Concerned with husband's recent forays into binge drinking
April 25, 2014 2:41 PM   Subscribe

My moderate-drinker husband has twice in the last month drank to the point of repeatedly vomiting. These binges are out of character and deeply concerning. Should he see his doctor? What can I do?

My 30 year old husband has been a moderate drinker as long as I've known him. 1-2 cocktails an evening on average (strong ones)-- some nights none, never overboard. He's recently gotten into reading about craft liquors and nerding out on visiting local distilleries, buying special rare bottles, etc. A few weeks ago we had a quiet evening at home, doing separate activities in different rooms. At the end of the night he came to bed and said he thought he had overdone it a bit with the liquor. I sort of shrugged this off, although I became concerned when he got sick and vomited several times. He apologized multiple times, swore it wouldn't happen again, said he was sorry for scaring me, etc. He said he overdrank a couple of times in college but hadn't thrown up from drinking since then (so 10 years).

Yesterday he went off in the evening to a liquor tasting event at a nearby store. Three hours later he was banging on the front door, unable to use his key, barely able to stand or talk, and covered in his own vomit. I was EXTREMELY alarmed and scared for him. He vomited several more times, laid on the bathroom floor and wailed about feeling like a bad person in a world where everything's good. I was thinking about calling an ambulance if he became unresponsive, imagining what would have happened if he passed out on the street or in a cab. Apparently he threw up at the store and again in the taxi (and had to pay a $100 clean-up fee). He eventually was able to shower, talk to me a bit, cry some more (I've never seen him sob like this in the whole time I've known him), apologize profusely, and fall asleep.

This is really extremely out of character for him. He's a nice, smart guy with a good job and no other vices that I know of, nor any history of addiction. We've both been counting calories for about a month in an effort to slim down, and this has naturally reduced his drinking somewhat. Perhaps this cutting down led to a binge when he was "out on the town" and there were free samples? Incidentally he weighs over 250 pounds and is in no way a lightweight. He is being treated by a psychiatrist for depression, which seems to be in remission. He's been medicated for two years and recently has been weaning off the medication.

This morning we talked about it some more, I reiterated how concerned and scared I was for him, these bad choices and behaviors are not okay... I want him to make an appointment with his psychiatrist, or his primary care doctor, to tell them what has happened and get some help, whether medical or therapy. He agreed, but now is brushing off the incident as a silly mistake, and saying he doesn't think a doctor's appointment is necessary. He jokingly sent me an online article about "how to drink without getting shitfaced," which was not at all funny to me, and I said so.

I don't know what to do. This is not the behavior I expect from a partner and future co-parent. I don't want to be put in a role of mothering him or controlling him, I want a full fledged adult partner who has normal adult impulse control. The first incident was concerning, but such an outlier I didn't read much into it. This second incident (within a month of the first) was much more extreme and shocking. I don't want to think of what a third incident along these lines would entail. Ideas, suggestions, advice, support, hivemind? I don't feel like I can confide in my friends or family about this because it is so embarrassing for him. What should I do?
posted by anonymous to Human Relations (42 answers total) 7 users marked this as a favorite
He's been medicated for two years and recently has been weaning off the medication.

Well, this leaps out like a salmon in a waterfall. He definitely needs to go back to the prescribing doctor and tell them that this happened. Maybe they'll say it's not known to be related, but maybe it's a huge red flag.

Or maybe he just lost track of how much "tasting" he was doing. It could be that just as easily. But twice is a little suspicious, and he should talk to a professional before it becomes a bigger problem.
posted by Etrigan at 2:47 PM on April 25, 2014 [45 favorites]

This is a legit hobby, but he needs to know his limit. If he's drinking to the point of helplessness alone, he needs to stop being alone at these things or stop going.

I find it very annoying that these stores are letting him hit it that hard; it's illegal in the US (that's a guess as to where you could be) to serve or sell liquor to an intoxicated person. Odds are he's buying liquor at the events (which is the point of liquor tastings, from the store's perspective) and indulging right away.

Without knowing otherwise he could just be overenthusiastic about a new hobby-- I discovered cigars and smoked my throat raw, once or twice.

