Social Drinking Concerns Lead Man to Want Antabuse

July 5, 2011 11:36 AM

I want to use Antabuse to cut my social drinking.

I'm thirty, single, and I'm in the night club industry. Every week my schedule is completely different, I wake up at 11am and don't sleep until 4 because thats how the late shift works.

I love my job, and I'm great at it, plus I make enough money to be very comfortable. Life is good-- but I am decently self aware and I know there's a big problem on the horizon.

I drink 4+ drinks-- five nights a week. All my closest friends drink most nights each week. I love spending time with friends more than anything in the world, and I hate being at home by myself. I also hate being at a bar surrounded by drunk people when I'm sober-- I feel let out and want to join in or go home. Going home leaves me bored and lonely. I'm the kind of person who craves real-life stimulation (TV bores me)

I don't drink and drive, and alcohol hasn't (yet) caused me much harm besides making me chubbier than I'd prefer. My major concern is that my family has a history of diabetes, and I fully expect to develop it myself unless i immediately curb the amount I drink.

More than anything, I want to be able to make a decision in the morning when I wake up that I'm not going to drink-- and I want that decision to last the entire day. It's incredibly hard to pull that off for me when its 11pm, I can't fall asleep until 3+ because of my sleep schedule, and all my friends are out having fun and texting me to meet up. Changing who my friends are is not an option.

Seeing a psychiatrist is a *non-starter* (explaining why would generate a ton of pointless pro-psychiatrist responses and distract from the question, so just trust me on this), but I'd be very willing to take something like Antabuse (if I could find a way to safely get it w/o a prescription) for a limited time in order to develop a habit/routine that I can finally stick to. I'd really like to force myself into having a very set schedule of what nights I'll let myself drink (2 nights a week), and no changing my mind late in the evening when I'm bored and my friends want me to come out.

I'd love advice on either how to legally get Antabuse w/o a prescription, or advice from people familiar with this SPECIFIC type of alcoholism problem.

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posted by anonymous to Health & Fitness (25 answers total)

I don't quite understand from what you've written here why you need to get it without a prescription -- has your doctor turned you down or is a doctor also not an option for some reason (obviously your general practitioner is very different from a psychiatrist)? If you can get a mod to explain whether doctors as a whole are entirely off the table, that would be helpful, but otherwise, I would suggest just starting with your regular doctor. Getting a prescription med without a doctor's supervision is very ill-advised.
posted by brainmouse at 11:50 AM on July 5, 2011 [1 favorite]

Disulfiram has a 60-120 hour half-life, so there's still a significant effect days after taking the dose. You won't be able to drink 'a couple of nights a week' on this stuff; it's much too long-lasting.

If you misjudged it and drank alcohol before the drug had worn off, you would really, really regret it. I caution against this.
posted by henryaj at 11:52 AM on July 5, 2011 [2 favorites]

[Antabuse] is absorbed slowly from the gastrointestinal tract and is eliminated slowly from the body. One (or even two) weeks after a patient has taken his last dose of Disulfiram, ingestion of alcohol may produce unpleasant symptoms.

Says the prescribing information, so what you suggest seems to be pharmacologicaly impossible.
posted by Jahaza at 11:53 AM on July 5, 2011 [1 favorite]

Furthermore, this kind of problem of ignorance of the effects is why you shouldn't dose yourself with prescription drugs without the supervision of a doctor.
posted by Jahaza at 11:54 AM on July 5, 2011 [23 favorites]

It sounds like you just struggle to tell your friends you don't want to drink (as opposed to being physically dependent on alcohol, which is what Antabuse is for). I reckon you'd have more success alternating alcoholic drinks with soft drinks, for example - you're still drinking and enjoying the drug but you're significantly cutting your intake.
posted by henryaj at 11:56 AM on July 5, 2011 [1 favorite]

You don't need drugs, you need a cocktail alternative. I like orange juice with a splash of tonic. Virgin Bloody Mary? Yum. Irish coffee, no booze? Double yum. Of course, if you can't enjoy your current friends' company sober, maybe you should get some new friends, at least for the late night excursions.
posted by Scram at 12:10 PM on July 5, 2011 [2 favorites]

You're enjoying but you want to curb your intake. Try slowing down, after every drink, drink a full glass of seltzer with lime.

I would not recommend taking drugs without a doctor's supervision.
posted by The Whelk at 12:20 PM on July 5, 2011

Some 5–10 minutes after alcohol intake, the patient may experience the effects of a severe hangover for a period of 30 minutes up to several hours. Symptoms include flushing of the skin, accelerated heart rate, shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural fainting, and circulatory collapse.

Or you could just carry around a tiny hammer and whack your thumb with it every time you take a drink.

If you did decide to take a more lifestyle/cognitive-oriented approach, HealthMonth lets you set up rules for yourself. Maybe you could try to have two drinks a night or something.

