March 23rd, 2022
A key function of National Drug and Alcohol Facts Week is to provide clear and concise factual information regarding drugs and alcohol to those who are curious and/or concerned about substance use. As a Certified Alcohol and Drug Counselor, I have witnessed how myths about addiction can often prevail over the truth. Part of the reason that myths about addiction become prevalent is that there is still a strong stigma regarding those who experience addiction.
When I ask people what they think about when thinking of someone who has a substance use disorder, it is likely that an image of someone like Rue fromEuphoria or Jackson Maine fromA Star is Borncomes to mind. Both of these characters struggle with addiction in a chaotic way.
In Euphoria we see Rue damage relationships, experience overdose, and risk her safety throughout her addiction to opiates while in A Star is Born we see Jackson Maine ruin relationships and swindle his career due to his problem with alcohol use. Both of these depictions of addiction are valid and real, however, they do not capture the experience of every person who has a substance use disorder.
This is where the myth of the “high-functioning addict” comes to the table. Someone who may think of themself as high functioning in their addiction may report that they are able to maintain their careers, responsibilities, and families while using substances maladaptively.
Often the ability to maintain these areas of life is why someone with addiction may not seek treatment. This might lead them to continue to use substances in a harmful way which can lead to lasting consequences. The chain of events I describe here is why I believe that the phrase “high-functioning addict” is harmful and is a myth that should ultimately be debunked.
Before discussing the issues with the phrase, “high functioning addiction,” I think it is first important to identify what it means to have an addiction. The following criteria as described in the DSM-5 are associated with a diagnosis of a substance use disorder:
Someone who meets two criteria has a mild substance use disorder, someone who meets three to five criteria has a moderate substance use disorder and lastly, someone who meets six or more criteria has a severe substance use disorder.
I include the diagnostic criteria for substance use disorders because it communicates the wide variety of symptoms that can contribute to maladaptive substance use. As you can see, the only symptoms of addiction that are related to fulfilling responsibilities at work, home, or school are criteria number five, six, seven, eight, and nine. This means that someone could be managing each of those areas well and still meet the criteria for a severe substance use disorder.
This reality can be dangerous as there is an increased risk of numerous consequences to continued abuse of substances. Some consequences of maladaptive substance use include:
If someone believes that they are high functioning in their addiction, they may not have awareness of the above consequences. By not acknowledging these risks for those who are able to maintain responsibilities at home, work, and school while having a substance use disorder, we lose an opportunity to prevent greater suffering. If you believe that you or someone you love is “high functioning” in their addiction, it is important to seek support and treatment.
There are a variety of types of treatment and support for someone who has a substance use disorder. Below I will describe the various forms of help that are available:
No matter how someone’s substance use disorder is presenting, they will likely need support and possibly treatment to find healing. Categorizing someone as “high functioning” may prevent them from seeking support which is a disservice to them and those who care for them.
Written By: Sarah Beerman, LCSW, CADC
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