The High Functioning Alcoholic


The understanding of a high-functioning alcoholic is the picture of my personal recovery journey. I began working within the field with little knowledge of the disease itself. Working a full-time job, being a full-time student, maintaining a family, and volunteering with local nonprofit organizations created a life that never stopped. I did not have a drinking problem. I only drank on special occasions or certain outings. This may seem relatable to many of those reading. A normal life, until it wasn’t. In a three-year span my life had changed. Important areas became unmanageable. Multiple overnight stays in the emergency room. My denial continued. I still was working a full-time job, finishing up my graduate work, and volunteering. How could someone accept that they have a problem when they can “handle” it? My life was not like those who I served. Yet, I was the picture of what we call an alcoholic. It was not until the moment that my life almost ended that I faced this harsh reality. I have a drinking problem and have been at risk of this my entire life.

How can a high-functioning alcoholic (HFA) be defined? This can only be understood through perception. Perception is the image or belief of an individual based on thorough personal understanding (Deuter, 2015). The idea of an “alcoholic” is one that is surrounded by stigma. This individual is one who steals, lies, and has no cares of others and their own well-being. Therefore, I prefer to identify as an individual with an Alcohol Use Disorder (AUD) rather than the term “alcoholic.” This is with an understanding that this term is one of endearment to many who have found long-term recovery through the fellowship of Alcoholics Anonymous. Remember, we are seeing the world through a perception that has been distorted and the identity that follows. 

The danger for HFAs is the perception that the problem has not yet become severe enough to promote change due to the societal stigmas that surround alcoholism. The stages of developing AUD are simple yet complex in being recognizable. This is best described in three stages.

Early - Fun

Middle - Fun with consequences

Late - All consequences 

The middle stage of addiction is where we find HFAs. My denial overpowered the recognition of my consequences. This misconception of alcoholism promotes a fatal untreated condition that countless individuals suffer while maintaining excellent careers, success with education, and maintaining relationships. While many HFAs are able hide their drinking from family and employers, the primary danger is within the inability to recognize it ourselves.

The Danger for HFAs

Addiction is a chronic medical illness that is treatable. It involves complex interactions within brain circuits, genetics, environmental factors, and life experiences (SAMSAH 2018). 

The ability for HFAs to conceal an addiction or maintain societal norms does not change the fact that we struggle with a substance use disorder. Someone struggling with alcoholism can only live a normal life until the disorder starts to affect their behavior and health. The individual will be at risk of social, legal, and health consequences as the disease continues to progress. Risky behavior becomes more common as an individual may drive under the influence or suffer chronic damage to the brain, heart, and liver. The individual becomes more likely to slip through the cracks during assessment due to rampant societal denial. 

An HFA may frequently not be viewed as an alcoholic by loved ones and society. This possibly places the HFA in a more dangerous situation than those traditionally viewed of an individual with an AUD. Many of these individuals experience functioning co-occurring mental health conditions while struggling with addiction. Many believe that that most individuals with an AUD are high functioning. Studies estimate that this number lands between seventy-five and ninety percent for those who are high functioning, while those at the bottom with severe AUD is at nine percent (Walker, 2022).


Three major areas that one can use to find risk for addiction are biological, psychological, and environmental factors. Does your family have a history? Is there a history of mental health struggles or trauma? Does the environment influence risky usage? These are factors that many do not recognize when taking a normal drink, yet can indicate the chances of future alcohol dependence. I did not know these risks, yet I was a high risk in all three areas. With early intervention, individuals can take preventive measures to minimize risk. HFAs are likely to show the following. 

