The hallmark of a functional alcoholic is someone who is able to maintain a productive and cohesive life while still being addicted to alcohol. As a result, it can be difficult to know what such a problem drinker looks like.

Some examples of a functional alcoholic may include:

• A successful businessman who drinks before big meetings or in the morning on a big day of work.
• A mother who drinks a few glasses of wine each day to cope with stress and loneliness.
• A college student who drinks alcohol at every party and while studying, but continues to keep up good grades.
• A working parent who finishes a six-pack or a bottle of wine each evening while still attending to all of their responsibilities at home.

Clearly, alcoholism does not always mean that a person's life is in shambles. Some people are able to keep their drinking a secret. The fact that someone is drinking alone or hiding their drinking habits is itself a sign of high-functioning alcoholism.

In 2007, researchers from the National Institutes of Health identified 5 alcoholic subtypes using data from nearly 1500 survey respondents with alcohol dependence. It was one of the largest and most trustworthy studies of its kind and has informed the addiction field as a whole on the nature of this type of dependency.

In this study, researchers found that most alcoholics could be categorized (mostly) as one of 5 different types: the Young Adult Subtype, the Intermediate Familial Subtype, the Young Antisocial Subtype, the Chronic Severe Subtype, and the Functional Subtype.

Below are some of the most notable characteristics of the Functional Alcoholic Subtype that researchers found in their study.

• Average age: about 41 years old.
• Onset of drinking: around 18.5 years old.
• Onset of alcohol use disorder: about 37 years old.
• Especially low incidence of antisocial behavior.
• About 31% chance first or second-degree family members have a problem with alcohol.
• Moderate probability of depression and low probability for anxiety.
• Average chance of being a smoker and low probability of abusing other substances.
• Subtype with the lowest probability of legal problems due to drinking.
• About 50% are married.
• More than 1 in 4 have college degrees.
• Subtype with the highest proportion of retired individuals.

Subtype with the highest mean total family income (around $60k/yr).

Any type of substance use disorder is going to come with crippling consequences. But when it comes to functional alcoholism, the threat is even direr for one reason in particular: most people don’t know it’s a problem at all.

With functional alcoholics, it’s harder for friends and family members to recognize that they’re addicted in the first place. And that means that they’re less likely to confront their loved one about their drinking or hold an intervention.

On top of that, the addicts themselves are less likely to seek out help on their own too. A common rationalization among functional alcoholics is that since their life is stable and even successful, there’s obviously not a problem.  

But despite just how deceptive this type of alcoholism is, it still holds the same far-reaching and potentially devastating risks that other types of heavy drinking have. These include physical, psychological, social, familial, financial, and legal risks.

Physical Risks

• Anemia
• Alcohol Poisoning
• Cancer
• Cardiovascular disease
• Cirrhosis
• Alcoholic Hepatitis
• Seizures
• Gout
• High Blood Pressure
• Infectious Disease
• Nerve Damage
• Delirium Tremens
• Pancreatitis

Drinking too much increases your chances of being injured or even killed. Alcohol is a factor, for example, in about 60% of fatal burn injuries, drownings, and homicides; 50% of severe trauma injuries and sexual assaults; and 40% of fatal motor vehicle crashes, suicides, and fatal falls.

- Rethinking Drinking from the National Institutes of Health

Psychological Risks

• Dementia
• Depression
• Blackouts and Memory Lapses
• Wernicke-Korsakoff Syndrome or “Wet Brain”
• Cross Addiction involving Heroin and/or Cocaine
• Brain Damage From Liver Dysfunction
• Impaired Hormonal Systems

We do know that heavy drinking may have extensive and far-reaching effects on the brain, ranging from simple "slips" in memory to permanent and debilitating conditions that require lifetime custodial care.

- National Institute on Alcohol Abuse and Alcoholism

Social Risks

• Embarrassing oneself in front of friends
• Saying things someone may not mean
• Forgetting about certain obligations or promises
• Breaking their trust
• Losing old friends for new ones that drink more

In terms of the broader picture, most of us – 73% of adults - have experienced some kind of adverse effect in the last year from someone else’s drinking. Of these, 5% were negatively affected in our work by a co-worker’s drinking, 16% by a relative’s or household member’s drinking, 11% by a friend’s.

- Robin Room, Director of Centre for Alcohol Policy Research via The Conversation

Familial Risks

• Fostering an environment of co-dependency and enabling
• Fetal Alcohol Syndrome (FAS)
• Building distrust in the family unit
• Accidental aggression or mistreatment
• Contributing to lifelong problems characterized by Adult Children of Alcoholics (ACOA)
• Increasing the risk that their children will struggle with alcohol abuse as well

Children of alcoholics are about four times more likely than the general population to develop alcohol problems. Children of alcoholics also have a higher risk for many other behavioral and emotional problems.

