Well hell, my eyes have been opened...

February 15, 2013 6:36 AM

This question opened my eyes up. I now realize that I'm an alcoholic. Yeah, I'm highly functional, but an alcoholic nonetheless.

I can't just 'stop' drinking, because research shows that after YEARS of drinking nightly if I just quit cold turkey I run a HIGH risk of withdrawal symptoms and the DT's.

So what do I do?

I've read the websites about drinking a beer every hour. I've read the websites over and over actually.

I can't go to the doctor. I'll lose my government security clearance if I do (don't debate that). I need to do this on my own.

How do I do it?

posted by anonymous to Food & Drink (28 answers total)

Sounds like something like AA might be just the thing.
posted by valkyryn at 6:38 AM on February 15, 2013 [2 favorites]

Yeah, go to AA. They're truly anonymous, and there are plenty of folks there who know the ropes and can give you lots of resources to get you started on getting through this.
posted by xingcat at 6:43 AM on February 15, 2013 [3 favorites]

I can't just 'stop' drinking, because research shows that after YEARS of drinking nightly if I just quit cold turkey I run a HIGH risk of withdrawal symptoms and the DT's.

As someone who commented in the other thread let me just point out that this sort of statement, while there is a basis in fact, is also your brain wanting to stay addicted, so it's worth being mindful that your brain is going to make every excuse it can to continue to drink. Don't do the "I need to get from New York to London, boats and planes not an option" thing.

If you can't go to your doctor perhaps you can do to another doctor or addiction specialist, pay in cash (i.e. not on insurance) and get some medical advice about whether quitting cold turkey is actually something that would be medically harmful for you. For some people it is, for some people it isn't. Can you get therapy? A therapist who is also a doctor could advise you in this area also.

I am not going to debate your security clearance statement except to say that many people who have petitioned to get their revoked security clearance reinstated because they had a drinking problem and are now undergoing treatment (at least in the US) get it reinstated. So it's a balancing act. Getting your clearance revoked because you make an alcohol-related mistake versus getting into treatment before it gets to that point.

What you need to do depends on what you're doing now, what your bad patterns of behavior are and where you're trying to get. While a lot of people suggest going cold turkey if it's medically appropriate (saying you can't just go to being a social drinker from being an alcoholic) other people say that moderation is achievable. I tend not to agree with them but I am not a doctor, just someone whose life was turned upside down by someone else's drinking. In either case, drinking in moderation is a hell of a lot better than where you are now, no? The problem drinker in my family had no alcohol in the house other than what he was planning on drinking that night. Not an awesome way to go about it, but it helped him "moderate" over the years. Do you have a family member or loved one who could help you with this. Often family and friends (if they haven't already abnadoned you) will be thrilled that you are at least trying.

I'd also suggest AA or Rational Recovery depending on how you lean. You don't even have to stop drinking so much as make a commitment to try as a first step and then see if you can find a plan you can stick with. I'm sorry, I know it's so awful. Best of luck with your first steps.
posted by jessamyn at 6:46 AM on February 15, 2013 [29 favorites]

You're already light years ahead of other alcoholics, because you've realized that you have a problem. Kudos to you for that. And yes, AA can help.
posted by walla at 6:46 AM on February 15, 2013 [3 favorites]

Congrats,

I'd go to a doctor who specializes in detox, pay in cash and get a plan.

Then go to a support group. There are AA groups for athiests if you lean that way.

It's not going to be easy, but it WILL be worth it.
posted by Ruthless Bunny at 6:50 AM on February 15, 2013 [4 favorites]

AA is quite effective. I don't know if it affects your security clearance; that might be your next ask.me. I suspect many people with security clearances go to AA. If you have a serious physical addiction, which I don't know how to define, but let's say 1 quart of 70+ proof a day, you'll need medical assistance to detox. Find an alcoholism specialist, and go see them without using insurance; you need professional advice. Drinking 5-10% less a day would be my approach, if it were me.

Alcoholism at the level that requires detox will kill you. You're damaging your pancreas & liver, increasing your rick of cancer, by a lot, and otherwise damaging your brain and body. Dealing with alcoholism may be worth more than your job.

