A very interesting breakdown. My understanding of a definition of an addiction, one that appears frequently throughout the literature, is "continued (drug) use inspite of adverse consequences".

Your description of HFA's doesn't appear to include many adverse consequences of their alcohol use or life problems in general. How is a High Functioning Alcoholic distinguished from a High Functioning Person Who Likes a Few Drinks? Is it the craving? Or the magnitude thereof? Or the simple amount of alcohol consumed?

You make a point that the HFA person has yet to lose significant things in thier lives and therefore does not recognize a bottom. This seems to suggest that not feeling out of control helps sustain the drinking behavior. Once a notable negative consequence occurs are HFA's more likely to stop drinking than the low functioning alcoholic? It seems to me like the bum on the street represents a person who has lost everything and still continues to drink while the HFA is a person who continues to drink because they have lost very little. So, is a HFA at risk for ever becoming a LFA? It seems thier attempts at life mangement serve as a protector from this darker form of alcoholism. Once the loss comes they will stop. Also, almost all homeless people suffer from severe mental health issues. They have co-mormid substance abuse issues. Very very few were once successful people who lost everything to booze. They had little to begin with.

I just finished a book called Raise the Bottom. As a manager, it's important to know that alcoholics can be high functioning. In fact, some attributes of alcoholism are the same as attributes of people who are succesful in the workplace, until the disease progresses. Great read and I recommend.
http://www.raisethebottom.come

Nice article. Alcohol dependent of every person is cause to many factor. It has many reason of their addiction and that is why it should be threaten differently.

Nice article and very informative. But the question is how can you approach an HFA person if they can say to you that they do nothing wrong and proven it by their status in life?

Part of the denial that high-functioning alcoholics (HFA)experience is the true belief that because they are successful professionally that they could not be alcoholic. If you are planning to approach an HFA it is important for you to be informed about the truth of alcoholis and the ability to challenge the HFAs denial. Alcoholism is not about how a person can maintain their "status" but about their relationship to alcohol (ie, loss of control of their intake, obsessing about alcohol, loss of morals when drinking, etc.).

It also can be effective to express how the HFA's drinking has negatively affected you or those around you. HFAs often do not have concrete evidence that their drinking is hurting others and it is crucial that their loved ones have the courage to express how the HFAs drinking has negatively impacted their lives.

It is also important to set boundaries and limits with an HFAs so that they get the message that their drinking is a serious problem leading others to choose not to be around them.

Al-Anon support groups can be a great support for loved ones of alcoholics to help navigate the complicated dynamics that can occur when you have an HFA in your life.

Nice article to read. The concerns about this HFA persons is their health and not their prepositions in life.

Yes, I admit to being a high-functioning alcoholic. I maintain "caps" on my drinking. I drink alcoholically, yet I never drink during the morning or daytime -- I live a normal life -- and I stop drinking long before I black out or sow the seeds of a hangover. Also, I NEVER combine drinking (even a sip) with driving. Despite these sanity checks, I know that I'm dependent on alcohol. I drink to reward myself for good times or relieve the stress of bad times. I can't go for very long without alcohol.

I don't want to change. I've made a compromise with my addiction, and I'm happy with the balance. So, what's the big deal? I'm not hurting myself, and I don't hurt my loved ones. I'm a happy drunk. Why should I worry?

I have actually addressed the question of what is the problem with being a high-functioning alcoholic in another posting on this blog:
http://blogs.psychologytoday.com/blog/the-high-functioning-alcoholic/200...

Specifically, alcoholics often set rules and limits around their drinking in order to justify and excuse it. When you have to control something then it is out of control. Therefore, given the progressive nature of alcoholism, it is crucial to keep in mind that you may reach a point where you are unable to maintain your "caps" on your drinking.

You have a condition that you are choosing not to receive treatment for that can lead to a variety of health problems. In addition, drinking is a maladaptive coping mechanism that prevents alcoholics from learning ways to deal with stress and life problems- essentially stunting emotional growth. What could you do with your life if you were free from the shackles of alcohol?

You mentioned that you are a "happy drunk" but the real question is are you a happy person when you are sober?