As for why he's doing it with alcohol, well, there could be a hundred things he's either trying to drown or find in a bottle, or self-medicating maybe. You've done a lot of good, it sounds like, and the root of the issue probably isn't going to unlock terribly easy, but, well, you've got to cut him off from this hobby or police it until he works out how it can be a hobby, not a self-destructive binge. If it can't be just a hobby, it's going to have to be something he never does again.
posted by Sunburnt at 2:49 PM on April 25, 2014 [2 favorites]

The fact that he brushed off your concerns is also a bit worrying; speaking as a recovering alcoholic, minimizing the consequences of overindulgence was one of the ways I justified continued problem drinking long before things truly spiraled out of control.

And depression is definitely comorbid with problem drinking, so this may be linked to so-called "self-medication" (which usually just makes things worse, again speaking from bitter personal experience).
posted by kewb at 2:50 PM on April 25, 2014 [4 favorites]

The two things that jump out at me are that he's weaning off medication and that he's doing a weight-loss thing. If he's lost a decent amount of weight recently, my guess is that this happened because he's grossly misjudged his own tolerance, and now he's embarrassed as hell about it.

But this is really a question for a doctor, and you should probably push a little harder to get him to talk to his.
posted by FAMOUS MONSTER at 2:53 PM on April 25, 2014 [16 favorites]

I would say wait for the third time before freaking out. You want a fully fledged adult partner etc etc but he has to learn to find his limits - I think after ending up worse for wear twice he should know better from now on.

Sometimes people feel like they want to really let it all go, but as we get older we realise we can't drink as much as we may feel like and that the consequences outweigh the couple of hours of fun the night before.

Monitor the situation, but don't freak out just yet!
posted by razzman at 2:54 PM on April 25, 2014 [3 favorites]

...laid on the bathroom floor and wailed about feeling like a bad person in a world where everything's good.

He's been medicated for two years and recently has been weaning off the medication.

Cherry picking, I know, but these combine to wave a red flag... it sounds like his depression is less in remission than it was a few months back.

I would suggest approaching this from the depression / medication front with the drinking viewed as a symptom rather than a root problem in its own right. If the depression is an issue you've been dealing with together for a long while then this may make it easier for you to put the problems across whilst still coming across as being on his side, and may help you to feel less angry about his recent misdeeds.
posted by protorp at 2:55 PM on April 25, 2014 [4 favorites]

I think he needs to delineate clearly what it is he did on these two occasions that he is never, ever, EVER going to do it again, whether that's the same thing or separate things, and if he can't spell out what exactly it was he did wrong, then the answer has to be "drinking". But, for example, if he was at a tasting yesterday and on the other occasion he was also trying lots of different drinks and that's how he accidentally had too much, then maybe he needs to limit himself to only drinking one sort of thing on a given evening and he'll be fine. Or maybe he needs to keep a written list of what he's had to keep track of the amount. Or whatever. But he needs to be able to express what it is he's changing, not just say it won't happen again. If you don't know what it is you did wrong, you can't change it.

Me plus a bottle of white wine on a nice summer night turns out to be a bad plan; I get relaxed, I stop keeping track, soon most of it's gone. So now I drink cocktails that require more thought to make each one (never a pitcher all at once!), and I never seem to have a problem with those. But everybody's different.
posted by Sequence at 2:58 PM on April 25, 2014 [6 favorites]

Spirits deliver a lot of alcohol to the drinker, fast. They are delightful if you can enjoy them carefully, in moderation. If you turn to them like I did, as a better drug delivery system (it finally became just unworkable to get as much alcohol as I wanted from drinking beer), that's pretty clearly a Bad Thing. It is not clear that this is what your husband is doing, but I do think it is cause for concern. How frequently do 30-ish social drinkers normally vomit from drinking alcohol?
posted by thelonius at 3:00 PM on April 25, 2014 [1 favorite]

Since it's so out of character and he doesn't have a history of this, I wouldn't immediately leap to him having a drinking problem requiring psychological counseling, etc., until you're ruled out possible physical causes.

1) He could have an underlying physical health problem that is making him get drunker/sicker faster, so he should go to a doctor for a full checkup, bloodwork, etc.

2) Nthing all above that the medication changes could be contributing.