Not being an alcoholic is not easy, but will feel so much better. Your loved ones will be able to have more meaningful relationships with you. You'll experience the world differently. I wish you the best.
posted by theora55 at 7:16 AM on February 15, 2013 [2 favorites]

If you get DTs when you stop drinking, you cannot quit without medical attention. Untreated delerium tremens can cause seizures and death.
posted by strangely stunted trees at 7:17 AM on February 15, 2013 [1 favorite]

If you have a government security clearance you're worried about, consider checking with HR and your work-related counseling. You're not the first cleared individual with a confidential problem, and there are ways around it. Don't shut off avenues until you discreetly check around and see what the rules really are.
posted by stevis23 at 7:20 AM on February 15, 2013 [1 favorite]

Doctors who are afraid to lose their licensure for getting treatment for substance abuse or mental illness pay treatment centers in cash, and sometimes travel to ones far away. If you are in a position to do that, I'd suggest it. Look for ones that advertise that they are geared towards doctors and/or famous people. They're not going to be cheap, but it's likely that if you have high enough security clearance, you make enough on the scale to be able to afford anonymous treatment. If you have a month or more of vacation saved up, tell your supervisor that you're near to burnout and need a long vacation to get things right again, and look into a treatment center in the Caribbean.
posted by juniperesque at 7:20 AM on February 15, 2013 [3 favorites]

drop in on us at www.reddit.com/r/stopdrinking

there you will find people staying sober in AA as well as people doing so with other forms of support, who will be glad to talk to you about their experiences.
posted by thelonius at 7:27 AM on February 15, 2013 [9 favorites]

A close friend of mine quit drinking cold turkey five years ago. He was drinking every single night, and often hard liquor, not just beer. Yes, he went through withdrawal. He was in his late forties at the time. The withdrawal symptoms were bad for about three days and were about as bad as a bad case of flu. He had no other health issues. He also started going to AA, twice a day at first. Now he goes once or twice a week and hasn't had a drink in over five years. Some people can eventually go back to occasional drinking, others cannot. He does not want to bother finding out the hard way that he is one of the latter.

I am not a doctor and I don't know you. If you live alone and you drink heavily, don't try cold turkey. If you live with someone supportive, or if you can get someone supportive to come stay with you for a few days. Call in sick.
posted by mareli at 7:28 AM on February 15, 2013 [3 favorites]

Forgive me if this is medically unwise or would make the actual act of quitting well and proper even harder, but is there a reason you couldn't just taper off over the course of a few weeks or a month? Wouldn't require any outside support (though a friend or significant other would be helpful in making sure that the tapering, you know... tapers) and I think* it might reduce the chance of serious withdrawal symptoms?

*this is my professional opinion as a photographer. :p
posted by rhooke at 7:43 AM on February 15, 2013 [2 favorites]

There was a really interesting article about the lack of evidence based addiction treatment in the NYTimes recently that's probably worth a read.

And another about how to pick a program that works for you.

And in case you want a non-religious 12-step program option you should check out Secular Organizations for Sobriety.
posted by brookeb at 8:06 AM on February 15, 2013

I'm not your doctor or anything else.

If you are really dependent on alcohol, you can't quit cold turkey, as mentioned above. You will have a more than reasonable chance of dying and if you don't die you could cause some pretty serious damage to your brain.

Tapering off might be a possibility although your body is going to fight you every step of the way.

In my understanding AA is good for helping you stay sober, but as far as getting you sober, an in-patient detox would be the way to go. Not totally sure how the government would find out but they can keep you safe along the way.

There are different levels of withdrawal, but you really, really don't want to mess with the worst of it. Ignore any advice that says you can.
posted by mockpuppet at 8:08 AM on February 15, 2013

You say you need to do this alone,but in my experience this is not possible. You need support from others who understand what you are going through. AA is a great place for that and good place to start. Please consider going to a meeting and reaching out for help. All the best to you.
posted by kejedo at 8:14 AM on February 15, 2013 [2 favorites]

is there a reason you couldn't just taper off over the course of a few weeks or a month?

No, this will work if you are able to stick with it. Which is a very big if for a drinker.

OP, I've gone off heavy drinking with xanax--taking it three times a day for three days and then rapidly tapering off over the next few days. The difficulty is finding a doctor who will help you with this (but they do exist). (I'm not clear on whether your resistance is to ANY contact with a doctor, or just to inpatient detox?)

After quitting, you can go on antabuse to help you stay quit.

Detoxing on your own is possible, it just takes either a ton of willpower or a doctor who is willing to take an unconventional approach.

Memail me if you'd like to, and good luck.
posted by torticat at 8:17 AM on February 15, 2013

Doing it alone is very hard. Moderation is achievable for some people, but I think there is a strong genetic component to it. If you have the wrong combination of genes, you'll have to quit entirely. There's no way of knowing unless you try. As others have suggested, your best bet would be to go to AA. If you really think your circumstances prevent that, then you should try to wean yourself. First, go about your business drinking as normal, but keep a diary of how many drinks you have every day. You can keep a pad on you, or maybe keep a note on your smartphone. The point is to know the outlines of the problem. How many drinks do you have every day, and what kind? (Tuesday: 2 whiskeys, 4 beers. Wednesday: 4 whiskeys. Etc. Etc.) Once you have established a baseline, after about a week or so, start ramping down. "Normally, I have four whiskeys a night. Tonight, I only get three. Two days from now, I get two. Next week, only beer. Then, one beer a night. Then one beer every other night. Then one beer every third night." You might find that keeping a hard record of your consumption changes your attitude towards the drinking. It will no longer seem like something fun, but rather a hassle. Keep track of how much money you are spending as well. Start thinking about it as a drug, as medicine, not as fun. The important part is, drink less. Remember: the key to quitting drinking is NOT DRINKING.

