Some of those who suffer from alcohol use disorder are incapacitated by their addiction, unable to work, or live any semblance of an ordinary life. In cases like these it is usually very clear to people around them that they are physically dependent on alcohol. For others however, alcohol use disorder can be concealed. Hidden alcoholism is also known as functioning alcoholism. Functioning alcoholics typically lead lives that involve some level of responsibility, they may maintain steady employment, attend school, or have a family. Just because functioning alcoholics are able to mask their alcohol use disorder does not make their disorder any less severe, or any less dangerous.
Due in part to their ability to maintain a life of relative normality, functioning alcoholics are less likely to seek treatment for their alcohol use disorder than others. As a result of this, there is less research about functioning alcoholics, and the effects of alcohol on their physical health.
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Denial and its Role in Refusing to Seek Treatment
Many of those who suffer from alcohol use disorder but refuse to seek treatment are in denial about their issues with alcohol. Denial can serve as a barrier, for people who suffer from alcohol use disorder, to seeking treatment. Functioning alcoholics are more easily able to stay in denial about their problem, because it is not obvious to those around them.
For some, denial can be broken when faced with terrible truths, such as the diagnosis of a medical condition related to excessive drinking, the loss of a house due to financial troubles, or legal troubles that arose as a result of excessive alcohol consumption. However, functioning alcoholics typically have less visible or noticeable problematic effects of their drinking in their daily lives.
Tolerance and Alcohol Use Disorder
As is the case with most mind-altering substances, when alcohol is consumed frequently, and in large amounts, the human body builds up a tolerance. As people consume more and more alcohol, their bodies will adjust to the consumption levels, meaning they will need more alcohol to achieve the same intoxicating effect. A high tolerance to alcohol develops due to excessive drinking, but can be accelerated by a number of other factors, including:
- Amount of regular alcohol consumption, as well as the speed at which it is drunk
- Body size and composition are known to affect tolerance, and include height, weight, body fat percentage, and other factors
- Hereditary factors can affect tolerance, include genetic enzyme deficiencies which result in a lower tolerance
- Women have less of the enzymes to break down alcohol, and as a result usually begin with lower tolerances than men with otherwise similar characteristics
- Ethnicity also plays a role in tolerance - those of Asian or Aboriginal descent generally have less of the enzymes to break down alcohol than other ethnicities, and as a result typically have lower tolerances to alcohol
Withdrawal in Functioning Alcoholics
Developing a tolerance, while it shows a pattern of drinking that can lead to problematic behaviors, does not necessarily mean that someone struggles with alcohol abuse or suffers from alcohol use disorder. As tolerance builds, people are more likely to develop a physiological dependence to alcohol, which leads to withdrawal symptoms in the absence of alcohol. Withdrawal from alcohol can be extremely dangerous, and in the worst cases, fatal. The symptoms of psychological and physical distress caused by alcohol withdrawal sometimes require medical attention, and can be life threatening if not treated.
Symptoms of alcohol withdrawal include:
- Severe mood swings
- Extreme feelings of overall discomfort
- Increased heart rate
- Nervousness and anxiety
- Difficulty concentrating
- Excessive perspiration
These symptoms, along with others, are known to present themselves as soon as eight hours after the last drink. Symptoms can worsen for between one to three days, where it is believed their severity peaks. Through experiencing these symptoms, those who suffer from alcohol use disorder may find that the easiest way to feel comfortable again is to continue drinking. This mindset creates a sort of loophole that encourages persistent excessive drinking to mitigate the symptoms of withdrawal.
Warning Signs of Alcohol Use Disorder
Alcohol use disorder is a clinical term used to describe this chronic disease, which is characterized by a persistent loss of control over drinking, despite the negative effects of alcohol consumption on various areas of life. Due to the near global legality of alcohol, as well as the general social acceptance of alcohol, specifically in Western nations, alcohol remains one of the most commonly used substances in the world. Figures on the number of people who suffer from alcohol use disorder in the United States vary, but the National Survey on Drug Use and Health from 2018 estimates that over 14 million Americans suffer from alcohol use disorder. There are also an estimated 90,000 alcohol related deaths each year in the United States alone, making it the third leading cause of preventable death.
Knowing the signs of an addiction can help to prevent problems from spiraling out of control. Through prevention and early intervention, the United States could save the lives of thousands of Americans each year. Some of the warning signs for alcohol use disorder include:
- Trying but failing to reduce your alcohol consumption
- Spending lots of time trying to purchase, consume, or recover from the effects of, alcohol
- Being unable to control the amount of alcohol you consume
- Intense cravings for alcohol
- Allowing alcohol consumption to interrupt other areas of life and impede responsibilities relating to work, school, or family life
- Continuing to use alcohol despite its adverse effects on other areas of life
- Losing interest in activities that were once a passion, opting to consume alcohol instead
- Experiencing blackouts
- Experiencing symptoms of withdrawal
- Developing a tolerance to alcohol
- Using alcohol in dangerous situations such as driving a car or operating heavy machinery
Seeking Help as a Functioning Alcoholic
Those who experience any of the symptoms of alcohol use disorder should consider seeking professional help. Alcohol use disorder can develop slowly over time, but its effects and consequences can be devastating.