Book Explores World of High-Functioning Alcoholics

A new book provides insights into the lives of so-called “high-functioning alcoholics” and the special challenges faced by those who need treatment but lack the impetus of hitting rock-bottom, the New York Times reported May 4.

Sarah Allen Benton, author of “Understanding the High-Functioning Alcoholic,” offers herself as an example: she holds a Master’s degree from Northeastern University, is a licensed mental-health counselor, and has been in recovery for five years. Benton writer that high-functioning alcoholics (HFA) can maintain jobs and relationships but often are in denial about their alcohol problems.

“The story of the HFA is seldom told, or it is not one of obvious tragedy, but that of silent suffering,” according to Benton, who estimates that up to half of all alcoholics can be classified as high-functioning. HFAs often abuse alcohol for years until an incident like a drunk-driving crash makes the problem too big for them, their family and friends to ignore, she said.

Others recognize the problem first and seek help in order to avoid disaster.

HFAs typically do not meet the criteria for alcohol abuse in diagnostic manuals: they have good jobs, function well in their daily life, and usually don’t get entangled in the legal system. “People can be dependent and not have abuse problems at all. They’re successful students. They’re good parents, good workers. They watch their weight. They go to the gym,” noted Mark L. Willenbring of the National Institute for Alcohol Abuse and Alcoholism. “Then they go home and have four martinis or two bottles of wine. Are they alcoholics? You bet.”

People in positions of power who can be classified as HFAs face special challenges, because workers and others often cover up for their behaviors and they tend not to be closely supervised at work, presenting fewer opportunities for intervention and recovery.

“If I was able to function, to get the work done, there was no reason to worry about drinking. It was part of living, one of the rewards,” noted writer Pete Hamill in his memoir, “A Drinking Life.”

“Having outside accomplishments led me and others to excuse my drinking and avoid categorizing me as an alcoholic,” wrote Benton. “My success was the mask that disguised the underlying demon and fed my denial.”

Benton said high-functioning alcoholics:

• Have trouble controlling their intake even after deciding that they will drink no more alcohol than a given amount
• Find themselves thinking obsessively about drinking
• Behave in uncharacteristic ways when they drink
• Experience blackouts during a drinking bout

“It’s not the number of drinks that defines an alcoholic,” Benton said. “It’s what happens to you when you’re drinking.”