Understanding the High-Functioning Addict And Why Treatment Matters

High-functioning addiction often acts to keep addiction hidden and help you stay in denial. By acknowledging the reality of the high-functioning addict and the unique dangers high function presents, you can come to appreciate the need for intensive treatment and the possibilities of life without substance abuse.

Jennifer Matesa is a loving wife, a wonderful mother, a celebrated writer. She is also an opioid addict. In her 20s, the painkillers were meant to stave off migraines and fibromyalgia, afflictions that worsened as she entered her 30s. But she quickly discovered that the pills could do more than just relieve her of her physical pain and she found herself chewing Vicodin with breakfast the way other people have coffee. As she writes in a moving essay about her experience:

“My ‘high’ was never the stereotypical sleepiness or so-called ‘nodding out’—it was like a shot of energy making me alert and able to tackle whatever life threw at me with less stress and anxiety. It was the only way I could handle juggling my work, my son, my marriage, and the upkeep of our large three-story house and garden. Without the drugs, I was terrified I’d crack.”

Soon, Vicodin with breakfast turned into putting Fentanyl patches on the roof of her mouth, doctoring dates on her prescriptions, and going into deep withdrawals on days between refills. And, yet, Jennifer’s addiction remained invisible even to her own husband, who knew nothing about the way his wife feared she would disintegrate when the patches ran low and attributed the shivers of withdrawal to the flu. “I was a respectable, high-functioning female,” she says, and, as a high-functioning addict, her illness eluded detection for years.

As for so many, high functionality was a cloak that allowed Jennifer to keep her struggle with addictionhidden from herself, her loved ones, and the world. And, like for so many, that high functionality ultimately delayed her getting the help she needed to heal. If you think you may be struggling with high-functioning addiction, understanding the realities and dangers of this condition is essential to regaining wellness.

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Acknowledging the High-Functioning Addict

When we think about addiction, we often focus on functional impairment—losing your job, being unable to have relationships, being too drunk to pick up your kids from school, losing the ability to care for yourself. However, while addiction indeed often triggers loss of function, that loss of function is not an inherent part of addiction itself; contrary to what many believe, people can and do maintain illustrious careers, loving relationships, and stable daily lives even in the midst of active addiction.

Dr. Howard Boss, Associate Director for Clinical and Translational Research at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), for example, says that, “Nearly 20 percent of alcoholics are highly functional and well-educated with good incomes.” Meanwhile, highly accomplished tech workers are increasingly sharing their struggles with cocaine addiction that have flourished during the height of their careers. Even some opioid users like Jennifer are able to keep performing at a high level personally and professionally while falling deeper into addiction. Functionality and addiction are in no way antithetical and drug use itself may actually enhance your perception of your own functionality, particularly if you are using it to cope with underlying psychological issues.

The Dangers of High-Functioning Addiction

While some erroneously believe that high functionality means you are insulated from the damage of substance abuse, in reality high-functioning addiction carries its own unique risks. Without obvious functional disruption, many high-functioning addicts are able to stay in a state of denial and fail to get early treatment, allowing their addiction to grow unfettered. As Melissa, a 55-year-old attorney, says.

I was so high-functioning with a good job, a husband and a big house that even if someone had come and told me I was an alcoholic, I wouldn’t have believed them. I was doing really high-level work for really prestigious firms, and it allowed me to maintain my level of denial because I thought if I can do all these things—if my bosses are giving me all this responsibility—I must be doing fine.

And your denial isn’t the only thing fuelled by high-functioning addiction; by keeping your addiction hidden under your accomplishments, you deny those around you the opportunity to recognize that you need help. Jim, 34, graduated from an Ivy League college and attended a prestigious MBA program before embarking on an illustrious and lucrative career. He was also addicted to heroin. “I used heroin like a gentleman, sniffing it for years. I didn’t shoot up. And because I went to good schools, had good jobs, and was making lots of money, nobody cared until the end,” he says. “Being a junkie was legitimized for me because I was doing well in all other areas of my life.”

Unfortunately, it often isn’t until you face obvious consequences of your addiction that you are able to break through your denial. For Melissa, that moment came when her functionality began to crumble and she faced the prospect of losing her job. It was only then that she realized she was powerless over her drinking and sought treatment. Today, she credits that moment with saving her life. “Do you want to get treatment when you have just gotten cancer or when you’re at stage four?” she asks. “I’m really blessed that I managed to get sober when I did, and not when I had nothing left to lose.” For others, however, the fact of being a high-functioning addict closes the door to opportunities for early intervention, letting your addiction grow stronger.

Seeking Treatment For the High-Functioning Addict

Research tells us again and again that early treatment leads to the best outcomes for all forms of addiction. If you believe you may be struggling with drug or alcohol addiction, seeking help as soon as possible is the best thing you can do. Of course, it is also never too late to seek treatment; even if you have lived with a substance use disorder for years, treatment can finally give you the chance to break free from addiction and create a new, sober life. However, just as high functionality can cause some to deny the existence of their addiction, it can also cause some to doubt whether they need intensive, residential addiction treatment. There are popular misconceptions that residential care is only meant for the very “worst” cases of addiction and that those worst cases inherently involve a loss of functionality.

In reality, residential addiction treatment programs are ideal settings for virtually anyone struggling with addiction, and clients have a broad range of functional abilities. This is particularly true in private residential treatment programs that cater to executives and other highly accomplished individuals who often exemplify high-functioning addiction. These programs provide the time and space to devote yourself fully to recovery while also allowing you to go through a comprehensive detox, assessment and treatment process. With the guidance of expert clinicians and peers who understand what you are going through, you are able to engage in a broad spectrum of therapies to help you uncover the roots of your addiction—including any co-occurring mental health disorders— and create meaningful strategies to remove those roots. By developing deep insight and concrete coping skills, you can find freedom from your substance abuse and create a strong foundation for ongoing sobriety. Your family can participate in this treatment process through dedicated family programming, helping you forge deeper bonds as you embark on this new chapter in your lives.

The façade of high-functioning addiction can help you disguise your suffering, but it does not remove it. By recognizing your addiction and connecting with a high-quality addiction treatment program, you can start the journey toward true wellness and allow your true self to flourish.

Alta Mira offers comprehensive treatment for people struggling with drug and alcohol addiction as well as co-occurring mental health disorders and process addictions. Contact us to learn more about our renowned Bay Area programs and how we can help you or your loved one find lasting recovery.