Just found this website after my lawyer recommended it. Going through a divorce with HFA who literally ignored me (would walk past me, say hello to the dog, on his way to vodka). The final straw was escalating drunk violence with children...the result is his recent arrest and removal from home for punching my six year old daughter while passed out. But he doesn't have a drinking problem and the divorce is all my fault b/c I found someone else. Gee, wonder why...

This started 6 weeks after marriage when I discovered he was using cocaine. That was 12+ years ago. He switched to vodka after kicking the coke habit in 2004. The sad things is, that despite his going through 4th rehab by court order, I know he still hasn't hit rock bottom and he will drink again.

I think this issue is more prevalent than we know because so many people are HFAs and "don't want to change." It's easier to believe the stereotype of the falling down drunk than to admit to being an HFA and doing something about it, right?

I am glad that you found this blog and I hope that some of the topics are helpful for you. It sounds like you are going through a painful divorce.

As you mentioned, the stereotype of the "falling down drunk" allows so many HFAs to justify and minimize their addiction. For HFAs it is easier to compare themselves to the worst case scenario, which feeds their denial that they have not hit "bottom."

I would encourage you and your daughter to attend therapy in order to have additional support and means to process all that you have experienced as a result of your husband's addictions.

After 24 years of marriage and two children, I have just recently accepted the fact that I'm married to an "alcoholic", a High Functioning Alcoholic, but an alcoholic none the less. It was as if a light bulb went off when I finally realized that the numerous problems we were experiencing were due to his drinking. It's really only been in the last 5 years that the problems have escalated to a point where I began to wonder what was going on. When I would ask him how much he had to drink, he would always lie and say 2 or 3. Then I found his hiding techniques and started counting and I realized that this has been going on a long time. And when I started watching his behavior I realized he is obsessing over alcohol, when he can drink without me noticing, where he can hide it to avoid detection, how he slams down a 6 pack before noon and then sleeps it off and why he goes on in the evening to finish another 6 pack and he's "so tired" he has to go to bed early. He also minimizes his drinking and surrounds himself with very heavy drinkers. He's experiencing health problems that he thinks are totally unrelated, a groin pull that isn't getting better. But when you drink as much as he does, his joints are dehydrated, he falls and is not steady and over time it just takes its toll. His body is too busy metabolizing alcohol to heal properly. At least this is my suspicion. He's also too checked out to go to the doctor when he should and follow the doctor's orders. Why should he when he can drink his pain away.

He is very deceptive and I guess I had an incentive to look the other way or just not pay much attention to what was going on around me. He is the primary bread winner, now the sole money earner and insurance provider in our family. He is very smart, able to fix anything, flips houses and makes lots of money doing it, flies airplanes, can do anything he wants or sets his mind to. He is also an excellent money manager and someone who I rely on for lots of things.

The problems arose when I realized what this was doing to my older daughter and now our 2 year old. He would have these mood swings and act funny. Either mad at the world and his job loss or mad at me a lot. We would get in huge fights. He would feel sorry for himself or would be overly jovial and act very annoying. I seriously thought he was losing his mind or that there was something wrong with me. He had had a few violent outbursts over the years but nothing like hitting me. He threw a chair at the dinner table once in front of my daughter but for the most part he is a "sleepy drunk". This made the problem even more difficult to diagnose because there wasn't any on-going violence but when added all up it all made sense. Both of our families have noticed the change in him recently and have made comments like what's wrong with him etc. which I guess is the effect of the progression of the disease. He tries to pick fights with me when he's drunk and he recently had a problem at work where he almost lost his job. He slowed his drinking down a lot after that but then it gradually picked back up. He drinks every day between 1 1/2 to 2 1/2 6 packs a day. I had no idea he was drinking this much. But now I know.

There is also a huge emotional toll on me and our family. He's checked out most of the time. Unwilling or unable to participate in family outings. Too "depressed" or too "tired" to go anywhere and mostly sits in his chair. We have grown so far apart I'm afraid we may never get back to a normal family life again. I'm losing sleep over this and have a hard time concentrating on anything but this problem at the moment. It's making me depressed and I feel VERY lonely.

