“It can be difficult to admit to yourself and loved ones that drugs are destroying your life when, on the surface, your life seems seems to be going okay. You have money and are able to work. Your friends, colleagues and even society tells you that you’re doing well and you want to believe them. This is the struggle experienced by some high functioning addicts and is often what prevents them from seeking help.”
— Dr. Mel Pohl, Chief Medical Officer at Las Vegas Recovery Center
By many people’s standards, Carly led a very successful life. She worked for a prestigious law firm, owned two homes and had the support of a loving husband and two adorable daughters. Yet Carly harbored a secret; a secret she’d been keeping even from herself. Carly was addicted to the prescription painkiller oxycodone. She had been for months; ever since she’d been injured in a skiing accident. Although few would probably be able to tell, Carly’s life had become unmanageable. Her supply of doctor-prescribed Oxycotin had run out, so she’d started ordering them off the Internet, dipping into the money her family had been saving for their upcoming vacation. She found herself lying all the time to her husband and colleagues about her irritability and moodiness and had stopped hanging out with friends. Carly knew what she was doing wasn’t healthy, but stopping now would mean she would be in pain again. While her addiction had caused some problems at home and work, it was still a better alternative to the excruciating chronic pain. Plus, everyone used pain medication these days, she reasoned. Half her clients and two of her coworkers were on them! How bad could it possibly be? Carly, like many addicts in prestigious, high-stress careers, is what addiction specialists refer to as a “high functioning addict”. Although she is physically dependent on a substance, she hasn’t yet lived through the life catastrophes commonly experienced by those with a substance use disorder. She hasn’t lost her job or spouse and she hasn’t been in trouble with the law. Few people have confronted her about her addiction because few, if anyone, know she has a serious problem.
Is the high-functioning addict the ‘new normal’?
19.5% of all alcoholics in the US (roughly four million Americans) are considered “functioning alcoholics”, according to a 2007 study by the National Institute of Alcohol Abuse and Alcoholism (NIAAA). With prescription painkiller misuse and abuse on the rise over the last decade, more of these high-functioning career men and women are now abusing prescription and illicit drugs as well. An estimated 1.9 million Americans experienced a pain medication use disorder in the last year, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Is high-functioning addiction becoming the new normal? Dr. Mark Willenbring, the former Director of Recovery Research at NIAAA, has pointed out that the face of addiction is changing. In an article on TheFix.com, Willenbring was quoted as saying: “Alcoholism isn’t what it used to be. We think of it as this really dramatic, debilitating disorder, but actually there is a wide range of alcoholism, from moderate drinking to at-risk drinking. Every alcoholic isn’t Mel Gibson or Lindsey Lohan…” Although he was speaking specifically about alcoholism, the same can be said of drug addiction. And that is precisely what can be confusing to friends and family members who suspect their loved one may have a problem with drugs. The addict’s behavior is erratic and irrational yet when pressed, he or she always has a reasonable-sounding excuse. “I’m just stressed and tired,” they may say. “I’m under a lot of pressure at work and just need to blow off some steam.” The following is a guide on how to tell if your friend or relative is a high functioning addict and what you can do to get them help before their addiction symptoms worsen.
Drugs frequently used by functioning addicts:
- Prescription painkillers: Many high-functioning opioid addicts begin abusing painkillers as teenagers and/or after being legally prescribed the medications by a doctor. While they may start taking the narcotic as a remedy for an injury or chronic pain, the highly addictive nature of opioid medications puts some at risk of developing tolerance, dependence, and addiction.
- Cocaine: Because cocaine is a stimulant, it can be a popular drug of choice for those in jobs that demand long hours and odd sleep schedules.
- Meth: Although people who use methamphetamines aren’t likely to stay high functioning for long, meth is used by risk-taking students, creatives, and workers in highly competitive fields.
Professions most at risk for high-functioning addiction:
Although high-functioning addiction isn’t limited to a specific industry, the following careers tend to produce a higher-than-average percentage of people who abuse alcohol and/or drugs. This is often due to the highly competitive and stressful nature of the positions.
Doctors and nurses have easy access to medications, which puts them at a higher risk for addiction. The stress of working long hours and the pressure to perform can also make them vulnerable to abuse.
Police officers are at a high risk of addiction because their stressful and dangerous jobs mean they are often prone to anxiety and depression, which can lead to alcohol and drug abuse and addiction.
One study found that over 20 percent of lawyers meet the criteria for an alcohol use disorder diagnosis, which is twice the national average. Lawyers work long hours and will often turn to alcohol as a stress reliever and then stimulants, like cocaine, in an effort to help them stay alert and focused.
Advertising companies often encourage social drinking, where it is not uncommon to meet with clients and coworkers for drinks both during and after work. This tolerance for drinking and drug use across the industry can result in smart and driven advertising executives developing problematic coping techniques.
The inconsistent pay, hard work, and odd hours make someone in sales prone to becoming a high-functioning addict. People in sales often spend a lot of time on the road, which can lead to loneliness and isolation; two of the risk factors for addiction.
