Millions of Americans can drink socially without encountering too many negative consequences, other than the occasional hangover and acting like a fool on the rare occasions they imbibe too much. Some, however, consider drinking so much a part of their life that they automatically think of ordering a drink when in a social situation or unwinding after a day at work or school. While they haven’t crossed the line into full-scale alcohol addiction, they may be well on their way. They may, in fact, be high-functioning alcoholics.
According to a study from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH), there are five subtypes of alcoholism, one of which is the functional subtype1, comprising 19.5 percent of alcoholics in the United States. These are typically middle-aged individuals who are well-educated, have stable jobs and families. Within this subtype, nearly one-third have a family history of alcoholism that spans several generations, and some 25 percent had a major depressive illness at some point. About 50 percent were smokers.
Despite the frequency and enjoyment high-functioning alcoholics get from drinking, however, there inevitably comes a time when all the troubles they’ve been able to avoid is at an end. Problems mount and consequences escalate in number, magnitude and effect. When and if a high-functioning alcoholic seeks to overcome this dependency on alcohol, it’s going to take determination, commitment and a willingness to get treatment.
How to Recognize the High-Functioning Alcoholic
Classic signs of alcoholism2 may be missing or disguised in the high-functioning alcoholic. They don’t look or act falling-down drunk. They’re able to hold down their jobs, perform family duties, get along with others and behave, for the most part, normally.
What’s hidden from others in public, however, comes out in private as the high-functioning alcoholic feels compelled to down several drinks in succession, drinks to take the edge off, has a drink first thing in the morning, and other signs of developing alcoholism.
When out with others, the high-functioning alcoholic can disguise his or her drinking by sneaking drinks, having three drinks to a single drink that others in their presence consume, often signaling the bartender to quickly refill a drink when a friend or companion excuses him or herself to go to the rest room.
Admitting the Problem Is the First Step
Self-denial on the part of the high-functioning alcoholic may go on for years before the increasingly negative consequences and their association with excessive drinking finally sink in and the individual finally admits to a problem with alcohol. This is a critical first step to overcoming high-functioning alcoholism.
Asking for Help Is the Second Step
After admitting to self and others that a problem exists with excessive drinking, the self-functioning alcoholic must ask for help. It’s not possible to overcome drinking on their own at this point as they’ve long passed the time when they could successfully quit drinking. Screening and brief3 intervention may be necessary if the high-functioning alcoholic admits (or not) to the problem yet refuses to get help in the form of treatment.
When asking for help, it’s important for loved ones and family members, as well as friends, to be supportive and encouraging. This is a tough time for the high-functioning alcoholic, a period when he or she is somewhat ambivalent about quitting drinking. After all, it’s been so much a part of their life for so long that the thought of being unable to drink fills them with fear. There’s also a huge void to fill once they no longer spend so much of their day drinking, thinking about drinking, overcoming the effects of drinking and starting the process all over.
Detox Is the Third Step
Getting all the alcohol out of their system is the third step in overcoming high-functioning alcoholism. This involves a process called detoxification, or detox4, a medically-monitored procedure for the removal of alcohol and/or drugs from the system. Under 24-hour supervision by medical professionals, the high-functioning alcoholic may receive prescription medication to ease withdrawal symptoms and make the alcohol detox more comfortable.
Choosing the Right Treatment Program Is the Fourth Step
Choices for treatment to overcome being a high-functioning alcoholic include alcohol treatment centers that are either inpatient or residential rehab centers or outpatient treatment facilities5. Making the decision to go into treatment must be followed by selecting the treatment center that’s most appropriate to help the high-functioning alcoholic reach their goal of ongoing sobriety.
Sticking with Treatment is Critical
Merely entering treatment isn’t all there is to overcoming high-functioning alcoholism. It’s important to stick with treatment6 to maximize the likelihood of success, defined as being well-equipped and confident of being able to live alcohol-free. Quitting treatment early is associated with a high rate of relapse. That’s because the individual lacks sufficient coping skills to be able to withstand the alcohol cravings and urges that are bound to occur. In addition, it’s too easy to return to former people, places and things associated with drinking without the benefit of a solid foundation in recovery.
Commit to 12-Step or Self-Help Groups
Following completion of treatment, for the high-functioning alcoholic in recovery to maintain sobriety, participation in 12-step or self-help groups is necessary. Alcoholics Anonymous (A.A.)7 is the oldest and most widely-recognized 12-step group and has millions of members worldwide. There’s strength in the 12-step community where each member is committed to helping fellow members achieve and maintain their sobriety as well as their own. Getting a sponsor and beginning work on the steps is an integral part of effective recovery.
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