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High-Functioning Substance Users: Do They Need Treatment?

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The term “high-functioning substance users” is not new.  It refers to people who maintain their jobs and perform daily tasks while concealing their drug or alcohol problems. Chances are you know someone with this problem without being aware.

In this piece, we will explore how these individuals maintain a seemingly normal life, and why they need to seek treatment before their addiction destroys everything they hold dear.

High-Functioning Substance Users are Good at Hiding the Truth

High-functioning substance users find ways to live a double life.  Others may see their lives as normal, but behind the scenes, an addiction lurks.  How does a person manage to continue the deception?  

It is not uncommon for high-functioning substance users to be intelligent, educated, and successful professionals.  Many of them are executives who have no supervision at work.  Some work from home or may travel often.  This provides an opportunity to secretly manage their substance use.  

Most hIgh-functioning substance users may be using the following:

  • Alcohol
  • Cocaine
  • Heroin
  • Prescription drugs
  • Tranquilizers/sedatives
  • Amphetamines
  • Methamphetamine

Although they may be able to keep their secret for a while, they will need professional help eventually.  One key characteristic of high-functioning substance users is that they have several enablers.  

How Do Enablers Play a Role in Keeping the Secret?

High-Functioning Substance UsersThe more enablers the person has, the longer they can keep up their ruse.  Who are the enablers?  They can be friends, coworkers, family members, bosses, doctors, or clients.  Generally, an enabler is someone who helps preserve the secret of the person’s substance abuse.  

Enablers facilitate the person’s ability to continue their deceit.  They may believe they are doing the right thing by helping the individual, and there are a variety of ways to accomplish their mission.  

These are some ways enablers help high-functioning substance users continue the behavior:

> Family and Friend Enablers

Family members and friends become enablers by making excuses or covering for the person’s behavior.  They may avoid the issue or project the blame onto someone or something else.  Financial assistance is also part of an enabler’s role.

> Employer Enablers

When a person is good at their job and making money for the company, it’s easy to overlook their substance use.  The employer may think he’s helping the person by continuing to provide employment.  This level of enabling is most prevalent among very wealthy or talented, famous individuals.  They receive years of enabling from family members, managers, fans, and friends.  

Can They Keep Up the Facade Forever?

It is unfortunate when enabling prevents an individual from acknowledging their substance use disorder until it is too late.  A high-functioning substance user doesn’t think he needs help.  They mistakenly believe everything is under control.  But, the addiction will inevitably take control.  When key parts of a person’s life spiral out of control, it may finally, but belatedly, be a turning point.  

The longer a person continues to lead this double life, the harder it gets to maintain control.  The gradual descent from having it all to losing it all can be a shock. The person must seek professional help to avoid the worst-case scenario.

Excuses High-Functioning Substance Users Make

High-functioning substance users have a handy list of reasons why they do not need help.  They are skilled at being persuasive and convincing.  Some of their excuses may include:

  • “The bills won’t get paid if I’m away from work for 30 days to go to rehab.”
  • “I know what I need to do and can do it without help from a rehab.”
  • “Who will take care of everything while I’m in treatment?  I’ll lose my job.”
  • “I don’t have time for rehab.  All I need is to detox.”

Most high-functioning substance users will do anything to continue their facade.  Before change can happen, it may be up to the enablers to take a stand.

Helping High-Functioning Substance Users Get Treatment

Without taking desperate measures, enablers can encourage a person to seek treatment.  Regardless of why they helped the individual continue the behavior, they must change their own behavior.  

Enablers can encourage someone to seek treatment by doing the following:

  • Family enablers must set and hold firm boundaries.
  • Refuse to lie or cover for the person’s behavior.
  • Don’t drink or do drugs with the person.
  • Resist making threats or unreasonable demands.
  • Stop providing financial assistance.
  • Refuse access to the home or car.
  • Employers can require the person to seek treatment and submit to random drug tests afterward.

No one is immune to addiction.  Although high-functioning substance users feel invincible, their addiction will get worse with time. People who misuse addictive substances face many consequences such as health issues, loss of employment, loss of home and family, and a risk of overdose.  

Help for Substance Use Disorder at Design for Change Recovery

Our team at Design for Change Recovery understands the various components of addiction.  We realize that no one chooses to become addicted.  Drug use problems often include contributing factors such as low self-esteem, social issues, family dynamics, environment, and physical or mental health disorders.

Our comprehensive program includes methodologies that address all contributing factors simultaneously.  In this way, we heal the whole person, not just the addiction.  

If you or someone you love is a high-functioning substance user, contact us today.  We can be reached online or by calling our Lancaster, CA facility directly.  We will be happy to assess your situation and recommend a customized treatment plan that is right for your needs.


  •– High-Functioning Addicts: Intervening Before Trouble HIts
  • – Familial, Social, and Individual Factors Contributing to Risk of Adolescent Substance Use
  • – How to Stop Enabling an Alcoholic or Addict
High-Functioning Substance Users: Do They Need Treatment?