alcohol withdrawal?

March 20, 2008 9:44 AM

Quitting drinking--should I worry about withdrawal symptoms?

I think I'm finally ready to get sober. I presently start drinking in the morning, consume between a pint and a pint and a half of vodka over the course of the day, and anywhere from 3-12 beers at night, on average. Should I worry about DT's, etc, if I were to just quit cold turkey? I know you are not my doctor; anecdotal experience and tips for tapering are welcome.

(note/background: I've been fucked up almost every day for twelve years. A couple years ago I went to detox/rehab for heroin/crack/benzo dependency. I'm clean still, but obviously not sober. I know I really have to want it, and I'm aware of various treatment/recovery options. I've been in Those Rooms and will probably be back in them.)

throwaway: [e-mail]

posted by anonymous to health (22 comments total)

Warning! Alcohol withdrawal can kill you.

Go see a doctor and get his advice about coming off the sauce.
posted by Electrius at 10:03 AM on March 20 [1 favorite]

Yes, you should be concerned about withdrawal. Ask a doctor about this.

Here's what the NIH's MedlinePlus has on alcohol withdrawal:

http://www.nlm.nih.gov/medlineplus/ency/article/000764.htm

Treatment

The goals are to treat the immediate withdrawal symptoms, prevent complications, and begin long-term preventative therapy.

The person will probably have to stay at the hospital for constant observation. Heart rate, breathing, body temperature, and blood pressure are monitored, as well as fluids and electrolytes (chemicals in the body such as sodium and potassium).

The patient's symptoms may progress rapidly and may quickly become life-threatening. Drugs that depress the central nervous system (such as sedatives) may be required to reduce symptoms, often in moderately large doses.

Treatment may require maintenance of a moderately sedated state for a week or more until withdrawal is complete. A class of medications known as the benzodiazepines are often useful in reducing a range of symptoms....

The health care provider will watch closely for signs of delirium tremens.

Hallucinations that occur without other symptoms or complications are uncommon. They are treated with hospitalization and antipsychotic medications as needed.

Testing and treatment for other medical problems associated with use of alcohol is necessary. This may include disorders such as alcoholic liver disease, blood clotting disorders, alcoholic neuropathy, heart disorders (such as alcoholic cardiomyopathy), chronic brain syndromes (such as Wernicke-Korsakoff syndrome), and malnutrition.

posted by zippy at 10:20 AM on March 20

Yes, you should worry about DT's if you are consuming that much alcohol on a regular basis. Although the DT's are rare, they can be fatal. You need to detox under medical supervision. I am sure you will hear from people that they know people who detoxed just fine on their own, but these people took a big risk that you don't need or want to take.

Please get into a treatment program, or present to the nearest emergency room. You will have an evaluation and will most likely be admitted. The most dangerous period is about 48-96 hours after you have stopped drinking - that's when the DT's usually show up.

Once you are past the acute phase of withdrawal safely, it will be time to address all of the long term effects of your drinking - damage to the heart, liver, pancreas, and nervous system.

You need HELP to get through this safely. Accepting help does not mean you are weak or don't have willpower. You will still be doing all of the hard work yourself no matter how much assistance you have from others. Don't be ashamed to admit you have a problem and take the help that is offered to you.
posted by tuff at 10:23 AM on March 20

Please see a doctor. I have a relative who has been through the DTs several times while in the hospital, and it was definitely not something he could have handled on his own.

On the bright side, he is finally sober and it is a wonderful thing. This is a great step forward you are taking and you will be in my thoughts.
posted by thejanna at 10:33 AM on March 20

DTs are for hardcore alcoholics, we're talking decades of abuse, quarts of hard liquor daily.

Pints and 12 packs ain't got you there yet.

You can go cold turkey, you'll suffer from anxiety for days, the body saying "I want my fix."

Unless you have a history of heart problems/high blood pressure, you'll be fine.

The hardest part is not picking up the bottle in those first weeks. As I said, you'll be anxious, have lots of time and plenty of excuses to drink up. THAT will be the stumbling block.

You'll also have more money than your used to, buy some books.

I am not a doctor, just an alcoholic. The longest I quit was for a year, cold turkey, after pints (gin) and cases for like 10 years.
posted by Max Power at 10:39 AM on March 20

DTs are for hardcore alcoholics, we're talking decades of abuse, quarts of hard liquor daily.

Pints and 12 packs ain't got you there yet.

Don't listen to this. A friend of mine recently tried to quit drinking on his own, and he drank a similar quantity of alcohol as you for a similar length of time - he definitely had to check into the hospital for detox, the DTs were that bad.

DTs vary by person and body chemistry. Just cause one person can quit cold turkey without turning into a pretzel doesn't mean that everyone can.

