"Leaving Las Vegas" or "Arthur"

April 23, 2012 8:07 AM

Posting for a friend who wishes to remain anonymous: I am at the end of my third day of not drinking alcohol after 5-10 years (I’m not exactly sure how long it’s been) of drinking almost every day. I have some questions about withdrawal that I can't seem to find the answers to.

The last time I remember not drinking in any 24 hour period was about three years ago, when I went 7-10 days without drinking. Back then, I didn’t have any physical withdrawal that I noticed.

For the past three years or so, a light drinking day would be 2-3 drinks (by “drink” I mean the standard one 12oz beer, one glass of wine, or one 1.5 oz shot of liquor -- though I almost always drank beer), a normal day (most weekdays) would be 4-6 drinks, and a heavy day (usually a Friday and/or Saturday) could be up to 10-16 drinks. I always drank after work on the weekdays (after 7pm) and usually started in the early afternoon on weekends. For reference, I’m a early-30s male, about 200 pounds.

I think compared to my friends, and indeed most people, I would be considered a pretty heavy drinker, except for 2 things: a) I never have had any of the warning signs of serious problem drinking, ie legal problems, fighting, waking up in strange places, hospitalization, drinking at work, (I live in a city where I don’t need to drive, and indeed don’t have a car) and b) more importantly, I almost never drink to get drunk -- I drank just enough to calm my anxiety. By that I mean, I was almost always a very steady drinker – so that when I drank a six-pack at night, it was over 5-6 hours, from when I got home at 7 to when I fell asleep at midnight. Even if I drank 16 drinks, it would be over about twelve hours. So from looking at BAC charts based on my weight, I am guessing that my blood alcohol usually was no more than the 0.10-0.19 level. I would be noticeably intoxicated, but not stumbling around, passing out, incoherent drunk.

The reason I drank steadily, every day, is that I was self-medicating my anxiety. I have had general anxiety and panic attacks since I was a teenager, and alcohol reliably relieved it for me. I was very anti-medication and psychology for a long time, and alcohol seemed a natural, and somewhat romantic alternative to me. I imagined myself as kind of the Winston Churchill/Frank Sinatra/Hunter Thompson type of drinker – highly functional (I have several advanced degrees and a great paying, very selective career), and someone whose health was never affected by drinking.

However, recently, my feelings about my relationship with alcohol began to change. While it still relieved my anxiety in the short term, I started to notice my anxiety getting much worse after a heavy drinking day(s) (usually on Monday morning). My anxiety would then affect my work, and in the last few months I even found myself either having a drink or two during the day at work (which I had sworn I’d never do), or leaving work to go to the hospital because I was having a severe panic attack. I began to wonder if my drinking was getting so heavy that I was having alcohol withdrawal – or even DT’s. As the symptoms of withdrawal and those of a panic attack are so similar, I started losing my ability to calm down, because while I have learned to deal with a panic attack (it is harmless), I know that true alcohol withdrawal can be very dangerous. Finally, I have become overweight and I am certain it is mostly because of the calories from all the alcohol I’m drinking.

Which brings me to now. I had tried so many times to stop drinking over the past year, and I could never bring myself to do it – mostly because I was afraid that if I stopped, I would have withdrawal symptoms or even a seizure or heart attack. I didn’t think my drinking was heavy enough for that, but the internet says that DTs usually occur in people who drink more than 7-8 pints of beer a day (which I exceeded a once or twice a week and got halfway to most other days). And if that’s the most severe withdrawal, then surely someone like me who averages five or six beers a day would have at least moderate withdrawal, right? But on the other hand, I thought, 7-8 pints of beer a day is one thing for a 120-pound woman and quite another for a 200-pound man. And 7-8 pints is one thing when you drink it in two hours, and quite another when you drink it over 6 hours, as I typically would if I were drinking that much. Either way, my anxiety would make me imagine the worst case scenario, and while I would occasionally cut down, I couldn’t quite bring myself to completely stop.

So anyway, here I am. It’s been 72 hours since I “stopped” drinking. I say “stopped” in quotes because in each 24 hour period I’ve had a single 12 oz can of beer, sipped very slowly, to calm my anxiety – and I don’t think I will need to do that again today. My only symptom during this time has been mild to moderate anxiety. I have gone running about 4km each day. I have also taken one 0.5 mg tablet of Xanax twice a day (in the morning and afternoon) – which I have historically taken when I have panic attacks. If you’re not familiar with Xanax, this is a fairly low dose.

