Advice on supervising my friend's withdrawal from alcohol?
March 17, 2010 7:02 PM   Subscribe

Tomorrow I will be 'supervising' my best friend and roommate as he goes through what will be the first full day of detoxing from his alcohol addiction. General pointers would be appreciated.

He's in his 30s, and just gone through a bad breakup with a cheating boyfriend. Ask if you need more details!
posted by tumbleweedjack to Human Relations (18 answers total) 1 user marked this as a favorite
 
This is something that should be handled by medical professionals. Alcohol detox can be fatal. If he isn't willing to go to a hospital, you need to keep a very, very close eye on him and do not hesitate to call 911.
posted by something something at 7:05 PM on March 17, 2010 [4 favorites]


Forgot to add: the day is starting with a trip to the doctor's office, so there will be some medical supervision as well.
posted by tumbleweedjack at 7:05 PM on March 17, 2010


What I really mean by my question is the relational aspect- how can I keep him busy, keep his spirits up, etc.
posted by tumbleweedjack at 7:07 PM on March 17, 2010


I think that his attitude towards this will dictate alot. If he's depressed about "never drinking booze again" (the horror!) then it's going to be a crappy day. If he's psyched about putting all this past him you could have a very positive day together. It really depends on the framing (how he chooses to see things).

You could also get him Alan Carr's Easy Way to Control Alcohol as bedtime reading.
posted by fantasticninety at 7:10 PM on March 17, 2010


I wouldn't worry so much about keeping him busy (his body will take care of that) as much as keeping him safe. He is going to be going through hell physically, and whatever distractions you manage to put together are going to be about as useful as a bucket on the Titanic.
posted by sallybrown at 7:12 PM on March 17, 2010


I guess remember that, really, you're there to observe, not supervise. He chooses if he drinks or not. Your role is to remind him why he is making the choice not to drink.
posted by howfar at 7:15 PM on March 17, 2010 [1 favorite]


Do you guys have any other friends in common? The more people around who are supportive, the easier it tends to be, especially considering the boyfriend thing. A lot of what you might do depends on his personality: what does he enjoy doing?
posted by StrikeTheViol at 7:18 PM on March 17, 2010


The psychological end of this process is fairly straight forward, as mentioned upstream, you don't want to get into forcing him to carry through with this...if he decides to get a drink, that's his decision.

There's a significant lack of information in your post as to the possible physical impact. Detox can look very different depending on the physical addiction. If you're dealing with someone who is going to go into DT's as opposed to someone who is just craving a drink, there's a world of difference.

I've worked on Substance Abuse wards, true DT's need medical treatment, you shouldn't do that at home....

We can't answer you question with the info provided.
posted by HuronBob at 7:20 PM on March 17, 2010


HuronBob: I would say 3-5 drinks a day as well as getting stoned once or twice a day at least. He made the decision to be sober on his own and asked me to be with him tomorrow.
posted by tumbleweedjack at 7:25 PM on March 17, 2010


No one quits drinking (or any addiction) without deciding so themselves, so the whole fretting over his attitude of being "depressed" over never "drinking booze again" is probably moot. He came to a decision. Otherwise he would be hospitalized.

He just need to get through the first stage. He's seeing a Dr that day - they will give him a lot of info then. Ask him for that info. Though he will probably give it to you, knowing you've signed up to be there with him through this. It may be uneventful yet very uncomfortable. I suggest movies. Food. A bath. Things that will calm him and make him feel comforted. Things that will underscore that he's now taking care of himself/healing. Clean his house for him, make sure he has things to read that he likes. Treat it like a sick day. Restfull. In bed. All with the attitude that he's getting stronger.
posted by marimeko at 7:34 PM on March 17, 2010 [2 favorites]


From this information you're giving, this isn't a "detox" situation, but rather a change in ingrained habits. The first day is not going to be the big problem. Distraction will probably be enough. Have as much fun as you can. You've got a day dedicated to being with a friend, have as much fun as you can.

If you really want to help him out of the booze in the long run, then you could spend some time working on things that he wants to do in the future. Why does he want to be sober?
posted by howfar at 7:52 PM on March 17, 2010


Assuming he's an alcoholic in these comments... There's different levels from binging, to daily drinker, to alcohol dependent chemically, to functional alcoholic, to being shitface drunk all the time.

Withdrawal isn't fun. He definitely needs to see a doctor for a prescription for an anti-convulsant such as Ativan that will last at least 4 days. Once on it, expect drowsiness.

A return follow-up visit to the doctor after a few days would be recommended. As well as blood-work, but the doc should know that.

Get some off-the-shelf Thiamine. Alcoholics usually have a deficiency. A good doc should know that as well.

Depending on how heavily he drinks, withdrawal will kick-in probably between 6-12 hours after the first drink. He'll get the shakes. That's what the Ativan or equivalent is for, and to prevent it.

He should be drinking lots of fluids to flush-out the system. I've usually been given ginger ale. It looks like beer, has enough sugar to keep the glucose levels up, and may help with any nausea.

Nutritious foods available as he feels like eating them. Appetite picks-up with sobriety.

Address the underlying issue. Boredom, anxiety, depression, etc.

If you can, help him avoid a relapse. One drink, and the detox is erased, having to start back over again.

The liver can heal with abstinence, but spending weeks in ICU due to liver failure... once it goes down, the other organs start to also shut-down in a chain-reaction and it's a challenge for doctors to keep one alive. The good thing is for a couple of weeks in ICU, it's unconscious most of the time. Recovery is the hard part for the person to the point of being weak as a newborn kitten and having to regain balance and strength to walk after weeks or months of being in a hospital bed.

