High Functioning Alcoholics: The Signs and Getting Treatment

What you need to know about high functioning alcoholics, the inpatient and outpatient treatment options, and other things to know!

Can you detect a high functioning alcoholic?

Knowing whether or not someone is an alcoholic can be hard sometimes as there functional alcoholics.

Part of the challenge of detecting whether a high functioning alcoholic or an alcoholic, in general, is because as a society we have this image in our head of what an alcoholic looks like.

We typically picture an alcoholic as someone who is constantly drunk, falling in the street because they are drunk, unkempt, he or she life is falling apart, they lost their job, et cetera.

The reality is that people who are known as high functioning alcoholics, they are common and they do not display the traditional signs of someone with alcohol problems.

You are probably one of them or know someone who is.

According to many experts, these types of alcohol addicts are common.

A study done by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) scientists, a part of the National Institutes of Health (NIH) found that 19.5% of America’s alcoholics are functional alcoholics.

The study also found that these types of alcoholics are typically well educated and have stable jobs et cetera.

 Non-functioning vs high functioning alcoholics – Definitions and the difference

When we hear of an alcoholic, the picture that comes to our mind is that of a person who is homeless and jobless due to alcohol abuse.

But the truth is that there are different levels in which alcohol affects people and how they react to it.

There are social or casual drinkers who have a cocktail or a glass of wine after a long and tense working day.

They have it just for relaxation and it doesn’t seem to do much harm to their jobs, emotional lives, or relationships.

Then, there are the heavy or binge drinkers who party until very late in the night, ingesting too much alcohol.

So what is a non-functional and functional alcoholic?

Non-functioning alcoholics are those who have failed miserably in life, are not able to hold a job for long, and fail in relationships.

They often get involved easily in fights or violence and are willing to do anything for the next drink which they just can’t do without.

Functioning alcoholics are those who look and behave normal and successful even though they are alcoholics.

They can lead a double life, having a good job and a career and are able to achieve goals, despite their heavy drinking problem.

The functioning alcoholic is able to appear sober and look normal most of the time without letting anybody know there is a problem.

But a non-functioning alcoholic loses everything in their life too, and may not even be aware of it and tends to blame others for all of their problems.

Some important things to know about alcoholism

Part of getting help for an alcohol problem is to understand the basics such as the definition, causes, signs, and types et cetera.


The condition where a person is unable to regulate or control the drinking habits due to emotional as well as physical dependence on alcohol is termed as alcoholism.

They do feel guilty about it and have a desire to cut down on the habit, but they are just unable to do so.

People who are having alcohol use disorders will continue the habit even when they know its negative consequences, like losing jobs, destroying loving relationships, losing physical and emotional health, legal issues, etc. They often promise to stop it but are just not able to do so.


Issues related to alcohol abuse are a major global problem as mentioned in a report released by the WHO (World Health Organization). More than around 3 million deaths, most of which are men, have been attributed to the detrimental use of alcohol in the year 2016.

As estimated globally by WHO, at least 237 million males and 46 million females suffer from this problem, mostly in the European and American regions. Surprisingly, high-income countries seem to have a higher prevalence of disorders due to alcohol abuse.

In the US, as per the CDC (Center for Diseases Control, six people are said to die each day due to alcohol abuse. 76% of these deaths are men who belong to the age group 35 to 64.

According to the NIAAA (National Institute on Alcohol Abuse and Alcoholism), almost 88,000 people are estimated to be dying annually from alcohol-related issues which is the third leading cause of preventable deaths in the U.S. Driving fatalities due to alcohol use accounts for almost 31% of all road deaths in the U.S.


The main symptoms of alcoholism are repeated as well as the compulsive consumption, even despite related health and legal issues. Some of the physical signs of intoxication and overconsumption of alcohol can be recognized by:

  • slurred speech
  • clumsiness and loss of balance
  • delayed reflex
  • stomach pain, nausea, and vomiting
  • blackouts

When the intoxication reaches a level where the respiratory system is affected and breathing stops, alcohol poisoning has become life-threatening.