Better safe than sorry - the point is for this to improve your life...not end it.
posted by The Light Fantastic at 10:59 AM on March 20

DTs are for hardcore alcoholics, we're talking decades of abuse, quarts of hard liquor daily.

Untrue. People's bodies are all different, and will respond differently. For anonymous's body, the level of consumption may well be enough to set of DTs or other serious withdrawal symptoms when s/he quits. It may not be. But the only person who can adequately judge is a doctor, and anonymous would do well to seek medical advice before attempting to quit.
posted by rtha at 11:03 AM on March 20

A message from an anonymous close acquaintance of mine:

"My fellow traveler on the Road I urge you to go to a detox center. You may or may not need further treatment beyond that starting point.

It is not possible to know for certain how severe your withdrawal symptoms will be. One thing is for certain and that is you will be more likely to be successful if you begin your sobriety in a supportive environment. If you choose to try it on your own please avoid consuming large amounts of sugar and coffee and drink lots of water. Attending Twelve Step Meeting with others who have traveled the Road is also suggested."
posted by Lokheed at 12:14 PM on March 20

Nthing medical advice - your body is going to react very badly to not getting alcohol. It might not get as serious as DTs, but you will likely get the shakes pretty bad, among other frightening symptoms. Better safe than sorry - check into a detox center. A doctor can prescribe Valium or a similar sedative to relieve withdrawal sypmtoms. If you absolutely can't or don't want to go into detox, at least don't be alone when you do it. Have one or more friends stay with you until you feel better, preferably if they've had experience with detox. A small amount of beer a few hours in can smooth the bumpy road.

Good luck.
posted by Koko at 12:19 PM on March 20

(By "prescribe", of course I mean "administer while in detox", lest you be wary of transferring addictions.)
posted by Koko at 12:29 PM on March 20

Withdrawal varies widely from person to person but it can be very serious. If you aren't comfortable getting medical help at least have someone around who can keep an eye on you and take you to the hospital if necessary. (My husband went through this a couple years ago in my parents' house. He was drinking at least as much as you described and ended up just sleeping/groaning/feeling wretched for a few days...YMMV.)

And don't forget to drink fluids (like Gatorade--which will replace the sodium/potassium/etc. you'll be losing) even if you don't feel like eating or drinking.

Good luck.
posted by hulahulagirl at 1:30 PM on March 20

i would go to the doctor, just to get some medical advice and prepare yourself for the process.

have you considered seeing an addiction counselor? it might be helpful to have a coach during the process, if for no other reason than to get some advice on coping strategies and give you some insight into what's happening inside your brain while you go through this period. i'm sure i would want one.

good luck. i'm glad you've made this decision.
posted by thinkingwoman at 2:40 PM on March 20

To say that pints and twelve-packs aren't enough to give you the DT's when you quit is, imo, really irresponsible considering we have no idea what your build is, how tall you are, how much you weigh. Please do go to your doctor, tell him/her you are ready and know the difficulties, and get them to help you through it. Your chance for success will be that much better. Good luck, and congrats on making this change!
posted by misha at 3:05 PM on March 20

People withdraw in the hospital all the fucking time on lots less than your habit, if you care. They're usually the social/functional alcoholics that don't come clean about their habit when they're admitted for something unrelated. Ethanol withdrawl kills people, so unless you're Superman (you are anonymous, after all), get an opinion from someone with a diploma from somewhere besides Metafilter or a liquor store.
posted by docpops at 3:59 PM on March 20

Follow-up from the OP

Hi all, thanks for your responses and encouragement. I realized I should clarify my question.

Inpatient treatment is at best a remote possibility. I don't have insurance and missing work would be disastrous.

"we have no idea what your build is"

Male, 5'9, 155 lbs.

My work requires a high level of manual dexterity and a lots of use of gnarly tools. (I know, unconscionable to have been doing so drinking. I'm dumb). So even bad shakes would be a major issue, there.

I think my question should have been: even if I face the possibility of withdrawal symptoms when I give up alcohol, how can I minimize their effect, likely without medical care? Have you tapered off, and what was your experience of doing so?

posted by jessamyn at 5:03 PM on March 20

Yes you drink plenty, and enough to have severe, potentially dangerous withdrawal.

No, this shouldn't stop you from quitting, but since benzos are a mainstay of managing withdrawal symptoms I think given your prior dependence, it'll be tricky managing withdrawal medically though I'm by no means an expert on outpatient detox techniques. Professionals that do this more frequently than I probably have ways of addressing benzo dependence and alcohol withdrawal in the outpatient setting. In an ideal scenario, I agree that finding such a person would be helpful. If that's absolutely not feasible I'd favor tapering over a month or more rather than the cold turkey approach.

