Medication, appetite, alcohol and interference

March 24, 2019 7:10 AM

I have a friend who mentioned recently that she's unable to eat on a new medication she is taking for mental health issues. She's lost a fair bit of weight. However, she's able to drink - while the rest of us were eating she tried unsuccessfully to eat a small amount, drank some wine and had to go throw up.

I've noticed her drinking rather a lot in the past and I know that now and then she tries to cut back but doesn't seem to be successful. I'm concerned about the combination of drinking and not eating (or not eating much) for what's probably been at least a few weeks at this point. I'm not sure whether her doctor is aware of the side effects she's experiencing and it's not hard to imagine her brushing that aside because I think she is enjoying the weight loss despite being frustrated with the other side effects.

We aren't especially close, we mostly just have hobbies that put us into the same group settings. She keeps me at arms length, so trying to sit down with her and express my concern is a no-go. I can try to talk about in a jokey, sarcastic way which is not my strength but seems to be what she is comfortable with. Any texts of sincere concern will be ignored or brushed off. I'm not close to her husband though she has a close friend I know somewhat better. I could make a pretext for getting the name of her doc and send a letter with my concerns. If I were to talk to her family members I wouldn't ask for info, just stress that this is a concerning and possibly life-threatening situation and perhaps offer some resources.

I've known people to die of liver failure and mismanaged medications. I'd rather interfere and have her be pissed at me permanently than not interfere and regret it. Are my concerns reasonable for the situation? Are there options I'm not seeing here?

posted by anonymous to Health & Fitness (11 answers total)

I have been your friend, and I would have appreciated AT MOST a gentle “I’ve noticed X and Y since you started taking Zzzzz, how are you feeling?” If we weren’t intimate partners and you contacted my doctor, we would no longer be friends and I’d start thinking restraining order. It sounds like you’re coming from a good place, but just NO.
posted by chesty_a_arthur at 7:15 AM on March 24, 2019 [16 favorites]

Are my concerns reasonable for the situation?
Yes. This is quite dangerous. A health professional who knew about her alcohol consumption would have advised her not to drink.

Unfortunately there's really nothing you can do about this. If she keeps you at arm's length, you're going to need to stay that way unless directly consulted. No unsolicited intervention on your part will be taken well.

Be aware that even if she brings it up and asks for your opinion, you are quite likely to lose this friend.

I'm sorry.
posted by aspersioncast at 7:16 AM on March 24, 2019 [1 favorite]

(Also: I took medication where I wasn’t supposed to drink. I tried drinking, I puked in the parking lot, I ...didn’t drink while on it anymore. Is your friend still drinking or did this happen recently and it alarmed you?)
posted by chesty_a_arthur at 7:19 AM on March 24, 2019

I believe that it depends on the meds. Some have made me puke after drinking even one drink. Most meds will discourage drinking and Drs will tell you just to take it easy. Alcohol is a depressant after all.

I also notice that drinking on an empty stomach while on meds makes me drunk and disoriented much faster than before I was on meds.
posted by kbbbo at 7:23 AM on March 24, 2019

It's 100% not okay to contact her doctor without her permission on her behalf, ever, I would go so far to say even if you WERE her intimate partner, and it does not sound like you're even especially close friends. This is a situation where you're drawing conclusions based on little information based on past bad experiences, but it's also one where the most you can do is ask her how she's doing and move on. You have no way of knowing if she has or has not told her doctor anything, and even if she hasn't if it's this obvious to you it would be as well to a decent physician.
posted by colorblock sock at 8:07 AM on March 24, 2019 [16 favorites]

I don't know. You seem really concerned for this person's life and I also have known folks who literally died from steady, but never one single overdose, of alcohol and Tylenol. People don't know or realize it's dangerous to combine alcohol with meds and I think it's more important to ease your concern that you've done what you could for this person than to follow perfect etiquette. While i would never contact anyone's doctor, there's nothing terrible about saying or emailing: "Hey, I'm sorry if this is intrusive and I don't mean to be, but I've known people who had scary side effects, like liver failure, from alcohol and medication combos. You mentioned your medication to me. Just in case you weren't aware. OK, hope you're doing well though!" and then move on. It's basically opening a neighbor's door and calling "yoo hoo!" when their house might possibly be in a fire path.
posted by nantucket at 8:19 AM on March 24, 2019 [1 favorite]

You need to back way off. This is super overreaching. You said she holds you at arm’s length. She’s not inviting your intimacies.

At most I think you could send her a quick text: “Hey just wanted to let you know I was a bit worried about you from the other night. I hope you’re okay.” She can ignore it if she wants.

Is this someone you are crushing on or somewhat interested in romantically? It sounds like she is trying to maintain some boundaries with you and you are trying to push way way past them. You seem very attentive to her.

I know you care, but people get to make poor decisions about their health.
posted by bluedaisy at 8:34 AM on March 24, 2019 [8 favorites]

it's not hard to imagine her brushing that aside because I think she is enjoying the weight loss despite being frustrated with the other side effects.


it should be hard. it should be harder than this for you to make up elaborate fantasies about what your acquaintance might say about her medical issues in the privacy of a doctor's office.

you think you have observed something that neither her husband nor her close friends have observed, and that you know more about what it means for her health than she, her husband or her close friends could know, and that you must step in because neither she, her husband, nor her close friends are as concerned or informed as you are. you have said nothing to indicate this has any actual basis.

you know her and yet you claim it's impossible/you are too timid to speak to her directly - her, the one person you could reasonably and respectfully approach. so if you won't do that, you obviously have no business trying to hunt down her intimate partner or her doctor to send secret messages about things they certainly know more about than you. if you persist in doing that, you are not just going to make her angry with you, you are going to get yourself permanently ejected from whatever social circles you both frequent. you will not be a hero.

you ask for ideas you may not have thought of, so here is one: if you see her apparently drunk or sick, ask her if she's ok and if you can get her anything or call anybody.
posted by queenofbithynia at 9:46 AM on March 24, 2019 [13 favorites]

She keeps me at arms length, so trying to sit down with her and express my concern is a no-go. Any texts of sincere concern will be ignored or brushed off.

So then why do you care that much about what happens to her? Not trying to be callous, but it sounds like she has close friends and a husband, so let them worry about her. Yeah, it's possible none of them have talked to her (because sometimes relationships aren't always what they seem), but again, who cares?
posted by unannihilated at 9:57 AM on March 24, 2019 [1 favorite]

I would just tell the story of what happened to people you knew who died of liver failure and mismanaged medications. Don't specifically address it to her, but just tell the story to the whole group, say what you need to say about the danger of alcohol + no food + meds, then stop talking. That's really all you can do.
posted by selfmedicating at 10:30 AM on March 24, 2019 [1 favorite]

You seem pretty obsessed about this, to be honest. Do you have codependent tendencies? Do you have trauma that this behavior is triggering? Or an anxiety diagnosis of your own?

I recommend getting extra help & support for yourself and your own issues right now. You’ve really been ruminating on the behavior of another adult in a way that’s not healthy.

As for your acquaintance, trust that she + her family + friends are aware of what she’s experiencing. If she needs to quit the medication, she’ll figure it out. But this medication even with side effects might be giving her a higher quality of life than she had before. Chances are good that you are not equipped with enough information to decide for her. You need to back off, really.
posted by ElisaOS at 1:29 PM on March 24, 2019 [1 favorite]