  • Avoiding any critical input or feedback about your drinking patterns.
  • Blacking out from alcohol consumption.
  • Concealing how much alcohol is consumed, such as drinking before or after an event, sneaking alcohol when at an event where alcohol isn’t served, drinking by yourself, or hiding alcohol around the house.
  • Continuing to drink even if it has caused or worsened physical or mental health problems.
  • Denial of a drinking problem because of a lack of severe consequences, such as missing days or showing up late for school or work.
  • Not fitting a predetermined image of an alcoholic, such as being able to maintain a well-groomed appearance.
  • Drinking a large amount of alcohol and not appearing intoxicated.
  • Drinking at lunchtime during work.
  • Drinking in situations that can be dangerous, such as before driving.
  • Drinking as a reward for doing a good job, or to cope with stressful situations.
  • Drinking excessively when not abstaining but not indulging regularly, or you rationalize it because you can go for long periods without drinking at all.
  • Experiencing cravings (i.e., a strong urge or need to drink) in specific situations.
  • Feeling guilty or ashamed about being intoxicated or about the behaviors displayed while under the influence of alcohol.
  • Making recurring commitments to moderation or abstinence..
  • Handling responsibilities well at home, school, and work despite drinking.
  • Justifying drinking as not problematic if the alcohol is top-shelf or is consumed at upscale events.
  • Lying to yourself and/or others about how much you are drinking and how strong your drinks are.
  • Making comparisons to people who have experienced worse problems with drinking, or severe consequences to show that your drinking isn’t that bad.
  • Not seeing excessive drinking, which may cause psychological distress, as a significant problem in performing tasks of daily life.
  • Obsessing over when you can attain your next drink.
  • Trying to control how much you drink.
  • Remaining well-known for doing an exceptional job at work or in school despite excessive alcohol use, which may or may not cause problems in other areas or psychologically (SAMSAH, 2008).

Opinion on Treatment 

Working with HFAs can be different from working with other individuals struggling with a severe AUD. Initial treatment can be a difficult decision due to the factors that have been stated. Many of these individuals find the decision to enter treatment difficult due to current life factors, which include family, career, and financial responsibilities. Many individuals who fit the stereotypes of an alcoholic have already hit what we call a rock bottom, meaning they have lost a great deal in their lives which creates a sense of desperation. HFAs have often experienced success in many areas of their life. This creates resistance against the idea that the way they are facing a possible drinking problem isn’t working. This is where, as a professional, we must show the different layers of the individual until they are open to change. Even though HFAs experience consequences for their lifestyle, these have not overcome denial. The biological effects on the brain and memory have already been affected by drinking. Though the physical sensation of dependence may look different, these things have already occurred. HFAs likely believe that they can control their drinking and need a safe place to find honesty within themselves. Creating connection and rapport is vital to establishing a cooperative effort to reach this goal. Professionals can use techniques like motivational interviewing to assist in breaking the denial that the clients are experiencing, while trying to focus on internal consequences. Although the 12-step programs are not found to be a theory or model of treatment, there is great success in the support that the groups create. This is a system of individuals who have faced the same addiction, many of which were themselves HFAs.


“Remember that we deal with alcohol—cunning, baffling, powerful! Without help it is too much for us” (Alcoholics Anonymous, 2019). There is help for those who struggle with alcohol use. There is hope to overcome denial. There are three paths to recovery, which mostly intertwine in one’s journey: clinical, peer support or self-help (fellowship), and a spiritual awakening to the person’s identity. All three accomplish the same goal; changing the thoughts and perception that the individual has of themselves. For some, one path can lead to long-term recovery. For others, it may take all three. For some, life will be riddled with denial and relapse, while others find long-term success quickly. There is not one direct path to recovery. In my life it took a combination of all three aspects for me to finally understand that I was the perfect example of an HFA. If you or a loved one are struggling to understand if you are an HFA, then you just answered your own question. Do not wait until the walls begin to crumble around you. Find help now. Find someone to confide and build trust in. It is only a matter of time before you find yourself as a “normal” drinker, until you are not. 


  1. Christenson, J. (2009). Hidden in plain sight. Counseling Today.
  2. Deuter, M. (2015). Oxford advanced learner's dictionary.
  3. SAMHSA. (n.d.). Risk and Protective Factors. SAMHSA - Substance Abuse and Mental Health Services Administration.
  4. W., B. (2019). Alcoholics Anonymous: The big book. Courier Dover Publications. 
  5. Walker, L. K. (2022). What is a Functioning Alcoholic? Signs of High-Functioning Alcoholism. American Addiction. ​

Contact Information

Jostin Holmes, MA,