The Signs and Symptoms of a Functional Alcoholic

A functional or functioning alcoholic appears to be maintaining a stable life and social relationships, while seriously misusing alcohol or being addicted to alcohol. Functioning alcoholics often do not exhibit the usual signs of alcoholism to indicate a alcoholuse disorder, but they might nonetheless meet the diagnosis criteria for alcohol abuse or drinking dependence.

Signs of Functional Alcoholism

The diagnosis of a drinking disorder (or any substance use disorder for that matter) should be made by a trained healthcare professional. However, there are some common signs and symptoms that an individual may fit the definition of a functioning alcoholic:

  • Amount consumed: For women, more than three drinks per day or more than seven drinks per week; and for men, four drinks per day or more than fourteen per week
  • Fluctuations in personality/mood: Unexplained changes in temperament or mood coinciding with access or lack of access to alcohol
  • Physical health problems
  • Changing appearance
  • Risk taking
  • Joking about harmful alcohol use
  • Secrecy
  • Drinking in the morning, throughout the day, and/or alone

While substance use-related functional impairments (difficulties at work or school, strained relationships, family disruption, health problems, financial issues, violence towards self and others, among others) are usually significant markers of alcoholism, not all individuals who meet criteria for alcohol abuse or dependence manifest these other lifestyle indicators of a problematic relationship with alcohol.

Functional Versus “Regular” Alcoholism

The ICD-10 (The World Health Organization’s classification of physical and mental health disorders) does not differentiate “functional” alcoholism from other types. Specific categories do include Acute Intoxication, Harmful Use, Dependence, and Withdrawal. The clinical diagnosis of alcoholism is made based on objective analysis of specimens and self-report of usage.

Drinking Alcohol Every Day

Drinking an alcoholic drink everyday after work may not make you an alcoholic but it can be a precursor to becoming an alcoholic. Functional alcoholics often start as ‘almost alcoholics’ by innocently drinking each day and gradually increasing the amount of alcohol consumed until consistency turns into dependency.

Drinking every night, having 6 beers every day after work for years and years… this type of relationship with alcohol is a clear sign of dependency. If you, a husband or wife, or a loved one drinks everyday or nearly everyday, special attention should be paid to treating this habit with professional support and expertise.

Functional Alcoholism Diagnosis and Treatment

People who believe they are experiencing functional alcoholism or know a functioning alcoholic should seek professional help. Our residential programme for alcohol addiction starts with a thorough assessment of the patient’s medical history, their substance use and in depth diagnosis.

This is followed by an individualised treatment plan devised by the multidisciplinary team of professionals involved in the patient’s care and tailored to the patient’s personal needs and diagnosis.

Patients will undergo a gradual, medically monitored detoxification. As soon as the patient is stabilised on their detox regime, they take part in the treatment community, attending all the therapy groups, activities and educational lectures of our inpatient programme.

How Can Family Members Help?

Relationships with functional alcoholics are fraught with difficulties. Is your husband, wife, partner, colleague or other close relative abusing alcohol while maintaining appearances to the outside world? Does this person have a relationship with you, or a relationship with alcohol?

Family members can help individuals struggling with alcoholism by compassionately supporting them in professional, clinical treatment programs. There are many education and support resources available for family members of alcoholics, including local mental health professionals and trusted medical professionals such as SFAD (Scottish Families Affected by Alcohol & Drugs) and Drinkaware, among others.