Antabuse doesn't seem like the sort of thing one should really try to score. "Circulatory collapse" seems like one of those life experiences best avoided entirely. Or as long as possible.
posted by A Terrible Llama at 12:32 PM on July 5, 2011 [3 favorites]

This isn't what Antabuse is for at all.

IANAD, but when I worked in a pharmacy, Antabuse was for long term treatment for the serious alcoholics.

Do you have any idea what happens when someone on Antabuse drinks? I've only heard second hand, but it was described to me as 'uncontrollable vomiting'. Hope that works out at your job.
posted by Sphinx at 12:42 PM on July 5, 2011 [1 favorite]

Ondansetron may be a better alternative.
posted by theperfectcrime at 12:56 PM on July 5, 2011

If you can't make a decision on your own to not drink and stick to you, then you're likely a problem drinker. Alcohol has some negative effects on you and you want to curb them, but you can't stop.

You're the kind of person who may become an alcoholic. Maybe you're not there yet (I'm assuming you're telling the full truth.), but it may help you to get some help (and that doesn't have to be a therapist. Maybe go to AA.

Antabuse is a serious drug for a serious problem and not to be used as frivolously as you suggest to use it.
posted by inturnaround at 1:01 PM on July 5, 2011 [3 favorites]

I also hate being at a bar surrounded by drunk people when I'm sober-- I feel let out and want to join in or go home. Going home leaves me bored and lonely. I'm the kind of person who craves real-life stimulation

This is where you are stuck. Even if anabuse did work, you would be miserable and probably not want to take it since the only alternative to being drunk is being let out and lonely. You need to give some really serious thought about options for what you are going to do on the nights you don't drink - there are options if you are open to considering something different - but as long as you believe the only choices are drinking=fun (and bad health in the future) and not drinking=lonely and left out now, you are set up for failure.

Here are two samples to start you thinking:
Find an on-line game that include chat functions and play with people overseas who are still wide awake at 2:00 am your time.

Take a sleeping pill when you are home alone, sober and can't fall asleep.

Good luck. Having to do anything by willpower is really hard. Changing your environment to support your preferred actions makes it much easier.
posted by metahawk at 1:06 PM on July 5, 2011 [8 favorites]

Like metahawk, I was going to point out that what you really need is another activity. Like gaming. Maybe some of your current friends would also be interested in doing something other than the bar scene.
posted by Eicats at 2:05 PM on July 5, 2011

Paradigm shift here: having 4+ drinks, 5 nights a week, is not "social drinking"
posted by kelegraph at 2:54 PM on July 5, 2011 [1 favorite]

Antabuse won't help in this situation. You'll sill want a drink when you want a drink, but it will just make you sick. It's aversion therapy. Try watching the movie "Leaving Las Vegas" if you want some aversion therapy - no prescription necessary.
posted by Diag at 3:08 PM on July 5, 2011

You'll have to do your own research, but kudzu?
posted by chocolatepeanutbuttercup at 3:22 PM on July 5, 2011

Paradigm shift here: having 4+ drinks, 5 nights a week, is not "social drinking"
posted by kelegraph at 2:54 PM on July 5 [+] [!]

Sure it is, if s/he's doing it socially. It's just heavy social drinking, to a degree that is becoming problematic. But that's a discussion for another time.

OP, I am or have been in your position - my first suggestion is to take a week off. No drinks for a week. If you're like me this will be surprisingly hard, but if you can't do this then nothing else will work. Get a nice pat phrase to explain it, 'eh, taking a booze holiday' or something. I'm guessing that there will be a whole swathe of occasions in that single week where you really need to go and have a drink i.e. best friends birthday, anniversaries whatever. Be resolute.
posted by Sebmojo at 4:43 PM on July 5, 2011 [1 favorite]

Scott Hall, the professional wrestler*, was on Antabuse. He was sprayed with beer in the ring and became uncontrollably, violently sick (in front of a huge audience, no less). He didn't even drink it.

I suspect being on Antabuse while around people who are drinking would be extraordinarily uncomfortable.

*My husband is the wrestling fan, not me. Not me!
posted by galadriel at 5:47 PM on July 5, 2011 [2 favorites]

Re: antabuse alternatives...

There are a dozen small-scale studies a year linking various random pharmaceuticals and nutritional supplements with reduced alcohol craving. One tends not to hear anything about them after the initial publication, however.

If there was a robust and clinically-accepted method of beating alcoholism, you would know about it. Like obesity, it's a widespread problem with no easy solution. This leads to a throw-anything-at-the-wall-and-see-what-sticks approach, which in turn results in a lot of false-positives. Take the news articles with a grain of salt.
posted by dephlogisticated at 6:08 PM on July 5, 2011

So my usual caveat, I work in substance abuse and on this topic I actually know a bit about what I'm talking about...unlike most of my ramblings here.

Oh man. I think you're in trouble - there is not a big problem on the horizon. The big problem is already here.