3) Did he used to drink hard liquor or just beer/wine? Or are the craft liquors he's drinking now higher proof than the liquor he used to drink? If his new hobby has him consuming harder alcohol than he's used to, then he is having to relearn what his limits are.
posted by Jacqueline at 3:00 PM on April 25, 2014 [8 favorites]

Speaking from direct experience: weaning off of psychiatric medication is a challenging enough process on its own without introducing hard liquor into the mix. (Not that beer/wine is better; just that it's much easier to overdo it with the hard stuff.) I would suggest that this is a time that your partner should be treating his body with extra care and gentleness, which probably includes laying off the sauce for quite some time. Depending on what medication(s) he was on, it can take months-to-years for the body to do a full reset. During that adjustment period, there is just too much unpredictability and change going on to make any sort of moderate-to-heavy drinking advisable.

Years ago, I had a helluva time weaning off the weapons-grade pharmaceuticals I'd been prescribed; and during that process, I made the strategic error of using alcohol to cope. This lead to a DEFCON 2 level booze abuse problem (happily, years behind me now). I say this just as a caution: it's not unusual for people to flip out on the booze during this delicate transitional phase. I hope your partner takes a wiser approach than I did.

Best wishes to you and him for smoother sailing ahead -- he'll feel better overall much sooner if he puts down the bottle.
posted by nacho fries at 3:02 PM on April 25, 2014 [9 favorites]

I also think that it's probably significant that this is happening while he's going off of his anti-depressants.

First of all, he should be tapering off of his meds under the guidance and supervision of his doctor. This is apart from the alcohol.

But also, and I could be wrong, but it sounds to me like the depression is back, and he's self-medicating with drinking.

My advice for you? Push him to go back to his doctor, and maybe look into an Al-Alon meeting. Good luck.
posted by Asparagus at 3:03 PM on April 25, 2014

Well, it sounds like his problem is that he doesn't know how to track his consumption in non-standard situations, and that may be combined with a diet-related (and weight-related) lower tolerance so that his actual limits are a mystery. The change in medication may be exacerbating the unknowableness of his tolerance.

And aging, oh my goodness. I had a really abrupt drop-off in my mid-30s for liquor. Now in my early 40s I can put away substantial wine, but if I'm going to have a cocktail it really can only be the one, or two if I drink a couple pints of water. I...did not learn that lesson after just a single incident, because I kept thinking it was a fluke.

It doesn't strike me as binge drinking, honestly, so much as no longer knowing how to drink in changed circumstances. You are right that he should take these two events to heart, especially the second one which is very scary from a security and safety perspective. This is maybe not going to fly as a hobby if he can't learn to spit or only take a sip or two.

It feels like you're pretty hair-trigger on any intoxication, though, since you were ready to call an ambulance for a drunk person being pretty classically drunk, and none of this is to say you should give up your own boundaries. If anything beyond slightly tipsy is not okay for you, that is fine for it to be not okay, but you should communicate that and the consequences in the name of being clear about what you will and won't stand for. You can't make his decisions for him, but you can make yours, and communicating them clearly may give him pause for thought.
posted by Lyn Never at 3:06 PM on April 25, 2014 [16 favorites]

I know that fancy cocktails have been a thing for a while & personally I found out the hard way (a couple of wicked, day-long hangovers) a few years ago that my normal drinking habits couldn't apply at these types of bars. Because at most, I'll have two or three drinks when going out, which is and was never a problem if I stick to regular types of beer or wine. But some of the cocktails.. wow.. It did not always register to me when ordering and consuming them that three drinks at a cocktail bar was not the same thing as three glasses of wine. Depending on what I ordered, it was basically three glasses of strong liquor mixed with slightly less-strong liquor, and way more than I could really handle. And I have also gone to liquor tastings and seen that some folks just didn't realize how much alcohol they were consuming all told and suddenly they were very drunk. So it could really be accidental in this case if he's never had any problems before.

Going off medication and dieting (and turning 30) also seem like they must be factors and.. can he just try to be cognizant of these factors if/when he goes out to try these drinks again? Just be mindful that it is really not possible for him to taste a whole lot of liquors or have more than a few drinks because it's going to make him ill, and he doesn't want that. Try one or two, and stop. Order a soda or a sparkling water instead of a cocktail every round. It is far better than making yourself sick.
posted by citron at 3:11 PM on April 25, 2014 [1 favorite]

The fact that he barfed in the damn store during the tasting event is really cause for concern (not to mention the cab-ride hurl, and the bawling at the front door). That far exceeds any reasonable definition of classically drunk behavior, I think; and you were correct to feel concern about him possibly needing emergency treatment given the uncharacteristic levels of emotion he was exhibiting.

