5 Signs of a Functioning Alcoholic

Dr. Saurabh Bhardwaj

Dr. Bhardwaj, Medical Director is a Board-Certified Addiction Psychiatrist (ABPN) and currently the Medical Director of Defining Wellness Center in Brandon MS. He is also an Associate Professor of Psychiatry and Medical Director of Center for Innovation & Discovery in Addictions (CIDA) at the University of Mississippi Medical Center. He has been in Mississippi since 2018, building Addiction services for the state's only medical center and joined Defining Wellness Center in 2022 to provide specialized dual diagnostic services. He is a recipient of Ruth Fox scholarship from AAAP and trailblazer teaching award from UMMC. He is also a Fellow of the American Society of Addiction Medicine.

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The societal view of someone suffering from alcoholism is that of the person who has lost everything due to his/her drinking – job, family, home, car, and self-respect. Many stigmas assume the alcoholic is the poor, unfortunate individual begging for change at the local intersection. Though this may sometimes occur as a result of addiction and life circumstances, not all alcoholics venture down the same path. The disease of alcoholism is complex in nature and affects every individual differently.

There are some individuals who are considered to be “functioning alcoholics” or “working alcoholics.” These individuals are generally able to manage and conceal their disease in a way that keeps legal, personal, and professional consequences at bay – at least temporarily.


A functioning alcoholic can usually stave off major consequences for a period of time. Generally, working alcoholics seem to live productive, normal lives. They tend to live in a constant state of denial and don’t believe their alcohol consumption is a problem. The lack of negative consequences can propel this vicious cycle as the functioning alcoholic feels their excessive drinking is completely normal.


Typically, functioning alcoholics like to drink at home alone to avoid scrutiny and judgment. Heavy drinkers are more likely to drink in solitary (Cahalan et al., 1969), escape drinkers drink to forget problems and disappointments (Cutter and O’Farrell, 1984). Furthermore, drinking in isolation relieves the pressure and challenges that arise from trying to moderate one’s drinking. Isolating from peers and loved ones gives the functioning alcoholic the freedom to spend their time drinking without worrying that someone will notice that they have a problem.

Binge Drinking

Functioning alcoholics may not drink during the week but often binge drink on the weekends. Binge drinking is considered 4 drinks a day for men and 3 for women. Functioning alcoholics may be able to go the entire week without alcohol but drink excessively on the weekends. Oftentimes, these individuals will obsess over the approaching weekend when they will be able to drink again.

Self-Medicating with Alcohol

Using alcohol to self-medicate the symptoms of stress, depression, and anxiety can be indicative of a problem – especially as it becomes habitual. Functioning alcoholics may only drink excessively when they are feeling stressed or anxious but eventually, this becomes a way of self-medicating.

High Tolerance/Withdrawal Symptoms

When an individual has a high tolerance for alcohol, this may signify that he/she is more than a moderate drinker. Building a tolerance of any substance represents a functional change in the brain. These changes indicate that dependence or addiction is present. Over time, as the individual builds up a tolerance they may also begin experiencing withdrawal symptoms. Withdrawal symptoms of alcohol are often extremely uncomfortable and potentially fatal.

More Signs of a Functioning Alcoholic

Here are the most common signs of a functioning alcoholic:

  • They make a lot of excuses or explanations about why they drink excessively.
  • Common blackout episodes
  • You notice they drink more than they consume food.
  • Obsessive thoughts consumed with when they will have their next drink and if their planned outing includes alcohol.
  • They have a hard time and are seemingly unable to moderate their drinking.
  • Major changes in behavior while under the influence of alcohol
  • Lying about the amount of alcohol they are consuming
  • Finding hidden bottles of alcohol in various places
  • Insomnia
  • Erratic mood swings
  • Decline in cognitive functioning
  • Anxiousness without alcohol
  • Decline in work/school performance
  • Isolation
  • Disinterest in hobbies/social functions
  • Drinking at events where drinking is not appropriate
  • Calling in sick or avoiding responsibilities

If you or your loved one may be a functioning alcoholic, you may be wondering how to offer help. It is most important that you remain vigilant. Most functioning alcoholics are in denial because it seems their life is operating normally.

Education is vital in explaining that their drinking is damaging their physical and mental health. Addressing the individual’s livelihood may influence him/her to change their behavior. An informal intervention, staged by an addiction professional, may help the individual to see his/her alcoholism and how it is affecting their loved ones.

Treatment of Alcoholism

According to the National Survey on Drug Use and Health (SAMHSA), in 2017 nearly 140.6 million Americans were current alcohol users.[1] Most functioning alcoholics suffer from an underlying mental health disorder such as depression, anxiety, and even untreated PTSD. These co-occurring disorders may drive addictive behaviors. Untreated mental health conditions and alcohol use generally create a vicious cycle exasperating both conditions.

This specific type of alcoholism, while disclosed, is often followed with serious consequences on the individual’s physical and mental health. Chronic alcohol misuse is linked to high blood pressure, heart disease, liver problems, and failure, as well as a number of different types of cancers. A functioning alcoholic, like others battling alcoholism, is at risk for a substantially shorter life span.

Most importantly, you do not want to encourage the individual to quit drinking cold turkey because this can lead to potentially life-threatening withdrawal symptoms for someone who has been drinking excessively. It’s always best to seek professional help when a loved one is dealing with any of the above 5 functioning alcoholic signs outlined in this article.

Fortunately, there are specific inpatient treatment programs for alcohol addiction. Therapies such as group therapy, and modalities like cognitive behavioral therapy (CBT) can help mitigate the underlying issues that lead to self-destructive behavior.


  1. Substance Abuse and Mental Health Services Administration NSDUH Annual Report: Alcohol Use

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