July 21, 2009 
By Erin O’Neill
It might be said that Sarah Allen Benton is stating the obvious when she reports “Throughout History, the military has had a reputation of fostering heavy drinking.” But, to the contrary, in her book Understanding the High-Functioning Alcoholic, Benton provides an eye-opening look into a subset of alcoholics who’ve been constantly overlooked and under-treated, sometimes right here in our own military community.
According to Benton, High-Functioning alcoholics (or HFAs as she refers to them in her book) are people who “may or may not be physiologically addicted to alcohol, but instead are psychologically dependent.” While they’re often individuals who meet many of the DSM-IV TR’s diagnostic criteria for alcoholism (the universal standard used by doctors, therapists and clinicians) HFAs frequently fall short of being diagnosed as “alcoholic” in one crucial area: functionality. Their lives are frequently strained because of alcohol, but they haven’t hit rock bottom yet and are still able to maintain their lives, jobs, and sometimes even their relationships, leading them and many others in their life to conclude they aren’t “really” alcoholics because they aren’t homeless or on the street.
“People can be dependent and not have abuse problems at all,” states Dr. Mark L. Willenbring, director of the Division of Treatment and Recovery Research at the National Institute of Alcohol Abuse and Alcoholism (NIAAA). “They’re successful students. They’re good parents, good workers. They watch their weight. They go to the gym. Then they go home and have four martinis and two bottles of wine. Are they alcoholics? You bet.”
Throughout her book, Benton cites numerous experts and provides extensive research as she explains why diagnosing and treating HFAs can be one of the most difficult tasks in addiction treatment. She finds that due to their high-status careers, over-achieving work habits and successful appearances, they’re often able to deceive themselves and others about the depth and severity of their addiction.
The problem seems to hit particularly close to home when Benton examines the role of high-functioning alcohol abuse within the armed services. While she states that “27% of young adults in the military aged eighteen to twenty-five years reported heavy binge drinking,” she also breaks it down by branch, stating that “The Marine Corps was found to have the highest binge drinking rate at 38% among young adults, while the air force [sic] has the lowest rate, at 24%.” (Yes, I too was annoyed by her lack of capitalization, throughout the book, when it came to the different branches.)
She goes on to interview a number of highly successful, professional HFAs, including a retired Air Force Lieutenant Colonel , who “reports that he drank alcoholically throughout his entire military career, which began after college.” More disturbingly, “he notes that his drinking habits correspond [sic] with the culture of the bases at which he was stationed.”
Here, Benton refers to an NIAAA research study on drinking within the military and takes some time to consider some of the contributing factors that often make alcohol an issue within the ranks. She notes that “There are cultural traditions, particularly within the navy [sic], that involve binge drinking and drinking to points of intoxication when on shore leave, after work, and particularly when on ‘liberty’ during deployment.”
While she does point out a few of the military’s responses to this problem—such as raising the price of alcohol on base and increasing substance abuse programs—she also notes that “research data indicate that these policies were more effective in reducing substance usage than alcohol usage.”
While at times, a bit navel-gazey—I, for one, could have done with roughly half the personal journal entries she includes to document her own path to recovery—and occasionally repetitive in its assertions, the book does do an excellent job at illuminating a population that desperately needs to be recognized and resourced. For readers who’ve wondered if they, or a loved one, might have a problem with alcohol—even if they don’t meet the current diagnostic standards—this book might serve as a much-needed wake-up call.
For more information, please visit:
http://www.niaaa.nih.gov/
http://www.tricare.mil/alcoholawareness/
http://www.highfunctioningalcoholic.com/
To find an Alcoholics Anonymous program near you:
http://www.aa.org/
To find an Al-Anon group (for loved ones of alcoholics):
http://www.al-anon.alateen.org/
The Secretary of Defense’s Order on Substance Abuse Treatment:
http://www.tricare.mil/policy/fy97/abus9729.html