The most common interpretations we see of people with substance use disorder are usually accompanied by very undignified and inaccurate depictions of individuals who, in reality, have a treatable disease. The damaging stigma surrounding addiction make it much more difficult for people to come to terms with having this illness, and even more difficult to seek help from medical professionals. These stereotypical characters often are seen at their lowest points, barely surviving day to day, and physically look to be unwell. While some people with substance use disorder do have this harrowing experience, there is a large population of people who don’t fit this image at all and have developed ways to mask their struggles with addiction completely.
From the outside, those with high-functioning addiction look much like everyone else; they maintain their careers and jobs, balance family obligations, and enjoy activities with their peers. Their appearance is carefully crafted to give the impression that they are completely fine, and sometimes, even more, extra effort is put in to seem physically put-together. This façade is a dangerous one and takes great strength to achieve, making people with high-functioning addiction very capable of living in denial of their own health issues.
Identifying High-Functioning Addiction
Determining and then acknowledging that you or someone you know has substance use disorder can be difficult, but when someone is high-functioning in their addiction, there’s an added level of difficulty. Usually, symptoms of severe impairment, job loss, legal trouble, and major health issues are just some of the most obvious signs someone is struggling. Yet, not everyone with substance use disorder will show them. Those who are high-functioning will go to great lengths to conceal the most obvious physical problems related to their illness. Those who have been doing so for so long make this situation even more difficult to identify because peers may view them to be functioning as usual, including any unusual behavior that has become the norm or seen as just a quirk.
Opioid use disorder is generally seen as debilitating because of the nature of the drug and the way it slows down the functions of the brain and body of the user; however, there are some people who are still able to appear as high-functioning while continuing use. This trend is particularly prominent due to the sheer number of people who first begin using opioids from a doctor’s prescription for a legitimate medical issue, which for many eventually leads to dependency and addiction. With opioids, the withdrawal symptoms can become physically impairing, pushing those who are high-functioning to create elaborate schemes and organization to ensure they will have the proper dose they need to ward off the symptoms.
Those who have high-functioning opioid use disorder may show the following signs:
- Frequent doctor visits
- Various doctors prescribing medications
- Claims of mysterious chronic pain
- Bouts of flu-like symptoms
- Secretive nature among personal items
- Prolonged periods of drowsiness
- Ritualistic social behaviors
Risks of Denial
Using highly destructive drugs like opioids while also managing to function highly doesn’t prevent the body from incurring the damage that comes with addiction and misuse. Some may feel that because they’re not using needles to inject these drugs that they aren’t doing as poorly as those who use them intravenously or show more visible and obvious symptoms. No matter how the drug is being ingested, the damage is occurring, but someone with high-functioning addiction is usually in deep denial, making them a very silent part of the opioid epidemic demographics. As long as they are able to keep their drug use separate from their families, career, and overall physical appearance, they may not feel they have a problem at all. If they were addicted, wouldn’t their life be falling apart at the seams?
Denial is a uniquely human trait; some would even say it’s a defense mechanism for people to maintain their status quo or protect themselves from psychological harm. This becomes even more complicated when people turn to drugs to cope with previous trauma, thus making high-functioning addiction a layered issue with levels of denial and resistance. Taking away someone’s means to cope with their issues can be threatening, making it very difficult to approach them and even more difficult when you may suspect you have found yourself to fall within this category.
Treating High-Functioning Addiction
Breaking through denial about substance use disorder can be a difficult process, but a very necessary life-saving one. Usually, addiction stories involve someone hitting “rock bottom” in order to receive the wake-up call they need to get help. With high-functioning addiction, that call may never come, as the drug use is concealed and kept secretive and discreet. Waiting for yourself or someone who you suspect may be high-functioning with substance use disorder to discover the illness can be harmful, especially with opioids due to the high risk of overdose when using alone or around others who are not readily equipped to administer a life-saving overdose antidote such as Narcan®.
When approaching someone who you may suspect is silently struggling with addiction, it’s important to remember that empathy is at the forefront of addressing the issue in a productive way. Those with high-functioning addiction will not respond well to accusations, particularly in a public setting and may be pushed further into reclusion as a result. This kind of intervention is ideally handled with much tact and private conversation. It’s also important to consider the nature of your relationship, as your approach may vary based on how you know the person you believe to be struggling with addiction.
Addiction doesn’t have one face, and it can exist in many forms and affect people from all walks of life. If you feel you may have gotten to a point where your drug use has essentially become your secret second identity, there is help for you. Treatment for your addiction doesn’t always require you to leave your job and family for months of residential rehab. With how much effort you’ve poured into managing and maintaining appearances in your personal and professional life while battling addiction, seeking treatment won’t disgrace you or “out” you to your peers, either. Treatment for your opioid use disorder can be done privately with the help of trained medical professionals who can prescribe medication-assisted treatment to help get you started. You can enter treatment and recovery discreetly to end the exhaustive cycle of addiction that is robbing your life, health, and longevity.