This might work for you, or it might not. If you are a functional alcoholic, as you claim, you have a shot. But it's hard to do alone. As others have said, support groups such as AA work for many people. If you must try on your own, try it. Start now. Even if you fail, you have learned something about yourself. But it's much easier to do it with help. Good luck.
posted by vibrotronica at 8:32 AM on February 15, 2013

I am not an alcoholic, but I have family, coworkers and a yoga instructor who are alcoholics in various stages of recovery.

I believe a tenet of AA is to take one day at a time. Go to an AA meeting. Then go to another one. Go to as many as you need. Your "lizard brain" that's addicted doesn't want you to go, and that is precisely when you need to go.

A coworker of mine struggled with getting sober last year and, after an in-patient treatment, decided to go to at least one AA meeting a day for 90 days straight. It was a good structure for her in her fragile days. So much so, that reaching the end of the 90 days was a little scary. But she's been sober for over 5 months now. So it really helped her.

My yoga instructor is pretty inspirational to me - a punk rock, beat poet kind of lady. She wrote a book 30 Days. Life in Early Sobriety that has helped others get through those first tough 30 days of sobriety. She's been there. She knows.

With regards to your security clearance and HR, I'm pretty sure alcoholism is considered a disease that FMLA covers. If you need to get treatment, take it. Your success and health are important. Any boss or HR person worth their salt will recognize that.
posted by jillithd at 8:48 AM on February 15, 2013

Based on my understanding of security clearance rules, you may need to have a long hard think about getting into the private sector as soon as humanly possible, for the sake of your health. It's not just that you can't seek treatment, but you're living under the immense stress of the constant threat of a polygraph, or an incident in which you are arrested or injured and not sober in a way that's going to give you away.

Everyone else: the OP is not joking about not being able to seek treatment in any sort of traceable or publicly recognizable way. Just being concerned that you may have a chemical dependency issue is enough to threaten your clearance.
posted by Lyn Never at 9:17 AM on February 15, 2013

I support you 100% in your efforts to get sober. As noted in the question you reference and other questions, my brother is an alcoholic, 18 months sober. He did his detox in jail. I don't recommend it. To stay sober after he was released, he does a combination of AA and one-on-one therapy with a psychiatrist. I'm wondering if you could go the cash + distance route to work with a medical professional to help you with your initial detox. I don't know if AA is appropriate in your case, as it is a public forum and you could be discovered that way. Perhaps working with a therapist one on one, someone who works out of a multidisciplinary practice so you have a decent cover, would help you? That way, if the therapy thing comes up, you could give a suitable cover: "Hey, yeah, I was really broken up after the death of X (my grandparent, my aunt) and decided to do some grief counseling".

I hope you find a way to get the help you need. Feel free to memail me if you want to talk.
posted by RogueTech at 9:46 AM on February 15, 2013

I don’t know your condition, but don’t assume you’re going to get DT’s. That message may just be another way your addiction is fighting you. I know lots of recovering alcoholics and very few people that got DT’s when quitting. Cravings and craziness are probably going to happen though, and it most likely won’t be pleasant.
posted by bongo_x at 11:33 AM on February 15, 2013 [2 favorites]

Are you sure you're physically dependant on alcohol? You don't drink during the day and you're fine, right? Maybe you should talk to a medical professional about this and not the internets. Pay cash or use a fake name or whatever but get yourself some real options.
posted by fshgrl at 11:53 AM on February 15, 2013

On the subject of the security clearance, it is my understanding that one thing that they don't want you to do is be dishonest about any alcohol or drug issue you might have. There is the issue of whether your alcohol consumption would make you susceptible to risky behavior (which may be more important, I don't know), but there is also a big issue if you seem to want to hide it from them and don't do the most you can to deal with the issue once you yourself have recognized it as a problem. If you are upfront and honest with the security clearance folks about how you have an issue, you recognized it, and you are trying to address it, it may do less harm than trying to avoid what might be logical steps to deal with it, like seeing a doctor. An article on alcohol abuse and security clearances states that "Alcohol problems involving people who already have a security clearance may be sufficiently mitigated, if they participate in a treatment program with satisfactory progress and have no previous history of treatment and relapse."