I think you are wise to be very worried.
posted by nacho fries at 3:13 PM on April 25, 2014 [11 favorites]

If his diet has been ketogenic or is otherwise severely carb-restricted, that can seriously, seriously affect a person's alcohol tolerance.
posted by cgg at 3:19 PM on April 25, 2014 [8 favorites]

This sounds to me like the disparity between a nerd-minded person's interest in mixology and their body's capacity to handle the sheer amount of liquor.

As someone who is into wine and craft beers (which often have a higher alcohol content than one would expect), but who is pretty small and with a relatively low tolerance, I've definitely been in situations where my brain was too consumed with trying new things and geeking out to be as rational as I usually am about setting limits. There are definitely times I thought I was stone cold sober but then stood up and the room started spinning, or I realized I wasn't good to drive, or made some kind of social faux pas. Nowadays I really try to pace myself, especially in contexts where people aren't spitting as a matter of course.

I can imagine there being an even more difficult margin for error with liquors, because a "taste" amounts to the same thing as a shot, at the end of the day. And it can hit you really hard, which is probably what's causing the sheer level of drunkenness. You can drink a lot of hard liquor before you really feel like you've overdone it, and again, being in a state of geeking out about new tastes can make it harder to tell when you've had too much.

I think this might be even harder for someone with a high tolerance in general. As a small person, I can have one cocktail, maybe two over the course of a long day and lots of food. So I know I can't go to a liquor tasting and go completely hog wild. Someone who isn't used to having to think carefully about alcohol consumption at all times might not be in the habit of keeping track.
posted by Sara C. at 3:20 PM on April 25, 2014 [6 favorites]

If his new hobby has him consuming harder alcohol than he's used to, then he is having to relearn what his limits are.

And he may need to switch to a lower-proof hobby. I think this feeds into the issue here -- a lot of interests have that early box-ticking "gotta have 'em all" phase, and that's sometimes exacerbated by blogs and forums that cater to a more obsessive and completist mentality. (In the online age, it is pretty hard to be only slightly interested in something.) If the hobby is collecting vintage belt buckles, then the worst you end up with is a box full of buckles -- although I won't belittle that if it meant spending the grocery money on them. If it's collecting and sampling small-batch limited-release spirits, where there's always another one showing up on the shelf, it can be both expensive and problematic, and it's harder to shift past that early eagerness into the eventual appreciation that you can't tick off (and pass judgement on) every bottle in the store.

If he's willing to work within limits, and you're willing to accept his drinking within those limits -- no "sampling sessions" at home, and especially not in public -- then you might be able to work things out without more explicit interventions.
posted by holgate at 3:22 PM on April 25, 2014 [2 favorites]

A lot of antidepressants can really wreak havoc when taken together with drinking. He would become more of a lightweight, and frankly, shouldn't be drinking AT ALL while on antidepressant medications. You're right to be concerned, and it sounds like he realizes he's overdoing it.

He should mention it to his therapist. If both you and the therapist say that he oughtn't to be drinking while on meds, he might take it more seriously. The drinking could very well be a result of the depression, too.
posted by tckma at 3:26 PM on April 25, 2014 [4 favorites]

Alternatively, he could be lying to you about his consumption.

A couple of strong cocktails each night for presumably years (as long as you've known him), unwillingness to face the complete unacceptable fact of drinking to the point of vomiting at all--much less in the poor drivers cab, much less to the point of provoking abject fear in his wife! My friend, from here that sounds like an already serious alcohol problem that's taken a turn for the worse. Highly suggest that he's lying about how much and even what he's drinking, and that he may have had a far bigger problem than you've realized for much longer.
posted by Sublimity at 3:37 PM on April 25, 2014 [7 favorites]

It also sounds to me that he just can't keep up with his hobby. I'm not that into booze aesthetics, but I have attended a couple of wine tastings and my understanding was you were supposed to spit things out. If he's steadily consuming even little amounts of high-volume alcohol with a lowered caloric intake, plus experiencing ad withdrawal, his eyes might just be bigger than his liver. (Or something to that effect.) He probably just thinks it's tasty stuff and is having more fun than he can take. He should slow it way down. Or at least eat more food when he goes to these things (maintenance calories for his current weight).
posted by cotton dress sock at 3:39 PM on April 25, 2014

