High-Functioning Addiction in Professionals: When Success Hides the Problem
By Chris Beerman, LCSW, CADC — gambling and alcohol therapist, Chicago. Reviewed September 2026.
You have not lost your job.
Your review was good. The mortgage gets paid. People rely on you, and they are right to. You may run a team, run a company, raise children, keep up a training schedule, sit on a board.
And you have also started calculating how late you can drink and still be sharp at eight.
Or moved money between accounts so your spouse does not see what happened on the sportsbook.
Or checked an options position eleven times during a meeting while telling yourself that because you understand markets, this is not what other people do at a casino.
Or set a rule — only weekends, never before five, no deposits until payday, no more contracts after a loss — and watched the rule quietly move.
People call this high-functioning addiction. The phrase is useful, and it is also slightly misleading. It describes how a problem looks from the outside. It says nothing about how serious it is.
And sometimes the ability to keep functioning is exactly what allows a problem to continue for years.
"High-Functioning" Describes the Presentation, Not the Severity
There is no diagnosis called high-functioning addiction. It appears in no diagnostic manual. It is a description of a gap — between what your life looks like from the outside and what is happening inside it.
What clinicians actually assess is different, and the details matter here more than they usually do.
The National Institute on Alcohol Abuse and Alcoholism defines alcohol use disorder as "a problematic pattern of alcohol use leading to clinically significant impairment or distress." It is diagnosed when at least two of eleven symptoms have been present in the past twelve months. Two to three is mild. Four to five is moderate. Six or more is severe.
Here is the part worth sitting with.
Of those eleven criteria, exactly one has anything to do with your job. That one is failing to fulfill major role obligations at work, school, or home — so it can be met entirely at home. The other ten are about drinking more than you meant to, unsuccessful attempts to cut down, craving, time spent drinking or recovering, drinking despite relationship problems, giving things up, drinking in risky situations, drinking despite a physical or psychological problem it is making worse, tolerance, and withdrawal.
Which means the arithmetic works out in a way most people find genuinely surprising: a person can meet the threshold for severe alcohol use disorder — six or more criteria — without ever meeting the one that involves work.
Your performance review is not a diagnostic instrument. It was never on the list.
The same logic applies to gambling. Gambling disorder is a recognized psychiatric diagnosis, assessed on nine criteria, four or more of which must be present within a twelve-month period. Those criteria include preoccupation, needing to bet increasing amounts, repeated unsuccessful efforts to cut back, restlessness or irritability when trying to stop, gambling when distressed, returning another day to get even after losing, lying to conceal the extent of the gambling, jeopardizing a relationship or job, and relying on others for money to relieve gambling debts.
Income appears nowhere in that list either.
The Honest Version of the Risk Question
A great deal of content written for this audience opens by suggesting that executives and professionals are especially prone to addiction — high pressure, long hours, expense accounts, therefore elevated risk.
The evidence does not really support that, and I would rather tell you what it does show.
Higher-income and better-educated Americans are more likely to drink, and more likely to binge drink. In CDC surveillance data, binge drinking prevalence rises steadily with income — from about 15% among adults earning under $25,000 to about 21% among those earning $75,000 or more.
But the rate of the disorder runs the other way. In the National Epidemiologic Survey on Alcohol and Related Conditions III — the largest US diagnostic survey of its kind, with more than 36,000 adults interviewed — twelve-month alcohol use disorder was highest in the lowest income band (16.2%) and lowest in the highest (12.7%). Lifetime rates were essentially flat across income.
Federal survey data by industry points the same direction. Substance use disorder rates in finance and insurance, and in professional, scientific and technical services, sit at or slightly below the all-industry average. The industries with the highest rates are accommodation and food services, construction, and arts and entertainment.
Long working hours do show a real association with risky drinking — a meta-analysis of more than 400,000 people across two dozen countries found roughly a 12% increase in the odds of risky alcohol use among people working long weeks. But the absolute difference was under one percentage point. It is a real effect. It is not a large one, and it is not an explanation.
So I am not going to tell you your job gave you this.
What is different about this group is not the risk. It is the delay.
Two findings say it better than I can. In a study of primary care patients who met criteria for alcohol use disorder and explained why they had not sought treatment, the most common reason by a wide margin was simply not recognizing the problem as a problem — cited by 55%. Among the patients with moderate to severe disorder, four or more criteria, it was still 52%. Recognition did not arrive with severity.
