Laura now realizes that this is no longer a joke. While she used to kid around calling herself a “functioning alcoholic,” that all changed when, after many attempts at cutting back, stopping drinking for a period of time, or setting limits, she suddenly lost her job of 10 years. She made an error that cost her company thousands of dollars and they fired her.

This was not her first mistake at work. Although the mistake was not attributed to alcohol use, it was serious enough to result in termination. Deep down in her heart, she questioned whether her nightly alcohol use had contributed but she then remembered that she is functioning just fine in all other areas of her life so she discounted these thoughts.

Here’s the back story:

Laura is a 40-something wife, mother, and sister seemingly at the top of her game. She has a graduate degree. She and her husband have been married for 16 years. They own a modest home in a nice suburban community. Her kids, ages 9 and 14, are busy and seem to be thriving. They are doing well in school and are active in after school activities.

Laura had been stable and secure in her job and had been doing it so long that she joked she could do it in her sleep. Her friends, family, and colleagues marvel at her ability to juggle fulltime work with managing a busy household. She is the family’s major breadwinner. She tries to attend her kids’ soccer and lacrosse games and participates in several carpools, although she prefers to avoid late-night pickups.

Once Laura gets home, she begins dinner prep for the family. She pours herself a glass of wine in order to unwind after a long day, because who doesn’t? Work is stressful, juggling is stressful. She tells herself “I deserve it.” When the family sits down for dinner, she pours herself a second glass and her husband has one as well. She keeps topping her glass off until the entire bottle is empty. She and her husband clean up from dinner and it’s time for the evening rituals of homework, bathing and teeth brushing for the children.

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Laura sits down at her computer to check her emails, pay bills and do some online shopping. Without even thinking, Laura opens another bottle of wine for herself. By the end of the evening she is watching TV and without much thought, opens another bottle of wine in order to drink a glass from it. Again, before she knows it a second bottle is empty. But she justifies, rationalizing that her husband did have one glass.

The following night she is scheduled to have dinner with a couple of girlfriends – other moms in the neighborhood. She has a quick glass of wine as she puts on her makeup, “pre-gaming” as they call it. At dinner, the three women each have a cocktail and share a bottle of wine. Laura returns home and sits in front of the TV. Without even thinking, she pours herself a glass of wine and before the glass is empty, tops it off one more time.

She doesn’t want to think about it, but she has had about 4-5 glasses of wine and a cocktail throughout the evening. There is a nagging feeling in her gut and her mind: “Is this a problem?” She quickly dismisses these thoughts and remembers that she is functioning just fine. No need to do anything differently.

Laura has a fitful night’s sleep and wakes up at 6am feeling groggy, with a headache and very dry mouth. She feels anxious. She looks in the mirror and notices that her skin is puffy under her eyes. She does the best she can with her makeup and figures her glasses will take care of the rest. She makes the kids lunches and gets them on the school bus before making her way to work.

This scenario plays out in one form or another almost every day of the week. On the weekends, her husband lets her sleep in while he takes care of the kids. After a week of early mornings and poor sleep, she is exhausted.

It wasn’t always like this for Laura. She hardly drank as a teenager or in college. She began having a glass of wine with her husband before the kids were born. During her maternity leaves, she would start drinking wine late in the afternoon before her husband came home as a way to unwind. Over the years, this progressed to where we find her now, drinking 2 bottles of wine a night and “barely feeling it.”

She has considered herself to be “functioning alcoholic.” That all changed when she got fired. After she was laid off, she became depressed and started taking antidepressants and antianxiety meds for her now increased levels of anxiety. Her wine consumption remained at 1-2 bottles per night. She began therapy but when she discussed drinking with her therapist, she minimized the amount that she really drank.

This is an all too common scenario. Does it sound like anyone that you know? Or do parts of the story apply? Alcohol Use Disorder (AUD) is now seen as a spectrum of usage patterns and amounts. Click here to learn what the National Institute for Alcohol Abuse and Alcoholism has to say.

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AUD can manifest in different forms: nightly drinking or binge drinking. But AUD in any form is progressive and gets worse over time. Abnormal pathways in the brain are established and there is little to no input through the prefrontal portion of the brain which helps regulate decision making. or this reason, more and more negative consequences occur including DUI’s, job loss, failed relationships and even incarceration.

I think the term “functioning alcoholic” is worth exploring. I believe it’s a myth. It can only go on so long because alcohol is an addictive substance and, as tolerance develops, use increases in order to keep the body from cravings and physical withdrawal. I recently read the term “currently functioning alcoholic” and to me, this is a much more accurate and realistic way of thinking about it. Eventually, the walls will cave in.

So, if you or someone you know and love uses the term “functioning alcoholic” to describe themselves, I hope that something will go off in your head to question whether the person is really functioning as well as they think they are and realize that their drinking will only increase until they make a change. Change can happen at any time. One does not have to hit “rock bottom” as believed in the past. Yes, sometimes that does happen but wouldn’t it be better to intervene before then?

Not every person with AUD needs detox. Withdrawal from alcohol can be dangerous. Your Primary Care Physician or an addiction specialist should review your case. If detox is recommended, the Coleman Institute for Addiction Medicine can help you detox safely and comfortably in 3-4 days. We have a proven track record for over 20 years. After that, we can help you develop a personalized plan that supports sustained recovery. And we will stay with you on your journey if you need us. We believe in you!

Deborah Reich, MD

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