There are many people who consider themselves functioning addicts. By definition, a functioning addict is someone who uses drugs and/or alcohol regularly but maintains a job, goes to school, has a family, and maintains other relationships on a regular basis. The functioning addict is under the illusion that they can control and are in control of their substance abuse.
A functioning addict can be addicted to any number of substances: alcohol, cocaine, meth, heroin, opioids, marijuana, gambling, or even food. What makes that person a functioning addict is that their life appears to be in order by all accounts and the addiction does not appear to cause major disruptions to the functioning addict’s life.
This is why it can be so devastating to family and friends when the functioning addict loses control and is no longer functioning. To those around the addict, everything seemed fine and there were no outward signs of substance abuse to be concerned about.
But a functioning addict needs treatment just as much as an obvious addict. You need to be on the lookout for signs of addiction, who is at risk, finding treatment, and arranging and supporting all forms of aftercare.
Signs that you Know a Functioning Addict
High functioning addicts are people who are addicted drugs or alcohol but still project a normal, outward appearance. Functioning addicts steer clear of the stereotype of an addict who is out of control. Most have steady employment, and many are highly successful professionals. Many maintain enthusiastic social lives and can successfully hide their addictions from everyone close to them.
But despite all this, the struggles of functional addicts are real and dangerous. Most functioning addicts will eventually crash to rock bottom. And, we are seeing more and more functioning addicts in our society. “Research seems to indicate that incidences of functional addiction are becoming more the norm. A 2007 study on alcohol abuse found that 19.5% of all U.S. alcoholics were considered ‘functioning’. That translates to about 4 million functional alcoholics.”
Realizing that addiction takes many forms is vital to recognizing a functioning addict. Functioning addicts are very skilled at hiding their addiction. Many live in fear that if they are discovered, their careers or very lives will be over. This leads to an enormous amount of stress, anxiety, and dread.
But, no functioning addict has a perfect image. There are always signs that addiction is present:
Excuses and Denial
It is very common for addicts of any stripe to exhibit denial. But with a functioning addict, their denial can actually sound sensible. They could say things like, “You need to drink/take drugs to do this job”. This is an obvious red flag, as no job requires habitual substance abuse to be tolerable.
During late-stage addiction, the addict will become less and less concerned about appearances. As the addiction starts to take its toll, you will notice that one day they were neat and presentable, but the next day, they were ratty and unkempt. This happens because as addiction continues, the addict’s physical health will suffer, and they will have less energy to devote to their own hygiene. Look for disheveled clothes and poorly cared for hair or skin.
Using More of a Substance than Intended
This sign occurs when someone cannot seem to control their intake of a substance. “Many people who only drink occasionally will go out for ‘one drink’, only to have that one become several. It becomes a problem when that scenario becomes the rule rather than the exception.”
Isolation tends to occur in the later phases of addiction. If it is a significant deviation from the addict’s normal behavior, you should be alarmed and take steps to intervene as soon as possible. As addictions continue, addicts will only focus on getting their next dose. Everything else goes on the back burner.
Enablers are problems for all addicts, but they are a particularly insidious problem for functioning addicts. Addicts tend to gather together, to both validate their bad behavior and to share substances. This is a problem for functioning addicts who work in enabling environments. They will try to justify their use by saying that people at work “use more than I ever do”.
Withdrawal is a frightening and dangerous symptom of addiction. Nausea, vomiting, anxiety, depression, headache, sweating, and fatigue are all common withdrawal symptoms. A functioning addict may ignore these warning signs. But this is dangerous because they are a sign of physiological dependency. Withdrawal is a part of the process in getting clean, and it can involve life-threatening complications. If you see someone in withdrawal, get them medical attention immediately.
Memory issues are common in all forms of substance abuse. Addicts can lose time or have total blackout periods. This requires immediate intervention. “Loss of memory indicates that the substance abuse is already affecting a person’s normal brain functions.”
Unexplained Financial Issues
Functioning addicts spend a lot of money on their habits. Most will end up in financial trouble, and they will turn to their enablers for help with getting their next fix financed.
If someone has a great job but is constantly in need of money, it’s clear that something is going on that needs to be addressed.
This sign means an addict is losing their ability to function. If the addiction becomes the only thing they care about, they will start to ignore their responsibilities. This is the easiest sign to spot in a functioning addict. They will start ignoring all the things that matter most, like work and family.
While it’s important to know these signs, it’s also important to note that there are certain groups of individuals who are at greater risk for becoming functioning addicts.
Who is At Risk
There are many categories of individuals who are at high risk for becoming functioning addicts.
Functioning addicts in professional positions who suffer from substance use are able to hide the consequences of their actions — at least temporarily. The functioning addict may have hangovers and other physical problems, but can hide the effects or lie about being sick to keep others from noticing. They may start to decline in work performance or start having more sick days than usual before someone notices the signs of the functioning addict.