And in a recent analysis of national US survey data, among adults with a substance use disorder who received no treatment, 94.5% neither sought treatment nor believed they should have. Of the small minority who did recognize a need and still did not get care, the single most common reason given — 76% — was thinking they could handle it on their own.
Self-sufficiency is not a character flaw. In most of your life it is the reason things work. It is also, in this specific situation, the most common reason people wait.
Success Gives You Evidence for the Defense
Every achievement can be entered into the record as proof that nothing is seriously wrong.
You got promoted. You hit the number. You made partner. You ran the half marathon. You made the 6 a.m. call on four hours of sleep and nobody could tell. You covered the loss out of the next bonus.
So: if this were a real problem, I could not be doing all of this.
The trouble is that people differ enormously in how long they can compensate. Intelligence, money, professional autonomy, a high tolerance for discomfort and a workplace that judges you on output rather than on how you got there will all extend the runway considerably. None of them makes the underlying pattern less serious. They make it less visible, and they make it survivable for longer — which is not the same thing as safe.
Which is why "am I still functioning?" is the wrong question.
The better one is: how much work does it now take to keep functioning?
The Skills That Make You Good at Your Job Can Also Protect the Problem
These are real strengths. That is exactly why this is worth noticing — nothing here is a character defect, and none of it needs to be dismantled. But each one can be quietly conscripted.
Compartmentalization
You are good at keeping things separate. Colleagues see one version of you, your spouse sees another, and what happens alone at night may be invisible to both. The intactness of one compartment becomes evidence about the others, which is precisely what compartmentalization is designed to prevent.
Problem-solving
You solve things for a living, and that instinct does not switch off. Hungover — build a better morning. Losing on weeknights — weekend-only rule. Position sizes creeping — cut them temporarily. Partner asking questions — get better at what they can see.
Each consequence generates a fix. The fixes work well enough to prevent the larger question from ever being asked, which is: am I solving the right problem?
Money
Money buys time before consequences arrive. A $5,000 loss is a catastrophe for one household and an irritation for another. But the ability to absorb a loss tells you nothing about whether the behavior producing it is under your control. For higher-income gamblers and traders, the damage often has to become genuinely large before money itself forces the reckoning — and by then a great deal has happened.
Self-reliance
You are usually the person others bring problems to. Asking for help is unfamiliar, and there is often a strong belief underneath it: if I created this, I should be able to fix it.
That belief produces years of private experiments — abstinence months, deposit limits, betting caps, app deletions, exercise, productivity systems, willpower. When those fail, the conclusion is usually "I need to try harder." Occasionally the more useful conclusion is that the approach itself is the thing that is not working.
Image management
The more competent people believe you are, the more expensive disclosure feels. There may be a license, a marriage, a board, a reputation, or simply the humiliation of someone learning that one area of your life has stopped responding to you. Secrecy starts as protection. Given enough time it becomes part of the problem it was protecting you from.
What It Actually Looks Like
The gap is easier to see when you set the two columns side by side. On the left, what other people observe. On the right, what is actually happening.
Excellent performance review. And drinking most nights to get your brain to stop.
High income. And gambling losses spread across several accounts so no single statement tells the story.
Disciplined investor. And increasing contract size after a loss, specifically to get back to even.
Never misses work. And planning the shape of the day around when drinking can start.
Travels constantly. And drinking substantially more alone in hotels than you ever do at home.
Socially successful. And increasingly careful about what your partner has access to.
"I take breaks whenever I want." And every break so far has ended the same way.
None of the items on the left are lies. That is the difficulty. They are all true, and none of them answers the question.
Alcohol, Gambling and Trading Hide Differently
Alcohol
For professionals, problem drinking often does not look like drinking all day. It looks like drinking moderately at the client dinner and continuing at home. Using alcohol as the only reliable way to get out of work mode. Drinking noticeably more when travelling alone. Avoiding events where there will be nothing to drink. Being unusually irritated when the evening's plan is interrupted. Maintaining an elaborate and shifting set of personal rules. And believing, simultaneously, that the drinking is a concern and that it is not bad enough to justify doing anything about it.
If you want a structured version of that question rather than a list, the alcohol use test on this site is the AUDIT, scored, anonymous, and about three minutes. There is also a longer piece on how to tell whether you have a drinking problem when your life still looks fine, which is written for more or less exactly this situation.
Gambling
Disposable income makes gambling much easier to hide, and professional competence can strengthen the illusion of control rather than weaken it. I understand probability. I can afford it. I'm not betting the mortgage. I'm still up lifetime.
