The disease of alcoholism wears many masks. Recognizing signs of alcoholism for what they are can be a real challenge to friends and family of those with a drinking problem. That’s because a diagnosable addiction to alcohol—defined by compulsive drinking behaviors like binge drinking that continue despite negative consequences—thrives in secret.
What was once seemingly harmless social drinking, and is now a full-blown alcohol use disorder, can thus prove difficult to catch—not to mention to stop in its tracks. Even the most obvious warning signs, symptoms, and side effects can go unnoticed, (and worse yet, untreated), when the masks that addiction wears elude recognition by those best positioned to notice them.
Fortunately, you don’t have to be a Sherlock Holmes or Columbo to determine whether a loved one is struggling with and hiding alcohol dependence. There are some reliable, telltale signs of a drinking problem you can spot without being a brilliant, world-class sleuth. Knowing and being on the alert for these ten signals can go a long way to helping friends and family identify the signs of a drinking problem and seek treatment for it.
Sign 1: A high tolerance for alcohol
“Tolerance” refers to the body’s response to the functional effects of alcohol—in other words, how quickly someone under the influence of alcohol becomes intoxicated and impaired. The degree to which the body tolerates alcohol’s effects depends on how long one has been drinking and how much one has been drinking. Over time, the more one drinks, the more alcohol they need to achieve the same effects—and, in turn, the higher their tolerance levels. “Functional tolerance” thus describes how chronic drinkers with very high blood alcohol concentrations can still operate with seemingly little behavioral impairment.
A longstanding pattern of chronic over-consumption of alcohol is a surefire determinant of high tolerance—if not the only one.
Genetic predisposition can be a determining factor as well, as studies comparing children of alcoholic fathers to children of non-alcoholic fathers indicate. Researchers have even discovered what they call an “alcohol tolerance gene”: those who have it reportedly are both better at holding their drink and more prone to abusing alcohol. Other factors, like weight, ethnicity, age, gender and even perception, can also affect how quickly intoxication develops and one’s overall tolerance.
If you’re unsure whether a loved one displays a high tolerance for alcohol, ask yourself the following: Do they show signs of intoxication and impairment after drinking three drinks over the course of an hour? (That’s typically the amount required for the average, 155-pound male to get tipsy.) If not, they may indeed have a high tolerance.
Sign 2: Hiding alcohol in unlikely places
Chances are that if that prized, souvenir bottle of tequila from last year’s trip to Mexico suddenly goes missing from your liquor cabinet, only to turn up beneath your son’s bed or in a spouse’s desk drawer, alcohol abuse may be the culprit.
Alcoholics are masters of covering up their tracks, addiction experts say. Recovering alcoholic William Moyers is the first to admit it: For every drink he’d have in a public setting, he’d have another stashed away in the bathroom. His spouse had no clue, he told NBC News.
Other alcoholics are even more creative, hiding their fix under ceiling tiles, in hollowed-out mattresses, behind books on bookcases—even in sports bottles in the back of their cars.
Sign 3: Drinking before and after parties and other social drinking situations
If a loved one is drinking before and after a party or other social situation, they may also be nursing an addiction under the radar and out of sight. A compulsive drinking problem often manifests itself as an internalized sense of shame on the part of the person struggling, with the result that they often do the bulk of their drinking in secret and alone, rather than in public.
As they develop higher alcohol tolerance over time, they can also find themselves needing to drink more to achieve the same effects. Heavy drinking in private serves this purpose also.
Sign 4: Mysterious and otherwise unexplainable injuries
If a loved one is frequently getting sick or falling prey to bumps, bruises, sprains and cuts, without an adequate explanation as to why, they may be hiding an alcohol use disorder.
It’s not unusual for injuries to happen in the course of an episode of binge drinking after all. Blackouts and falls are common signs of excess drinking. Consider the experience of one alcoholic who, while in her 40s, broke her foot stumbling down some stairs, after drinking more than 20 beers in one sitting. (When her mother asked what happened, the woman was too ashamed to tell the truth—so she made something up.)