Alcoholism could be contributed to several factors such as:

  • Biological – Genetic predisposition and physiology can make some people more vulnerable.
  • Environmental – Availability can be a trigger as well as suggestive advertisements.
  • Social –Children of alcoholics are more susceptible, as well as those who start off with social drinking.
  • Psychological – Those who suffer from anxiety, stress, depression, or certain mental health issues may have more chances to develop alcoholism.


The National Institute of Health (NIH) has conducted extensive research on the topic of alcoholics and has come up with five subtypes for a better understanding of the problem.

  • Young Adult Alcoholics 

Almost one-third of all the alcoholics fit into this subtype, which is 31.5% in the United States. They are mostly college students, away from home for the first time, and are surrounded by peers encouraging and promoting social drinking.

  • Young Antisocial Alcoholics

They are in their mid-twenties and have started drinking much earlier, mostly with a family history of the same issue and are struggling with an antisocial personality disorder. The excessive abuse of alcohol lowers anxiety and social inhibitions and makes them feel more relaxed and daring. Most of them also suffer from other disorders related to mental health such as bipolar disorder, depression, anxiety disorder, or other substance abuse.

  • Functional Alcoholics

They are typically middle-aged, well-settled, well-educated, and holding a steady job, and nothing seems wrong on the outside. They are often successful in employment, relationships, and life, so to speak.

They mostly deny that they have a problem with alcoholism and are not likely to seek professional support.

  • Intermediate Familial Alcoholics

They are typically middle-aged and most of them have a multi-generational family history of alcoholism. This group of alcoholics typically do not abuse one substance, increasing the potential risk factors and in the end, become severely addicted to one or both of the substances.

  • Chronic Severe Alcoholics

They account for almost 9% of all alcoholics in the U.S. They tend to become anti-social, violent and may suffer psychiatric disorders as well, having battled with alcoholism for years. Severe substance abuse and life problems are common among them.

The 4 signs of a high functioning alcoholic

The following are the signs by which a high-functioning alcoholic can be identified:

  • Consumed to cope with problems

The drinking habit gets out of control when you are drinking to reduce stress or anxiety or to lift your mood which becomes habitual over time. Being a depressant drug, alcohol cannot help in such situations but makes you more addicted to it.

  • Consistently drinks alone

Drinking casually and moderately in a social setting, with family and friends, is often considered a healthy drinking habit. But when it is done alone, and in secret, it is hard to limit the amount consumed.

  • Drinking too much and too often

NIAAA has defined that low-risk drinking for women is not more than 3 drinks in a day and 7 drinks in a week. For men, it cannot be more than 4 drinks in a day and 14 drinks per week. If your consumption of alcohol exceeds this, you are at risk.

  • Experiencing withdrawal symptoms

Functioning alcoholics start experiencing difficulties if they have to go too long without taking a drink. Withdrawal can be anything like depression, anxiety, irritability, nausea, or lack of energy which occurs around the same time of the day that you usually drink.

How to get high functioning alcoholics into rehab

Since high-functioning alcoholics often deny they have a problem and even attempts to hide problems, it is all the more important for family and friends to be vigilant.

They may also hesitate to ask for help due to fear of judgment.

They may need an intervention to be made aware of the risk that their livelihood and health are facing.

Early intervention is always the best way to make sure that alcoholism does not have long-lasting effects.

A complete blood test, a CT scan, and a liver functioning test may give scientific evidence to convince them that they need medical help.

A doctor can advise them on the results and how to lessen or even reverse the problems.

It is important that the person enrolls in a functional alcoholic rehab program before quitting alcohol. Those who are highly dependent on alcohol may suffer withdrawal symptoms which can be quite alarming and needs to be handled professionally.