- National Institute on Alcohol Abuse and Alcoholism

Financial Risks

• Spending outside of means in order to support alcohol habit
• Risk of losing job due to poor work performance or legal matters
• Costs of medical bills can be debilitating
• Court and legal fees can be quite expensive

So how much is drinking actually costing you? If you have three drinks a day, five days a week, at an average of $10 a pop, you’re spending $150 a week, $650 a month or $7,800 a year just on alcohol ― not including any additional costs, like server tips or taking a taxi instead of driving.

- Ann Brenoff, Huffington Post

Legal Risks

• Risk of being charged for Driving Under the Influence (DUI)
• Risk of drunk and disorderly conduct
• Risk of assault for being in a fight
• Risk of other crimes associated with alcohol

Alcohol, more than any illegal drug, was found to be closely associated with violent crimes, including murder, rape, assault, child and spousal abuse. About 3 million violent crimes occur each year in which victims perceive the offender to have been drinking and statistics related to alcohol use by violent offenders generally show that about half of all homicides and assaults are committed when the offender, victim, or both have been drinking. Among violent crimes, with the exception of robberies, the offender is far more likely to have been drinking than under the influence of other drugs.

- National Council on Alcoholism and Drug Dependence, Inc.

Addiction is defined as a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

Loss of Control: One of the biggest signs of any form of alcoholism, even for high-functioning alcoholics, is the loss of control over drinking habits. A functional alcoholic may be able to hide the effects of alcohol from others, but it will be extremely difficult for them to deny themselves a drink once alcohol addiction has formed.

In fact, research has shown that the brains of addicts work in a way much different than that of a non-addict. The National Institute on Drug Abuse states:

Brain-imaging studies from people addicted to drugs show physical changes in areas of the brain that are critical for judgment, decisionmaking, learning, memory, and behavior control. Scientists believe that these changes alter the way the brain works and may help explain the compulsive and destructive behaviors of an addicted person.

A functional alcoholic, then, may want to slow down or quit entirely. But due to the changes in their brain that addiction has caused, they may be unable to do so despite all of their efforts.

Negative Consequences: One of the other hallmarks of addiction is the continued use and abuse of a drug despite negative consequences. This can be anything from having problems at home or at work to running into legal trouble.

The important point here is that an alcoholic recognizes that these negative consequences are due to their drinking but still keep doing it anyway. This might be a conscious decision, or it might be an inability to cut down or quit on their own.

Either way, sticking with drinking even after identifying that it is having a real negative impact on life is a sure sign of a serious problem.

Building Up Tolerance: Tolerance is defined as needing to take a higher dose of a drug in order to achieve the same level of response achieved initially. Essentially, it’s the result of the body becoming more and more used to a drug being in the system.

And when that happens with alcohol, it takes more booze to get the body drunk.

While tolerance is thought of by many as a sign of “manliness” or “willpower,” it’s actually just a sign that drinking has become a serious, physical problem.  

Experiencing Withdrawal: A physical dependence on alcohol means the body has become both used to and dependent on alcohol being in the bloodstream.

And when it’s been a long time since the last drink, someone dependent on alcohol can experience what are known as withdrawals.

A functional alcoholic will experience uncomfortable withdrawal symptoms after about 8 to 12 hours of not having any alcohol at all. These symptoms will last longer and look worse the longer that alcoholism has been a problem for the individual.

While the clinical criteria for alcoholism is a great starting point, sometimes it’s more helpful to recognize certain behaviors instead of just the broad categories talked about above.

Below are some of the most common behavioral signs of a drinking problem, even as a functional alcoholic.

• They always have an excuse to drink (i.e., a bad day, a good day, an off day, etc.).
• They tend to only frequent social events that have alcohol at them.
• They get defensive about their drinking.
• They always finish all the drinks on the table.
• They drink to handle tough emotions.
• They drink alone or at inappropriate times.
• They promise they’re going to take it easy on the drinking tonight but can never live up to that promise.
• They feel agitated, irritable, and angry when they can’t drink.
• They lie about how much they’re drinking.
• They tend to associate with other problematic drinkers.
• They joke about drinking too much (usually a defense mechanism).
• They black out from drinking all the time.
• They often replace entire meals with drinking.
• They constantly push others to “keep up” with them.
• They hide bottles around the house to conceal their drinking.
• They steal valuables from around the house to fund their drinking problem.

Behaviors are one thing, but what are some physical signs of a functioning alcoholic to be on the lookout for?

Below are some of the most notable.

• Strong breath that always seems to smell either of booze or mouthwash (to cover it up)
• Broken capillaries in the face
• Frequent sweating
• Flushed cheeks and nose from rosacea
• Dry skin and brittle hair
• Shaky hands when not drinking
• Yellow skin and eyes (signaling liver damage)
• Frequent hangovers
• Nausea or vomiting