One of the things that worries me about your post is how you essentially foreclose on all options that would require you to do much of anything to change your drinking habits: you can't change jobs, can't change friends, can't not drink around drinkers, can't be sober around drunk folks, can't be alone, can't see a shrink, can't get a legit prescription, can't make a decision not to drink stick etc. etc. You've painted yourself into a corner...and it happens to be the one with all the booze in it.

In short, you're drinking alcoholically and you're thinking like an alcoholic. The "specifics" of this type of alcoholism is not all that special or unique (sorry) - you're a drinker and you don't want to mess with the parts of your life that you like but are the same parts that make drinking inevitable. Pretty standard stuff (sorry).

So really, you have a few choices - change the inevitability of you drinking in your current context or change the context.

So here is what I suggest to go after the inevitability of you drinking...

Ditch the Antabuse idea for now. You can't get it legitimately without a prescription and no doctor worth anything will give it to you without substance abuse treatment and a full exam with blood work up, liver enzyme test, lipid panel to screen for health risk (and there are plenty). What the others have written is spot on - it is for persistent alcoholics for whom even treatment isn't enough to stay sober. It's half-life also means that you might feel crappy Thursday night even though you only intended not to drink Tuesday night. Besides, most folks who do get Antabuse without treatment give it up in short order.

Do hold onto what your desire for Antabuse is telling you - that right now, by yourself, you can't control your drinking even though you want to. Alcoholics are folks who can't, by themselves, stop drinking or control their drinking even though they want to.

I'm not at all saying you need to haul your ass of to AA, but there is test you can give yourself to see if you're simply a very heavy drinker or an alcoholic.

It goes like this. Spend the next two weeks monitoring your drinking. Keep a written tab every night of what you drink. Don't try to control, just monitor. Be precise. Not "a few beers" but "two double scotches, a gin and tonic and three pints of beer." After a week, go over your lists and decide exactly what you plan on drinking before you go out. Also be precise - two pints of beer, and one single shot mixed drink...whatever. The nice thing is that you don't have to go from 4+ to 0, just try going from 5 to 3. Go slow in the whittling down. Record everything, even if you go over or under your target.

Do this for three months. If you can go three months and predict with certainty and consistency (no yeah buts, no exceptions) when you drink, how much you drink, and what happens to you when you drink (within reason - i.e. did I make an ass of myself, did I fall down and sprain something) then you might be okay. From there you can continue to taper down the volume of your intake and the number of nights you drink.

If you can't do this, if you don't see improvement over time or if the whole experiment falls apart after a few weeks, then please consider treatment.
posted by space_cookie at 6:45 PM on July 5, 2011 [24 favorites]

I really do not believe there is a chemical solution for your issue. If there were it would be in widespread practice--and it isn't. I am not aware of any drug regime that would meet your need. @sebmojo--depending on how you define "social drinking' the poster by most reasonable definitions is not a social drinker. In the post and in his/her own words expresses concerns about drinking, difficulty controlling it, the associated fears and behavior that most probably would be considered of alcoholism. Think about it--He/she say they are unable to limit drinking, sees it as a problem, drinks to resolve anxiety/loneliness, feels he/she can not control what days to drink and recognizes the amount of drinking poses current and future health risks. And it is not just a matter of words--it is a matter of dependency and abuse. regardless--I wish for him/her and hundreds of thousands more there was a readily available and safe chemical solution/restraint/solution. were it so "easy".
posted by rmhsinc at 6:52 PM on July 5, 2011

oh yes.....what galadriel said. Alcohol absorbs through the skin very quickly and Antabuse will react with even trace amounts of alcohol in the body. Antabuse+bardenter = one sick as hell bartender, unless you can guarantee that you never spill a drop on exposed skin.
posted by space_cookie at 7:47 PM on July 5, 2011

Listen to space_cookie....they know of what they speak.

I worked in a psych hospital with a drug/alcohol unit and the addiction certified psychiatrists wouldn't consider using the stuff with anyone. It's not magical by any means. You have to make the decision to take it, and also make the decision to avoid alcohol. One screw up and the decision not to take it (for fear of "accidentally" ingesting alcohol) will be the easier decision. If you can choose to take the antabuse one night and choose not to ingest alcohol for the next 36 hours while it is possibly lingering in your system, you are strong enough to choose not to drink alcohol in the first place.
posted by MultiFaceted at 8:59 PM on July 5, 2011 [1 favorite]

If you are looking for a pharmacological solution, may I suggest Naltrexone? This website could be a good place to start. As a binge drinker I have personally found naltrexone to be helpful when taken via The Sinclair Method.

As everyone else says, Antabuse is for people who are committed to abstinence (at least for a period of time).

FWIW I had no problem with getting a prescription for either of these drugs (in Australia) but I know you can buy them both online too.
posted by Weng at 2:09 AM on July 7, 2011

Naltrexone worked for me, pretty much as advertised. I no longer take it because I lost interest in drinking. I did find that habit was a significant part of it for me, as I tend to overdo just about anything I find interesting. Now the habit of not-drinking is just as strong as the previous habit of drinking was. Good luck.
posted by cairnish at 1:37 PM on July 8, 2011