Top 5 Signs You’re Not Just a ‘Social Drinker’ and Have ‘High-Functioning’ AUD
Many of us enjoy having a drink. After all, alcohol consumption can be a fun and highly social activity – in moderation it seems to relax us, whether at home or at a party, and helps us celebrate big occasions and life’s special moments. On TV, in the movies, and in many advertisements, drinking is also often made out to be sophisticated, glamorous, and even funny. “Cheers” anyone?
On the face of it, a drink every now and then doesn’t seem to pose serious health problems or negative consequences. However, while many of us may think the signs of alcohol addiction, or as it is medically known Alcohol Use Disorder (AUD), are obvious, sometimes we need to look closer. The progression from being a “social drinker” to something more serious can be so gradual that it may go unnoticed – at first.
So what are some of the warning posts along this slippery slope of alcohol use? Let’s explore the Top 5 signs if you have high-functioning AUD. But first a note regarding the use of terminology:
Start With the Right Terminology
Leading experts in healthcare and medicine recommend against the use of terms like “addict,” “alcoholic,” and “drug/alcohol abuser.” They include the Director of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow; the Director of the National Institute on Mental Health (NIH), Dr. Joshua Gordon, and; the Director of the National Institute on Alcohol and Alcoholism (NIAAA), Dr. George Koob. It is suggested – and we agree – that such stigmatizing terms actually serve to perpetuate negative attitudes towards serious mental health conditions like alcohol and substance-use disorders.
People with these mental health conditions need professional help and support from our communities – certainly not stigma, embarrassment, and shame, which are well-known barriers that prevent people from seeking treatment. Simply changing our language goes a long way to improving the health of our loved ones, our communities, and our society more broadly. For more information, please consider reading this commentary published by Drs. Volkow, Gordon and Koob in the journal Neuropsychopharmacology .
Still at High Risk with High-Functioning AUD??
People engaging in harmful alcohol use may not always appear to suffer many negative consequences in their personal or professional lives. As many as 20 percent of people with AUD are in fact “high-functioning.” In high-functioning AUD, daily responsibilities like attending to one’s job or career, personal hygiene, work around the home or childcare, taking care of bills, and personal relationships may not seem to be dramatically affected by a person’s drinking habits.?
However, being high functioning doesn’t mean that alcohol consumption is any less harmful for your health and well-being. On the contrary, high-functioning AUD is at high risk for going untreated and has many long-term effects on the brain and body. For more information about the health effects of harmful alcohol use, check out this other LinkedIn article I recently shared regarding AUD awareness and novel treatments:
What are the 5 Signs You May be in Need of Help?
So, how can we recognize someone with high-functioning Alcohol Use Disorder? Here are five key indicators that a person is engaging in problematic drinking and may need help:
?1) Having a hard time controlling or abstaining from drinking
A person may say things like, “I can stop drinking whenever I want to,” or “I can go days or weeks without drinking.” While this may be true in the short term, over longer periods of time people who have high-functioning AUD may experience strong cravings to have a drink during periods of abstinence or, after a period of abstinence, may return to drinking at greater volumes or higher intensity than before. Known as a “rebound,” this is when the body and brain seek to make up for lost time in consuming alcohol, and can manifest as a binge-drinking episode.?
?“During a ‘rebound,’ the body and brain seek to make up for lost time in consuming alcohol.”
?Remember, binge drinking is defined as consuming four or more drinks in two hours or less. One drink is counted as 1.5 ounces of 40 percent alcohol like vodka or rum, 12 ounces of 5 percent ABV beer, or 5 ounces of 12 percent ABV wine. A standard-sized margarita in a restaurant therefore often contains two to three drinks!
2) Hiding drinking from others or needing to drink prior to social events
Many times, people with high-functioning AUD may not acknowledge how much they drink or how frequently. However, on some level people with problematic drinking are often aware that their alcohol use is harmful and that they are having difficulty controlling their drinking. Because of this, they may attempt to hide from others how much alcohol they are consuming.?
Hiding alcohol use can manifest in many ways, from sneaking away from a social event to sip from a flask or a nip, or refilling liquor bottles with water or other liquid to mask how much they drank. They may also hide empty bottles or even toss the empties in a neighbor’s recycling bin or other areas, along with myriad other creative ways to disguise their use. People with high-functioning AUD may express a strong desire or even an intense need to “pre-game,” or to drink before attending social events that may also have alcohol available. This can be due to social anxiety or even to fear that they won’t be able to get enough alcohol to achieve a ‘buzz’ at the event, or that they’ll be embarrassed about drinking as much as they would like to in front of others.