I'm rambling, but speaking from personal experience, don't let him get that bad.
posted by hungrysquirrels at 7:53 PM on March 17, 2010 [1 favorite]


No one quits drinking (or any addiction) without deciding so themselves, so the whole fretting over his attitude of being "depressed" over never "drinking booze again" is probably moot. He came to a decision. Otherwise he would be hospitalized.

Lots of people make these decisions and then second guess themselves or find ways out so that they don't have to go through with what they truly want. I sincerely think that as a friend the more he helps focus this guy on seeing this as a celebration of sorts and not some mourning or drab period will help the long term success.
posted by fantasticninety at 8:05 PM on March 17, 2010


Just be really nice to him. He may be anxious on the first day so avoid anything that can frighten or upset him such as scary movies. It's not the time for deep conversations about his addictions unless he initiates it.

If you can get hold of fresh fruit and vegetable juices get a generous supply, along with a variety of mineral waters and sodas (but avoid caffeine).

Basically treat him like a child with the flu.
posted by heytch at 4:13 AM on March 18, 2010 [1 favorite]


Other people know the medical side much more than I do, so I won't comment on that. It seems like there's a good likelihood that he will be physically miserable, so you probably want to focus your activities indoors. A lot of this depends on his personality, so take what you will.

Does he like video games? Bring over some new ones that are in his style, or a gaming system that he's not used to. Even if he's not a big gamer, most people can adapt pretty quickly to the Wii. Look into borrowing one from one of your other friends.

On a similar note, you could bring new videos he would like, or old ones that he loves.

Introduce him to a hobby of yours. Preferably something sedentary (if you want to do it that day), but I guess you could like explain to him the basics of rock climbing or whatever. A new hobby right off the bat could make him feel like he has something to replace the hours spent drinking.

Bring stuff for a baking project - he doesn't have to eat it if he's not feeling up to it, but something like baking/decorating cookies or making easter eggs could be silly fun that can take as much or as little effort as you want.

Does he like animals? You could bring over one of your own pets to hang out with.

(This one could be an awful idea depending on your friend, so take heed) If he has always wanted a pet, perhaps you could go shopping for one or make concrete plans to get one. It's sometimes hard for people to feel like they deserve to be treated well, but a cat or dog could be the thing that is worth keeping sober for. Again, this could be a really bad idea if he is not ready or willing to care for an animal.

Best of luck to you and your friend, and you're a great friend for doing it!
posted by fermezporte at 5:30 AM on March 18, 2010


I would just make sure you are 100% up front with the doctor. I realize that there are different levels of alcoholism, BUT detoxing from alcohol can kill you. Dead as a doornail. There's a reason you do it in the hospital. So I would be upfront with the doctor, and if he even indicates for a second that it would be good for your friend to go to a program to detox, I WOULD TAKE THAT ADVICE.

Scariest day of nursing school: talking about alcohol detox. Scared me shitless. It's no joke.
posted by sully75 at 6:57 AM on March 18, 2010


IANAD, but I do drink. 5-6 drinks a day is not going to result in a huge detox. I think the bigger elephant is going to be the justification he/she starts to work out as to why having a drink is no big deal. It happens to me every time I try and quit smoking. I get so worked up that I justify smoking to myself as a better thing than the stress of giving up.
posted by Frasermoo at 8:05 PM on March 18, 2010


A little late to the party, but for future searchers, here's something I copied off the craigslist recovery forum. sober82 has a good track record. I know him offline, too, and trust his experience in this.

Here are a few suggestions <>
2010-03-08 14:01:12 +5

1. Find an a.a. meeting. You may not accept the program or you might, but for right now - as in today and tomorrow - you will find men and women who have also experienced kind of sickness that you are experiencing right now....You will find them generous with their time and the women will be very supportive....Whether you accept the program or not is a decision for another time.

2. For today (or this evening where you are) try to drink water, or something like Gator-aide - stay away from the power drinks and caffeine...AND sodas...part of why you feel so lousy is that you have dehydrated yourself. If you haven't already done so, get a good top quality multi-vite with a heavy source of B complex in it...This will help to bring your nervous system back to normal....

3. Take some regular exercise - if you do not already do so - a brisk walk around the block a couple of times will get you started...you want to reach an aerobic rate and keep it for 15 to 20 minutes (don't expect to do this right away). This will stimulate the production of serotonin which will enable you to generally feel better and to sleep better, it will also go along way to overcoming the depression that usually accompanies the kind of hang over that you described.

4.Get a hold of and read Under the Influence by James Milam, Ph.D. it is science based, easy to read (even when you don't feel good) and only cost $10.00 and Barnes and Noble or at Amazon...it will break it all down for you and has been indispensable to many many alcoholics.

&

Lots of us detoxed at home <>
2010-03-08 14:17:56 +5

If it is necessary you can to....If you have a trusted friend who can check in on you or stay with you so much the better....If you have a history of seizures this is not going to be such a good idea, but it is doable....if you begin to seize you MUST call 911!....That is the major risk of detoxing off of alcohol...

Depending on the attitudes where you live you might go to the E.R. and speak to a doctor.....

You are stornger than you feel right now...You really are....
Right now you feel ill, this shall pass...you feel scared because you cannot see what the future holds...It may not be a a rose garden but you will survive it if you do not drink. If you survive it and get yourself together you can-brick by brick- build yourself a sober centered life...Many of us have had to this this and we have....You feel much weaker and more powerless than you really are...trust me on this...no matter what your situation you are not as helpless as you feel when ill from too much booze for too long....

You Can Do This
posted by small_ruminant at 12:04 PM on March 19, 2010


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