And another thing - I don't know too much about the procedure once you do have a security clearance, but is there any reason that they would necessarily find out about this issue right away? I mean, is there some renewal of the clearance you do on a regular basis that you would run into trouble with the next time it came up? Because if not, it seems like you could just take the necessary measures to deal with it now and then if it comes up later, you will be able to demonstrate your responsible actions.

The bottom line in any case is that if you really feel like you have a problem, you will probably do yourself the most good in the long run by taking the actions that are most likely to best address it, whether that be AA or seeing someone in private.
posted by thesnowyslaps at 12:01 PM on February 15, 2013

The thing about alcohol withdrawal is, it's not a sound practice to give you medical advice about how to stop over the internet. I used to go up to 5 days between massive drinking bouts (usually less) so I wasn't very concerned, when I quit. But that, my experience, is not a real basis for advising you what to do, even if your drinking pattern was just like mine, because you may or may not have other circumstances such as medications you take that could be a factor, or any other health condition.

Tapering off can work, but as said above, by the time you need to try it you are pretty much by definition not someone with a real strong record of being able to limit what you drink in a day.

If you go see a doctor, he will probably just give you a prescription for Librium or something similar, as an anti-seizure precaution, and he will be able to advise and supervise your alcohol cessation. If you aren't needing a drink in the morning to stop the shakes and that kind of thing, you probably don't need an inpatient detox, but really it is best to talk to a medical professional.
posted by thelonius at 12:14 PM on February 15, 2013 [1 favorite]

I need to do this on my own.

You're not alone. You have special circumstances, to be sure, but there are thousands and thousands of people out there battling this problem who are doctors, lawyers, pilots, nuclear power plant technicians, and yes, security clearance holders. Many go to meetings, get help from medical professionals, and support each other online. You can be among them, and there are lots of people who are there to help you, including us. You are not on your own.
posted by zachlipton at 12:22 PM on February 15, 2013

Yeah, I was going to say that it looks like you just did the first step of AA pretty much. I know there's is research showing that it doesn't work for some people, and it may well not, but my mom was sober 13 years through AA and it really changed her life for the better. It's worth a try, and if it's not for you, it's not for you. Good for you for being honest with yourself and getting a new start.
posted by mermily at 12:28 PM on February 15, 2013

I don’t know your condition, but don’t assume you’re going to get DT’s. That message may just be another way your addiction is fighting you. I know lots of recovering alcoholics and very few people that got DT’s when quitting. Cravings and craziness are probably going to happen though, and it most likely won’t be pleasant.

Yeah, while I hesitate to give or suggest anyone follow medical advice on the internet, I would suggest doing research on the difference between withdrawal and the DTs. DTs are indeed life threatening and dangerous. However, they really only generally happen to the constant-drunk, wake and bake kinds of alcoholics. Or the kind that drink SO much every night that even though they don't drink for 18 hours a day, they are still constantly drunk and start getting the shakes toward the end of the workday.

Withdrawal, however, is unpleasant but not usually life threatening.

The wikipedia article says that something like 50% of habitual alcohol users will suffer from some kind of withdrawal, and only 5% of them will suffer actual DTs. So unless you think you are among the 2.5% of the highest consuming alcoholics, you will probably be fine.

This is completely anecdotal, but I have known some alcoholics in my time, and some ER personnel. The only people who actually get the DTs are full on, stinking of booze, drunks. Or people with abnormal liver function such that they process alcohol very slowly.

So "doing it alone" is probably going to work out fine. On one hand, every addict must go through it alone, because every journey is unique, and the decision to abstain is ultimately your own. But for many people, the idea of going it alone is scary enough that it acts as a barrier to quitting. So the support and structure of something like AA can be helpful.

I would follow the advice of going to an addiction specialist and paying cash for at least a single consultation to give you a plan and/or an all-clear to go ahead and quit cold turkey. There is no need to feel weird about this, just tell them that you have a sensitive job and don't want it to show up on any records.

Another thing to watch out for is benzodiazepines. They can be very helpful for bridging the gap between alcoholism and sobriety, but they can also be quite dangerous from an addiction standpoint. I've known alcoholics who have said that kicking Xanax was way harder than kicking the alcohol. If a doctor suggests using them, it may be fine. But you should discuss using longer acting ones than Xanax. It has a very short halflife which triggers addictive behaviors. Something more like Klonopin or Valium is much more appropriate. Xanax has its place, but that isn't addiction treatment.

The last thing I'd mention is something like Prozac to take the edge off of any underlying anxiety that you may have.
posted by gjc at 5:55 AM on February 16, 2013

> Yeah, go to AA. They're truly anonymous,

I don't know about that, as I've heard gossip about so-and-so being seen at a meeting before. Would it be possible to go to an AA meeting that isn't in your town, or seems to cater to a cohort other than your own, in order to get another layer of privacy?
posted by The corpse in the library at 5:14 PM on February 16, 2013