Alex has been married to his wife, Nora, for five years. They’re happy as can be, proud parents of two girls: Heather, who’s three years old, and Hailie who is still in her first month of life. Nora is a stay-at-home mom and has been since Heather was born. Alex works at a local factory and makes pretty good money.
They live in a large flat near a beautiful river. It has central air and a backyard, two rare luxuries for the small city they live in. Everyone is well-fed, sleeps well, and has fun. As with any family, there are the occasional tiffs, but overall Alex’s is the American dream family. He’s got two great daughters, a loving wife, and a nice place to boot. He even got four raises in the past eight months at the factory.
Everyone who knows Alex loves him. They consider him jovial, caring, genuine, and good-spirited. He went to a prestigious high school, served in the military, and became a family man with a great job and a great place to call home.
Alex drinks fifteen fluid ounces of vodka just about every day, sometimes while at work. When the vodka’s unavailable at his favorite liquor store (because he bought it out), then Alex gets himself an 18-pack of beer.
It’s harder for him to drink the beer at work, but he pulls it off.
Not all alcoholics have disheveled lives. Alex is what’s called a functioning alcoholic. He seems fine, even great, doing well at work and raising a wonderful family. But in reality, Alex is just as much an alcoholic as your stereotypical homeless bum using beggar’s money to buy a bottle of rum. Another term for someone such as Alex is ‘high-functioning alcoholic.’
People who know Alex may not know he’s a drinker. Or they may be aware he drinks, but not so problematically. Another possibility is that they are fully aware of his rampant alcohol use but due to his high functionality they ignore it.
“You can still be one even though you have a great ‘outside life,’ with a job that pays well, home, family, friendships, and social bonds,” to quote Sarah Allen Benson, mental health counselor and expert on functional alcoholism. She goes on to explain in the article how a functional alcoholic will likely not portray any signs of alcoholism.
In fact, Benson says that a functional alcoholic may be (and likely is) responsible, productive, successful, and even an honest go-getter. It is for this reason that people who know someone like Alex will oftentimes overlook the problematic drinking – that is if they even know it exists.
Denying the Problem
Functional alcoholics tend to not believe they have a problem. According to Benson, “He might think, ‘I have a great job, pay my bills, and have lots of friends. Therefore I am not an alcoholic,’ or he might make excuses like, ‘I only drink expensive wine’ or ‘I haven’t lost everything or suffered setbacks because of drinking.’”
Denial is actually fairly common among all types of alcoholics. So, when you consider someone like Alex who has alcoholism but also lives a successful life, it’s easy to see how he could be in denial.
According to Dr. Robert Huebner of the NIAAA, (National Institute on Alcohol Abuse and Alcoholism), it is simply impossible to “drink heavily and maintain major responsibilities over long periods of time. If someone drinks heavily, it is going to catch up with them.”
The Alcoholism Subtype Study
Back in 2007, the NIAAA (which is the “primary U.S. agency for conducting and supporting research on the causes, consequences, prevention, and treatment of alcohol abuse, alcoholism, and alcohol problems”) conducted a study to determine the subtypes of alcoholism.
Researchers in the field have known for a long time that subtypes exist. For instance, the bum-on-the-street alcoholic is not the same type of alcoholic as a teenage binge drinker, who is not the same type of alcoholic as someone like Alex.
The NIAAA subtype study analyzed data from 1,484 members of a previously conducted study called NESARC, the National Epidemiologic Survey on Alcohol and Related Conditions. NESARC included over 36,000 people and took over four years total to complete. The NIAAA subtype study “applied advanced statistical methods to data from the NESARC.”
All 1,484 people were clinical alcoholics. The researchers concluded there to be five subtypes of alcoholic. Four main factors were used to determine these subtypes:
- Family history of alcohol use
- Age when problematic drinking began
- Mental disorders and/or use of other substances
- Symptom patterns
Note: Symptom patterns, regarding alcohol abuse, are essentially ups and downs in the amount of drinking which are caused by something else in your life. As written on the University of Michigan’s mental health site, “For instance, people with depression sometimes notice that their symptoms grow worse during the late fall and winter months when there is less daylight.” When it comes to alcohol abuse, consider ‘symptoms’ to be bouts of heavy drinking.
Let’s briefly discuss the five subtypes of alcoholic found in the study, with a focus on what’s called the ‘Functional Subtype.’ Then let’s discuss the signs of functional alcoholism, as well as some methods of quitting and preventing alcoholism in people like good old Alex.
1. Young Adult
Believe it or not, more alcoholics belong to this subtype than any other. Young adult alcoholics usually have little to no family history of alcoholism. Being young adults, legal drinking is either around the corner or brand new. Also, they typically show little to no signs of mental disorder or abuse of other substances. Symptom patterns are most likely flat, meaning the same amount of drinking every time.