If a functioning alcoholic stubbornly refuses high-functioning alcoholic treatment programs, the family and friends may become helpless, however, concerned they are. In such cases, it is always better to seek a professional intervention plan which involves an interventionist.

The interventionist is qualified to provide guidance before and after an intervention and also facilitates it. They can help the family identify symptoms of addiction and can also judge whether the addicted person needs to be admitted into a functional alcoholic rehabilitation center.

Some states have the option to petition with the local court so that a non-cooperating alcoholic is involuntarily committed to a rehabilitation program.

Inpatient and outpatient treatment facility options for a functional alcoholic

The type and severity of addiction determine the suitable treatment for a high- functioning alcoholic.

The inpatient treatment is recommended only for those who can be a danger to themselves or others or who struggle to stay sober.

Very severe addictions may require inpatient treatment during high- functioning alcoholic treatment programs. They need to stay at centers or hospitals with residential facilities. After the initial detox program, group and individual therapy sessions need to be attended along with medication.

  • Partial hospitalization

Partial hospitalization involves a lower-care level than inpatient treatment and can be an alternative or step down to it. You can live at home and continue with hospital visits during the week.

  • Intensive outpatient treatment

The intensive outpatient program involves a series of scheduled visits that are more in-depth and longer than the outpatient program. It is also suitable for those continuing with recovery therapy and is designed to balance family and work life.

Outpatient treatment for a functional alcoholic rehab is for those who have moved on from inpatient rehabilitation or those with milder problems, helping them to stay sober and prevent a relapse.

It includes services from medical care to counseling and training for life skills.

Outpatient programs are financially more advantageous than residential ones for some people since the patient can still continue to work and get wages even while undergoing treatment, whereas, in a residential program, you may be required to take a vacation from work which may not always be paid.

How a typical alcohol treatment center process works

A functional alcoholic rehab is essentially for those who have tried stopping the drinking habit on their own but have repeatedly failed.

  • Intake

The process for intake involves the initial contact and comprehensive formal evaluation at the functional alcoholic rehab center once the decision for treatment is made.

These procedures help to develop an individualized treatment plan based on a comprehensive appraisal of the medical, social, and emotional performance of the high-functioning alcoholic.

The detox stage of high-functioning alcohol treatment programs is when the body is cleared of alcohol and might cause serious repercussions for heavy or long-term drinkers.

This is because the body has to try and adjust to functioning without the daily dose of alcohol. Withdrawal symptoms can be severe and can cause seizures, delirium, or hallucinations. A typical detox program can be from a few days to a week.

  • Main Rehab

A wide range of psychological and medical treatments are used during the main session of functional alcoholic rehab. The group, as well as individual counseling sessions and daily therapy, is provided to help them cope without alcohol.

  • Aftercare

Leaving the inpatient treatment program may be a difficult and intense experience for a recovering addict. Therefore, step-down programs are planned to make the transition easier.

Intensive outpatient, as well as outpatient programs, are advised by the functional alcoholic rehab center as per individual needs. 12 step programs are also a huge part of an aftercare program.

Popular traditional and holistic treatment approaches during functional alcoholics rehab therapy

Some traditional treatment approaches used in high-functioning alcoholic treatments are discussed below:

  • Cognitive-behavioral therapy

This therapy is widely used in the treatment of addiction and helps those who are recovering to identify their negative thinking patterns. They are then taught new and positive behaviors to overcome their earlier abuse patterns.

  • Family therapy

Treatment programs for functional alcoholic rehab can have better results if the family and close associates are also involved in learning about the problem and their role in the recovery path.

  • Relapse prevention therapy

This therapy aims to prevent occurrences of relapse by helping the recovering addict to anticipate circumstances that might trigger a relapse. They are then taught to develop strategies to deal with such situations in advance.

  • 12-step facilitation therapy

Also known as TSF, it is an intervention program designed for recovering addicts to receive ongoing support from self-help groups. It is to be implemented in 12 steps and is a very effective tool for providing aftercare to those who are recovering.

