Each time that I mention the term "high-functioning alcoholic"(HFA) people often respond that they have a relative, colleague or friend who is an HFA. Usually the HFA they know has not received help and is still actively drinking. The crux of the problem is that they are still functioning. Ironically, their success is a curse that leads their alcoholism to go untreated. Going out for drinks after work with heavy drinking co-workers or friends allows HFAs to blend into their surroundings in chameleon-like ways. They may delude themselves into thinking that their alcoholic drinking is normal by associating with people who drink as they do. Typically, alcoholics are drawn to other alcoholics and this may further convince them that they do not have a problem.
The question still remains, why are so many HFAs still actively drinking and going untreated? It is extremely difficult for friends, loved one and colleagues to gain "leverage" to convince HFAs to get help. Interventions, such as those seen on the HBO series "Intervention" occur when friends and loved ones confront the alcoholic who has hit a low bottom and lost everything (ie, job, housing, relationships, etc.). The intervention specialist guides friends and loved ones to coerce the alcoholic into going to treatment-they always have tangible evidence of how the alcoholic is destroying his or her life. I have yet to see an episode featuring an HFA and there is a reason for this. HFAs are fulfilling their life responsibilities and may even be providing financially for their family or excelling academically. Therefore, the HFA continues drinking the way that he or she wants to because, "I deserve it", "I work hard, play hard", "I always go to work", "I am getting good grades," etc.