I am so glad I found your blog and the articles and when I read them it was if you were describing my life. Al-Anon has really helped me as well. I've only been to a couple of meetings but I was surprised at how I could relate to the problems these people describe with their own reactions to their alcoholic. I could also relate to the things their alcoholics do and say. It makes me feel better that I'm not alone.

Sorry for such a long post but this is all so new to me and I needed to vent. Hopefully someone can learn from my experience and from your blogs and book. If nothing else, the person that wrote about why should I quit, it's not hurting anyone else can see that that may be true, even for 15 or 20 years, but eventually it takes its toll and progresses to a point where there is no turning back, where the damage can't be undone to your brain, your body, your job or the people around you.

Sarah,
I just came across your blog and have read a fair amount of it.

I will qualify myself in that I abuse alcohol. I may be a HFA or even a a medium functioning alcohol abuser. Right now I identify myself as a person with an alcohol problem/addiction who is in a growth process. I have experienced long tern sobriety (16 years without alcohol or drugs) and then lapsed. It has been nearly 4 years since I started drinking again. I left AA consciously after about year 5 and continued to grow in my sober life through therapy. After a bad depression I chose to pick up the drink again. I remain in therapy and have also tried SMART mtgs. Truth be told, if I could afford it I would go into treatment today; an alternative treatment center that offered a non-AA program. I believe there are a few in the United States. ( It seems to me that generally medical insurance is covering less and less in the way of treatment for alcohol abuse-even12 step centered treatment.)

I am GLAD to read that this topic (of HFA's) is being explored--The idea that there are many degrees and "looks" to alcohol abuse (and other addictive behaviors).

What I take issue with is the treatment options. AA is not the cure all. Only 1% of people that go to AA are known to maintain long tern abstinence (defined as1 yr.) These are AA's numbers.
I wish that therapists, doctors, treatment professionals would begin to open up to other modalities. And that alcoholism is a disease has not been proven.
It's great that we can all have more awareness of the many faces and colors of addiction, whether it be food, chemicals, the list goes on...but I believe that until the treatment community and those who fund them remain attached to the very limited 12 step model, then only the same small numbers will benefit.

Further I think long term sobriety is just difficult to maintain. The few folks that I do see that have achieved long term sobriety seem depressed or just staving off the drink. Sure, AA can help that 1% get a running start, but can't see one through the long haul, in my opinion.

I bring up my personal situation because I think it qualifies me to talk about this. I really have experienced this from many sides. I took issue with AA in sobriety and I believe in my heart of hearts, that group and one on one therapy was what helped me to stay sober as long as I did. That was what *I* needed then. ( I realize I have introduced another topic here: long term sobriety.)

I guess my point is: scientist and psychologists are finding out so much about how to identify addiction, but there is not much new developing in the area of treatment. I don't blame my personal situation on this specifically, but it seems like if we have all of these "addicts"/ "alcoholics" on our collective hands then we (the treatment community) have got to be significantly more open-minded, creative and proactive in helping to treat them.

Reading everyone's comments has helped me a little and made me feel like maybe I'm not alone. I think my husband is a HFA. He drinks everyday and I guess has for as long as I can remember. I don't ever remember it being a problem until the past year and a half or so. I was pregnant and my nine months of sobriety opened my eyes to see how much he really drinks. Somedays he may only hae a couple of drinks, others 4,5,6, or more, and this is during the week. On the weekends it's usually much more at least a 12 pack or so Fri. and Sat. night and close to that on Sun also. He never gets violent or mean and actually may act nicer than usual when drunk, but when confronted about the amount that he drinks he becomes very defensive and refuses to believe he could have a problem. He will attempt to minimize the amount that he says he drinks when I confront him when I have evidence otherwise right in front of me. I have asked him to just take 2 nights off during the week which he agreed to do a couple of months ago but has yet to do. The most he's gone is 2 nights in a month. I don't know what to do anymore and the more I try and talk to him about it the more I am nagging. I've even tried to involve his family and talked to his mom but this also didn't help much. Any suggestions or eyeopening moments for HFA's that helped?