“Any patient stories shared here are composites drawn from my more than 20 years in medical practice. They are not about any single individual, but rather reflect patterns, themes, and experiences I have encountered across many patients over time. Details have been intentionally blended or altered to protect privacy while still illustrating real-world clinical lessons.”.
They Held Everything Together And Alcohol Was Quietly Tearing It Apart
My maternal grandfather was a functioning alcoholic. So was my maternal aunt.
If you have ever loved someone who fits that description, you understand the complexity of it. They showed up. They went to work. They took care of their families. They were present in the ways that society tends to measure presence — financially, physically, functionally. From the outside, everything looked intact.
But functioning does not mean unharmed. It means the damage is happening quietly, on the inside, over time.
My grandfather died at 65. My aunt died at 53. Both losses were linked, directly and undeniably, to the long-term effects of alcohol on their bodies. And both losses left my mother carrying a grief that was complicated not just by the loss itself — but by years of watching people she loved choose a substance over their own health and longevity. That emotional weight did not disappear when they did. It shaped her. It shaped our family.
I share this because I know our family is not the only one
The Truth About Functioning Alcoholism
“Functioning alcoholic” is not a medical term, but it is a real lived experience — and it is one of the most underrecognized patterns in primary care. Here is what I want you to understand as your physician:
- Functioning does not mean healthy. Someone can maintain their job, their relationships, and their daily routine while alcohol is simultaneously damaging their liver, heart, brain, and immune system.
- Tolerance is not safety. When the body adapts to alcohol and requires more to feel the same effect, that is a warning sign — not a sign of strength or control.
- The effects are cumulative. Chronic alcohol use does not announce itself loudly at first. It builds. Quietly. Steadily. Until one day it cannot be ignored.
- The family carries it too. Alcohol use disorder does not only affect the person drinking. It affects every relationship in their orbit — and that emotional burden has real health consequences for the people left behind.
What The Data Tells Us
In the United States, alcohol is the third leading preventable cause of death. Chronic alcohol use is linked to liver disease, heart disease, several cancers, high blood pressure, pancreatitis, and neurological decline. It increases the risk of stroke and significantly weakens the immune system.
Within Black communities specifically, alcohol-related liver disease is diagnosed at higher rates and at younger ages. Access to addiction treatment has historically been limited by cost, stigma, and a lack of culturally competent care. These are health equity issues — and they are deeply personal to me.
What I Want My Patients To Know
If you are reading this and something here feels familiar whether in your own relationship with alcohol or in someone you love I want you to hear this clearly:
There is no shame in having this conversation with your physician. In fact, it is one of the most important conversations we can have together.
In my practice, I screen every patient for alcohol use as part of routine preventive care. Not to judge. Not to lecture. But because it is my job to see the full picture of your health and because early intervention changes outcomes.
Questions I encourage you to sit with honestly:
- How often do you drink, and how much?
- Do you drink to unwind, to cope, to sleep, or to feel normal?
- Have people close to you expressed concern about your drinking?
- Have you tried to cut back and found it harder than expected?
If any of those questions gave you pause, please make an appointment. Not when things get worse.
Now.
For The Families Carrying This Weight
And if you are the one watching someone you love the way my mother watched her father and her sister I see you too. The emotional toll of loving someone in active addiction is real, and it deserves care just as much as any physical symptom.
My grandfather and my aunt were more than their struggle with alcohol. They were loved. They were full people. And their deaths preventable as they may have been do not define them. But they do remind me why this conversation matters.
Every April, Alcohol Awareness Month gives us a moment to stop and say: this is worth talking about. This is worth naming. This is worth treating.
At Dominion Health Family Wellness Center, we create space for the hard conversations because that is where healing begins. We are accepting new patients. We would be honored to be your family’s physician.
