Can I be a quasi-healthy drunk?

December 12, 2005 1:51 PM

How much can I drink before cirrhosis sets in?

I realize this is going to raise some indignant hackles, and rightly so, but I plead for actual answers instead of denouncing me as a worthless waste of spunk.

I'm in my thirties, single, live alone. For many years, I used to drink socially or have a few beers, and I've been known to sometimes overdo it with the drinking when I'm deeply depressed or when there've been serious crises in my life. But over the last few months, ever since a particularly bad series of outside events, I have increased my drinking considerably. Let me be very clear that I do NOT drink and drive, ever -- I don't even go to bars anymore, actually, because I'm aware of the danger I would pose to others at this point. Instead, I buy cases of beer, jugs of cheap wine, or bottles of liquor and strictly drink at home, alone.

If you were to ask me "How much do you drink?" I wouldn't be quite sure how to answer, other than "a lot." Some days I don't drink at all; some days I limit myself to a couple of beers; other times I drink glass after glass of whiskey on the rocks or vodka drinks until I have to go lie down. Rarely, I drink too much too fast on an empty stomach and black out.

So obviously I have a drinking problem, and I probably ought to get some help with this, but that's not actually what I'm asking here. I'm curious about just how badly my innards might be getting damaged without any symptoms showing up, and, yes, how much can I keep drinking before my innards start to really get shot? Yeah, I know. No, really, I know.

I don't have health insurance, so seeing a doctor and getting expensive testing done on my liver is not going to happen. (Besides, no ethical doctor would tell me anything other than, "You really need to cut back on your drinking.") I've Googled extensively about alcohol poisoning and cirrhosis of the liver. I know it's bad. I also know that I might one night drink too much and die. I know that I'm in a very self-destructive place right now. Regardless, I want to keep drinking, at least for now. But I hope one day to pull myself out of this, and I'd like not to have to be on an organ-donor waiting list when I get there. The question I'd like answered is, Is there any way for me to know how much is really too much?

posted by anonymous to health & fitness (34 comments total)

I'm not a doctor. You know that, though. If you were able to keep it down to, say, a glass or two of red wine, you'd probably end up healthier. Some advice has it that you might even become smarter after drinking two pints of beer a day.

But.

The amount of liquor you're drinking is not only deteriorating your body, it's deteroriating your mind. You say you want to pull yourself out of "this", but you're becoming less and less able to every day. Soon you'll need medical intervention to quit, or you could have seizures and die.

Get some help. This isn't an option.
posted by jon_kill at 2:07 PM on December 12, 2005

It is screamingly, blaringly, explosively and utterly obvious from your post that what you are doing right now is too much for your liver.
posted by xmutex at 2:10 PM on December 12, 2005

i can't answer your question, but if you want to minimize the damage to your liver (as much as possible with your current intake), be sure to avoid painkillers, aspirin, etc., as much as possible. you're still young, so if you were drinking say, a case of beer a day or only drinking in the evening, you'll probably be okay for the next year or two without doing permanent damage. maybe that will be long enough for you to drink yourself out of the slump and pick yourself back up.
posted by booknerd at 2:12 PM on December 12, 2005

As I understand it, the MDs don't really know the answer to this either. Keeping away from the aspirins and tylenol is essential, but otherwise, with an otherwise healthy lifestyle, you might be able to go on like this for years.

Or you might be fucked already. By asking this you are clearly trying to show some ethical regard for your actions, that is good. But, really, your drinking problem has repercussions that tax everyone else - even if you don't require a new liver. There are healthier ways to get through this that won't make you a burden on the rest of us in a few years. Good luck with this, man.
posted by jmgorman at 2:21 PM on December 12, 2005

Given the complexity of alcohol's effects on the body and the complexity of the people who drink it, blanket recommendations about alcohol are out of the question.

There won't be a quantity of alcohol where you can say "above this limit is dangerous; below it is safe". From this page: About 10 to 20 percent of heavy drinkers develop alcoholic cirrhosis, or scarring of the liver. Other studies define "heavy drinkers" as about 35 drinks per week. So you might be destroying your liver right now. (So might I). You will not get a safe limit as an answer to your question.