So that’s my story – here are my questions:
1. I have read dozens of articles online about alcohol withdrawal. Many of them say that symptoms usually start 2-12 hours after the last drink, that more severe symptoms like seizures can happen 24 to 48 hours after the last drink, and DTs can occur 48 to 72 hours after the last drink. I’ve even seen some sources say DTs can happen 7 to 10 days after the last drink.
a. How could severe symptoms begin so long after the alcohol has left a person’s body?
b. Could a person have no (or mild) symptoms for two or three days after their last drink, and then suddenly develop severe symptoms (seizures) after that?
c. Would drinking literally one can of beer somehow “reset” the clock, so that even though I had one beer a day over the last three days, I am not really 72 hours “after my last drink”?

2. I’m already feeling really great about my decision to stop drinking, and am going to give it at least a month. However, I feel right now that I have enough control over my drinking that I don’t need to give it up completely forever. While I don’t plan to go back to drinking the amounts I used to, does anyone think it’s reasonable to believe that my way of “steadily” drinking was healthier, and less addictive, than binge drinking to drunkenness (even if someone only binge drank on the weekends, instead of steadily drinking every day like me).

Thanks for reading. I would really appreciate your thoughts, and especially hearing your own personal experiences with similar situations.

posted by banishedimmortal to health & fitness (23 answers total)

Detox is really, really different for everyone. Your mileage will truly vary. Most people don't have seizures; some do. Some people just feel exhausted. Some people intensely crave sugar. Some people get shakes; some get headaches. Some people actually feel great!

It would be great, if you're not going to do this in a facility, where professionals assist people in getting off alcohol, if you at least had a friend who was (at the very least) checking in on you, if not actually physically present.

And yes: by any sane person's account, today, it sounds like, you are at Day One of your 30 day experiment. I think it would seem to most people totally reasonable that you didn't go the full cold turkey. Still, having "a beer" is "drinking." People who "do not drink" do not "drink beers." :)

You can make whatever plans about your future drinking you like. It seems great that you're starting a month's vacation from alcohol today.

As for all your Internet reading.... Reading online about alcohol detox is sort of like reading online about cancer treatment. All in all, rarely helpful, mostly useless. Is there some reason you're not willing to just talk with a professional about this in person? That would probably be really helpful, to have someone reality-checking you, and looking at you from the outside. (Not suggesting you check into a 28-day program! There's tons of out-patient and ad hoc alcohol treatment programming that you can use as needed--as well as people who are specialists in anxiety, which seems like something really worth treating.)
posted by RJ Reynolds at 8:35 AM on April 23, 2012 [1 favorite]

Really tackle this thing. Do you have a doctor you can trust with this information? Go to them, if only for the peace of mind you will get from having "medical supervision" and a medical professional you can reach out to during this period. Better yet, a detox facility. Failing either of those, call a nurse line or alcohol abuse hotline and get some information about withdrawal. Psychologically, get some support for your anxiety and ending your alcohol use. Whether that be individual therapy or attending some kind of alcohol support, AA, Al-anon, etc. you NEED some support through this.

All the problem drinkers I know are "high functioning." The have jobs and a life. It is a total myth that most problem drinkers/alcoholics are home all day drinking, unemployed, ranting and actively destroying their lives. The real toll is the time you lose when you are drinking every night to calm your anxiety. How much more satisfying could your life be with your anxiety truly under control, all that extra time for you to pursue hobbies, or relationships, or just true relaxation?
posted by Katine at 8:36 AM on April 23, 2012 [2 favorites]

For me, the worst withdrawal day was at about day 3. Day 1 was general anxiety and killer insomnia. Day 2 was shakes. Day 3 was full-blown crazy. I was very lucky to have somebody to keep an eye on me, as well as providing small doses of klonopin to help me sleep through the nights. Quite frankly, I probably should have been in a medical facility on day 3, but I was on the tail end of it, so I just toughed it out, telling myself that it wasn't any worse than a bad flu.
My drinking was heavier than what you describe, and I did go completely cold turkey (except for a small glass of whiskey which got me through the first day, which I no longer count among my sober days), so I'm not sure how the two compare. My guess is that if after three days, you're only at my day 1, then you're probably going to come out of it just fine. Total physical withdrawal can take you as long as a month. I'm not sure of the 'why' behind that, but that was my experience. Feel free to me-mail me if you want the gory details on what you might expect.
posted by Gilbert at 8:45 AM on April 23, 2012 [1 favorite]

To address the last part of your question, in my experience being witness to a similar situation your thinking is reasonable but wrong. By that I mean that you are able to reason with yourself to come to those conclusions -- that this is a self-medication, that you are in control, and that you are not suffering consequences from your drinking. Your arguments are compelling to yourself because they reinforce what you want to believe, but will not stand up to objective scrutiny.