Such experiences are common among those who abuse alcohol. Researchers at Northwestern University set out to study the health effects of binge drinking among college students, and found that one in four will harm themselves while drinking. As blackout rates went up, so did physical injuries, such as falls, burns, gunshot wounds, car accidents and other traumatic injuries. (Strikingly, one in three trauma patients have alcohol in their system.)
A lesser-known fact is how binge drinking compromises the body’s immune system, as another study found.
Sign 5: Using vodka to disguise one’s drinking
The hard liquor, vodka, is a great enabler of efforts to conceal a drinking problem. Vodka’s very high alcohol volume—40 percent—is an easy quick “fix” for alcoholics. It’s also colorless and doesn’t smell, so it’s easy to smuggle. Some alcoholics spike their morning coffee with it. Others slip it into sports bottles, topping it off with an energy drink like Gatorade.
The habit is more common than you’d think: An article in The Atlantic reported that roughly one in four people in their early 20s have mixed vodka with an energy drink of one kind or another. Those who drink alcoholic energy beverages also happen to drink more heavily and for longer periods than those who drink just booze, researchers found. They cited what they believe may be a “masking effect”: those who drank alcoholic energy drinks were more likely to underestimate their intoxication and drink more.
Sign 6: Lying about one’s drinking
Hiding liquor—whether in the trunk of a car, under a pile of linen in the laundry room, or in other odd places—is one form of lying. But there are other forms. The most obvious example: if your loved one comes home intoxicated, the smell of liquor strong on their breath, yet still denies they were drinking or at the bar. Another subtler form of lying that can be very common, according to a recent study of drinkers in England: lying about one’s weekly alcohol intake to a family physician.
Sign 7: Extreme mood swings
As a depressant, alcohol can cause potentially dramatic negative changes in mood and behavior— especially when consumed in excess. For people who binge drink, the morning after a bender can be fraught with depressive symptoms, for example.
There is also the fact that under the influence, many heavy drinkers can become irritable, aggressive and in some cases violent putting their own life and the lives of others at risk. In fact, the National Institute on Alcohol Abuse and Alcoholism has noted that scientists have long recognized a two-way association between alcohol consumption and violence and aggression.
Alcohol also interferes with sleep. This in turn can introduce changes in mood characterized by irritability, anxiety and depression.
Sign 8: Problems at home, work or school
Alcohol is among the most used drugs in the workplace and a habit of excess alcohol is bound to cause issues at work or school— if not immediately then eventually. Even high-functioning alcoholics will ultimately suffer the negative consequences of a drinking problem. These can include:
- Showing up late to work or school
- More absenteeism
- Mistakes on the job
- Poorer grades
- Compromised productivity
- Altercations with peers, colleagues, teachers and/or supervisors
- An inability to manage chores, finances or other domestic responsibilities
- Problems in family relationships
Sign 9: Legal problems
It is not uncommon for alcoholism that goes untreated to result in troubles with the law, such as:
- A DUI (Drinking Under the Influence) or DWI (Driving While Intoxicated) charge
- A citation for public intoxication (for disturbing the peace when drunk)
- A charge of contributing to the delinquency of a minor
- And, in rarer cases, charges of assault, domestic violence or theft
These symptoms of excessive drinking can create long-term damages on home, personal life, and careers. If your loved one has recurrent alcohol-related legal issues, it is very possible they are masking a drinking problem. If you are concerned your loved one has a problem, get help organizing an intervention.
Sign 10: Inability to quit
Previously unsuccessful attempts to quit may also indicate your loved one has issues with alcohol. If they have gone through one or more cycles of remorse about a drinking habit, followed by the resolution to stop drinking, they may not be able to quit on their own and may need professional intervention.
Diagnosing Alcoholism: Assessment, Detox and Treatment
Spotting the above signs is only the start in determining whether a loved one has a diagnosable alcohol use disorder. But it’s an important start. Only an assessment by an addiction professional can ultimately determine whether a loved one’s drinking problem is a diagnosable addiction that will benefit from detox and treatment.
For more information about how to get help for a loved one, see the following related articles:
- Alcohol Detox Guide
- Alcohol Abuse: How to Get Help
- The Complete Guide to Drug and Alcohol Intervention
- What’s the Success Rate of Alcohol Recovery?
- What to Ask an Interventionist to Find the Best One for Your Situation