MedlinePlus is a good starting-point for this – it links to scientific reports as well as government propaganda.
posted by nowonmai at 2:36 PM on December 12, 2005

do a google search on coffee and heavy drinkers....there were many articles out there last week on coffee cleansing the liver after drinking bouts....i too drink way too much, 2 wines a night and about 3 to 4 whiskeys a night....my family is in the liquor/wine business, so i have grown up with it...

my doctor says my liver is overworking itself from some test he gave me....and that my cholesterol is raised because of the sugars in the alcohol and that my blood pressure is high because of the alcohol...i live with it and take the drugs he gives me....I am not going to quit drinking....that's just me....so take this for what it is worth....
posted by jamie939 at 2:40 PM on December 12, 2005

There's a genetic component to cirrhosis so there's no x number of drinks within x number of years answer.

Like others have said, stay away from the asprin. Also, stay hydrated, and maybe add a couple of cups of coffee to your daily diet (there was that recent report about drinkers who have a couple of cups of joe a day had decreased risk for liver damage compared to drinkers who didn't drink coffee).

That said, jon_kill is right. It would be in your best interest to seek help - perhaps not to stop drinking - but to deal with the things that may be driving you to drink.

I average about 150 mg of ethanol (13-15 drink equivalents) a day for the last 3 or 4 years now. Have been a heavy drinker for another 6 years before that. My liver function (through urine analysis) appears normal. My adaptive immune system is below average for my age, but my innate immune system is gangbusters - which may cause problems from being too good.
posted by PurplePorpoise at 2:44 PM on December 12, 2005

xmutex is correct except he (she) was not sufficiently emphatic. It realy is like asking whether one should spin the chamber clockwise or counter clockwise while playing Russian roulette to delay death. It is going to come down to how many bullets are in the chamber (how much are you drinking) and how frequently you pull the trigger (drink). Maybe never and maybe tonight. Your chances of early liver disease is greatly increased if you are woman. And remember, you may not qualify for a liver transplant. My daughter was 28 when she was diagnosed with alcoholic hepatitis. She is now sober ( 2 years) and it was estimated she was 2-6 months away from cirrhosis. My best wishes. Let me (or us) know how you are doing and if you want any help quitting. BTW, the solitary drinking is particulary ominous.
posted by rmhsinc at 2:46 PM on December 12, 2005

I've been drinking 10-20 beers a night, usually alone, for the last 5 years, and the worst I've noticed is weight gain.
posted by cmonkey at 3:02 PM on December 12, 2005

Sigh. My stepdad went two days without wiskey and ended up having a seizure at a roadside motel. It was the D.T.s. His heart rate was 165bpm for a week in hospital, yet somehow he lived.

Cirrhosis is just one thing to look out.
posted by anthill at 3:05 PM on December 12, 2005

Echoing anthill. A friend of mine in HS's father landed in the hospital (and hit bottom) when he had his last drink, and his esophagus began bleeding. Ulcers, kidney disease, alcoholic hepatitis, Korsakoff's[sp?] Syndrome - it's not just cirrhosis you should be worried about.

On a personal note, those AA Memorial Day picnics were a lot of fun. Real nice guys there. Just so you know.
posted by kalimac at 3:24 PM on December 12, 2005

Wow.
All I can say is, mental health is just as important as physical health. And a decline in one is just as serious as a decline in the other. So I would take PurplePorpoise's advice and seek treatment (from a private therapist, not AA) to figure out what's going on.

To the rest of you, not to derail, but: Why do you drink to excess alone? Do you consider yourselves alcoholics?
posted by Saucy Intruder at 3:25 PM on December 12, 2005

I guess my reaction isn't so much indignation as confusion. You will get cirrhosis eventually if something else doesn't kill you first, so why not assume that your next night of binge drinking will be that one night too many? Is your goal to go right up to the edge of killing yourself, but then pull back? Cause I don't think it works that way -- you're already doing plenty of damage as you go along.
posted by Hildago at 3:37 PM on December 12, 2005

Musicians whose alcohol abuse led to liver transplants (via Wikipedia):
David Crosby, transplant at age 53, still alive at 64.
John Phillips, transplant at age 57, lived another 9 years.
Rory Gallagher, transplant at age 47, dead at age 47 from complications of transplant surgery.
So you probably still have a few years left.
posted by TimeFactor at 3:37 PM on December 12, 2005

And, yeah, get help. You're an alcoholic. You are going to die from it if you don't get help. And it'll be a painful ugly death. And a painful ugly life for you and those who care about you until you die. So get help.
posted by TimeFactor at 3:44 PM on December 12, 2005

Binge drinking is harder on the liver than daily drinking. For example, drinking a 12-pack on Saturdays is much worse than drinking 2 beers daily (which would be 14 beers/week).