The self-medication aspect: Whether or not the anxiety that you experience was originally linked to your drinking, it is now. The alcohol you consume has been reinforcing your belief that drinking can solve your anxiety, but is now creating greater anxiety than what you used to experience, to the point that you have to drink to address it while you are at work. Also, since you have been numbing yourself to the feelings of anxiety you have, you've never had a chance to look for and solve their root cause. As long as you are using alcohol to numb your anxiety, you will not be able to seek a cure rather than the debilitating treatment you have found. Often when people stop drinking they experience a resurgence of the things that drove them to seek alcohol in the first place -- it looks like you have already found a friend in banishedimmortal that you can talk to about those feelings as they come up, but a professional therapist will be even better equipped to help you. Please consider meeting with a psychiatrist, as alcohol does strange things to brain chemistry, and they are trained specifically in how brain chemistry can affect mood and behavior.
posted by kitarra at 8:50 AM on April 23, 2012 [3 favorites]

IANAD and I have no personal detox story. But here's an assessment tool that healthcare providers use to evaluate the severity of alcohol withdrawal (sorry, it's a PDF - Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)). If you score less than 10, usually you won't receive any treatment beyond "eat right, stay hydrated, maybe take some b-vitamins and NSAIDs." If you're between 10 and 20, they'd want to keep an eye on you and maybe start you on drug treatment. If you're over 20, they would be trying to get some drugs into you and probably keeping you in an inpatient setting.
posted by mskyle at 8:51 AM on April 23, 2012 [1 favorite]

I am not a doctor, this is not medical advice, but if you are drinking a little bit and taking benzos, I would guess that it would significantly reduce your withdrawal effects.

I have no idea what will happen if you stop the one can of beer and Xanax - has it done it's work and now you have no significant withdrawal effects? Or do you get delayed withdrawal effects? This would be a good question for an actual doctor.
posted by insectosaurus at 8:56 AM on April 23, 2012

Congrats on day one. You're on a journey now. Come back after a month and let us know how it went. You're going to learn a lot about yourself. Pay attention to your body and mind and do what seems right. Seconding the above that "not drinking" means zero drinks. As for the second part of your question, the answer is no. There is nothing about your drinking that is "healthier or less addictive" than people who also drink heavily but in different ways. If you were to surround yourself with people who have decided to quit drinking and listen to their stories, I think you'd find a lot you can relate to.
posted by TurkishGolds at 8:59 AM on April 23, 2012 [2 favorites]

My husband had a very similar drinking pattern/level as you do, and there's also an element of anxiety self-medication going on in his case (although his anxieties are not severe and he doesn't experience panic attacks). He never got falling-down drunk, and got stumbly/slurred speech drunk pretty rarely. He never got violent or angry, or missed work, or any of those things. He quit drinking a little over a year ago, after many, many failed attempts to "take an alcohol vacation" or moderate his intake.

When he quit, he did not experience any serious withdrawal symptoms, although of course that's merely ancedotal and doesn't address your question of whether/how it might happen to you.

The thing that finally compelled him to quit was when he was diagnosed with alcoholic cardiomyopathy, although even then, "alcoholic" thinking pushed him to try to find any other possible reason for his enlarged heart.

The thing that helped him succeed at quitting was working with an addiction therapist. That helped him with concrete strategies for avoiding drinking, explore the motivations that were driving him to drink and come up with alternative strategies, and clarify some of the distorted thought patterns that are characteristic of addition (my pattern of addition isn't as bad as some other pattern, so it's not that bad...I can just go back to a "normal" relationship with alcohol once I'm sober for a while, etc.).

