Alcoholism Discussion Thread Version 7.0

[Moreaux]

I think you mean Ryan from this Drugged episode. He did not die from alcohol withdrawals - he made it to like the 20th day. He actually died from a depressant overdose (possibly benzos mixed with some other depressant), administered to him by the careless staff. He was actually not the only one who died that way, AFAIK, although I can't remember the source I read it from - sorry.

But nonetheless, alcohol withdrawal is nothing to joke about, and it can potentially kill you.

@Moreaux: I'm not familiar with the pharmacology, will a regular antiseizure medication like the ones you listed help in alcohol withdrawal against seizures, as benzos would?

The rehab I attended twice frequently gave out either Dilantin or Depakote to us drunks, so I guess they are effective enough. Imo a benzo would have made the experience much more tolerable and it would have prevented the glutamate over activity which ends up having a horrible cascade of nasty effects and neurotoxicity which takes significant time to recover from. I think now they use phenobarbital and that seems to be more effective in terms of comfort, than just an anti siezure meds alone.

I think benzos are preferred because they are similar to alcohol so they can essentially be used to do a taper so it's not such a systemic shock and it makes withdrawal and subsequent PAWS much more tolerable.

 

[belligerent drunk]

I never attended rehab (I don't abuse alcohol anymore). Perhaps they thought that benzos could be abused since the person was already an addict, and that is why they didn't give them?

I've pondered whether NMDA antagonists (especially stuff like memantine) would be good for GABAergic and/or opioidergic (opioid receptor activity seems to be connected to glutamatergic pathways) withdrawals. I tried O-PCE for codeine withdrawal, and it seemed to help somewhat, but me trying something on myself is far from a proper scientific inquiry. Oh, this made me want diethyl ether, lol.

 

[nuttynutskin]

Fact remains that the situation is not dire

How can you say that as you know it as a fact? It sounds fucking dire to me. Like someone else said alcohol withdrawals can KILL you, and if your tolerance is high enough you could still drink and go into withdrawals. It's happened to me.

Jenny can wait for treatment and keep drinking, she can do a taper if she has a loved one who can manage her and control the booze, she can go cold turkey and get some supportative meds like a beta blocker, antisiezure, and go to the ER as needed, final option is she can come back to the US and get treatment.

Apparently you missed the post where she said she was TURNED AWAY from the ER. I never would have advised doing what I mentioned in my post that got edited and infracted if it wasn't for the fact she isn't getting the fucking care she needs. Doing what I mentioned and coming out with a script for librium or ativan makes a whole lot more sense to me than just to continue drinking. And as far as tapering, if she is an alcoholic good luck with that. She already stated that she hadn't tapered successfully.

 

[FLA]

Thanks TPD, very sweet message from you.

Hopefully Jenny is finally receiving inpatient treatment. After browsing this thread I will never bitch about the state of medical care in the US again!

 

[Moreaux]

How can you say that as you know it as a fact? It sounds fucking dire to me. Like someone else said alcohol withdrawals can KILL you, and if your tolerance is high enough you could still drink and go into withdrawals. It's happened to me.

Its not dire, she doesn't have to stop drinking right now. It's not like she got cut off cold turkey - she has access to alcohol and therefore does not have to be in a life threatening withdrawal. Regarding your tolerance statement - she never mentioned that her tolerance is extraordinarily high where she will continue to withdrawal while drinking - I'm not going to address that as its speculation. I'm certain if that were a component in her situation she would have mentioned it.

Apparently you missed the post where she said she was TURNED AWAY from the ER. I never would have advised doing what I mentioned in my post that got edited and infracted if it wasn't for the fact she isn't getting the fucking care she needs. Doing what I mentioned and coming out with a script for librium or ativan makes a whole lot more sense to me than just to continue drinking. And as far as tapering, if she is an alcoholic good luck with that. She already stated that she hadn't tapered successfully.

Apparently you missed the part of the post where she said she was in the UK - they don't hand out scripts for benzos - to anyone. It's not done. Your advice was not even applicable to the situation.