The amount matters, but it is not the thing to watch. The National Council on Problem Gambling lists six warning signs: thinking about gambling all the time, needing to bet more money and more often, going back to try to win money back, feeling restless or irritable when trying to stop or cut down, feeling unable to control yourself, and gambling despite negative consequences.
Chasing losses is the one I would pay closest attention to, because it is the mechanism by which a manageable loss becomes an unmanageable one. I have written separately about how to stop chasing gambling losses, and about recovering financially after gambling losses, which is usually the more urgent worry.
The gambling addiction test here is the PGSI, also scored and anonymous.
The question is not whether you can survive the next loss. It is whether you can reliably decide not to place the next bet.
Trading
This is where the ambiguity is greatest, and where I spend a surprising amount of clinical time.
Investing is not gambling, and active trading is not an addiction. But the label on the account does not determine what is happening psychologically, and options, leverage, crypto and short-dated speculative positions can start to function the way a sportsbook does.
Useful questions: Are you following a strategy you set in advance, or reacting? Do you increase risk after a loss? Are you trying to get back to even? Do you break your own position-size rules? Does the account balance set your mood for the day? Are you checking compulsively? Have you tried to step away and found it much harder than expected?
Understanding markets does not protect anyone from reinforcement schedules. If anything it supplies better arguments. There is a fuller treatment in is day trading gambling?, and therapy for compulsive trading if you already know the answer.
Seven Questions More Useful Than "Am I an Addict?"
People get stuck on the label. Whether the label fits is a clinical question and it can be answered properly in an assessment. But you do not need to settle it before you look at the pattern.
1. Have I repeatedly broken promises I made to myself? The rule matters far less than your ability to keep it.
2. Am I hiding any part of this? Secrecy usually measures the distance between how you want the behavior to look and how it actually looks.
3. Am I using it mainly to change how I feel? Alcohol to switch off anxiety. Gambling to produce intensity when everything feels flat. Trading for focus, urgency, or escape. The more load the behavior carries emotionally, the harder it is to put down.
Many of the professionals I see describe the evening drink as the only reliable off-switch for a mind that will not stop working. That pattern has its own guide: alcohol and anxiety, when drinking to relax keeps you stuck.
4. How much mental space is it taking? You can look extremely productive while spending a large fraction of your attention anticipating, planning, concealing, or recovering.
5. Have my rules moved? Only weekends, then Thursdays. A hundred dollars, then five hundred, then two thousand because you are trying to undo yesterday.
6. Is someone close to me more worried than I am? You do not have to accept every accusation. But sustained concern from someone who knows you well is data, and partners generally see it years before colleagues do.
7. If nothing catastrophic ever happened, would I want to live this way for another five years? Assume you keep the job, the marriage survives, no one intervenes, nothing dramatic occurs — and the pattern simply continues. Is that acceptable?
That last one is the question I ask most often, and it is the one people tend to answer immediately.
Do I Need Rehab?
Usually not, and the assumption that treatment means disappearing for twenty-eight days is one of the more expensive misconceptions in this field.
Treatment exists at several levels of care. NIAAA lists outpatient care — regular office, virtual or telehealth visits for counseling, medication support, or both — alongside residential programs, and states plainly that "there is no one-size-fits-all solution." For many people with mild or moderate alcohol use disorder, treatment reasonably begins with a weekly outpatient appointment. That is still treatment.
It is worth knowing how few people get any. Of US adults with past-year alcohol use disorder in 2024, about 7.5% received any treatment, and about 2.4% received medication — despite three FDA-approved medications for alcohol use disorder being available.
One serious caution. If you drink heavily and regularly, you may be physically dependent, and stopping abruptly on your own can be medically dangerous. Significant tremor, sweating, vomiting, confusion, hallucinations, a seizure, or any history of complicated withdrawal all require medical attention rather than a therapy appointment. Outpatient therapy is not a substitute for medically supervised withdrawal, and I will say so directly if that is what your situation calls for. There is more on this on the alcohol addiction therapy page.
An assessment does not commit you to a treatment plan. It is how you find out which level of care your situation actually needs.
Can I Keep Working While I Get Treatment?
In most outpatient cases, yes — and for this population that is usually the deciding question, so it deserves a real answer rather than a reassuring one.
A plan might involve weekly individual therapy, in person or by telehealth; a medical or addiction-medicine consultation where appropriate; medication for alcohol use disorder discussed with a physician; concrete changes to access — blocking software, self-exclusion, moving money out of easy reach; financial safeguards; involving a partner where that is wanted and useful; peer or recovery support if it fits; a plan for the predictable high-risk situations, which for this group usually means travel, conferences, entertaining, and Sunday afternoons in the autumn.
