Alcoholism is a substance use disorder that involves abuse, dependency, and addiction to alcohol. However, addiction affects everyone differently, so one person who is diagnosed with alcohol use disorder may have a vastly different experience from someone else with the disorder. Alcoholism is a complex disease that requires a complex treatment plan to address effectively. Does that mean there are different kinds of alcoholism? And is there such a thing as a “functioning alcoholic?”
Learn more about alcohol use disorders and how they can affect people differently.
There is an idea that some people can have alcohol use disorder in a way that is functional and doesn’t interfere with their daily lives. This myth is perpetuated by portrayals of characters in movies and TV that just need a drink, and then they’ll be able to get the job done. However, the myth of the high-functioning person with alcoholism is more fiction than fact.
It’s true that an alcohol use disorder can affect people at different levels at different times. A mild alcohol use disorder is anyone who develops a habit of binge drinking without necessarily being chemically or psychologically addicted. This is common among young adults and college students.
College binge drinking has been a significant problem for years. However, even though binge drinking is considered a mild alcohol use disorder, people aren’t graduating from college addicted to alcohol in percents as high as thirty or more. Binging comes with its own serious risks and consequences like alcohol poisoning, increased risk-taking, and a higher percentage of being involved in an automobile crash. However, it’s possible for some to binge drink for a certain amount of time without becoming addicted.
On the other hand, some people who have alcohol use disorders struggle to make it through the day without a drink. Their bodies are dependent on alcohol, and their brains have adapted, too. If they have become addicted, they will also have a psychological dependence on alcohol.
However, if you’ve developed a level of alcoholism where you need to drink to feel normal, as is the case with psychological or chemical dependence, it will start to affect multiple aspects of your life in a way that severely hampers your “functionality.” You may find yourself scheduling your day around alcohol. It may start to affect when you can safely drive, your work or school performance may suffer, and you may start to have health problems. If you are struggling to adapt your life around substance abuse, you are no longer in control of it; it’s in control of you.
If you feel like you need a psychoactive substance to function, you’re hardly high-functioning. Plus, the longer alcoholism wears you down, the more it will affect your life. Addiction slowly starts to take over every aspect of your life, causing physical, psychological, social, legal, and financial problems. If you have seen signs of an alcohol use disorder in your life, the only way to continue functioning in a fulfilling life is to address it, not to accept it. That being said, even severe alcohol use disorders can be effectively treated, and you don’t have to live in active addiction forever.
Alcoholism, like all substance use disorders, exists in three levels of severity, according to the Diagnostic and Statistical Manual of Mental Disorder (DSM-5). Alcohol use disorders are diagnosed as mild, moderate, and severe depending on the number of signs and symptoms present. According to the DSM-5, there are 11 signs that you may have substance use disorders, and the number of them that applies to you determines the severity of your disorder. The signs are 11 questions about your past year use, including:
The presence of two to three symptoms is indicative of a mild substance use disorder, four or five symptoms are moderate, and six or more symptoms are considered severe. However, different symptoms may indicate different aspects of a substance use disorder. If you have drunk more than you intended and engaged in risky behavior while drinking with no other symptoms, you may just be engaging in alcohol abuse with no physical dependence.
If it takes more alcohol for you to achieve the desired effects or if you experience withdrawal symptoms when the alcohol wears off, you may be physically dependent. This means your brain is reliant on alcohol to maintain normal chemical functioning. Without it, your brain chemistry is thrown off until it readjusts back to normal, which can be an uncomfortable and even dangerous process.
Finally, if you continue to use alcohol even as it’s disrupting your life through health issues, getting in the way of personal responsibilities, or by causing relationship problems, you may be addicted. Addiction is defined as compulsive behavior despite problems that come as a direct result of that behavior.
Technically, alcoholism is another word for an alcohol use disorder. The disease is progressive, and people can find themselves at different stages of the disease or different severities. However, it’s all the same disease. Still, the best way to address alcoholism is to tailor treatment plans to the specific needs of an individual. There is no one-size-fits-all addiction treatment solution. If you see some of the signs of alcoholism in your life, it’s important to seek help as soon as possible.
If you or someone you know is struggling with a substance use disorder involving alcohol, it’s important to seek help as soon as possible. Alcohol can cause potentially dangerous withdrawal symptoms if you go through them without medical treatment. There is help available to give you more information about alcohol detox and addiction treatment.
American Psychiatric Association. (n.d.). Diagnostic and Statistical Manual of Mental Disorders (DSM–5). from https://www.psychiatry.org/psychiatrists/practice/dsm
National Institute on Alcohol Abuse and Alcoholism. (n.d.). Alcohol Use Disorder. from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders
National Institute on Alcohol Abuse and Alcoholism. (2018, August). Alcohol Facts and Statistics. from https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics