High-functioning alcoholic

A High-functioning alcoholic (HFA) is a form of alcoholism where the alcoholic is able to maintain their outside life such as jobs, academics, relationships etc. all while drinking alcoholically.^[1] Many HFAs are not viewed by society as alcoholics because they do not fit the common alcoholic stereotype. Unlike the stereotypical alcoholic, HFA's have either succeeded or over-achieved through their lifetimes. This can lead to denial of alcoholism through both the HFA, co-workers, family members and friends. Functional alcoholics account for 19.5 percent of total U.S. alcoholics, with 50 percent being smokers and one-third having a multigenerational family history of alcoholism.^[2]

Signs and symptoms

1. Drinking Patterns

When they have one drink, they experience a craving to have more and cannot predict what their alcohol intake will be.
They obsess about the next time they will be able to drink alcohol.
They behave in ways that are not characteristic of themselves while drunk and continue to repeat these behaviors and patterns.
Surround themselves socially with heavy drinkers.
Getting drunk before actually arriving at social engagements.
Setting drinking limits (i.e., only having 3 drinks, only drinking 3 days per week) and not being able to adhere to them
Driving drunk and not getting arrested or involved in an accident
Always having to finish an alcoholic beverage or even another person's unfinished beverage.
Using alcohol as a reward
Having memory lapse due to excessive drinking (blackouts)
Taking breaks from drinking and then increasing alcohol consumption when they resume drinking after a period of time
Engaging in risky sexual behavior when intoxicated
Not being able to imagine their life without alcohol in it

2. Denial

Have difficulty viewing themselves as alcoholics because they don't fit the stereotypical image and because they feel their lives are manageable
Avoid recovery help

3. Professional and Personal Life:

Well respected for job/academic performance and accomplishments
Can maintain a social life and intimate relationships
Surround themselves with people who drink heavily

4. "Double Life":

Appear to the outside world to be managing life well
Skilled at living a compartmentalized life (i.e., separating professional, personal, and drinking lives)

5. Hitting Bottom:

Experience few tangible losses and consequences from their drinking.
May hit a bottom and not recognize it clearly

References

^ Benton, Sarah Allen (2009). Understanding the high-functioning alcoholic: professional views and personal insights. Greenwood Publishing Group. ISBN 9780313352805.
^ Howard B. Moss, M.D.; Chiung M. Chen, M.A., Hsia-Ye Yi, Ph.D. "Researchers Identify Alcoholic Subtypes". National Institutes of Health-National Institute of Alcohol Abuse and Alcoholism. Archived from the original on June 28, 2077. http://www.nih.gov/news/pr/jun2007/niaaa-28.htm. Retrieved October, 2 2011.