Are you drinking too much? Ask yourself the CAGE questions: (1). Have you ever felt you should cut down on your drinking? (2) Have people annoyed you by criticizing or complaining about your drinking? (3) Have you ever felt bad or guilty about your drinking? (4) Have you ever had a drink in the morning (eye opener) to steady your nerves or get rid of a hangover?
posted by neuron at 3:51 PM on December 12, 2005

As others have noted, it's really impossible to give a precise answer to the question of how many drinks does it take to develop end stage liver disease. That said, your story is certainly consistent with someone well on their way to cirrhosis, and it wouldn't surprise me if you already have a fair degree of liver damage. What's more, you are already at high risk for developing a whole host of rather unpleasant maladies including but not limited to: alcoholic hepatitis, pancreatitis, heart failure, gastrointestinal bleeding, cerebellar atrophy, peripheral neuropathies, frontal lobe dysfunction, Wernicke/Korsakoff's syndrome, etc.

In short, YOU ARE ALREADY WELL ON YOUR WAY TO KILLING YOURSELF. I'm neither going to be indignant or empathetic about this. Instead let me be as frank as a I can be. If death is your goal, then may I suggest you find a less brutal and costly way to bring it about. I see this almost daily, so I can assure you that dying of liver failure is actually quite slow and unpleasant. Your life will truly become far more miserable than you may already think it to be. And being a transplant recipient, on immunosuppression, in and out of the hospital for the rest of your life is also no endpoint to look forward to from where you're currently standing. Not that you'd even necessarily be a good candidate for a transplant.

On the bright side, you sound like you're at the point where you might actually be salvagable, but the door is closing fast. DON'T WAIT. GET HELP.
posted by drpynchon at 3:55 PM on December 12, 2005 [1 favorite]

I'm just echoing what others have said. I have a family member who has consumed large amounts of scotch and wine every day for atleast 40 years. Her liver tests always come back okay.

A good friend of my mother's ended up with cirrhosis at the age of 30. She's been sober over 30 yrs now, but her liver is still a bit fragile (liver function tests are monitored often).

As nowonmai said, you really can't know exactly when cirrhosis could happen to you.
posted by jdl at 4:07 PM on December 12, 2005

drpynchon has said it the best.

yeah, there's a big hazy area regarding the quantity of alcohol consumed over any period of time in respects to the development of liver failure. the question isn't "how much can i drink before i get cirrhosis?" but rather "do i really want to die?"

death from liver failure is terrible. recently i've had to take care of a 35-yr-old schoolteacher who was an alcoholic since college. she suffered for three weeks. there were pictures of her and her family and schoolkids, and there were cards all over the room.

actually, you know what? i don't even like telling this story because it makes me sad, angry, and ridiculously small.


in short: drpynchon is right. don't fuck around, man. your liver can chug along at a fraction of its total functional capacity, then suddenly "give out." not having health insurance doesn't mean you can't get it. try yr local "community service board" or health department. good luck.
posted by herrdoktor at 4:13 PM on December 12, 2005

your liver can chug along at a fraction of its total functional capacity, then suddenly "give out."

Now that's something to think about.

I come from a very long line of heavy drinkers. Typically we live to our mid 70s. (Both sides of the family.) And usually die from complications from strokes. As has been said, everyone is different, so there is no definitive answer for you.

I would suggest that you REALLY watch your health. You'll see signs when stuff starts giving up. Your kidneys will hurt, your eyes will lose their lustre and and begin to yellow. Your skin will dry up and develop little things that look like ringworm which is acutally your skin, as an organ, failing.

If you must drink, then you must also work hard physically and eat well. I don't suggest that you continue with this binge that you're on, but I have heard strories about people living into their 100s while drinking a 5th of vodka nightly. But they were strong, hardworking people who lived off the land in Poland.

Are you that tough? Or should you consider some of the options listed above. AA. Counseling. Excersize. Less drinking.

I feel for you and I hope you can take care of yourself!
posted by snsranch at 4:47 PM on December 12, 2005

I am sorry to learn of your current state. I hope that you are able to get to a better place soon.