3) Becoming angry and defensive when asked about drinking
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People who are high-functioning with AUD may pride themselves on their ability to maintain their personal and professional lives with few obvious consequences as a result of their drinking. Some people may even believe that alcohol enhances their work and social lives in some way. As a result, when friends, colleagues, or loved ones of the person with AUD suggest he or she may be drinking too much, or may need to “slow down,” that individual may become angry and defensive. They may attempt to justify their drinking in many ways, or may even try to flip the conversation and begin blaming or attacking the person expressing concern. Although this may make the friend or supporter feel angry and pushed away, this behavior is often a cry for help and a telltale sign that professional treatment is needed.?
4) Using alcohol to relax and deal with stress or negative emotions
Many of us occasionally enjoy a drink to help us unwind after a long day. However, people with high-functioning AUD may routinely use alcohol to “self-medicate,” to help themselves relax, escape from daily stress, and even to numb themselves from experiencing unwanted feelings.?
“Drinking to unwind can spiral into a regular habit with harmful long-term effects on our brains and bodies.”
When drinking becomes a crutch to such emotions, it hinders our ability to manage feelings in a healthy and productive way, and to cope proactively with our events in daily lives. Drinking to unwind can quickly spiral into a regular habit that impacts our ability to get through the workday, disrupts our sleep, makes us short-tempered with colleagues and loved ones, and has harmful long-term effects on our brains and bodies.??
5) Being in denial about problematic drinking
Since a high-functioning person with AUD may not experience many immediate, negative consequences of their drinking, it can be a real challenge to encourage them to seek professional help -- for a problem that they don’t believe they have. When confronted with someone who expresses concern or opposes their drinking, people with high-functioning AUD may quickly deny that there is any issue with their alcohol use, justify it, get defensive, claim that they can stop drinking any time, and engage in other behaviors, as described above. Even when people with high-functioning AUD experience signs of alcohol withdrawal (headaches, anxiety, fatigue, shakiness, nausea, and difficulty thinking) that can be alleviated by having another drink, they may still deny they have a problem and unwilling to explore whether drinking less might be beneficial to their health and wellbeing.??
How Should We Help People with High-Functioning AUD?
While it can be challenging to seek help or encourage others to seek help, the benefits and rewards for addressing problem drinking can far outweigh the initial frustration. Even just limiting drinking, rather than stopping completely, or quitting drinking for short periods of time can have multiple health benefits and allow the brain and body to begin recovering from inflammation and other toxic effects of alcohol that accumulate over time.?
“Treatments range from medications to non-invasive brain stimulation like transcranial magnetic stimulation.”
?Although they may become defensive or be in denial, people with high-functioning AUD should still be routinely encouraged to speak with their primary care doctor or another healthcare professional about reducing their alcohol use. Anonymous helplines also can be a good way to start a conversation about harmful alcohol use. The Substance Abuse and Mental Health Services Administration (SAMHSA) offers one such helpline 24/7, in both English and in Spanish, by calling 800-662-HELP [4357].?
Finally, there are many treatments available to help anyone reduce their alcohol use, from medications to quick, non-invasive brain stimulation procedures such as that which is offered at GIA Miami. By activating parts of the brain that control motivation and alcohol craving, procedures like transcranial magnetic stimulation (TMS) can quickly help people regain control over alcohol use.??
GIA Miami takes a whole brain-body approach
The internationally-recognized team at GIA Miami takes a whole brain-body approach to mental wellness, offering discrete treatments with revolutionary new TMS procedures. With TMS, many GIA Miami clients have experienced overnight reductions in alcohol craving that have led them to drink less and enjoy life more.?
To learn more about TMS and the services offered at GIA Miami, visit our website or call 833-713-0828.?
Additional Reading:
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NCPRSS, NYCPRS, NCPT3, CRPA, CARC, CASAC-T
2 年A useful list of symptoms. I was never "high functioning" in my addiction, I barely pass for normal after 34 years of staying sober, but I have family members and friends who were, or are. I think, that it is harder to admit one has a problem when in many respects you present yourself to the world as someone who is very successful. You might have a great job, a good income, an outstanding professional reputation ect. and yet unbeknownst to most people your drinking problem is becoming progressively worse. You might have never lost a job, gotten arrested, or suffered from an embarrassing lapse in judgment, and yet you could still wind up with a wet brain or cirrhosis of liver. Sometimes I think that those of us with the obvious drinking problems are the lucky ones, because we are the ones most likely to be referred to treatment. In any event this isan interesting topic that deserves further exploration.