Sometimes a higher level of care is genuinely indicated, and that judgment is part of the assessment rather than something to decide in advance. But asking for help does not automatically mean putting your career on hold.
Will Anyone Find Out?
This is the question I get asked most often by physicians, attorneys, executives, financial professionals and business owners, and it deserves a specific answer rather than a blanket promise.
It is also not an idle worry. In the largest survey of American attorneys on this subject, roughly one in five screened positive for hazardous or harmful drinking, and the two barriers respondents most often named were not wanting others to find out and concerns about confidentiality. The concern is widespread, and it keeps people away.
Here is the accurate version. Therapy is confidential, with specific exceptions set by law — the familiar ones involving imminent danger and the safety of children or vulnerable adults. In Illinois, mental health records carry additional protection under the state's Mental Health and Developmental Disabilities Confidentiality Act, which generally requires your written consent before records are disclosed. Federal law adds a separate layer for substance use disorder records held by certain federally assisted programs under 42 CFR Part 2 — though that rule applies to particular categories of program, and whether it covers any given clinician is a question to ask that clinician rather than to assume.
What I would not tell you is that nobody can ever find out anything. If you use health insurance, a claim is submitted and a record of billed services exists. If you hold a professional license, have a security clearance, are involved in litigation, or are on a plan where someone else receives the explanation of benefits, those are specific circumstances with specific answers.
Ask before you start. Ask about your situation, not the general case. You are entitled to understand the limits of confidentiality before you decide how you want to proceed — including whether to use insurance at all.
Do I Have to Decide to Quit Before I Start?
No.
You can come because you are worried. Because your spouse is worried. Because you tried moderating and are no longer sure it is working. Because you already know you want to stop. Or because you genuinely do not know yet, which is more common than people expect.
With alcohol, treatment can start with an honest look at the pattern, the severity, the risks and what you have already tried. Some people conclude that abstinence is the only thing that will hold — and NIAAA is clear that for some people, depending on severity and circumstances, it is. Others start by reducing. What matters is being able to look at the evidence honestly rather than deciding in advance what you are permitted to consider. I have written about that choice at length in moderation versus quitting.
Gambling and high-risk trading need their own assessment, and I am more cautious there. Access to credit, the speed at which losses compound, debt and secrecy change the calculation in a way that does not apply to a glass of wine.
When "Functioning" Starts Getting Expensive
For most professionals, work is the last thing to go. The bill arrives somewhere else first, and usually earlier than people remember afterward.
Sleep gets worse. Baseline anxiety climbs. Intimacy declines. You are physically present at dinner and somewhere else entirely. You are irritable specifically on the nights you are trying not to drink. You wake at four reconstructing what you said. You check the account before you speak to your partner. Your phone becomes something you protect. Questions that used to be reasonable start to feel like accusations.
And a partner stops believing what you tell them about money, which is a loss that takes far longer to repair than the money itself. If that is where you are, there is a guide written for partners of someone with a gambling problem — it may be more useful to them than to you.
You are still doing everything you are supposed to do. The life around it is just getting smaller.
So "I haven't had consequences" is usually not quite right. There have been consequences. They have not reached your career yet.
What Treatment Would Actually Look Like
I work with adults on alcohol, gambling, sports betting, compulsive or gambling-like trading, and related patterns. We would not start by taking your career apart. We would start by understanding the system that has allowed the behavior and the rest of your life to coexist this long, because that system is the thing that has to change.
In practice that means looking at the pattern — when it happens, what precedes it, what keeps it going. The severity, honestly, including whether outpatient care is the right level. Your goals, including the possibility that you do not have one yet. Access, and what could be changed about it, since making the behavior harder to reach reliably outperforms deciding to want it less. Triggers: stress, boredom, conflict, travel, unstructured time, the football calendar, a bad print. The thinking — rationalization, chasing, all-or-nothing rules, overconfidence, and the belief that one more attempt with more discipline will settle it. Emotional regulation, because if the behavior has become your fastest route to feeling different, anything replacing it has to actually compete. Relationships and the repair of secrecy. And relapse prevention, which is less about getting through a good week than about what happens when stress, money, opportunity or success show up again — as they will.
For many people that work happens while their career continues more or less unchanged. What changes is how much of their life is being spent backstage.
There is more on the approach itself in can therapy help gambling addiction?, and on the practice pages for gambling addiction therapy and alcohol addiction therapy.
