High-Functioning Alcoholic

High-Functioning-Alcoholic

What is a High-Functioning Alcoholic? – A high-functioning alcoholic is someone who can attend to many societal obligations and maintain a livelihood despite the regular overuse of alcohol. This behavior may sound like a conflict of interests, but the truth is, many alcoholics can be considered “functional” in one way or another.

In fact, one of the many stigmas surrounding alcohol addiction is steeped in how well the alcoholic can manage responsibilities in his or her life. For example, compare the “gutter” alcoholic to an upper-middle-class family man in the suburbs – they appear very different on the outside, despite having one very defining characteristic in common.

Another common difference between the functional alcoholic and other sufferers is the level of acceptance. At some point, many severe alcohol abusers who have suffered great loss acknowledge the fact that they have a problem – and mainly because they have no choice. Moreover, they are forced to sit by and watch, seemingly hopeless, as their lives and relationships crumble around them.

High-functioning alcoholics, however, may be the last ones to know. As long as the bills are getting paid and the user feels as if he/she is in relative control of things, it’s easy to remain in denial. If you ever hear someone use the phrase “I work hard and play hard” consider that an indicator that the person may be a high-functioning alcoholic or drug abuser.

Who is an Alcoholic?

According to experts, alcohol abuse and alcohol addiction (commonly known as alcoholism) now both fall under the classification of “alcohol use disorder.”

According to the Mayo Clinic, alcohol use disorder (AUD) “…is a pattern of alcohol use that involves problems controlling your drinking, being preoccupied with alcohol, continuing to use alcohol even when it causes problems, having to drink more to get the same effect, or having withdrawal symptoms when you rapidly decrease or stop drinking.”

Unhealthy alcohol use is further defined as such that “includes any alcohol use that puts your health or safety at risk or causes other alcohol-related problems.”

This also includes binge drinking, which is “a pattern of drinking where a male consumes five or more drinks within two hours or a female downs at least four drinks within two hours.”

Functional Alcoholism – Signs and Symptoms

High Functioning AlcoholicA functional alcoholic is someone who…

…regularly engages in life-sustaining employment or ongoing education.
…typically affords food, shelter, and the necessities of living.
…may financially support a family, at least in part.
…may be well-educated and a high-achiever.
…may hold a position of power or authority.

And yet…

…drinks to excess on a regular basis and often can’t control their drinking once started.
…minimizes and/or conceals the severity of his or her problem, and reassures others that’s everything is okay.
…may be quick to point out others whom he/she deems to be a more severe and less-functional alcoholic.
…occasionally fails to meet critical responsibilities as a result of drinking.
…may have encountered legal problems or family conflict as a result of drinking.
…may have been hospitalized for excessive alcohol use and/or is experiencing health-related conditions such as liver disease.
…others have recognized there is a problem but are afraid to address it.

The Case of Stephen

Example: Stephen, 35, is an assistant manager at a high-tech firm and has a bachelor’s degree in computer networking. He shares a suburban home with his wife and toddler son.

Stephen has been drinking excessively since college, including both daily and binge-style alcohol consumption. He rarely misses work due to his drinking patterns, however, despite regular late-night binges after his son has been put to bed.

High-Functioning AlcoholicStephen’s wife knows that he is an alcoholic, but rarely confronts him.

She has talked to his family, who continue to insist that his heavy alcohol use can’t be a problem and that she should appreciate the long hours he works and the things he can provide.

Still, Stephen had a DUI five years ago, but he still regularly engages in drinking and driving, however, and occasionally comes home from after-work gatherings completely intoxicated. Stephen has no plans on quitting drinking or seeking help for his problem despite escalating issues with his wife and ongoing risky behavior.

All Alcoholics Need Help

High-functioning alcoholics, despite an outward appearance of relative normality, still face the same risks as anyone who engages in alcohol abuse, such as damage to relationships, loss of employment, and threats to security.

Also, they continually endanger themselves and others when intoxicated,  possibly just one DUI away from long-term incarceration due to vehicular homicide.

Finally, they incur the same increased risks for liver cirrhosis, pancreatitis, and cancers of the throat, esophagus, liver, colon, and breast.

Moreover, high-functioning alcoholics are by no means immune to the effects of alcoholism, and should immediately seek help in the form of detox and long-term inpatient or outpatient addiction treatment.

Getting More Information
We provide a comprehensive, holistic method to treatment, encompassing a wide array of different evidence-based practices in combination. All of Midwood Addiction Treatment’s primary therapists are either licensed or master’s level clinicians; our programs are structured with various components of evidence-based treatment practices and holistic approaches to treatment that provide our patients with the knowledge and tools they need to be successful in their recovery.

If you or your loved one is suffering from substance abuse, please seek help as soon as possible.

Call us now to learn about our treatment options.

888-MAT-1110

Delerium Tremens

Delirium Tremens | Midwood Addiction Treatment

DTs, or delirium tremens, is a rapid attack of disturbing, possibly life-threatening symptoms brought about by abrupt cessation of alcohol. It is sometimes referred to as Alcohol Withdrawal Delerium (AWD.)

The typical onset of symptoms is about 72 hours after the last drink and persists for another 2-3 days.