Apparently he threw up at the store

The use of the word "apparently" jumps out at me. If you're using it in a casual, conversational way, then never mind. But if this is his night of/morning after recollection, I would want to verify exactly what happened with the store. Did they really serve him to the point of puking? Did he become ill suddenly? And about the cab, did the store send him out on his own in his state, or did he get help? I think this is information that will be helpful, no matter what the cause turns out to be.
posted by Room 641-A at 3:42 PM on April 25, 2014 [2 favorites]

I've lost a lot of weight in the past year, and one of the more surprising side effects for me has been how radically it has changed my alcohol tolerance. The difference between having one or two drinks, then and now, wasn't too great. But the difference between having three or four drinks, then and now....whoo, boy. On a couple occasions, I've gotten way drunker than I meant to and had a nasty hangover the next day, in a way I hadn't really since college. It took me a couple of those bad experiences to fully appreciate what was going on and adjust. Two terrible hangovers in recent months after both losing weight and switching up medications seems like he might be going through a similar thing. I wouldn't freak out, myself --- if you were noticing a marked increase in his consumption, that'd be one thing. But you seem to be noticing a difference in his reaction to what used by a fairly typical amount of booze for him. I'd have him talk with his doctor about his medications, and maybe rethink the diet you're on --- it's awful easy to go overboard on an empty stomach.
posted by maggiepolitt at 3:52 PM on April 25, 2014 [2 favorites]

I'd caution against over-reacting. This stuff happens, and having had more than a few medicated friends, the shift in medication is likely involved more than incipient alcoholism or anything.

In fact, I have a friend who tapered off of a depression/migraines combo, and found their tolerance exponentially reduced, i.e. going from four drinks and not getting a buzz to four drinks and massive puking spins. It was a long recalibration process.
posted by klangklangston at 4:06 PM on April 25, 2014 [2 favorites]

1-2 cocktails an evening on average (strong ones)-- some nights none, never overboard.

How much alcohol would you say this involves? A lot of people talk about drinking a cocktail and it's really 3 or more ounces of liquor, if you measure it out. If he's been doing this for years while taking anti-depressants, I think he should really talk to his doctor. He may have been kicking his liver in the ass all this time, for one thing.
posted by BibiRose at 4:06 PM on April 25, 2014 [6 favorites]

So, I've attended a number of wine, beer and spirits tasting events in the last few years. It's very easy to overdo it. However, I also notice that some people at those events are just alcoholics enjoying a free night of their drug of choice. If your husband is hanging with those folks -- who can be very chatty and outgoing and happy to hang with you all night long, nudging you in the direction of the good stuff and hooking you up -- it can be bad news.

Also, with his particular cocktail of issues -- he should really go talk to his doctor. And I don't think the time in your life when you're weaning yourself off some long-term depression medication is the best time to take up a drinking hobby. I mean, really. You can also call his doctor and relay your concerns. It's likely that he will simply ask that your husband come in for a check-up and check in.
posted by amanda at 4:12 PM on April 25, 2014 [3 favorites]

I don't think the time in your life when you're weaning yourself off some long-term depression medication is the best time to take up a drinking hobby.

posted by feral_goldfish at 4:17 PM on April 25, 2014 [4 favorites]

- Psychotropic meds mess with your tolerance
- Weaning off meds messes with your tolerance
- Weight loss REALLY messes with your tolerance
- Some diets mess with your tolerance more than others (like low-carb ones)
- Getting older messes with your tolerance

It's quite possible he's geeking out at the tastings and is not taking things slow enough to gauge his tolerance levels. That is, he tastes a lot of liquors in a short period of time, and it's not until 20, 30 minutes later that he realizes his mistake--and that half-hour is more than enough time to continue drinking. Getting to the point where he's barfing at the store during a tasting tells me he has no clue how much is too much for him until it's too late.

Have you discussed with him how much he's drinking and how fast he's drinking it?
posted by schroedinger at 4:21 PM on April 25, 2014 [9 favorites]

Particularly the second incident sounds scary. And I also find it scary that he now "is brushing off the incident as a silly mistake".
Do you think it would be helpful to film him in his pitiful state should he turn up drunk and soaked in puke again? Because apologizing and crying while he's drunk seems not to make a difference long term. If he could watch a video of himself, maybe that would open his eyes to how bad the situation really was.

