Smoking lush seeks hospital advice
November 29, 2009 7:50 AM   Subscribe

I drink like a fish and smoke like a chimney. Help me survive a possible hospital stay.

By the end of this week I may well be in the hospital due to an ongoing (nonsurgical) medical issue. My doctors do know about my habits. To the extent it doesn't interfere with my treatment, how are such addictions dealt with on an in-patient basis?
posted by anonymous to Health & Fitness (7 answers total) 1 user marked this as a favorite
Have you considered asking the medical staff to help you with quitting? There isn't a place much better than a hospital when you wish to give up the booze and smokes. They have all the best withdrawal medications and professionals who will manage your recovery. Give it a go. Lots to gain and not much to lose. All my best to you.
posted by netbros at 8:06 AM on November 29, 2009

Might get treated with benzodiazepines for the alcohol withdrawal, if you are at the point where withdrawal symptoms will cause issues with your treatment. For tobacco, perhaps you can ask about nicotine patches, but I'm thinking that may not fly, as it could cause conflicts with other treatments you are getting.
posted by kellyblah at 8:25 AM on November 29, 2009

NHS: staff will not help you go out for a smoke, but they also will not prevent you. Smoking areas are outside, and very limited in scope - though people do ignore that, there are occasional crackdowns. Depending on your level of mobility you may find it nigh on impossible to indulge in the fags. However, a common sight at my local hospital is people who have had a limb amputation due to smoking dragging themselves out on a wheelchair for another fag, so I wouldn't like to underestimate your determination in that respect.

As netbros suggests, you could ask your docs to plug you into smoking cessation services; if your condition is exacerbated by the fags there may be specific programmes.

For the booze, I genuinely have no idea. I suspect it will be along the same lines of not enabling, but not preventing either, but I have no evidence. And however desperate you get, don't think about drinking the alcohol gel for disinfecting your hands because it can kill you.
posted by Coobeastie at 8:26 AM on November 29, 2009

They will probably give you a nicotine patch for your smoking.

It's very important that everyone knows about your drinking, because you do not want to start detoxing accidentally. It's a medical emergency, if you are really dependent on alcohol. You could die. No joke. So make sure everyone on the care team knows the story because you'll have to be managed one way or another. There's a chance that they will want to RX you beer (seriously) but you will also have to be on other medications while you are there.

Seriously though, if you are this addicted, one of these will eventually kill you in a horrible, horrible way. Not sure if this is the time to detox, but I would discuss it with your doctors. It may or may not be a good time. But I think a: Do I like this picture? moment might be a good thing to think about.
posted by sully75 at 8:30 AM on November 29, 2009

To the extent it doesn't interfere with my treatment, how are such addictions dealt with on an in-patient basis?

Sensible question.
Nicotine patches are likely available (yes, you do have to ask), but on a possibly (excessively, to you!) rationed basis. They may be meticulously collected by nursing staff before you go to sleep - on the grounds the nicotine might keep you awake, and handed out rather late the next day.

I agree with netbros that a collateral benefit of a hospital stay is enforced bad habit changing!
You might want to bring your own supplementary supply of patches, however. It's seldom soothing to be an in-patient. And if you can manage to keep sane with regular patches instead of cigs in hospital, you might pursue patches as a habit-breaker afterwards.

All my very best to you as well.
posted by Jody Tresidder at 8:31 AM on November 29, 2009

Cardiothoracic ICU nurse here! Most of my patients drink/smoke like it's going out of style, and that's why they need coronary bypasses and lung resections. So... it's probably in your best interest to quit. That being said, thank you for at least being honest about your habits and telling your health care providers about them. A lot of people aren't, and it causes us to go on unnecessary wild goose chases trying to figure out a problem that is really easily remedied.

I don't know where you are, but no hospital in the US is going to let you use your own supplementary supply of nicotine patches, and you will get your nurses in a shitload of trouble if you try to sneak in your own, so please don't. We'll supply them for you though, and charge you god knows what for them.

Some of our docs are totally fine with writing an order for beer. If it doesn't interact with any medication you're taking, we'd much rather you have your drink than go through withdrawal symptoms on top of everything else that's going on. As mentioned above, we use benzos as well.

Even though you've already told your primary care doctor about your drinking/smoking habits, make sure to reiterate them when they do your intake history/physical when you go into the hospital. Sometimes things do get overlooked, and this is something that shouldn't be.
posted by makonan at 9:11 AM on November 29, 2009 [3 favorites]

I think the idea that the OP would be detoxing at all means that he/she is totally addicted to substances. If the OP can go to the hospital and be off the substances without detoxing, that's great. But the risks of alcohol detox are great.

The brain likes things to stay the same, and when you continually add a depressive like alcohol. It responds by increasing the sensitivity to certain excitatory neurotransmitters, most notably GABA. As long as you continue to consume alcohol, and as a result depress brain activity levels, all is fine (except for the hundreds of other health deficits accompanying alcohol abuse) but should you ever stop drinking, the brain is suddenly lacking in the near continual presence of the depressant chemical, and because it has been "rewired" to be extra sensitive to excitatory neurotransmitters, without anything slowing it down, it races ahead.

This racing brain presents with symptoms such as anxiety, insomnia, vomiting, shakes, hallucination, seizures and convulsions and a possibility of heart stoppage. There are few drugs that present with a detox as dangerous as alcohol.

posted by sully75 at 10:24 AM on November 29, 2009

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