You Do Not Have to Wait Until You Stop Functioning
There is a trap inside the idea of rock bottom. It turns every consequence short of catastrophe into evidence that nothing needs to change yet.
You still have the job. The house. The marriage. The money. You still look fine.
So you wait.
But nothing in the diagnosis, the research or the treatment literature requires you to lose more before you are allowed to address this. The question was never whether things are bad enough compared to someone else's version of addiction. It is whether this is becoming a life you would rather not keep managing.
You can deal with drinking before it reaches your work. You can deal with gambling before the financial damage becomes structural. You can change your relationship with trading before the next attempt to get back to even becomes the next loss.
And you can talk to somebody about it before anybody else knows.
Performance at work is not proof that everything is fine. It never was. The goal is treatment that works with your life, not one that requires you to blow it up first — and the best time to do it is usually while there is still a great deal worth protecting.
Frequently Asked Questions
Is high-functioning addiction a real diagnosis?
No. It is an informal description, not a diagnosis in any manual. A person can meet full criteria for alcohol use disorder or gambling disorder while performing very well professionally.
Can you have alcohol use disorder and still be successful at work?
Yes. Alcohol use disorder is assessed on eleven criteria, only one of which concerns failing to meet major role obligations at work, school or home. It is possible to meet the threshold for severe alcohol use disorder without ever meeting that one.
Are executives and professionals more likely to become addicted?
More likely to drink and to binge drink, yes. More likely to have alcohol use disorder, no — US survey data shows twelve-month rates are modestly higher at lower incomes, and substance use disorder rates in finance and professional services sit at or below the all-industry average. What is distinctive about this group is how long a problem can be absorbed before it is recognized.
What are the signs of high-functioning addiction?
Unsuccessful attempts to cut back, secrecy, rising mental preoccupation, using the behavior to regulate mood, personal rules that keep moving, chasing losses, tension at home, and needing steadily more effort to keep everything else looking normal.
Do I need residential rehab?
Not necessarily. Treatment exists at multiple levels of care, and many people are treated effectively through outpatient therapy, medical care, medication, peer support or some combination. Some situations do require medically supervised withdrawal or a higher level of care — that is what an assessment determines.
Can I keep working while getting addiction treatment?
In many outpatient cases, yes. Sessions can be scheduled around work and telehealth is available. Whether outpatient care is appropriate depends on the severity and safety of your particular situation.
Is addiction therapy confidential?
Therapy is confidential with specific exceptions set by law, and Illinois adds statutory protection for mental health records. If you have concerns involving insurance, a professional license, an employer, a security clearance or a legal matter, raise those before treatment starts and ask about your specific circumstances.
Can stock or options trading be a high-functioning addiction?
Trading is not itself a diagnosis. But it can become gambling-like when it involves chasing losses, escalating risk, secrecy, repeated failed attempts to stop, heavy preoccupation, or trading mainly to change how you feel.
Talk to Someone Before Anyone Else Notices
I am a Licensed Clinical Social Worker and Certified Alcohol and Drug Counselor in Chicago, working with adults on alcohol, gambling, sports betting and compulsive trading, in person and by telehealth across Illinois and Minnesota.
You do not need to know what to call it before you make the appointment.
Email me to schedule a consultation, or start anonymously with the alcohol use test or the gambling addiction test.
If You Need Help Right Now
Alcohol and other substances — SAMHSA National Helpline, 1-800-662-HELP (4357), free and confidential, 24/7. In Illinois, the Illinois Helpline for Opioids and Other Substances, 1-833-2FINDHELP (833-234-6343).
Gambling — In Illinois, 1-800-GAMBLER, or text GAMB to 833234. Nationally, 1-800-MY-RESET.
In crisis — call or text 988 for the Suicide and Crisis Lifeline.
This article is for general information and is not medical, legal or financial advice, and it does not create a therapist-client relationship. It is not a diagnosis. If you may be physically dependent on alcohol, talk to a physician before stopping — withdrawal can be dangerous. For questions about confidentiality in your own circumstances, ask your own clinician or attorney.
Research and Sources
Alcohol use disorder criteria and severity — National Institute on Alcohol Abuse and Alcoholism, Alcohol Use Disorder: From Risk to Diagnosis to Recovery (Core Resource on Alcohol). AUD defined as "a problematic pattern of alcohol use leading to clinically significant impairment or distress," diagnosed on at least 2 of 11 criteria within 12 months; mild 2–3, moderate 4–5, severe 6 or more.
