High-Functioning, Still Struggling: What Hidden Addiction Can Look Like 

Functioning substance use is much more common than most people realize. Unfortunately, because it can be easy for some people to hide their addictions, they frequently go untreated, sometimes for years. 

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Perhaps you have concerns about your own substance use, or someone you love seems to be abusing drugs or alcohol. Either way, it is important to understand what functioning substance use is so that those who are impacted are more likely to get the help they need. 

What is High-Functioning Substance Abuse? 

The simplest definition of a high-functioning substance abuser or addict is this: a person who continues to exhibit normal behavior in their everyday life, both professionally and personally, despite struggling with substance abuse. 

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A person in this position may appear to “have it all together” on the outside. They often have strong personal relationships, marriages, and friendships. They may excel at their jobs to the point of working long hours and receiving promotions. 

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Functioning addicts tend to be great at covering up many of the more obvious signs of addiction. It is easy for them to maintain appearances because their tolerance levels are high. This allows them to avoid looking impaired when they are using, and when they aren’t, they can hide their withdrawal symptoms.

How Do Hidden Addictions Go Unnoticed and Untreated? 

An article featured in the Canadian Medical Association Journal (CMAJ) about former Toronto Mayor, Rob Ford’s drug and alcohol use sheds some light on this question. When questioned about his substance abuse issues, Ford stated, “If I’m an addict, I could not show up to work every single day.” The truth is, nothing could be further from the truth for someone with high-functioning substance abuse. 

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Dr. Steven Melemis specializes in treating addiction in Toronto. He stated, “The job is always the last thing that goes...you need your job first and foremost to continue with your addiction.” Of course, substance abuse does tend to be progressive in nature unless something is done to interrupt that progression. That is why Dr. Melemis prefers to use the term, currently functioning addict. 

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There are several reasons substance abuse problems may go unnoticed and untreated for high-functioning individuals, including: 

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• Employers may not want to intervene unless job requirements are no longer being fulfilled.
• Family members may not want to rock the boat if anger issues or other mental health concerns are present. 
• Socially, alcohol and even drug use may be accepted as normal for some types of professionals. 

What are the Common Characteristics of Currently Functioning Addict? 

If you suspect that someone you love is a high-functioning substance abuser, here are some of the characteristics you can look for. 

The Inability to Stop Using

People with substance abuse issues may attempt to cut down on how much or how often they use without success. It is also common for them to use drugs and alcohol in secret, such as in the middle of the night, or only at the office. 

The Need to Constantly Use More

Ever-increasing tolerance is a common sign of addiction. When an individual finds that they need to regularly use more of a substance to feel its effects, they are likely already heavily addicted. 

Being in Denial

High-functioning addicts tend to deny having substance abuse problems until they hit rock bottom. Even then, they may blame others instead of taking responsibility for their own behaviors. 

Rationalizing Their Behavior

Rationalization is extremely common among high-functioning individuals with substance abuse issues. For example, the person may insist that drinking alcohol helps them unwind at the end of the day, but in reality, it’s a way of self-medicating anxiety or depression. 

Poor or Declining Physical Health

Continued substance abuse will eventually lead to serious health issues as it progresses. A health decline may not be as obvious in someone who is a high-functioning addict, but any of the following may eventually become a concern: 

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• Weaker immune system, which means more frequent illnesses
• Brain damage
• Heart issues
• Hormonal problems
• Liver or pancreas issues
• Skin or muscle problems
• Gastrointestinal difficulties or conditions
• Chronic pain
• Feeling physically exhausted, with or without breathing issues
• Changes in weight, malnourishment, dehydration, and vitamin deficiencies

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Physical health issues should be treated by a doctor right away. However, it is vitally important for the individual’s health team to be fully informed about their substance abuse issues. This will allow for a more well-rounded treatment plan that addresses all aspects of their health at the same time. 

Treatment Options for High-Functioning Addiction

Effectively treating substance abuse requires a personalized treatment plan. Without a tailored plan in place that addresses every aspect of the person’s needs, they are likely to return to using. 

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For a person with high-functioning addiction, inpatient treatment may not always be a viable option. However, there are other ways to move forward with recovery, including: 

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• Medical detox to address withdrawal symptoms. 
• Medication-assisted treatment, which has demonstrated successful outcomes.
• Intensive outpatient programs, which offer a higher level of care and the necessary flexibility.

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Family therapy, behavioral therapy, and even 12-Step Programs may also become vital parts of a person’s treatment plan. 

Treating High-Functioning Substance Abuse at Focus Treatment Centers

At Focus Treatment Centers, we have worked with many people who struggle with high-functioning addictions. We understand their unique needs and the best way to address the issues they face, including offering dual diagnosis treatment to address mental health concerns. 

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If you are a high-functioning substance abuser, please know that you are not alone. You may be tempted to attempt to recover on your own; however, that can be dangerous. Professional recovery help is available to you. 

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To learn more, please contact Focus Treatment Centers today by calling 423-308-2560. 

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