What does high functioning alcoholic mean

Characteristics of high functioning alcoholics

Alcoholics have poor attendance at work. Alcoholics drink every day. Alcoholics are mostly old men. Alcoholics are usually homeless. Alcoholics cannot do well in their careers. Alcoholics always drink in the morning.

These are just some of the stereotypes about alcoholics that are common across society. These stereotypes increase rejection and prevent many alcoholics from receiving proper diagnosis and treatment. Highly functioning alcoholics (HFAs) defy these stereotypes and often go undetected because they do not fit the image of a "typical" alcoholic.

The term "high functioning alcoholic" seems to understand or identify with most people, but ironically it has yet to be formally defined or explored. A pioneering study in 2007 by the National Institute on Alcohol Abuse and Alcoholism categorized alcoholics in 5 subtypes: 20 percent are the "functional" subtype, 32 percent are the "young adult" subtype, 21 percent are the "young anti-social" subtype, 19 Percent are middle family (middle aged with mental illness) subtype, and only 9 percent are chronically heavy subtype, which corresponds to the low-bottomed alcoholic stereotype. Other addiction experts estimate that between 75 and 90 percent of alcoholics are highly functional.

An HFA is an alcoholic who is able to sustain their external life such as work, home, family, and friendships while drinking alcoholically. HFAs share the same disease as the stereotypical "skid-row" alcoholic, but they manifest or develop differently.

Many are not considered alcoholic by society because they have functioned, been successful, and / or have been overachieved throughout their lives. These successes often lead to an increase in personal rejection as well as rejection from colleagues and relatives.

HFAs feel less of needing treatment or help for their alcoholism, and often slide both medically and psychologically through the cracks of the healthcare system from undiagnosed. Unfortunately, according to the National Epidemiological Survey on Alcohol and Related Disorders, only 25 percent of alcoholics are ever treated - indicating a serious problem of denial at the societal level.

HFAs can have different characteristics at different times or phases of their drinking, which can be broken down into different categories. They include, but are not limited to:


  • Have trouble seeing yourself as an alcoholic because you don't fit the stereotypical image
  • Believe they are not alcoholics because they are successful
  • Use alcohol as a reward and / or justify drinking for stress relief

Professional and personal life

  • Can maintain constant employment and / or education
  • Well respected for professional / academic accomplishments and accomplishments

Interpersonal relationships

Drinking habits

  • An alcoholic drink creates cravings
  • Obsessed with the next drink
  • Display personality changes and / or moral compromises when drunk
  • Repeat unwanted drinking patterns and behaviors

"Double life"

  • Appear on the outside to manage life well
  • Experienced in a divided life (separation of work and drinking life)
  • The appearance contradicts the alcoholic stereotype

Meet below

  • Experience few noticeable losses and consequences from drinking, often through sheer luck
  • Experience recurring thoughts that you didn't hit the ground because you didn't "lose it all"

My understanding of HFAs is also from a personal point of view - I've been recovering from alcoholism for almost five years. I also struggled to see that I could succeed academically and then professionally while drinking alcoholic. My image of the alcoholic has always been a person who couldn't hold his life together, and I certainly didn't fit that description. My rejection was ingrained and reinforced not just by loved ones but by society at large.

Alcoholism is a chronic, progressive, and lifelong disease that needs treatment whether the alcoholic is a lawyer or a homeless person. The alcoholic's face needs to be changed and the walls of denial torn down so that alcoholics everywhere can get the right diagnosis and treatment.

For more information on this topic, see my book, Understanding the Highly Working Alcoholic: Professional Views and Personal Insights.