It’s rarely the guy on the park bench. Honestly, that image of the "drunk" is a stereotype that keeps people in denial for decades. Most people looking for how to recognise an alcoholic are searching for answers about a spouse who still holds down a job, a parent who never misses a bill, or a friend who is the life of every single party. They don't look "sick" yet. But the damage is happening under the surface.
The clinical term nowadays is Alcohol Use Disorder (AUD). It's a spectrum. It isn't a binary "yes or no" switch that suddenly flips one morning. Instead, it's a slow slide. You might notice they’re drinking a bit more on Tuesdays. Then it's every Tuesday. Then it's every night "just to decompress."
Alcoholism is stealthy. It hides behind craft beer culture, "mommy wine" memes, and high-pressure corporate environments where a three-martini lunch is just "networking." If you’re here, you’ve probably noticed a shift. Maybe it’s a vibe. Maybe it’s the smell of peppermint gum covering up something sharper.
The physical tells that go unnoticed
Everyone knows about the slurred speech. That's easy. But there are much subtler physical signs that crop up long before the liver starts to fail.
Take the face, for instance. Chronic alcohol use dilates small blood vessels. You might see a persistent redness or "spider veins" around the nose and cheeks, known as telangiectasia. It isn't just a "healthy glow" from being outdoors. It's vascular damage. Then there’s the puffiness. Alcohol is a diuretic, but it also causes the body to retain water in the tissues, leading to that classic bloated look in the jawline and under the eyes.
Watch the hands.
Ever seen someone’s hands tremble slightly when they’re trying to pour a glass of water or sign a receipt in the morning? That’s often a sign of minor withdrawal. The central nervous system is over-excited because it's been suppressed by ethanol for eight hours, and now it’s "rebounding." It usually goes away after the first drink of the day.
- Rhinophyma (thickening of the skin on the nose)
- Frequent bruising that they can't quite explain
- Yellowing of the whites of the eyes (jaundice - this is a late-stage emergency)
- Sudden weight gain or loss without a change in diet
- A "sour" or "sweet" smell on the breath that lingers even after brushing
Sleep is the big one. Alcoholics almost never sleep well, even if they "pass out" quickly. Alcohol disrupts REM sleep. So, you’ll see someone who is chronically exhausted, irritable, and reliant on caffeine to survive the morning, only to "need" a drink to "relax" by 5:00 PM. It’s a vicious, exhausting cycle.
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Behavioral shifts and the art of "The Lean"
When you’re trying to figure out how to recognise an alcoholic, you have to look at their relationship with time. Alcoholics are obsessed with the next drink. They might not say it, but their schedule revolves around it.
They’ll start suggesting restaurants based solely on the bar menu. They’ll get anxious if an event is "dry." You might notice "pre-gaming." That’s when someone drinks before going to a social event where alcohol will be served, just to ensure they have a "head start" or because they’re worried the host won't serve enough.
Then there’s the "Lean." This is a subtle behavioral adaptation where a person leans against a wall or a kitchen counter while talking to appear steady. They’re focusing incredibly hard on not swaying. It looks like casual relaxation. It’s actually high-level motor control compensation.
The disappearing act
Have you noticed they vanish for 15 minutes during a movie? Or maybe they’re always the one volunteering to "run to the store" for something trivial? This is often a cover for sneaking a quick drink in private.
Secrets are the hallmark of AUD. You might find "stashes." Empty nips in the spare tire well of the car. Wine bottles tucked behind the laundry detergent. If they are hiding the amount they drink, they already know it's a problem. Healthy drinkers don't hide bottles.
Why the "High-Functioning" label is a trap
According to Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), about 20% of people with alcoholism are highly functional. They are often well-educated and have high incomes. This is the hardest group to help because they use their success as a shield.
"I can't be an alcoholic, I just got a promotion," they’ll say. Or, "I ran a marathon last month."
Functioning is a stage, not a diagnosis.