In any case, communicate again how stressful those incidents were for you and ask him to go see his psychiatrist. Good luck.
posted by travelwithcats at 4:29 PM on April 25, 2014 [1 favorite]

One way to approach this with your husband to get him to work on it would be instead of "you have a drinking problem, go a psychiatrist to address your alcoholism" you could point out "a sudden reduction in alcohol tolerance can be an early symptom of a various serious health problems (diabetes, ulcers, liver disease, etc.), please go to your primary care physician for a full checkup with bloodwork." Bonus persuasion line: "maybe it's something they can fix so you won't get sick from drinking anymore."

It's a semi-sneaky way of getting him to the doctor -- while it's definitely true that he could have an underlying health issue, that doesn't seem to be the primary thing you're worried about here -- but at least you'll be able to rule out possible physical causes and get him to start a dialogue with a health professional about his drinking habits.
posted by Jacqueline at 5:16 PM on April 25, 2014 [4 favorites]

If I were you I would ask him to stop drinking for a month. His reaction to this request might tell you a lot.
posted by bq at 5:32 PM on April 25, 2014 [11 favorites]

My body's ability to deal with alcohol -- and the ways in which it signaled to me that I had had enough for the evening -- changed DRAMATICALLY and rapidly in my early thirties. I, too, had not gotten sick from alcohol since college...and then it happened twice in three months, which was humiliating and alarming for myself and my SO.

Your husband needs to take his recallibration seriously and re-learn how to drink responsibly. But he's not the only person to go through something like this.
posted by Narrative Priorities at 7:09 PM on April 25, 2014 [1 favorite]

I know someone who has a high alcohol tolerance and stuffed up rather spectacularly at an event where alcohol was served in such a way that it was easy to lose track of one's drinking. I realized the hazard -- I'm a smaller person, and have a much lower alcohol tolerance -- this person didn't. Indignity ensued, about near to the level described here (fortunately minus the cab cleaning bill). Next day, they chalked it up largely to a silly mistake which they vowed never to repeat and then, so far as I know, never did repeat.

It's pretty much the factor of not being a lightweight that can lead folks astray sometimes, it seems. And then one learns.

And the matter of having a number of things going on that can potentially radically affect his tolerance -- I can see how that could happen once, or even twice under the circumstances. I'd say that incident #2 doesn't necessarily say there's a Problem problem, but it does seem to say that hobbyist events involving black diamond forms of alcohol consumption are not on until the obvious tolerance issue settles down -- and if that's a problem, well there you go.
posted by sparktinker at 7:21 PM on April 25, 2014

An old pro here. With lots of hilarious and not-so-hilarious stories from the past and my own learning experiences.

Chiming in to agree with people who are asking him to look at the weight loss, changes in diet, and, yeah, hitting 30. I am now 30. I can still drink a lot for my size. I cannot, by any means, drink at the level I did two or three years ago, even though my metabolism is faster than a jackrabbit.

If I'm drinking liquor (which is pretty rare now), I only drink when I've prepared it, and I have one or two liquors that I stick with. I don't try anything else; I don't drink anything else. That has made a substantially positive impact. I make strong drinks, but they are MY strong drinks, and I know how they will affect me.

If he slows down, and finds what is comfortable for him, and recognizes "hey, my body doesn't react like it did; I should adjust my behaviors," he will be fine.

If he doesn't change things within the next few months, I'd start to worry then.
posted by sara is disenchanted at 9:27 PM on April 25, 2014

Former alcoholic, weighing in.

Bear in mind that the following should be filtered through your knowledge of your husband as a person. For instance, how he would normally deal with embarrassment, how much ownership of his depression issue he has actually taken (i.e. was his adoption of medication and psychiatric care voluntary or grudging), etc. One size does not fit all. Anyway:

The Probably Normal

- Drank too much, in new, exiting "kid in a candy store" settings. I'd be wary of a common pattern of "whoops, how did I do that?!?" but misjudgments of tolerance can happen.

- Threw up. Worrisome from your perspective, for sure. Alcohol is a poisonous chemical, though. Too much of it, and the body gets mad. (In many cases, when someone is a long-term, full-blown alcoholic, this process flips, and the vomiting occurs mainly when they haven't had their scheduled dose. So unless he's throwing up in the morning before work, we can probably rule that out.)

- Embarrassed himself pretty badly. You may be feeling some shame about this too, as part of the unit; it's probably uncomfortable to be affiliated with him, just now. I'm not trying to read your mind, or create that feeling if it isn't there, but if it is you shouldn't shy from recognizing it.