  • Motivational enhancement therapy

These therapists guide the patients in helping to change their behavior and thoughts in relation to alcohol. It also helps in treating mental disorders that might occur.

Holistic or complementary approaches are also currently being used in many functional alcoholic rehab centers in the US.

The holistic approach focuses on the body and mind for complete healing and attends to both their physical and psychological needs.

This treatment includes meditation, acupuncture, massage, yoga, and experiential therapies which generally helps them in rehabilitation as well as in their daily life.

A combination of both traditional and holistic approaches works best for some people dealing with alcohol issues.

Typical alcoholism treatment lengths

Unless you are enrolled in rehabilitation by court order, you can decide how long you need to stay at the facility and that determines the cost involved.

For some at least, a short detox program followed by a few days of intensive medical care might turn out to be enough.

However, it is highly recommended that people spend 90 days or more in rehab as research has shown that longer-term rehab has a better positive outcome for most people.

All in all, there are options for 28,30, 60, 90, 120, 180, and 360 days.

The cost of getting professional help

The cost involved in entering a high-functioning alcoholic treatment program varies from center to center, with some being relatively inexpensive and others costing thousands of dollars per day.

Outpatient treatment programs can cost $250-$350 a day. Some charge $10,000 a month as well, but again, it depends on how often and for how long the visits to the center are.

Some centers for inpatient rehab charge $500-$650 per day and maybe around $6000 for a month-long program. There are also centers that charge more than $20,000 for a month.

In high-functioning alcoholic treatments, the major factors which affect cost are:

  • Type of treatment facility

Residential or inpatient programs naturally cost more and medical care is also available all the time. Outpatient programs just need you to be at the facility for one or two hours for few times a week which typically makes the costs less.

  • Medication involved

The medication needed also increases the price tag since some medication for addiction treatment is really expensive.

  • Length of the treatment program

The length of treatment will also determine the cost. For example, an inpatient 28-day treatment for alcoholism will be less expensive than a 60 day one.

  • Amenities offered

The price involved increases when the facility offers more and more amenities. Luxury rehab clinics are also available for celebrities with resort-style facilities.

How to pay for treatment

Alcoholic rehab is not going to be inexpensive, however, many clinics offer finance and payment plans.

In fact, paying is beneficial in one way since the patient is much more likely to utilize every second of the time spent in the facility.

Paying via health insurance is also another common option. The amount covered by insurance depends on the stipulations of the health plan taken and the health provider. So, make sure to contact your insurance provider and get details on the services that you are entitled to.

Some of the insurance types which cover addiction can be:

  • Medicare
  • Medicaid
  • health insurance financed by the state
  • health insurance financed by the military
  • private health insurance

Many state social service departments, as well as local health departments, offer free or low-cost rehab programs, but they may have a waiting list and may not be located in convenient areas.

Non-profit organizations, faith-based groups, or charity services also offer free rehab programs for alcohol and drug abuse.

Alcoholics Anonymous is also a support group that is completely free and has led millions of addicts all over the world on a path to recovery.

The Salvation Army also provides free rehabilitation services to those in need. The challenge with the free and government rehabs is the waiting list that could take months or even years to get into.

This is why private rehabs make sense as there will not a waiting list.

Speak with a professional for a free consultation

As you can see being high functioning alcohol doesn’t mean that one doesn’t face the same dangers, risks, or need professional treatment help as a non-functioning alcohol addict.

Knowing this, you should contact an alcohol treatment center immediately to get professional help for your self or a loved one.

If you are looking for more information on which rehab facilities to talk to, please call the number on the website to be connected with an addiction recovery provider admission counselor for a free consultation.

There is no cost for you to call the number on the site or obligation to check into the treatment center you will be talking to.

Get the help you or a loved one need as a functioning alcoholic. 866-579-8780


Updated on December 4th, 2019