According to the Substance Abuse and Mental Health Services Association (SAMHSA), “restaurant and food preparation/service is the profession that carries the highest risk for addiction. The construction and media/entertainment industries are #2 and #3 on the list. Other professions, such as law enforcement, have relatively high rates of addiction because of the work culture, as well as the stress and cumulative trauma involved.”
However, many of the professionals that fall prey to substance abuse and act as functioning addicts are Healthcare Professionals and Pilots. It is estimated that 10% to 15% of health care professionals misuse alcohol or drugs at some time in their careers. Alcohol is most commonly abused, followed by prescription drugs.
Others at high risk for substance abuse as a functional addict may be emergency room doctors, emergency nurses and ancillary medical staff, anesthesiologists, dentists, veterinarians, pharmacists, and psychiatrists. Studies of drug addiction and functioning addicts among professionals talk about the “unrestricted” access to addictive pharmaceuticals, or “convenience” to drugs as a major factor in whether or not professionals get addicted.
Other professionals, such as lawyers and financial managers, become functioning addicts due to the high-stress nature of their work, burnout, or a poor work-life balance. Often, physicians and other health care professionals become functioning addicts for the same reasons. Eventually, these professionals need to get treatment for their addictions.
Treatment for High Functioning Addicts
Addiction treatment for functioning addicts, with a severe substance use disorder, is most effective when it includes the following:
- 30 to 90 days of treatment with other high-functioning peers.
- Discussion and problem-solving around professional issues
- Ongoing monitoring to prevent relapse
- Self-help programs such as Alcoholics Anonymous
- Accepting, viewing and treating addiction like a disease
One of the major concerns of functioning addict when seeking treatment is the loss of their job or academic goals. Therefore, any treatment program must be a safe space where those working their recovery can learn to be honest with everyone, including themselves. Addiction is an isolating disease, and treatment should not further isolate the addicted professional.
Because they are masters at hiding their addictions, most functioning addicts are struggling with advanced behavioral, emotional, and physical issues by the time they get to treatment. In other words, their disease is often more advanced than it is for others who seek treatment. As such, treatment for functioning addicts should include all of the biological, psychological, and social risk factors and triggers. Family therapy is also essential as functioning addicts need their families’ support and assistance to avoid relapse.
The first step in treatment is to be assessed by an addiction psychiatrist trained and experienced enough to make an accurate diagnosis and provide individualized treatment suggestions. In some cases, inpatient treatment may be the best option for the functioning addict. Once treatment is complete, the addict will need lots of aftercare support.
Providing Aftercare Support
Because any aftercare plan is designed to address the specific needs of an individual addict, no two plans are alike. Treatment plans can have similar components, but they will always address the needs of each addict. Here are some common components of a typical aftercare plan:
Therapy is essential in addiction treatment due to its efficacy. During cognitive behavioral therapy, “clients learn to evaluate their thoughts, attitudes and behaviors and replace those that are harmful with those that are healthy and productive. They also develop an array of coping skills and strategies for handling stress and other triggers that can quickly lead to relapse.”
Sober Living Community
Sober living communities, sometimes known as sober houses or halfway houses, give the functioning addict a safe place to live immediately following treatment. These facilities are designed for people transitioning from inpatient treatment back to everyday living. These residences offer both structure and support.
These types of facilities are particularly useful for functioning addicts who don’t have a secure, drug-free living environment. Sober homes have strict rules about abstinence and often test for drugs or alcohol regularly. Residents must participate in house meetings and attend support group sessions, such as a local AA or NA group. The facilities also help to foster healthy lifestyle changes by offering workout facilities or providing a gym membership and encouraging other aspects of self-care.
According to the Substance Abuse and Mental Health Services Administration, “addiction is a family disease that leaves the family system in a state of chaos as it tries to compensate for the unhealthy behaviors of an addicted family member.” Reestablishing function in the family is a vital part of addiction treatment, and the aftercare treatment plan normally requires ongoing family therapy.
Participation in a 12-Step or Alternative Support Group
Peer support for functional addicts is an essential component of aftercare treatment strategies. Twelve-step programs like Alcoholics Anonymous and Narcotics Anonymous, and 12-step alternatives like Smart Recovery or Celebrate Recovery, offer high levels of support, “promote personal responsibility and accountability, and foster the development of healthy relationships with non-using peers.”
The studies conducted regarding success in a 12-step program are numerous. Most have come to the consensus that participation in these programs can significantly reduce the risk of relapse. The relationships built during these programs, with sponsors and accountability partners, greatly increase the chances of success when a functioning addict returns to daily living.
But more than anything, family support is the best way to help an addict remember why staying clean is the first priority.
It is important to remember that functioning addicts often think that they don’t have a problem at all. Recognizing the signs, getting the addict into treatment, and supporting them in their aftercare are essential to ensuring the functioning addict becomes clean, sober, and ready to start a new path in life. If a teenager in your life appears to be a functioning addict, reach out to see how Beachside can help!