The one difference he had compared to you was many, many FAILED quits. He didn't have a hard time quitting at all! He did it lots of times! The hard part was staying quit. He'd delude himself, just like you are, that he could control it.
posted by SomeTrickPony at 9:01 AM on April 23, 2012 [1 favorite]

If your expectation is that drinking constantly, or drinking moderately or lightly but constantly, is an okay thing, because you have a great career, or in order to avoid delirium tremens, or because you have diagnosed yourself with anxiety, or because you've gained weight but aren't altogether unattractive and still do things like jogging, then my friend, if my experience is worth a single damn to anyone, you might have a drinking problem.

Let me suggest some thoughts, since there's only so much one can share in a format such as this. What is drinking for? Isn't it to have a good time, celebrate? Meet people, be casual, have fun? Drinking is not for quelling panic attacks. You're using a hammer to screw in a nail. People having a good time drinking don't go home and check blood alcohol level charts.

Normal people don't look at homeless drunks and people in the hospital and think "at least I'm not that bad." Have you considered the idea that if you have to "control" your drinking, then despite your rationalizations, by definition it is out of control?

Since it sounds like you are a very earnest and well-intentioned person, I would suggest you read up on alcoholism as a "chronic and progressive" illness. If you take a month off drinking and then start to drink again, and the same issues pop up again, and if you try to stop drinking again and start again and seem to get nowhere, and if things never seem to get better, and in fact start to get worse, and you're all alone and you keep this a secret from people you love, you might have a drinking problem.

Honestly I think the best thing you can do is get some help from someone. (You can mefimail if you want too.) Because it sounds like you are trapped in your head but you are trying to reach out. Good luck.
posted by phaedon at 9:06 AM on April 23, 2012 [13 favorites]

I quit drinking for a month once. It was utterly meaningless in the long term - I just resumed drinking, sure, somewhat less at first (only on the weekends! never before 5 PM!), but I was right back where I had been before, or worse, before long. If you've reached the point where you really have an alcohol problem, you are just not going to make it go away by short term abstention. And yes, a month is short-term.
posted by thelonius at 9:07 AM on April 23, 2012 [3 favorites]

So, look, you haven't stopped drinking. You've tapered way back. If that feels good to you, keep doing what works, but kidding yourself about what you're doing isn't useful.

I have no idea what kind of alcohol intake is going to be your threshold for not triggering extreme physical withdrawal symptoms, and really the only person who does is a physician experienced in treating people with those issues. None of us can tell you, and the Internet isn't going to be able to tell you.

Honestly, you sound like a (high-functioning) alcoholic to me, the way you are going to such lengths to rationalize why it's OK for you to drink and why it's important to you to keep drinking and why your drinking really isn't a problem because you weigh 200 pounds and everyone else is doing it and you can stop any time you want.

Except, fuck it, you CAN'T stop any time you want. You have to keep drinking and taking benzos (and 1 mg a day of Xanax isn't a "low dose", it's an average dose) so that you won't get the DTs. How is that drinking that's under control?
posted by Sidhedevil at 9:38 AM on April 23, 2012 [5 favorites]

I quit drinking for six months once because my then-boyfriend was giving me shit about what he saw as my excessive drinking. I was also self-medicating anxiety and drinking at bedtime to get to sleep.

I quit cold turkey (and didn't have any physical reaction except digestive issues and headaches, thank heaven!) I didn't touch a drop of liquor or any recreational alcohol for a year, but added tasting wine back after six months (tasting wine was actually part of my job responsibilities at that time, and the colleague who was covering for me became pregnant so she couldn't keep doing it).

It was easy for me, so I felt comfortable going back to social drinking since I had broken the pattern of drinking at bedtime, etc. I might have four or five drinks a week at most, now.

You're talking about this as though your month of lessened drinking and average Xanax use is an experiment that is going to prove you're not an alcoholic so that you can go right back to your current drinking patterns. Do you not see how little sense this makes?
posted by Sidhedevil at 9:44 AM on April 23, 2012 [2 favorites]

It's not a direct answer to any of your questions, but you may want your friend to check out the 'stopdrinking' group at Reddit. There are a lot of people there with varying experiences and good support. YOu can easily drop this question in there and get some good feedback.

I gave up drinking about 8 months ago, and while I pretty much suspected I was in no danger from withdrawal, I did it with support from my doctor just to keep things monitored and in check. I strongly recommend this.
posted by Frasermoo at 9:50 AM on April 23, 2012 [4 favorites]

does anyone think it’s reasonable to believe that my way of “steadily” drinking was healthier, and less addictive, than binge drinking to drunkenness

Sort of? This is tortured thinking. You've done a great job sort of outlining why you drink and how it's affected your life and good on you for addressing it but I echo other people that you haven't stopped drinking. You may want to spend some time googling "Functioning alcoholic" for a lot of examples of people who do not do the "drink til i am puking in the gutter" thing but at the same time still have alcohol being an organizing factor of their life.