I applaud you on coming to this decision. It's not easy but you owe it to yourself and your loved ones to try (safely of course).
posted by drpynchon at 6:07 PM on March 20

Inpatient treatment is at best a remote possibility. I don't have insurance and missing work would be disastrous.

More disastrous would be not getting treatment at this point. Having been through treatment before, I suspect you know this. Really, it's a matter of life and death.

What are the things that would make work absence disastrous? Would you lose your apartment? Maybe you could work something out with your landlord. Do you have dependents? Well, they are surely better off with a sober parent, is there someone who can care for them while you are dealing with your problem? If it is simply a matter of worrying about losing your job, then, well, there are other jobs out there and your health comes first. If you're drinking all day, then you might not have that job much longer, anyway.

Do you have a good, solid friend or family member? Go to them and tell them what you've told us. Ask for their help. Tell them that you would like help. Anyway, this good, solid friend should be "deputized" to help you with the things from the last paragraph (with, of course, the understanding that this person is not your babysitter, simply the friend who is helping you with some logistical issues).

As for insurance, there are options for people who are not insured. Depending on what state you are in, you may be eligible for state- or municipal-run programs for the uninsured. Not ideal, but again, better than your current situation. Many of the better centers have "scholarship" programs. When you go to the doctor, ask him/her about these options, or call the people at Hazelden who may be able to refer you to resources in your area. Or hell, just spend the three days to a week in detox and then commit hardcore to AA.

Good luck, and please do let us know how this goes.
posted by lunasol at 7:26 PM on March 20

I don't think it proper to give you medical advice as to what could occur. I'm an alcoholic.

Withdrawal should always be done under medical supervision. A doctor should monitor the process.

That said, I would encourage you to investigate www.soberrecovery.com. It is a community of addicts, family and friends. It is a magical place with thousands of members. I am in my fifth week of recovery and it has been a godsend. Join the newcomers forum and you will be instantly welcomed into the world of recovery. In a week you will have friends from all over the world who share your addiction.

This community is a very safe place and is "open" 24/7. It is in large part responsible for changing my life in a very short time. The majority of people are AA types but all are welcome. I am very serious; it could be the best move of your life. I hope to see you there.

Mention metafilter and I will help guide you around!
posted by private_idaho at 7:51 PM on March 20

Pints and 12 packs ain't got you there yet.

Pints of vodka.
posted by oaf at 10:09 PM on March 20

You are at risk of a severe, life-threatening withdrawal syndrome. Max Power is wrong - you do not have to drink for decades or drink quarts of hard liquor a day to die of DTs. (One study showed that people who went into DT's in a hospital had only a 75% chance of surviving to hospital discharge.)

There are other ways to die of alcohol withdrawal without going into DTs - a withdrawal seizure, resulting in a skull fracture, resulting in a fatal intracranial hemorrhage is a popular way that some of my alcoholic patients have used to check out permanently.

I applaud your willingness to make a positive change in your life and sober up. Please start by coming to medical attention. There are ways to do this easily and safely, and many doctors will be happy to help you with it.
posted by ikkyu2 at 10:23 PM on March 20

Congratulations on making the decision to change your life!

Conflicting advice:

1- People sober up on their own all the time. Chances are, you'll be fine. It will suck, but memories of that discomfort could be good.

2- Or not. The medicos are right, bad things can happen. I've found that medical professionals tend to bias toward bad things because they are trained to have an abundance of caution, and because they generally see only the bad things that have happened. Nobody goes to a doctor to say "I solved my problem myself."

3- There's another theory that memories of the discomfort are bad. That the stress of worrying about having to go through that again tends towards relapse.

4- A good compromise might be finding a psychiatrist who understands both the physiological and psychological issues involved, and working out a plan that fits with your life and goals.

5- There's also a theory that using drugs for their intended use in a therapeutic setting is not a violation of your clean. It probably depends on your individual makeup. Using drugs in a controlled environment to treat a condition is different than using them to get high. The "the dose makes the poison" theory. It's a dangerous idea, however, and best explored with a pro.

Good luck!
posted by gjc at 7:45 AM on March 21

Withdrawal symptoms are not necessarily correlated with how much you have drank in the past, especially when comparing anecdotes. Each person is different. Obviously, as many have said, you should sober up under medical supervision.

Depending on what state/city you're in, the lack of insurance can be dealt with. The easiest way to do this is to contact your county hospital/health clinics and see what resources they have. Also many university/teaching hospitals have missions to treat the uninsured. There may be outpatient rehab programs as well. Another place to ask for help with your specific situation may be the local AA.

Like others have said, it may be possible to level with your employer for taking time off work for a brief inpatient treatment. Something you would know best, obviously.

There are people out there who want to help and have the resources to; the hard part is getting the people who need the help and the people who can help to find each other.

Good luck and congrats for taking the first steps to a better life.
posted by the druid at 8:58 AM on March 22