Living with a functioning alcoholic

‘Functioning alcoholics’ or ‘high-functioning alcoholics’ are often described as people who are able to maintain a career, have good relationships with family and friends and remain financially stable, at the same time as having a drinking problem. Functioning alcoholism is not a medically diagnosable condition but a colloquially used term.

If you're living with a functional alcoholic, or think you may be living with one, this page can help you to spot the signs that can suggest someone has a drinking problem. We have also looked at what you can say and do to help the person get the support they need.

How do you know if someone is a functioning alcoholic?

Some of the most common signs someone might be a functioning alcoholic include:

• They rationalise their alcohol consumption and use it as a reward. For example, they may say they’re treating themselves to a drink after completing a project at work
• They say they need alcohol to relax and/or enjoy themselves after a busy day or week
• They're unable to socialise without a drink or make excuses to avoid socialising when drinking isn’t an option
• They deny they have a drinking problem or become defensive if it's suggested
• They have mood changes, appearing angry, irritable or annoyed at times
• They can’t drink in moderation, but maintain the belief that they aren’t drinking to excess
• They undertake dangerous behaviours such as driving under the influence of alcohol

How to help a high functioning alcoholic

It’s common for functioning alcoholics to be in denial about their dependence on alcohol. They may try to rationalise their level of drinking by saying that if they’re able to hold down a job and a healthy social life, then they can’t possibly have a problem.

The term ‘currently functioning’ is often used in association with functioning alcoholism. It means that, while the person might be able to go about their daily life right now, it’s often only a matter of time before they see the negative consequences of addiction.

That’s why it’s important that you, as a loved one of the person struggling with addiction, is able to help and support them as best you can.

Opening up the conversation

Alcohol addiction can be a very sensitive issue, especially if it's being raised with the person for the first time. Consider the following steps to reduce the likelihood of them becoming defensive and increase the chance of them being receptive to your ideas.

• Don’t have the conversation when the person is drunk. Instead, talk to the person when they're sober. This way, they'll be more receptive to change
• Remain non-judgemental and be empathetic. Make them aware that you're genuinely concerned without placing any blame on them
• Suggest that you want to tackle the problem together and that you'll support them throughout their recovery
• Try not to talk down to the person or appear angry
• Try not to collude or enable them by lying to anyone on their behalf, or drinking with them

Use some screening questions

Someone struggling with alcoholism may find it hard to accept they have a problem if it’s just coming from your observations. An alternative route to breaking through could be with screening questions like the alcohol use disorders identification test (AUDIT). Recommended by the National Institute for Health and Care Excellence (NICE), this 10-question screening tool can help to establish a drinking problem, with a score of 20 or more possibly indicating a dependency.

It includes questions like:

• How often do you have a drink containing alcohol?
• How often during the last year have you found that you were not able to stop drinking once you had started?
• How often during the last year have you had a feeling of guilt or remorse after drinking?
• Has a relative or friend, doctor or other health worker been concerned about your drinking or suggested that you cut down?

Consider an intervention

If you're struggling to have this conversation, you may also want to think about an intervention. There are a number of different models you can use to convey your thoughts and feelings in an effective manner, so the person you care for can see their addiction clearly. One example is the Johnson Model. In this model, the addict is not forewarned of the intervention and a letter is written that lists examples of where the addiction has caused damage to them and the people around them.

Staging an intervention can come across as confrontational if it's not handled with care, but they're a powerful tool for helping people recognise they need help. Be sure to prepare thoroughly, leaning on support from friends and family.

How to live with a functioning alcoholic

Living with a functioning alcoholic can have a serious effect on your own health and wellbeing. You may be constantly concerned about the person, worn down by their behaviours or anxious about what they may do next.

The road to recovery from alcohol addiction can be challenging and you’ll need to be strong to support your loved through this journey. Here are some tips for making sure you look after yourself and put yourself in the best possible position to offer support:

• Create a support network – you can’t do all of this alone. Consider other members of your family and friends that could offer help and support. Even if it’s just for a brief chat about how you’re doing, you’ll need someone you can rely on
• Take a break – once you’ve got that support around you, lean on them and take the opportunity to enjoy a well-earned break. For example, you could ask someone to take your place and attend a support session like Alcoholics Anonymous (AA)
• Look after your health – you’re going to encounter some stressful and anxiety-inducing challenges. Looking after yourself physically and mentally can help to make sure you don’t burn out and can keep being as supportive as possible
• Be a role model – try your best to be a positive influence in their lives. This doesn’t have to be limited to drinking habits. It can include things like eating well and getting regular quality sleep – things that will help your loved one with their alcohol addiction

Support for functioning alcoholics

Once your loved one shows signs of acceptance when it comes to their addiction, it’s time to consider next steps. Here are ways you can find support for functioning alcoholics.

Support groups

For people living with a functioning alcoholic, Al-Anon Family Groups provide support for those affected by someone’s drinking. These types of groups create safe spaces for loved ones to discuss their problems with alcohol in a non-judgemental environment. It can be a great place to start if you’re finding opening up the discussion too difficult at home.

Treatment

People suffering with alcoholism don’t have to do so alone. Many evidence-based treatments can help people overcome alcohol addiction. The most common treatments include alcohol detoxes, rehab and therapy.

Encourage your loved one to open up a discussion with their GP. They can assess their symptoms, provide a diagnosis and outline what course of treatment might be best for them.