About 50% of alcoholics will experience withdrawal symptoms upon cessation. Of these, up to 5% will develop DTs or have seizures. Long-term alcoholics are at the greatest risk for DTs, especially if they are suddenly unable to drink without immediate access to medical care.

Effects may include the following:
  • Shaking and shivering
  • Sweating
  • Arrhythmia (irregular heartbeat)
  • Hallucinations
  • Elevated body temperature
  • Seizures

Occasionally, experiencing an elevated body temperature or seizures can be fatal. Alcohol is one of the few substances that may produce life-threatening withdrawal effects. Benzodiazepine and barbiturate withdrawals can produce similar symptoms, however.

DTs usually occur only in those who have consumed alcohol heavily for over 30 days. Symptoms are often worse at night.

Signs and Symptoms of Delerium Tremens (DTs)?

The primary symptoms of DTs include the following:

  • Nightmares and disturbed sleep
  • Agitation
  • Confusion and disorientation
  • Hallucinations and environmental illusions (visual, auditory)
  • Formication (tactile hallucinations “crawling skin”)
  • Fever
  • Hypertension
  • Excessive sweating
  • Increased heart rate

Moreover, DTs is the most severe sign of alcohol withdrawal syndrome. DTs often include intense feelings of fear, anxiety, paranoia, approaching doom, and imminent death.

DTs can also produce uncontrollable tremors in the extremities, panic attacks, and confusion. The latter is frequently noticed by others as those suffering from DTs often have difficulty constructing simple sentences and performing basic calculations.

The usual cause of death during an episode of DTs is cardiac collapse.

What Causes Delerium Tremens?

Delirium Tremens | Midwood Addiction TreatmentThe exact cause of DTs is up for debate but is widely thought to be related to the neurotransmitter GABA, a chemical responsible for inducing relaxation and peace.

Moreover, drinking extreme amounts of alcohol, especially over a long period, impacts the body’s ability to regulate GABA.

To elaborate, when a person drinks excessively, experts believe that the body begins to mistake alcohol for GABA, and as a result, reduces production. So when a chronic alcohol abuser stops drinking abruptly, alcohol levels decline, and the body interprets this not having enough GABA to properly function.

This condition then leads to DTs. Christopher Pelic, MD and Hugh Myrick, MD stated the following in the journal Current Psychiatry (2003).

” The implication is that withdrawing alcohol triggers an “excitatory state” until the brain can readjust the fine balance between excitation and inhibition, a process that takes weeks to months. Some changes may never reverse because of the neurotoxic effects of alcohol and alcohol withdrawal.”

Is DTs the Same as Alcoholic Hallucinosis?

Delirium tremens is different from alcoholic hallucinosis (AH) as the latter manifests in around 20 percent of alcoholics admitted to a hospital and is not often fatal. DTs, on the other hand, is rarer and occurs in up to 10% of alcoholics, yet is fatal 15-40% of the time, depending on whether or not the individual receives treatment.

Finally, DTs are often characterized by “altered sensorium” or a full hallucinogenic experience without real-world perception. AH is rarer, and is usually limited to intense, acoustic, auditory hallucinations.

Treatment for DTs

Delirium Tremens | Midwood Addiction TreatmentAlcohol-induced DTs often require aggressive treatment and high doses of benzodiazepines (benzos) may be needed to avoid death.

Through the worse phase of DTs, the person typically remains sedated with benzos such as diazepam (Valium) or lorazepam (Ativan.)

Other pharmaceutical treatments include Haloperidol, an antipsychotic, intravenous thiamine, and Acamprosate.

Treatment should ideally be administered in intensive care unit. As noted, the death rate without treatment is about 15%-40%, but medically supervised patients die in approximately 1%-4% of cases.

Delerium Tremens: A Case Study

The following story (with minor edits) originated from Reddit and details a individuals’ personal experience with DTs.

“When I stopped drinking I was fantastically anxious. My ears were ringing, and it felt like I was surrounded by static. In fact, I felt like the world was closing in on me.

I went to lunch at a regular place, and I was sweating. I could not hear my lunch companion, but I could see her lips moving and her eating. …the guy across the restaurant, five tables away, I imagined I could hear his conversation as clear as a bell.

I returned to my office, and I had a panic attack believing irrationally that if I continued standing or walking around, I would be sucked out of my office window and that I would fall to my death. I laid down on my carpet and sunk my fingers into the pile of the carpet for safety. My heart was racing.

Everything I looked at was washed out…or looked as if it had been burned out. I had intrusive thoughts, and I could not sleep. The panic, the sweats, the crazy thoughts, the audio hallucinations, and the panic and racing thoughts continued for a few days, but never as bad as this meltdown moment around the first day or two.”

 

Getting More Information
We provide a comprehensive, holistic method to treatment, encompassing a wide array of different evidence-based practices in combination. All of Midwood Addiction Treatment’s primary therapists are either licensed or master’s level clinicians.

Our programs are structured with various components of evidence-based treatment practices and holistic approaches to treatment that provide our patients with the knowledge and tools they need to be successful in their recovery.

If you or your loved one is suffering from substance abuse, please seek help as soon as possible.

Call us now to learn about our treatment options.

888-MAT-1110