The Probably Bad

- He's trying to deal with changes in his depression treatment and simultaneously increasing his drinking. Depression is horrible (I'm trying to deal with a periodic bout, myself), and problem/addictive chemical use frequently just makes it worse. If depression hadn't openly been in this picture already, I'd be much more likely to tell you that he's just made a couple of dumb mistakes.

- He ... laid on the bathroom floor and wailed about feeling like a bad person in a world where everything's good. This is the major flag. Early on in my own alcoholism, I heard something very wise from a fellow heavy drinker. In essence: It's not uncommon for someone to say something super-dramatic, or intensely emotional -- a surprise confession of love, or a more-surprising insult -- and then have them brush it off as "just the alcohol talking." This is not true; it's alcohol allowing a deeper, sometimes darker part of themselves to do the talking.

The sort of primal anguish he was expressing last night could have come straight from my mouth, circa 2004. It could "just" be his depression, but it sounds so familiar. I am going to posit that he has been feeling bad about his drinking for longer than these past two incidents, and that buried shame is starting to surface. And if he's feeling that bad... Well, it's not a given that he's a budding alcoholic, but it's definitely a troubling sign.

Now, what can be done about this? If he is a borderline or committed alcoholic, probably not much. Things very frequently have to get worse before they get better. I don't want to be put in a role of mothering him or controlling him is a worthy sentiment, and a healthy goal for you. However, if he is developing a dependence on alcohol, you should be prepared to have him see your attempts to help in exactly that way. I would not suggest immediately putting him on notice or pushing the issue just yet, although setting personal limits and calling him out on his lame attempt to gloss things over is fine. It sounds counter-intuitive and enabling, I know, but too much pressure too soon could feed a dynamic of concealing and greater denial. Better to firmly express your concerns about his health, and observe his reaction to your suggestion -- or his doctor's orders -- that he curtail his drinking.

Best of luck to both of you.
posted by credible hulk at 11:57 PM on April 25, 2014 [2 favorites]

Just to add a little to the "this may not actually be a sign of a larger problem" suggestions, it sounds to me like your husband's age may be catching up with him.

I'm 32. A year or so ago I was drinking at home. Whiskey. I am not and have never been a heavy drinker, and on the night in question I had just as many drinks as I used to have on a semi-regular basis when I was in my mid-twenties with no real problems. Three or four, as I recall.

Puked my guts out. Which came as quite a surprise, because I hadn't done that for years, and the last time I did it I'd had quite a bit more.

Haven't done it since either. I find myself drinking maybe 2/3 as much as I did in my mid-twenties, if that, because more than that doesn't agree with me any longer.

So I would encourage you to listen to the people saying that your husband's problem may have more to do with entering in to being middle-aged than with nascent alcoholism. Encourage him to stay on top of these things, and by all means get annoyed at him if this continues. But give him at least a little while to figure out what's going on with him before you take it upon yourself to do it for him. Encourage him to bring it up at his next psych appointment, but coming down too hard on this too soon doesn't strike me as being productive.
posted by valkyryn at 12:00 AM on April 26, 2014 [2 favorites]

Alcohol inebriation and shame are deeply intertwined in our culture, and that might be why your husband is trying to act lighthearted about these two incidents. He's probably unwelcome at that store, talked about by his friends who were at the event, humiliated at the cab cleaning fee,

I second that losing weight and changing meds can do really wacky and unexpected things to brain chemistry. The best way to hack that cause-and-effect loop is to find a way to circumvent the shame and find a way to engage him about what's going on in the moment, especially when he is thinking of drinking (or considering pausing).

If you ever want your husband to confide in you again, please don't stalk him with a camera to present him with video of him being drunk like someone above suggested. That's incredibly mean and in no way called for given what you've described.
posted by SakuraK at 12:11 AM on April 26, 2014 [1 favorite]

It sounds like there are a lot of changes going on with your husband that might mean he needs to re-evaluate his tolerance, maybe with the advice of his doctor. As others have said, it could be as simple as changes due to the switch in medication, lower capacity due to smaller body size, or just not understanding the alcohol contents of the new things he is trying.

But...your husband's reactions to your feelings on the matter are key here. If he brushes off the fact that his behaviour scared you, and does not acknowledge that this kind of thing should not be happening often, I'd be a bit concerned. (I now have a rule: only one unfamiliar drink per social event. When I was bigger, it could have been more, but it is just not worth feeling the way I did a few months ago, after I radically underestimated the effects of two large champagne-and-some-exotic liqueur cocktails and Lovely Boyfriend had to pour me into a cab.)

