how to help an alcoholic stop drinking

July 25, 2006 6:52 PM

What is the best way for a long-time alcoholic to quit? Primarily concerned with medical aspects/health risks of detox.

10 year functional alcoholic. No other drug habits besides cigs. Average 12 drinks/night. Want to quit, but concerned about withdrawl health risks. What medications are recommended? How long does physical withdrawl last?
Not interested in 12 step information, purely medical advice requested.

posted by anonymous to health & fitness (15 comments total)

Here are two reliable articles to give you an overview.

Alcohol Withdrawal

Delerium Tremens
posted by wryly at 7:21 PM on July 25, 2006

As you probably know, delirium tremens is your primary concern. Be aware of the symptoms, and be ready to report to the emergency room if it starts to get bad. It might be a good idea to have someone else (a responsible party) around for the first few days. Unfortunately, the recommended treatments are mostly heavy sedatives, which would be a bad idea to self-administer even if you could get ahold of them. After about two weeks, you should be in the clear. Note that there's a lot of variation in withdrawal symptoms: everything from insomnia, to the shakes, to full-on convulsions and psychosis. Again, it might be a good idea to have some help for this.
posted by mr_roboto at 7:26 PM on July 25, 2006

not medical, but i found non alcoholic beer to be a great crutch.
posted by lester at 8:18 PM on July 25, 2006

"Non-alcoholic beer" contains some alcohol; it's not a good idea for an alcoholic on the wagon to drink it.

By law if it's less than 0.5% alcohol they can call it "non-alcoholic".
posted by Steven C. Den Beste at 8:39 PM on July 25, 2006

Avoid acetaminophen entirely. You'd be at risk for alcohol-acetaminophen syndrome, especially in the first few days. That can cause liver injury and death.

You may wish to consider carrying your medical information with you and giving a copy to whatever friend or family member may be helping you out.

Good for you, and good luck.
posted by sculpin at 11:01 PM on July 25, 2006

I would seriously consider checking myself in. There are professionals who understand all about the medical aspects of withdrawal who can help get you through it. Why go it alone?
posted by ottereroticist at 11:18 PM on July 25, 2006 [1 favorite]

If you've been averaging 12 drinks a night for ten years, you need to be under the care of an M.D. It may suck and it may put you in some debt, but you'll be alive. Going cold turkey by yourself is going to be insanely difficult and dangerous.
posted by Optimus Chyme at 11:29 PM on July 25, 2006

Is tapering off an option? If you have the will to stop, surely you can summon the will to gradually decrease your intake.

This may not work for you, and others may recommend against it, but it's an idea.
posted by Bud Dickman at 6:32 AM on July 26, 2006

The primary concerns you should have are a) it's next to impossible for alcoholics to stop drinking on their own (tapering is not a realistic option), and b) alcohol withdrawal is perhaps the most dangerous kind of withdrawal. You've likely seen movies with heroin addicts chaining themselves to beds to kick it... If you try that with alcohol, you could very well wake up dead.

You need to have your blood pressure and physical status regulary monitored while you're getting over the withdrawal symptoms, and to have a medical professional evaluate your symptoms and administer drugs accordingly.

Please talk to a doctor before trying this. You're much safer keeping with the 12/night until you can get to the doctor than you are trying to do it yourself immediately.
posted by dsword at 6:54 AM on July 26, 2006

Medical care can be a short (3 - 4 day) hospital detox. Many people don't know this, and assume a 30 day residential program is the only type of option. Insurance may pay its share for a detox. Positive - They can safely sedate you. Negative - They will twelve-step you, you will not have a private room, you will be strip searched. But it's over in a few days, and you can go forth and try your hand at staying sober after that with no obligations (only recommendations) for follow up care or 12 stepping. Call your insurance/doctor, if applicable, first, or call the hospital for an estimate. Just report to the emergency room first thing in the morning and check yourself in. Good luck, whatever you choose.
posted by rainbaby at 6:55 AM on July 26, 2006

By law if it's less than 0.5% alcohol they can call it "non-alcoholic".

I found it interesting that in Holland NA Heineken is 0.1%, and in the US it's 0.5%.

So, what, they make it the maximum allowed by law for each market?
posted by StickyCarpet at 6:58 AM on July 26, 2006

So, what, they make it the maximum allowed by law for each market?