My dad died last year after being a functioning alcoholic [good job, decent life] for my entire life. His life wasn't negatively impacted by his drinking because he had basically decided to revolve his life entirely around alcohol. He was also an anxiety-managing alcoholic who would start drinking at 5 pm on the dot and if he couldn't start then for some reason, he'd start shaking. His wife left him when he turned 69 because he was a crabby drunk and his last years were not his finest. Like you he had weight problems and health problems and a variety of coping strategies and rationalizations for why his life was the way it was, mostly blaming the family that he'd driven away.

I say this to you not to be all "so quit drinking for real, you dumbass!" but mostly to say the issue is that if you don't develop coping strategies for your anxieties and/or your loneliness and whatever, you lose the ability to do that as you get older. Your romantic perception of yourself comes up against other people's perceptions of you less and less because you interact sincerely with fewer and fewer real life people. This enables you to keep doing what you're doing with fewer and fewer reality checks. You stop trusting people because their perspectives are marred by what you think of as their own "wrong" thinking about your drinking and how it's either helping you or not hurting you, fuck them.

So, yeah, no, I'm not going to call your regular drinking healthier any more than I'd call smoking half a pack of cigarettes a day healthier than smoking a full pack. You're still in the "you're cruising for a cancer diagnosis" range and listening to you justify it is just too familiar. Sorry and best of luck with whatever you decide to do.
posted by jessamyn at 9:51 AM on April 23, 2012 [14 favorites]

Lots of good comments in this thread. I'm just going to speak from my personal experience as an alcoholic who has spent a lot of time around other alcoholics. The PROGRESSIVE nature of alcoholism is pretty important and relevant here. I drank for a long time just like you and I knew I was a heavy drinker but I had a job and a house and my stuff seemed under control until it wasn't anymore. That switch turned so quickly for me that even friends and family who were aware what a heavy drinker I was were shocked that I could not stop.

I do think there are a lot of rationalizations in your story and that is something that throws up red flags for those of us that are alcoholics or have spent a lot of time around alcoholics. I can rationalize ANYTHING! Including drinking in the morning! Alcohol can alleviate symptoms of anxiety, but they almost always come back worse. That you were once opposed to pyschiatry and drugs but perfectly fine with self medicating through alcohol is almost exactly my story. I believed that I was in control with benzos and alcohol that I took at my discretion. The stuff I was often prescribed almost never provided the particular effect that I was looking for. I learned later that what I was looking for was not meant to be treated with medicine. I was constantly chasing the perfect drunk/high/level of relaxation/numbness etc. Modern medicine is not meant to provide that.

My withdrawal and detox from alcohol was much more severe than yours. However, the first time I detoxed the worst day was day 4, that is when I began to hallucinate. My very crude understanding is that the cause of withdrawal is not the alcohol leaving your body. It is your body attempting to function without the presence of something it has grown to expect in your body. So when all the traces are gone, your brain does not know how to work "properly" without the substance it has come to depend on.

Look, I would never call you an alcoholic because that is something you must decide for yourself. However, if you really want to take a serious crack at this, try to give up alcohol for a year. Really give yourself a chance to learn some new coping mechanisms for your anxiety, without thinking "just one or two more weeks and I can go back to what I used to do". I hope I don't sound judgmental to you. I promise that it can be an amazing experiment, and you might decide you never want to go back to daily drinking ever again. If not, alcohol will always be right there where you left it. I would love to answer any specific questions you have if you'd like to memail me.
posted by thankyouforyourconsideration at 9:54 AM on April 23, 2012 [7 favorites]

I am a doctor. I am not YOUR doctor, and this is not medical advice.

I am not going to address your feelings about alcohol vs. medication or whether you have a drinking problem because I think the commenters above have done that much more eloquently than I could. However:

The chronic effects of alcohol on the brain are still poorly understood, but it is clear that chronic alcohol use has a significant effect on the levels of certain neurotransmitters (NMDA and GABA for example). When you remove the alcohol, some neurotransmitters have been downregulated (the brain is producing less than it would otherwise) and some have been upregulated (the brain is producing more). This results in some wild swings in brain chemistry that manifest as withdrawal (and this is why it can take a few days to really kick in).