Levels of care, medications and treatment goals — NIAAA, Treatment for Alcohol Problems: Finding and Getting Help. Source of the outpatient/residential descriptions, the three FDA-approved medications, and "there is no one-size-fits-all solution."
Treatment rates — NIAAA, Alcohol Treatment in the United States (Alcohol Facts and Statistics), 2024 National Survey on Drug Use and Health: 2.0 million of an estimated 27.1 million adults with past-year AUD (7.5%) received any treatment; 665,000 (2.4%) received medication. NIAAA notes 2021–2024 estimates are not comparable with 2020 and earlier because the survey was redesigned.
AUD by income — Grant BF et al., "Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III," JAMA Psychiatry 2015;72(8):757–766. n=36,309 US adults. Twelve-month AUD 16.2% in the lowest income band versus 12.7% at $70,000 or above.
Binge drinking by income — CDC, "Binge Drinking Among Adults, by Select Characteristics and State — United States, 2018," MMWR 2021;70(41). Age-standardized binge drinking prevalence 14.6% under $25,000 rising to 21.4% at $75,000 or above.
Substance use disorder by industry — SAMHSA Center for Behavioral Health Statistics and Quality, Substance Use and Substance Use Disorder by Industry, NSDUH 2008–2012 combined, adults 18–64 employed full time. All-industry past-year SUD 9.5%; finance and insurance 9.4%; professional, scientific and technical services 8.8%; highest in accommodation and food services (16.9%), construction (14.3%) and arts, entertainment and recreation (12.9%).
Working hours and alcohol — Virtanen M et al., "Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data," BMJ 2015;350:g7772. Prospective analysis, 100,602 participants: new-onset risky drinking odds ratio 1.12 (95% CI 1.04–1.20); adjusted absolute difference 0.7–0.8 percentage points. The authors note causal inference cannot be drawn from observational data.
Problem recognition as a barrier — Probst C, Manthey J, Martinez A, Rehm J, "Alcohol use disorder severity and reported reasons not to seek treatment: a cross-sectional study in European primary care practices," Substance Abuse Treatment, Prevention, and Policy 2015;10:32. 1,008 primary care patients with past-12-month AUD across six countries; of the 251 who gave reasons, 55.3% cited lack of problem awareness, and 52.1% of those meeting four or more criteria did the same. European primary care sample, not US.
Perceived need and treatment use — Choi NG, Marti CN, "Treatment Use Among U.S. Adults with a Substance Use Disorder," International Journal of Environmental Research and Public Health 2025;22(4):640, analyzing NSDUH 2022–2023. 14.4% of adults with SUD received any past-year treatment; 94.5% of non-users neither sought treatment nor thought they should; among those perceiving a need but not receiving care, 76.3% said they thought they could handle it without treatment.
Attorneys and alcohol — Krill PR, Johnson R, Albert L, "The Prevalence of Substance Use and Other Mental Health Concerns Among American Attorneys," Journal of Addiction Medicine 2016;10(1):46–52. 12,825 licensed attorneys; 20.6% screened positive on the full AUDIT; the most-cited barriers to help were not wanting others to find out and privacy concerns. This is a screening instrument and a convenience sample with no calculable response rate — it indicates hazardous drinking, not diagnosed AUD, and is not directly comparable to the national figures above.
Gambling disorder criteria — DSM-5 criteria for gambling disorder: nine criteria, four or more within a 12-month period, including preoccupation, escalating bets, unsuccessful efforts to cut back, restlessness or irritability when stopping, gambling when distressed, chasing losses, lying to conceal involvement, jeopardizing relationships or work, and relying on others for money.
Gambling warning signs — National Council on Problem Gambling, help and treatment FAQ. The six signs quoted are NCPG's; concealment is a DSM-5 criterion rather than one of NCPG's six.
Language — NIAAA, When It Comes to Reducing Alcohol-Related Stigma, Words Matter. "Stigma is a significant barrier in many people's willingness to seek help for alcohol problems"; NIAAA recommends "alcohol use disorder" and person-first language over "alcoholic" and "alcohol abuse." That is why this article uses the clinical terms even though the search phrase people type is usually the older one.
Confidentiality — 42 CFR Part 2, Confidentiality of Substance Use Disorder Patient Records (§ 2.11 definition of "program"); HHS, Understanding Confidentiality of Substance Use Disorder Patient Records; Illinois Mental Health and Developmental Disabilities Confidentiality Act, 740 ILCS 110.