Yes. It's slightly more work to remove slightly more alcohol. But the costs add up, so why make the product more expensive than you have to?
posted by Mayor Curley at 8:14 AM on July 26, 2006

I would encourage you to give more consideration to the answer from mr_roboto and less to the hyperbole from dsword.

You can do it yourself and probably get through it ok. But having someone around is a smarter idea - fitting is not alllllll that uncommon during withdrawl. It is difficult to predict and I wouldn't have a clue about the likelihood other than to pluck from the sky a figure of maybe 20% of people. Best of course, as people are suggesting, is to go through a short in-patient detox clinic.

The first 2 days should see you through the worst of it. Expect to be on edge, nervous, agitated, sweating, maybe headaches or visual disturbances (double vision and the like), perhaps sneezing and skin crawling/itching/disturbed sensation. Perhaps the more intrusive symptoms will be your thinking -- difficult in concentration, short tempered, a depressed and/or swinging mood and self doubts. [I hope you're seeing why having someone around will likely make all of this just a tad easier, if only to take your mind off yourself].

The simplest treatment, if you're not going to see professionals is to self medicate with simple analgesics and drink heaps... HEAPS of water +/- juice/flavoured drinks --- whatever will keep you happy. But H.E.A.P.S.

If you decide for one reason or another to be by yourself when you do this, at least let somebody know that you'll be out of action for a few days. I wouldn't suggest trying to do things like sensitive/concentrated/mechanical work and I would avoid driving or doing any other kind of activity where you'll get stressed or there may be repercussions for you or somebody around you. [so, at the very least, if you're working 5 days a week, the most sensible time to have your last drink would be on the thursday night --- saturday will probably be a bit more uncomfortable than friday, if you follow]

Get a bunch of junk food or nibblies - whatever you can handle, just to have a bite from time to time. You probably won't feel like too much; in fact you may be doing a bit of dry retching (maybe) or even vomiting -- unlikely beyond anything you've experienced in the past.

Don't be a smartass and leave alcohol around your place. If you're going to do it, which is commendable of course, give it a good shot. Plan a little bit and be a bit sensible and you will have a little bit more confidence and thusly will you have a better attitude and a better time getting through it. Forget the 'life or death' thinking which just sets you up for great potential disappointment. It's something you want to do so give it a sensible attempt without bothering to get all het and psyched up. Just trying is a brave thing and you just might find that it's a bit easier than you expect. It'll be alright. Hitting 'enter' after writing this question was the biggest step.
posted by peacay at 8:27 AM on July 26, 2006

Pardon me while I disagree with peacay's suggestions for self-managed detox entirely.

12 drinks a night, if they're standard 1 & 1/2 oz jiggers, is 18 oz of booze / day, which is serious daily alcohol intake, no matter what you're drinking. A 10 year history of functional alcoholism, at any where near this level of daily intake means probable long term medical complications. I doubt that a "do-it-yourself" approach to detox would work, and it is almost certian you'll have DT and medically significant complications during detox. Your only practical choice is medically supervised in-patient detox, probably with heavy sedation.

No human body can keep up with that volume of alcohol intake indefinitely. Go to detox, get some nutrition, get past the shakes and headaches, and do what people at detox tell you to do, whatever that is, for the next 30 days. A month from now, you may or may not be in a position to make sober decisions about sobriety, but it's long, long odds (like 10,000 to 1) that for the next month, you won't be able to do that. The brain and the mind can recover from all that booze, but it takes a lot longer than 30 days, just for whatever physical rejunevation can happen to occur. At three months you'll still be seeing changes in your face, at 6 months your liver may have made it back to something like normal function, and at a year, if things are coming along, you may not be having aches and pains from a full day of normal activity. Somewhere around the end of that first year you sense that your brain is hitting on all cylinders again.

It's a memorable day, and it's one you can remember, if you make it that long. Good luck.
posted by paulsc at 10:38 AM on July 26, 2006 [1 favorite]

paulsc I don't disagree --- "Best of course, as people are suggesting, is to go through a short in-patient detox clinic."

And yes, I think 30 days in a facility would be even better. I won't get into arguing about the health implications from such an intake: there are lots of other factors that come into it.

But I was aiming to outline a 'safety net' approach, in that, you know, people don't always go and visit the professionals.
posted by peacay at 11:00 AM on July 26, 2006