The objective physical signs of alcoholic cirrhosis will not appear until your liver is completely destroyed. Some people drink like fish and never damage their livers; some folks drink less and get cirrhosis at age 40. I don't think there's a good way to predict when you will get cirrhosis, and there's no way to assess the current state of your liver without expensive tests.

Bear in mind that alcohol affects every organ system, not just the liver. Manifestations you may notice include palmar erythema (red palms), parotidomegaly (enlargement of the salivary glands that are about 1 inch in front of your ears), spider angiomas (little broken blood vessels all over your skin), obesity, gynecomastia (breast enlargement in males), testicular and penile atrophy, and impotence.

The neurologic manifestations of alcoholism are classic, including ataxia, diminished visual acuity, poor judgment, a disordered state of consciousness, and amnesia while drinking; tremor, anxiety, hallucinations, and delirium while withdrawing; and permanent damage to the peripheral nerves (muscle atrophy, loss of sensation) over time. Some alcoholics lose the ability to move their eyes due to thiamin deficiency; if not corrected, permanent dementia ensues, with inability to store memories and a profoundly diminished capacity.

Psychiatric correlates include anxiety and depression; alcohol is causative of these but alcoholism is probably caused by them. This is a positive feedback loop which is very dysfunctional and you are clearly there already.

no ethical doctor would tell me anything other than, "You really need to cut back on your drinking."

I don't believe you're capable of thinking clearly at this time, my friend. You need to cut back on your drinking, yes; but you won't be able to do this yourself. You need professional help, immediately.

If you don't want help for the alcohol use, you should obtain it for the accompanying severe thought disorder which, I assure you, you definitely have. In spades. It's spoiling your ability to make good judgments on your own behalf.

I hope you feel better soon.
posted by ikkyu2 at 5:04 PM on December 12, 2005 [1 favorite]

If you don't want help for the alcohol use, you should obtain it for the accompanying severe thought disorder which, I assure you, you definitely have.

I'm trying to format that sentence with larger text to make it stand out.
posted by ikkyu2 at 5:05 PM on December 12, 2005

I've also seen all I ever need or want to of liver failure. Add me to the list of people saying, it's about one of the most excruciating ways to go.

To address the questions: by the time you start to experience symptoms, your liver may already be damaged beyond the point of salvation. Therefore, unless you won the genetic lottery for alcoholics, your innards are probably already pretty shot, and any more drinking is going to exacerbate the problem.

My mother kicked her drinking into high gear, much as you have described, started experiencing symptoms of cirrhosis within six months, and was dead two years later. It can happen fast, and the end is incredibly unpleasant. There is no way you can keep drinking and not stare this death in the face. There is absolutely no way for you to walk the line or maintain a manageable habit. The first time you puke blood, you're deep in it. Medical science, advanced as it is, will probably not be able to save you. If you are drinking enough that you're worried about cirrhosis, you're drinking enough to kill yourself within a couple years, period.

This isn't intended to scare you straight or perform the miracle of reasoning you out of your addiction. It's just the truth as I know it from watching someone do exactly the same thing, from start to finish. Please, get help now, while you still can.
posted by Errant at 5:07 PM on December 12, 2005

It seems like you already know that you are drinking too much, but just want us to confirm. So: yes, you are drinking too much.

You've already heard basically everything. There's no way to be sure you haven't already broken something, and by the time you get to noticing obvious physical symptoms of liver damage (jaundice, edema, etc), it's far too late.

Off-topic to what you're asking: it's clear that you're self-medicating with alcohol. Many mental health providers have a sliding fee scale depending on what you can pay, and having real treatment would be better. For the uninsured like yourself, they can make things reasonable enough for you to be able to attend regular sessions. If they prescribe you medications, they'll give you samples and put you in touch with groups (often pharmaceutical companies themselves) that can get you medications at low cost or for free.
posted by NucleophilicAttack at 5:12 PM on December 12, 2005

From an NIH website :

Cirrhosis of the Liver
Alcoholic liver disease. To many people, cirrhosis of the liver is synonymous with chronic alcoholism, but in fact, alcoholism is only one of the causes. Alcoholic cirrhosis usually develops after more than a decade of heavy drinking. The amount of alcohol that can injure the liver varies greatly from person to person. In women, as few as two to three drinks per day have been linked with cirrhosis and in men, as few as three to four drinks per day. Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates.
posted by zouhair at 5:22 PM on December 12, 2005

Echoing ikkyu and drpynchon, keep in mind that one of the most common accelerants for cirrhosis is obesity, and it's sequelae steatohepatitis. People with this very common problem often aren't that obese, but ethanol can greatly increase your risk of cirrhosis and increase your odds.