The young adult subtype comprises 31.5% of American alcoholics. Help is rarely sought by young adult alcoholics, as alcohol itself is usually relatively new in their lives.
2. Young Antisocial
Problematic drinkers in their mid-twenties make up this subtype. According to the NIAAA researchers, over half of young antisocial alcoholics have a family history of alcohol abuse. Also, the majority of them began drinking with regularity at an early age. A little less than half either have a mental disorder (or multiple), or abuse substances other than alcohol. Symptom patterns fluctuate, meaning there are spikes and valleys in the amount of alcohol consumed. This is likely due to a high presence of depression, bipolar disorder, and/or anxiety among this subtype.
Young antisocial alcoholics constitute 21% of American alcoholics. Help is sought approximately 35% of the time.
Functional alcoholics, like Alex, tend to be between thirty and forty years old, with about one-third having a family history of alcoholism. [Please note that Alex is indeed based on someone in real life, whose family history consists of little to no alcohol abuse]. This subtype usually begins drinking problematically at an early age. Also, about half of functional alcoholics suffer from depression. About one out of five suffers from bipolar disorder. Symptom patterns tend to be flat with occasional spikes.
A whopping 19% of American alcoholics are functional. This means that for every four obvious drunkards there is one person who basically lives their entire life drunk but is seemingly succeeding. Consider functional alcoholism to be the quiet addiction. Almost always well-educated with a stable life, functional alcoholics rarely seek help.
4. Intermediate Familial
This subtype of alcoholics contains middle-aged people who have been drinking for a long time, half of whom have both a family history of alcohol abuse and clinical depression. Just as with functional alcoholics, about one out of five suffers from bipolar disorder. The majority of intermediate familial alcoholics smoke cigarettes. Almost 20% concurrently abuse either marijuana or cocaine. Symptom patterns vary. Only a quarter of this subtype seeks treatment.
Nineteen percent of American alcoholics belong to this subtype.
5. Chronic Severe
Here we have people middle-aged and older who began drinking early and likely never stopped. An overwhelming 80% of chronic severe alcoholics have alcohol abuse in their family history. Among other mental disorders, this subtype tends to exhibit antisocial personality disorder, depression, bipolar disorder, anxiety, and high rates of law-breaking. Chronic severe alcoholics also have the highest rate of illicit substance abuse, mainly concerning marijuana, cocaine, and opiates. Symptom patters vary, but alcohol intake is generally rather large.
This subtype makes up 9% of American alcoholics. Although two-thirds of chronic severe alcoholics seek treatment, which is hopeful, the reverse of this is simply that they are the “most prevalent type of alcoholic in treatment,” as written in the study. Because untreated alcoholism only worsens, the previous four subtypes are all in danger of eventually becoming chronic severe alcoholics.
Signs of Functional Alcoholism
So how would you know if either you or someone you know belongs to one of these five subtypes of alcoholics? First and foremost, go with your gut. If the question has to be asked or whether or not a problem exists, chances are a problem exists. If no drinking problem existed, the need to question it would never occur.
Here are some signs of functional alcoholism:
- Drinking in the morning, or before work, or alone, or all of these simultaneously
- Denying there is a drinking problem (or even drinking at all)
- Hiding alcohol around the house
- Becoming angry when asked about alcohol use
- Needing a drink to feel normal
- Legal problems, such as a DWI
- Getting drunk when unintended
- Joking about being an alcoholic (but never taking it seriously)
- Uncharacteristic behavior patterns
As previously noted, this writer knows Alex in real life. His name, as well as his wife’s name and their two daughters’ names, have all been changed. However, nothing else written here is untrue about [Alex’s] life. He is one of this writer’s best friends, and truth be told, there are times when this writer worries about him, and there are times when this writer has nothing but pride and adulation for him and his success. It’s a tricky road to walk down, but if and when the time ever comes that intervention is required, you better believe this writer is ready, willing, and able.
Functional alcoholism can either be a silent killer or simply a disease that accompanies an otherwise successful and ‘normal’ life. Either way, the toll is taken on the body and on the brain. Whether it’s someone like Alex, who drinks liquor before work sometimes and then gets four raises or it’s someone like the stereotypical bum on the street who begs for money to drink one shot of rum, it’s a human body.
Click here for an in-depth article on the damage alcohol causes.
Please, if you or someone you know is either exhibiting signs of functional alcoholism or is for sure a functional alcoholic, seek help immediately. Alcoholism is a dangerous disease, responsible for nearly 90,000 deaths a year in the US alone. Worldwide figures are in the hundreds of thousands.
Anybody can be an alcoholic. Anybody. Never judge books by their covers.