or they are afraid of the career consequences of going to a treatment facility. The people around them may not believe that they have an alcohol problem, and this can contribute to the denial associated with functioning alcoholism.
Doctors can screen for signs that someone is a functioning alcoholic by asking how much alcohol the person consumes, whether the person has obsessive thoughts about drinking, and checking for physical signs. However, this screening must be conducted with care, as the patient may lie or obscure details to maintain denial about the alcoholism.
I came from an alcoholic family myself, and I'd say my mother was a functional alcoholic and my dad was not. My mom could still keep the house clean and cook meals and pay our bills, but my dad could barely walk from the bedroom to the kitchen sometimes. She understood she had a drinking problem, and she would make a point of sobering up before going out in public.
I don't know how many of her friends really knew how much she drank at home. She could act very normal at a point when others would have been slurring their words or stumbling. The thing about functional alcoholism is that other people may have a hard time believing there's a real problem. I tried to stage an alcoholic intervention with her friends when I got older, but they thought I was overreacting and wouldn't participate. She finally died from liver disease caused by her alcoholism.
My dad was a functioning alcoholic, although we didn't realize it at the time. We knew he had a drinking problem, because there was always cases of beer or bottles of whiskey in the house. He would get very drunk on the weekends, but I rarely saw him miss a day of work during the week. He'd be miserable on Monday mornings, but I thought that was normal for everybody. I didn't want to get up on Monday morning, either.
I thought he had things under control until his boss called the house and asked to speak to my mother. She started crying after a few minutes and hung up the phone. I found out later that my dad's
boss discovered some empty bottles in my dad's desk at work and the company had a very strict policy on alcohol in the office. Dad got a written reprimand and an unpaid week off, and that's when we realized how bad it was.
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