Telling someone about all the potential hazards of ethanol abuse is sadly pointless, most of the time. How's this: imagine being the butt of jokes from tired, edgy ICU nurses who have been up half the night cleaning your room because you keep shitting blood and liquid stool all over the place? Imagine that for three days straight while you go through alcohol withdrawl until you're finally put into a chemical coma. Imagine standing in your doc's office trying to explain your belly pain, except instead of taking off your shirt you stripped naked from the waist down and pissed on the floor because you were lit. Because these are the functional and non- alcoholics that physicians deal with and you're off to an awesome start.

Alcoholism has a wonderful way of turning someone into the most repellant and pathetic possible mass of tissue better than any other drug of abuse, imo. But you can get help.
posted by docpops at 6:08 PM on December 12, 2005

Telling someone about all the potential hazards of ethanol abuse is sadly pointless, most of the time.

Well, he asked. Besides, it's kind of fun to describe all this stuff. Besides, in the 1 patient out of 100 who hears what he needs to hear to change, it's worth it, isn't it?
posted by ikkyu2 at 6:45 PM on December 12, 2005

Yes.
posted by docpops at 6:46 PM on December 12, 2005

Yes...Saucy Intruder....I am an alcoholic....but a functioning one...
posted by jamie939 at 6:48 PM on December 12, 2005

Well I'm a sober alcoholic whose got some advice you probably don't want to hear. I think you really want to ask "how much is too much" and the answer is if you're asking the question, you're there.
I, like you, thought I could go to a certain point and then stop, based on false criteria. You're doing it with health. I did it with money. In either case, you're a classic alcoholic in training.

"Don't do that, you'll go blind".... "I'll only do it until I need glasses". "I'll stop before I need a drink in the morning". "I'll stop after this last one".
It doesn't work that way. Here's the typical, very condensed process that you, as an alcoholic (you might as well get used to the name) are going to go through:
Your tolerance toward alcohol will continue to increase. You'll need more and more to get to the same level of drunkenness. As you move up the scale you'll probably switch to full-time hard liquor.

Your ability to think rationally will decline. You'll begin to focus a great deal of thought and energy on getting the next drink. Planning for it, knowing you're going to start drinking at 5:30, and thinking about it at lunch. Thinking about drinking all the time is not rational thought. You're probably doing it now.
The time between drinks will continue to shorten (as the glass holding the booze gets bigger - who needs ice?). You can vary your drinking habits today, but that will change.

There will come a point when you'll have the shakes without a drink. You'll feel sick. The only way to fix it is to have a drink. At this point you are an end-stage alcoholic with a permanent physical addiction.

After a certain physical threshold is reached (differs by person), your tolerance for booze will end. One day you can drink a fifth, and the next day you can't drink more than one small cocktail. Hangovers will become very intense.

This is the point where you have done permanent damage to both your brain and your liver. You're no longer processing alcohol to remove the toxins. They're hitting you constantly. Wet brain is now very possible. If your liver lasts. You may notice some swelling on your side. That's your liver. In some people it will triple in size.

If, at any time in this process you decide to stop drinking, and then start again, you will start at the same point you stopped. There is no "backing off for a while". If you drink a fifth of booze a day and then stop drinking for 5 years, you will end up at a fifth a day within months of starting again. It is not a process you can control.

So, then you start hitting AA. AA works, it's a great thing. It can also be humiliating, difficult, very painful, and often extremely long-term. There are no short term solutions. You will need a support system - friends, family, whatever - to keep you on track, probably for the rest of your life. Many alcoholics never stop going to AA. It's a twice a week routine, without fail.

Then there are the treatment centers. You might end up in one, voluntarily or not. In any event, they're not fun either. Alcohol class, day in, day out, all day long. Constant, overwhelming exposure to the information you need to stay sober - all done with the hope that you'll get the concept.

Your social and family relationships will take a huge dive if they haven't already. I'm sober 11 years with one break in the middle, and I still get very odd looks or phone calls if I don't make regular phone calls to let people know I'm still okay. That translates to "no trust". No one will truly be able to trust you, have faith in your reliability.

