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Originally Posted On: https://www.marrinc.org/what-is-a-functional-alcoholic/

It’s important to note that “functional alcoholic” is not a clinical term. Instead, it is a colloquial term to describe a person with potentially problematic levels of alcohol use but who has been able to maintain normal daily functioning.

From our experience working with people struggling with addiction, terms like “functional alcohol” or “functional addict” are not typically employed unless there is already some problem surfacing in the individual’s life. These terms usually start coming into use when the individual or their family members need a way to talk about the problem without fully recognizing the scope.  

DSM Criteria for Alcohol Use Disorder

The standard psychological diagnostic tool is the DSM, which stands for the Diagnostic and Statistical Manual of Mental Disorders. The most recent edition, DSM–5, published in 2013 presents a list of 11 criteria that can potentially qualify a person for Alcohol Use Disorder, which diagnoses people on a severity scale. These criteria are broken down on this facts sheet put out by the National Institute on Alcohol Abuse and Addiction. 

Some of the criteria for alcohol use disorder include: 

• “Had times drinking more or longer than you intended.”
• “Continued to drink even though it was causing trouble with your family and friends.”
• “Wanted a drink so badly you couldn’t think of anything else.”
• And 8 other criteria.

When a person meets 2 to 3 of these 11 criteria, he or she is diagnosed with “mild alcohol use disorder.” At 4 to 5, the diagnosis increases to “moderate.” And when a person meets 6 or more criteria, the diagnosis escalates to “severe.” There is also a similar diagnosis and set of criteria for Substance Use Disorder. 

When is Alcohol or Drug Use No Longer Functional?

From our experience, it is common for a person to meet several of these criteria and be surprised by the diagnosis. 

Often, the person and sometimes even family members can still sincerely believe that they do not have a problem. We have a remarkable ability to adjust to adverse consequences. The Big Book of Alcoholics Anonymous describes the person suffering from alcoholism as someone who believes “their alcoholic life seems the only normal one” (“The Doctor’s Opinion” page xviii). 

In other cases, people struggling with substance abuse may be able to acknowledge a portion of the problem, but not the entire extent of it. These are usually the times when we typically hear our clients use the term “functional alcoholic” or “functional addict” employed. 

Denial of alcoholism or addiction is a foundational aspect of the disease of addiction, both for the client and the family members.  

We help our clients and their families recognize and accept the extent of the effect of addiction in their lives. Beginning to identify the problem, accept it, and allow others to help is a process. It takes time. 

And often, this process begins with the first phone call or message to our Clinical Assessment Team. These licensed and certified clinicians are available for a confidential and complementary conversation about the next steps you can take to get help for yourself and your loved ones. Call us at (678) 736-8694, or you can reach out via the chat box in the lower right-hand corner of our website.