Bottom line, I wouldn't panic just yet, but see how he handles things going forward. Have you thought about attending some of the events related to his new hobby with him? That might help him put things into context a bit better.
posted by rpfields at 2:40 AM on April 26, 2014

With regard to this situation, my advice is to stay away from professionals (counselors, therapists, psychiatrists, etc.), if at all possible. Or, at the very least, take their advice with a large grain of salt. They are very likely to magnify the severity of the problem and push your husband into attending a month-long inpatient rehab (which may end up being expensive and perhaps harmful). See also a book called Bedlam: Greed, Profiteering, and Fraud in a Mental Health System Gone Crazy, by investigative reporter Joe Sharkey.
posted by alex1965 at 4:43 AM on April 26, 2014

Self medication, because the medicine he was on became intolerable for one reason or another - this happens a lot. If he was on an SSRI, it may be time to investigate SNRIs or Wellbutrin with his doc.
posted by Slap*Happy at 6:08 AM on April 26, 2014 [1 favorite]

From the OP:
Thank you all for your insight and perspective, reading these answers has been really helpful. We had a heart to heart about the situation when he said he didn't see any reason to call a doctor and thought that was an overreaction. It turned out that he had blacked out some of the previous night's events-- he remembered coming home and throwing up, but he thought he threw up once and went to sleep, when he was actually sprawled on the floor weeping and throwing up every 10-15 minutes for over an hour. When I filled him in on what I had observed, he understood better where my heightened concern was coming from.

He has agreed to call his primary care physician on Monday, to tell them about the whole situation (weight loss (only 5 lbs so far, so I don't think this necessarily impacted his tolerance, and he did have a big old burger right before the whiskey tasting event), drug tapering (which is approved and organized by his psychiatrist, although they have no plans to meet again anytime soon), recent over-drinking and reactions to over-drinking). I explained that I don't know if there's a medical reason behind this, but I'd rather let a doctor weigh in. If they say it was probably a fluke and everything's fine, great! If not, we should know.

He said that he felt totally fine at the tasting, and then the dizziness and nausea hit all at once. He doesn't think most people at the store were aware of what was going on (although he did say that he threw up in the bathroom but not entirely in the toilet...), and a new friend from the tasting hailed him a cab and sent him home. The severity of the sickness increased in the cab and at home before tapering off. He realizes that he consumed a lot more than he usually would, so it wasn't a mysterious reaction to a "normal" amount of alcohol, he definitely got caught up in tasting everything and consumed way too much. He says he didn't buy any bottles at the tasting (there's no evidence of this), and that it's going to take a while before whiskey holds any appeal. No drinking has taken place since this happened (in the past 36 hours).

I think and hope that those of you who described an overzealous nerd getting super excited about a new hobby and going overboard on it were totally right. I don't think I over-reacted, I'm glad I reacted the way I did and that he's going to check in with his doctor next week. We talked about how what happened cannot and will not ever happen again, and that if anything like this occurs again (a third time) that will be a sign of serious problem drinking and lack of self-control. As it is, he agrees that he may not need but would likely benefit from some sessions with a therapist, to make sure he's in optimal emotional condition during a time of some major life changes.
posted by restless_nomad at 5:56 PM on April 26, 2014 [2 favorites]

Throwing up every 10-15 minutes for over an hour is not a normal reaction to alcohol.

Is it possible there was either something wrong with the alcohol he was given, or that something was put in it without him knowing?
posted by mani at 3:43 AM on April 27, 2014

I agree with most of the sentiment of the answers here.

I'll just throw two things out there:

I'm 34 and I can sock it to a bottle of bourbon if I wanted to do that.

But Tequila? Two shots and I'll blow chunks (multiple times) and have a headache for a day. I'll just feel truly awful. A friend made salsa and added two shots for flavor. Even a few chips before I realized, my mouth was dry and super headache for the next 12 hours.

I have a firm no tequila policy and never intend to do that again either. So maybe some sort of sensitivity or allergy that he drank or ate at event.

I also had a friend who after losing a bunch of weight and still dieting would skip food to balance out the calories from the occasional drinking night. This obviously was not wise.
posted by PlutoniumX at 9:32 AM on April 28, 2014

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