So, physical damage aside, you're being incredibly selfish. Don't you think your impending illness, wet brain, and ultimate death will have a deep, lasting effect on the people around you? Who will bury you? Who will cart you around in your wheelchair with the bag on the side of it? Don't you think you're going to impact others with this behavior?

I think you are a thinking, rational person at this point. Your question is not a crazy-person question. It shows you can stop now.
Change your course. Believe me, you do NOT want to go down the one you're currently on.

Sorry this was so long. I know not all of my facts are perfect. I wrote this from a different angle than completely fact-checked.
Good luck, I'll be thinking about you.
posted by Slap Incognito at 8:36 PM on December 12, 2005 [1 favorite]

You wouldn't be posting if you didn't know you had a problem. I appreciate your honesty. Most moribund alcoholics are anything but honest.

Realistically, for the uncontrolled alcoholic, different organ systems get to different folks in the end. For some it's the liver. for others, the pancreas. The brain goes for others. Some get cancer. A lot hit a social brick-wall in the end. But let's face it. Many die with alcoholism. Some die of it. Heck, I have Irish blood. I sympathize.

As for the liver? It's heavy on the genetics as others have noted.

If you chose to keep drinking, whether a little or a lot... Be sure to take a B-complex daily. B-50 is fine. But you also should consider something that converts to glutathione in the liver.

Glutathione protects the liver from any number of insults, including alcohol. SAM-e can be found at any Wal-Mart but is very expensive.

Acetyl-L-cysteine (mucomyst) is what hospitals use to protect from acute liver poisoning. It's kinda hard to find as a supplement (try the internet), and smells like skunk, but it readily converts to glutathione.

I recommend Trimethyl Glycine (TMG, also called betaine) which converts to SAM-e and glutathione readily in the presence of adequate B-12 and folate. A company on the web called Beyond A Century sells it extremely cheaply. Swanson Vitamins has it encapsulated. Puritan's Pride calls it betaine.

Your liver will thank you. Might also help your mood and joints...
posted by INFOHAZARD at 8:53 PM on December 12, 2005 [1 favorite]

I understand why you want to continue drinking - I did too, for much too long. There is life after alcohol - good, great, wonderful, sparkling life without booze, though you are sure that's impossible right now. The hitch is, you have to be ready and willing to face up to the shit that you are now trying to drown out. You don't see that you are making your life worse, or you don't care, because it seems so pleasant to be numb. For me, it was a question of whether I wanted to live or to die soon and unpleasantly. Something in me wanted to live and allowed me to not only stop drinking (which I could always do for a day or 2) but to stay dry. I say "within me", but my friends in AA say that they called upon a Higher Power at this point in their lives, in their drinking. If you are a believer, I suggest you start praying for help.
posted by Hobgoblin at 6:51 AM on December 13, 2005

anon asking person sent me the following:

Those who expressed concern and good wishes, thanks, I honestly appreciate it. Those who made attempts at answering my questions and linked to additional reading material, thanks, I appreciate that too, very much. Some of the simplest advice I can and will start implementing, like drinking coffee, cutting the Tylenol, getting back on my daily vitamins, getting back into an exercise routine, and so forth. For the record, I have attempted to get on an antidepressant -- I was given some samples by my doctor, but the (generic) prescription is far too expensive and unfortunately I don't seem to qualify for lower cost/free meds or therapy such as NucleophilicAttack mentioned. I applied at several programs, but I'm not disadvantaged" enough.

Those who brought out the "scare tactics," well...I thought I made it pretty clear in my post that I already know how dangerous and destructive the behavior is. I crafted such a long post trying to head off all that stuff at the pass, stating that I know I have a drinking problem, I know I should probably get help, that I've read a lot about cirrhosis and other negative effects, and I know I might die. I'm not downplaying any of this.