Lies high-functioning addicts often tell themselves and others
“I have a great job and a wonderful family. People with successful careers and loving families don’t have addiction problems.” “There’s no way I use/drink enough to be addicted.” “I can’t have a problem because I don’t use/drink every day.” “I have a lot of stress and I work really hard. I deserve to have fun every once in a while!” “Everyone else uses/drinks as much as I do—a lot of them use/drink even more than I do!” “Drug rehab is for people with real problems, like homeless people.” “You have to drink/use to work in my industry. Everyone does it.”
Signs and Symptoms:
- They always have an excuse
An addict’s denials about their drug use frequently sound reasonable. Maybe they’ll say they’re “just stressed” or that their drug use is normal because all of their friends and co-workers use more than they do. While loved ones may buy the excuses at first, eventually it will become clear that things just aren’t adding up.
- Unexplained financial issues
If your friend or loved one is always asking for money or seems to have continual financial woes despite the fact that they have a well paying job and few major expenses, then this could be another red flag that their drug use has become unmanageable.
- All their friends are big partiers
A high-functioning addict will often use the excuse of “But all my friends do more drugs then I do!” to explain away their addiction. Having a lot of acquaintances who heavily abuse substances is not typical, however, and this should be a red flag.
- They can’t stop or control their drug use
Addicts will swear to themselves and to you that “today they won’t use”. Because addicts are able to fulfill that promise every once in a while, their loved ones will commonly take that as a sign that “maybe they don’t have a problem after all.” Friends and family shouldn’t focus on the exception, however, but rather on the behavior as a whole. If nine times out of 10, your loved one uses after they’ve promised they wouldn’t, then this is one of the biggest signs he or she is in trouble.
- They look sick (especially in the morning)
The physical signs and symptoms will differ depending on the substance, but if your loved one generally has a a sluggish or “unwell” look about them, they might be experiencing withdrawal symptoms.
Why it’s difficult to convince a high-functioning addict or alcoholic to get help
- They use their successes in life to justify their drug abuse
When confronted about their using or drinking, high-functioning addicts or alcoholics will often list their numerous successful achievements as evidence for why they don’t need to seek help. They’ll point to their high-paying job, their recent promotion, or their nice home and fancy car as proof that they don’t need therapy or rehab. Often times these people are well-respected experts in their fields or esteemed members of their community. When you couple this with the stereotype many have of a “typical addict” being the corner drug dealer, prostitute, or vagabond living under the bridge, the high functioning addict has all the arguments he needs to fuel his denial. This can make it hard for them to see reality clearly.
- They haven’t experienced significant problems as a result of their using
By definition, a high-functioning addict has been able to keep their using from completely destroying their lives, hence the word “functioning”. Because their addiction has been somewhat maintained, they feel as if they don’t need to stop because “they’ve got everything under control”. This is just an illusion, however. While some may be able to remain an addict their entire lives without facing any monumental negative consequences, that number is low. Even if an addict is able to keep his job and avoid run-ins with the law, his relationships, health, and quality of life will suffer.
- They have less pressure to change
Because they’re often extremely adept at hiding their addiction, work colleagues, friends and even family members may not be aware of the extent of their using. Because few have noticed or confronted them about it, they feel they don’t need to make any changes.
- They may not meet all the diagnostic criteria
Mental health professionals use a set of criteria determined by the Diagnostic and Statistical Manual of Mental Disorders in order to determine whether or not someone has a substance use disorder. Because high functioning addicts frequently aren’t able to check off every box on the signs and symptoms list (they haven’t experienced “repeated legal problems”, for example), they assume this means they don’t have an issue.
- They feel they don’t have time for rehab
While it can be tough for anyone to take 30 to 60 days away from work and family responsibilities to stay in a treatment facility, it can be particularly difficult for someone whose identity and feelings of self-worth are so closely tied to their careers. Plus, their jobs may demand they work 60 to 80 hours a week, and they may feel it’s simply impossible to devote the time to get away.
How to help a functioning addict
Stop enabling The best way for you to help a functioning addict (or any addict) is to first identify the ways in which you might be enabling their addiction. Are you avoiding confronting them? Are you looking the other way or making excuses for them when you know you shouldn’t? Are you supporting them financially in any way? Once you’ve identified the ways in which you may be contributing to the problem, you’ll need to stop these enabling behaviors immediately. Educate yourself
Knowledge is power. Before you confront your loved one, make sure you’re first armed with all of the facts. Read addiction literature and speak to an addiction specialist or treatment center. Get help for yourself first You won’t be able to help your loved one if you yourself are drowning in feelings of anger, resentment, pain and fear. While these are all common emotions and completely expected given the circumstances, the best thing you can do for your friend or family member is to ensure you’re in the best emotional place possible. Seek out a support group or therapist or contact a recovery center. The admissions counselors at Las Vegas Recovery Center are available 24 hours a day to take your call and field any questions you may have about you or your loved one’s particular situation.