Not every person living with addiction or alcoholism is homeless, seeking social services, or struggling with legal problems.
In fact, a large segment of those who need treatment for drug and alcohol dependence are completely functional – even high-functioning – at the top of their careers, living in nice homes with a spouse and multiple children, and active in the community.
In some ways, the fact that they are so high-functioning can often contribute to their difficulty in accessing treatment. It’s not as apparent to them or the general public that they have a problem that requires help; thus, many don’t even consider it to be an option, much less a necessity. Only those who are closest to them may recognize the issue, know how serious the health effects are, or see the “near-misses” in terms of overdose and accident.
What Does High-Functioning Addiction Look Like?
To the outside viewer, functional addiction looks like a successful life. Those living with addiction who are functional may appear to “have it all.” Unfortunately, the cost of addiction – even if substance abuse originally helps them manage stress or accomplish more things at work – can ultimately take away all that they’ve worked for or cause health problems that can be fatal.
Though the person who is clearly struggling in every aspect of life due to drug and alcohol use is easy to identify, most people living with an alcohol use disorder are functioning at work and home, and it may not be so easy to recognize the problem. They are powerful executives in boardrooms, multitasking super moms, and practicing attorneys and physicians – often the last people one might suspect to be with struggling with drugs and alcohol.
However, no matter how good people are at hiding the problem, the following can indicate that they are struggling with addiction and in need of help:
- Denial: People with high-functioning addictions may not drink or use drugs every day. They may not struggle with financial problems or overt health issues. Because they do not experience some of the more obvious issues that typically plague those living with addiction, they may view their use of substances as normal and even safe. Even if they agree that perhaps they drink a little more than they should or sometimes overindulge, they may not see that it’s a problem. They certainly would not identify with those who live in addiction and need treatment, especially if they are surrounded by people who also drink heavily or use drugs.
- Changes due to substance abuse: Even if the person can usually hide the bulk of the effects of drug and alcohol use, chronic and heavy use catches up to everyone, one way or another. You may notice that your loved one has unexplained personality changes from time to time, misses out on important events or becomes “missing in action” at those events for long periods of time, or becomes moody or exhibits erratic behavior from time to time. You may also see the physical effects of chronic drinking or drug use: chronic fatigue, increase in cold and flu symptoms due to a lowered immune system, shakiness, paranoia, and other issues related to drug use that vary according to the drug of choice and the dose. Failing to manage commitments at work or home as well as taking part in risky behavior may also indicate a substance abuse problem in a high-functioning person.
- Excuses, excuses, and more excuses: People who are high-functioning but have addiction issues often have a range of excuses at the ready to account for slipups and erratic choices caused by drug and alcohol use. They may say that they had to drink heavily because they were entertaining clients or taking part in an office-wide celebration over a big contract. They may attribute stimulant abuse to the need to stay up late or increase their productivity, or they may simply deny that they overused any substance and dismiss concerns as unfounded.
- Signs of a double life: Though the objective viewer may believe people who are high-functioning yet living with addiction have it all, these individuals are usually struggling deeply with the secret they must keep from everyone. Unwilling to admit they are out of control, many struggle with the weight of the lies and sneaking around as much as the cravings, withdrawal symptoms, and other issues related to addictive use of drugs and alcohol. Many who are living with addiction and hiding it from everyone feel very alone and struggle with depression and/or anxiety as well, waiting for some major event that can signify they have “hit bottom” to make it clear that they need help – an event that may never come.
Addiction knows no bounds. It can strike anyone of any race, creed, gender, sexual identity or preference, of any economic status, of all ages, in every region around the world. Whether someone’s use of an addictive substance is known or a well-kept secret, it can have the same negative impact on the risk of disease and accidents that can be fatal. High-functioning addiction is still addiction, and like all medical diseases, requires intensive treatment and immediate intervention.