In these cases, the signs are more emotional and cognitive. Look for "Dr. Jekyll and Mr. Hyde" personality shifts. Someone who is kind and reserved during the day might become aggressive, overly sentimental, or inappropriately sexual after a few drinks. Their "filter" doesn't just thin; it vanishes entirely.
They also tend to have a very high tolerance. If you see someone finish a bottle of wine and still speak clearly and move with precision, that is a massive red flag. It means their brain has neurochemically adapted to the presence of a toxin. It’s not "impressive." It’s a sign of physical dependence.
The psychological defense: Denial and Gaslighting
If you confront someone about their drinking and they immediately turn it back on you—"You're just being controlling" or "I wouldn't drink so much if you didn't stress me out"—that’s a classic defense mechanism.
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Alcoholism feeds on denial. To admit there is a problem is to admit they have to stop, and for an alcoholic, the idea of never drinking again is terrifying. It feels like losing a limb or a best friend.
- Defensiveness: Getting angry when the topic of alcohol comes up.
- Justification: "I had a hard day," "It's a celebration," "Everyone else was doing it."
- Minimization: "I only had two," when the empty bottles in the trash suggest six.
- Memory Gaps: They don't remember the conversation from last night. They aren't lying; their brain literally stopped recording memories. These are "brownouts."
Impact on the family: The "Elephant" in the room
Usually, the family knows something is wrong long before they have a name for it. You might find yourself "walking on eggshells" in the evenings. You stop inviting people over because you don't know which version of your loved one will show up.
This is co-dependency. You start covering for them. You call their boss to say they have "the flu" when they're actually hungover. You handle the bills they forgot. You're trying to keep the ship afloat, but in doing so, you're removing the "natural consequences" that might actually lead the person to seek help.
Real-world numbers to keep in mind
It's helpful to look at what the NIAAA defines as "heavy drinking." For men, it's more than 4 drinks on any day or more than 14 drinks per week. For women, it's more than 3 drinks on any day or more than 7 drinks per week.
Most people are shocked by these numbers. A "drink" isn't a heavy-handed pour of whiskey in a tumbler; it’s 1.5 ounces of 80-proof spirits, 5 ounces of wine, or 12 ounces of regular beer. If your loved one is drinking a bottle of wine a night, they are well into the "heavy drinking" category, regardless of how well they "handle" it.
How to move forward: Actionable steps
If you’ve recognized these patterns, the worst thing you can do is wait for "rock bottom." Rock bottom is often death, a permanent disability, or a prison sentence. You want to intervene while there is still something left to save.
1. Document the evidence.
Don't do this to be cruel. Do it because alcoholics truly forget or minimize. Keep a quiet log of how many drinks they had, the time they started, and any specific incidents (arguments, falls, missed obligations). When the "I don't have a problem" argument starts, you have data.
2. Choose the right time to talk.
Never try to have "the talk" while they are drinking or while they are hungover and feeling defensive. Find a "dry" window, usually a Saturday morning or a quiet evening when they haven't started yet. Be calm. Use "I" statements: "I feel scared when I see how much you’re drinking," rather than "You’re a drunk."
3. Seek professional guidance.
You aren't a doctor or a therapist. Alcohol withdrawal can actually be fatal—it’s one of the few substances where the "cold turkey" approach can cause seizures and DTs (delirium tremens). Consult with an interventionist or a primary care physician to discuss detox options.
4. Set firm boundaries.
Decide what you will no longer tolerate. "I will not attend parties with you if you are driving," or "I will not lie to your mother about why you missed dinner." Stick to them. Boundaries are for your mental health, not to control them.
5. Look into support for yourself.
Groups like Al-Anon or SMART Recovery Family & Friends are vital. You need to learn that you didn't cause it, you can't control it, and you can't cure it. This is their journey, but you have to protect your own peace in the process.
The path to recovery is long, and it's rarely a straight line. Relapse is often part of the process. But recognizing the reality of the situation is the only way out of the fog. Stop looking for the "cliché" alcoholic and start looking at the person in front of you. If their drinking is causing problems in your life or theirs, it is a problem. Period.