By drinking steadily rather than binging, you're avoiding the immediately toxic effects of alcohol but not the chronic effects like those on the brain, liver, and heart, which are being constantly bathed in alcohol and making complex physiological changes to adjust for that. It is not particularly healthier than binging except that you are not bumping into things or getting into fights and you're unlikely to get alcohol poisoning that way.

It is impossible, over the internet, to tell how bad your withdrawal is, especially since it sounds like you have an anxiety disorder that you have been self-medicating with alcohol as well. I would strongly urge you to see your doctor about this, because the physical exam is really important to assess withdrawal severity.

Just FYI, the hands-down worst case of alcohol withdrawal I've ever seen was in someone who had been a fairly senior member of a recent Presidential administration. Withdrawal and alcoholism are not just things that happen to vagrants and there are a LOT of functioning alcoholics out there, some of whom have very high level jobs.
posted by The Elusive Architeuthis at 10:56 AM on April 23, 2012 [9 favorites]

One way of categorizing your consumption of alcohol is "high risk." You've not run into major consequences yet... YET!

The National Institutes of Health publishes guidelines for what "low risk" drinking looks like. Here's a webpage: http://rethinkingdrinking.niaaa.nih.gov/IsYourDrinkingPatternRisky/WhatsLowRiskDrinking.asp

This may be good information to keep in mind as you reconsider how much you should drink.
posted by u2604ab at 11:38 AM on April 23, 2012

What I don't see in your plan is getting therapy for anxiety. Leaving aside the question of your drinking habits for a minute, what strikes me is that your fixation on withdrawal symptoms seems to have a lot to do with your anxiety.
posted by yarly at 12:56 PM on April 23, 2012 [3 favorites]

I quit drinking 22 days ago. My previous "record" for not drinking in the past four years was 7 days. Most nights I drank until I was numb, but not drunk, just like you. I'm in my 30's, just like you. I'm overweight, probably from the extra calories in the alcohol, just like you. And I could easily go through a large bottle of rum over a weekend, just like you.

If your relationship with alcohol is anything like mine, quitting for a week is not going to cut it. I'm tired of being consumed. I'm tired of getting sick because my body is busy fighting off poison instead of germs. I'm tired of waking up in the middle of the night with a dry mouth and a full bladder. It's over. I decided on April Fools' Day, of all days, that I will not be a slave to this anymore.

The last time I "quit" I gave myself an out. I planned on quitting for a week, just to prove I could. And on day eight, I drank to celebrate my success. This time it is completely different. No outs. No wistful looks at the liquor store. I even took my son to a hockey game last week and wasn't envious of the guys drinking beer because I could visualize the bright future in front of me - one free of alcohol.

It sounds cheesy, but it's true. And I know I'm just starting too, because 22 days isn't very long. So I will pray for you and success beating this and I'll also continue to pray for my own success. Good luck out there.
posted by tacodave at 3:53 PM on April 23, 2012 [9 favorites]

IANAD, but I have gone off drinking at heavy levels (similar to yours) with the aid of benzos at the level you are taking, under medical care (by which I mean, my doctors--plural because I've done this more than once--knew what I was doing and prescribed the xanax), without trouble.

I do not think that, three days in, you are going to suddenly have a seizure, especially not with the xanax to help keep things under control. And no, a single beer does not "reset the clock." Going cold turkey off a regimen of heavy drinking can be dangerous; you are not going cold turkey, but using xanax and "tapering" with the single beers (though that's such a drastic reduction it hardly counts as tapering; you could probably have done as well with just the xanax). But--just to answer your question--if the single beer reset the clock, then it wouldn't be possible ever to taper off alcohol--and tapering IS one way to go off alcohol, just like any other drug; it's just not a method that is commonly used because alcoholics are pretty much by definition not great at controlling intake.

To address the questions about whether you will be able to pick up drinking again at a safe level, statistically it's probably unlikely, but individuals can't be reduced to statistics. I think it's great that you feel great and that even the single beer seems unnecessary to you now. Be on guard, I guess is all I'd say, because that switch in the brain between "this feels great! I love being sober!" and "fuck it, I want a drink, and I'm having one" is... well, it can flip in an instant. I'm someone who thought I could quit for a while and then pick up drinking moderately, but later had to acknowledge that any level of drinking just wasn't going to work out for me.

