It’s extremely common for addicts to rationalize their substance use and minimize its gravity. This why it shouldn’t be surprising that they try to maintain high-functioning façades for loved ones and coworkers. But not everything is as it seems. Someone who may appear to have it all together could be seconds from intense withdrawal. Addicts will nearly always believe that they don’t have a problem until it’s too late – maybe not even then. The ability to maintain belief in their functionality stops them from asking for help. It also keeps friends and family from making a fuss about troubling signs they’ve noticed. Read on to learn why the “high-functioning addict” is a dangerous myth that we should seek to dispel.  

The Spectrum of Addiction

Addiction exists on a spectrum of severity, also called the continuum of substance use/abuse. Depending on quality of life and substance use habits, physicians consider drug use mild, moderate, or severe in nature. Before the DSM-5’s changes in criteria, substance use and substance abuse were two separate diagnoses. Today, these exist under the shared definition of substance use disorder.

Mild addiction

Includes experimentation with drugs and alcohol, usually in a social setting. These individuals may try marijuana at a party or take a friend’s Adderall to prep for an exam. This use isn’t associated with any sort of drive or need beyond interest or peer pressure.

Moderate addiction

Defined by the development of habitual behavior. The person is using consistently in a social or recreational way. Maybe they smoke every day after work or drink heavily every weekend. Casual users begin to overindulge and experience consequences for their actions – hangovers, missing class or work, and academic or career failures are common at this stage. Dependence may develop, characterized by cravings, tolerance, and withdrawal symptoms. Individuals continue using despite issues created by the substance.

Severe addiction

Also known as compulsive use. Here, the substance takes precedent over everything else in life. Work, school, family, friends, and hobbies all fall by the wayside in favor of using. The addict uses in inappropriate or risky situations and may experience legal consequences for this (DUI or DWI). Cravings dictate behavior.  

Who is High-Functioning?

Your perception of an addict has to shift significantly in order to understand the high-functioning addict or alcoholic. They aren’t homeless or all alone – far from it. They probably have successful careers and loving families. Unfortunately, they’re very close to losing it all. You can distinguish high-functioning addicts from nonusers with the following signs:

• They make excuses for their use. Maybe they argue that cocktail hours or long nights out are a requirement for their profession, or they claim that their substance use is deserved because of their success.
• They often consume more than they mean to. “Just one drink” spirals into two, three, four, all the way up to blackout drunk, often in inappropriate contexts.
• Their friends have issues with drugs or alcohol. The phrase “you are who you hang out with” applies here. If their close-knit group of friends is made up of binge drinkers or users, it’s a sign that your loved one could eventually turn down this path.
• They look haggard or ill in the mornings. This may be explained away by claims of poor sleep or hating mornings, but can be a key indicator of hangovers, comedown, or withdrawal.
• They’re beginning to care less about their passions. Drugs and alcohol will begin to fill up time once reserved for hobbies.

Addiction as a Progressive Disease

At its core, addiction is more similar to heart disease than one may think. Both of these conditions have elements that categorize them as progressive. This means that they have a set pattern of development and that they worsen over time. For addiction, this all happens within the context of the brain. As someone consumes drugs and alcohol, the brain is constantly adapting and rewiring. Neurotransmission alters, and the body develops a tolerance to the substance of choice. The way that the brain communicates within itself (and to the rest of the body) is fundamentally changed. The reward system also transforms, radically impacted by foreign substances, affecting how one perceives life without the substance. These changes become more and more dramatic as time passes in active addiction. The body develops a tolerance along with cravings, and once a threshold is passed, withdrawal symptoms begin to come into play, too. All of these factors create the drive to snowball, quickly degenerating the addiction as one consumes more and more of the substance at ever-shortening intervals. As the substance use worsens, those delicate façades of normalcy begin to crumble. Addiction is selfish. That attitude takes over every aspect of one’s life, from career to family, and drugs start to come first. What may begin as a few call-offs at work could turn into several unscheduled absences and missed deadlines, eventually resulting in job loss. Pushing away a spouse and keeping a few secrets only becomes more common as use continues, and it’s typical for that to result in separation or divorce. Nobody starts drinking or using with the intent of becoming addicted. No one thinks they’re out of control. It’s a natural part of the process, which is why it’s important to stop while you’re still able to.  

Is It Too Early to Seek Help?

Often, one of the biggest barriers to treatment is a false conviction that “it’s not bad enough” yet. This is due to the pervasive belief that an addict must hit “rock bottom” in order to receive help. Studies actually show better outcomes the earlier addiction is treated – this means that wasting time waiting for things to deteriorate only creates more damage. It’s also commonly held that the addict must be willing to seek treatment in order to get clean. This is untrue as well; research indicates that even those who enter rehab without volunteering are better off than people who received no treatment whatsoever. While it’s always preferable for someone to desire treatment themselves, often an intervention or other focused conversation is necessary to illustrate just how out of hand things have gotten, motivating them to pursue professional help.  

Addiction Treatment for All

At Spearhead Lodge, we help young men at every phase of the addiction process. From high-functioning addicts to those with multiple relapses, we understand that treatment should be a fully individualized process. No two situations are the same. If you recognize signs that your loved one is a high-functioning addict, we encourage you to call us today at 888-483-0528, before it’s too late.