I wasn't asking for details on all the horrible things I can look forward to when my body breaks, and frankly, I resent it when people use those tactics. There's a certain sanctimonious "tone" to some of these remarks, like, "Go ahead and KILL youself, it's going to be really nasty but GO AHEAD if that's what you want," and it actually makes me want to withdraw into myself and sink into self-destructive behavior even further. Please try to bear that sort of thing in mind before you lay into someone who clearly isn't giving a shit about their life very much, because comments like that can really backfire. In fact, being greeted with attitudes like that is one of the very reasons I don't seek help at times when I need it -- with my history of depression, I've had quite a few encounters with health care professionals, and an alarming number of them seem to think they're helping by throwing me
guilt trips and scare stories. (Don't even get me started on the one incident several years ago where the nurses treated me like I had waltzed into the ER of my own free will for the sole purpose of wasting their time, when in fact I had been brought in by ambulance because someone close to me thought I was attempting suicide. WTF?)

I'm sorry for those of you who have lost friends and loved ones and patients to chronic drinking and other destructive behavior, and I understand those who get angry when they see other people willfully and needlessly throwing their lives away. I get it, really. It saddens you and pisses you off and you want to tell them (me, in this case) what a selfish fuck they're (I'm)
being and hopefully get through their (my) thick skull that it doesn't have to be this way and maybe if you just point out how hideous it's going to get towards the end and how bad it's going to hurt other people, maybe that will make a difference.

I suppose that tactic does work on some people; I can only speak for myself, though, and I can tell you that it only pushes me away. I would just suggest, to those people who pull out the gruesome anecdotes and the tongue-clucking, that you think about whether it's really going to help or whether it might nudge the already-self-destructive person a little further down the spiral. You might think you're "just being honest" or "doling out some tough love," but the result is that instead of opening up, I find myself wishing that I hadn't reached out in the first place. I'm sure some of you might think I'm just being ungrateful or defensive or in denial or "don't want to face up to the facts," but I'm just saying it's possible, as demonstrated by several thoughtful people in this thread, to be frank about the facts of matters like this without being reproachful.

Regardless, I would like to thank everyone who commented. I'm sure everyone who did so commented out of genuine concern and a desire to help.

posted by mathowie at 7:57 PM on December 13, 2005

Okay, talk about raising some hackles. Here goes. I hope you still read this. All I can say is drink until you are tired of being drunk. It is only a short term coping mechanism. One that no one else will tell you that it is okay to use. I will. If you are suffering, hey, whatever gets you through the day is okay by me. Fuck people who tell other people to just get it over with and end it. That is not very good advice. Excuse me, but DUH. Understand, however, that whether you use Xanax, Paxil or Alcohol as your coping mechanism, that it can only be for a short term. Understand also that you have a choice. Street drugs, Script drugs or alcohol can be used as a coping mechanism. Just be prepared to pay the price when you decide it is time to come off of it. I'm not talking all of the lovely liver disease stories and slow death stories, I am talking about when you are finally ready to quit, you will have to deal with some unpleasant withdrawals. You have to pay the piper. This is true of any chemical coping mechanism. So if you decide to use alcohol as your coping mechanism, try to wean your self down instead of quitting cold turkey. And for all of youlovelys out there who think scare tactics are a way to help out, let me help you out by telling you that the liver is a regenerative organ. Google that. I think that when you have a lot of shit going on in your life all at once that you can't cope with, your mental ability to cope goes into hiding. There are those self righteous people out there who would totally condone an anti depressant, all the while having no earthly idea what it does to your brain and your body. Let alone the w/d symptoms that come with it when it is time for you to come off of it. Take an SSRI, they say. It is much better than alcohol. Heres a tip. Anything other than unprocessed food and straight water is going to tax you liver, brain and immune system. And everything else. You sound like you have a lot going on, but your post was very articulate, and you spelling was excellent. You were very forthright, honest and logical. You know that you are taking "medication" that is potentially dangerous, but you don't have any info available to help guide you like there is with pharmeceutical medications. All of this info you gave makes me believe that you are an intelligent, logical human being who is going through some tough stuff right now. When you do decide it is time to stop the drinking, have people around who can help you and wean off of it. This will lessen your w/d symptoms and become a platform for you to regain your own confidence in your self control, and you ability to be self willed. I think that you will know when it is time to stop. If you need to "talk" (etalk, LOL) you can email me anytime. Don't feel bad about yourself, and don't let anyone else make you feel bad either. You will come through this, and when you do, you will be able to help someone else. Empathetically, without judgement, and with caring. You can be above the crowd on this one because you will have been through it, and you will find that you are able to speak to that person without shitting on thier esteem. Take it easy on yourself, and take good care. And drink lots of water.
posted by kloedanser at 8:12 PM on January 31, 2006