Just be careful, and be honest with yourself. Good luck.
posted by torticat at 6:05 PM on April 23, 2012 [1 favorite]

Seconding the recommendation of /r/stopdrinking, which is a very fine support resource, that has been of great help to me.
posted by thelonius at 6:18 PM on April 23, 2012

First of all, congrats for quitting. I think it's great that you have come to this decision and I applaud you for it. I've seen many others who never reached your stage of insight, and lost their lives (in a drawn-out, suffering-filled way) because of it.

As an ER doctor, I deal with a lot of drunk people. I deal with a lot of people who come in after doing something stupid, with a high blood alcohol level, and they get hurt or they hurt someone else. And a lot of these people, you wouldn't guess to look at them how high their blood alcohol level is going to be. Because they are so "high functioning" - that term is just another way of saying "so used to drinking large amounts of alcohol that they don't seem drunk when they do it." So just a couple of things from my point of view.

First of all, your definition of "problem drinker" is problematic, and it's inaccurate. It's your own definition you've come up with to make yourself feel better. This is the way medical professionals define problem drinking, and it has nothing to do with your income, your social status, or how you function while drinking.

C - Have you ever felt the need to Cut down on your drinking? (obviously, you asked this question)
A - Have people ever Annoyed you by criticizing your drinking? (how do you feel after reading the answers?)
G - Have you ever felt bad or Guilty about your drinking? (yes)
E - Ever had an "Eye opener" to "steady your nerves" in the morning? (yes)

By what you've already described, you're a "yes" to 3/4 of these questions, and possibly all 4. Answering yes to 2 or more of these questions makes it extremely likely that you are an alcoholic, that you are addicted to alcohol.

I can't tell you what kind of withdrawal you will experience, but I can tell you that you will not just be sitting there minding your own business and then bam! - have a seizure. Severe DTs don't strike out of the blue. They start as anxiety and build upwards and upwards. That's why you need a friend or ideally, a professional to help you through this process, to make sure you don't get to the point where you don't really have the capacity to figure out what's going on with yourself enough to keep yourself safe.

I would suggest you consider seriously the possibility that you may have had anxiety many years ago that you started to self medicate with alcohol, and what you experience as 'anxiety' and 'panic attacks' now might be you withdrawing from alcohol. Conveniently, the treatment for anxiety and the treatment for alcohol withdrawal (benzodiazepines) is the same.... this may or may not be the case but just wanted to point out that you may be using your anxiety as an excuse to yourself, i.e. "I have never gotten symptoms of alcohol withdrawal - I just get anxious if I don't drink and the anxiety gets worse and worse the longer I've stopped drinking!"

As for the question of whether a steady high intake of alcohol is 'healthier' than binge drinking, I think the comparison above to cigarette smoking is an apt one. The steady high intake of alcohol can still lead to liver disease/failure, heart failure, and certain forms of dementia. And don't forget that high alcohol intake is a major risk factor for a number of deadly cancers such as esophageal cancer, mouth and throat cancers, liver and stomach cancers.

Best of luck and again, so glad to hear you're quitting - it's the best thing you can do for your health.
posted by treehorn+bunny at 10:12 PM on April 23, 2012 [1 favorite]

Wow, reading some of these posts I am a little surprised at the responses. My guess is these people have never lived in a mill town or worked in a heavy construction crew, or on a highway crew like I did and stayed in FEMA trailers where they stacked 6 of us in there every night. The NIH link would be a joke to these people. 4 in one day in the past year? Christ, a six pack a night was the norm. It's no more complicated than the fact that these guys liked their beer. But they were in bed early and out the door earlier than most of you hear the alarm clock and then spent the rest of the day working their asses off around equipment you would not want someone playing with that was even slightly inebriated. Most accidents I recall were caused by faulty equipment or stupid mistakes, not drinking related. I never thought of any of them as alcoholics.

I cannot see putting a number on the number of beers per day/week/year as any sort of indicator for alcoholism, whatever that is. Good luck with whatever you do but don't let someone else decide what's best for you.

(By the way, every doctor, and most nurses that I can recall that I knew, saw, or came into contact with since I was 5 or so was overweight. Do I want them telling me about healthy eating habits? Hell man, my dermatologist was sunburned the last time I saw him).
posted by bellastarr at 11:37 AM on April 26, 2012 [1 favorite]