You apparently also missed the part where the ER told her to come back if she was having an emergency - she was not allowed to stay in the ER to detox. They were not refusing her service, they were not allowing her to stay to detox - there's a difference.

As an alcoholic, I understand wanting to quit, feeling miserable, and wanting to fix everything instantly, but sometimes we don't always get what we want. I also understand what it feels like to go through severe alcoholic withdrawal, and how to stop that withdrawal. My heart goes out to her, but she does not have to put herself in danger with a cold turkey withdrawal. She is choosing to do this right now - she does have other safer options available to her, which were also mentioned in my post and also mentioned in her posts, which you choose not to address.

I made the remarks that I did because everyone is treating this situation as an emergency life or death scenario and it isn't. Dismissing the harm reduction rules of this website for one person who chooses to put themselves in danger is not acceptable. Publicly suggesting that she try to scam meds from a hospital is reckless and potentially damaging to the other hundreds of not thousands of people who will read that advice and potentially attempt it themselves.

 

[strity1994]

I made the remarks that I did because everyone is treating this situation as an emergency life or death scenario and it isn't. Dismissing the harm reduction rules of this website for one person who chooses to put themselves in danger is not acceptable.

I understand but isn't alcohol really bad for your liver and can cause life threatening issues/health deterioration? I know people have died from cirrhosis because they couldn't stop drinking. Some have gastrointestinal issues. Either way, I hope Jenny gets help before it's too late.

 

[Moreaux]

I understand but isn't alcohol really bad for your liver and can cause life threatening issues/health deterioration? I know people have died from cirrhosis because they couldn't stop drinking. Either way, I hope Jenny gets help before it's too late.

Drinking is bad for you overall, but she was told they could get her into treatment in a couple of months so in that case it's safer that she keep drinking then try to cold turkey stop if she can't do a taper. In theory a taper would be fine but most alcoholics wouldn't be alcoholics if we could control our consumption well enough to do a taper lol The other insidious issue with alcohol withdrawal is that they get significantly worse every time one goes through it, so it's also safer to continue drinking than doing a bunch of starting and stopping.

Regarding the liver - it's an incredibly regenerative organ. I was a 17 year heavy alcoholic and have been sober for two years and my liver is completely normal now according to CT scans and bloodwork. The only time is doesn't really regenerate is if somebody is already in late stage liver disease.

I hope Jenny is doing alright as well. The U.K. doesn't treat addicts well at all, it seems they devote very little to resources going to help them. It doesn't help that she's not a citizen either, it would be great if she could come back to the States for treatment.

 

[belligerent drunk]

I will second Moreaux regarding the liver (and other organs) and drinking. Prolonging drinking for a short while (well, a couple months doesn't sound like it to me, but whatever*) is better than attempting a detox on her own. Yes, alcoholics are impulsive and cannot control use - we wouldn't be that if we could. And repeated withdrawals (from attempting cold turkey or bad tapers) do cause some (reversible) neurological damage and make the next withdrawal tougher, so there's a point against trying to detox yourself without benzos.

*As far as organs go, typically if a person is so heavily dependent that they hallucinate and seize from CT alcohol withdrawal, it means they've been at it for years. So as far as that goes, a few more months won't be a killer (unless she already has life-threatening stage of liver disease). The same cannot be said for other aspects of her life. Excessive drinking usually entails monetary loss, possible job loss (or at least failure to work properly), relationship problems, and so on. I would not want to continue the cycle for a few more months if I knew that I was getting myself into that again. But health-wise, yes, it's more advisable to drink than not.

 

[Moreaux]

Jenny - I hope all is well with you. If you can, please let us know how you're doing. So I've been trying to find alternatives to benzodiazapines to help you detox at home and haven't really come up with too much that I would be comfortable recommending. I did find a decent article discussing phenobarbital and was wondering if you could see a doctor and tell them you want to detox at home and get a script for that? I'm not familiar with the UK's policy for barbiturates, though I suspect it's probably fairly strict as well. Here's the article for reference:

http://emcrit.org/pulmcrit/phenobarbital-monotherapy-for-alcohol-withdrawal-simplicity-and-power/

The only other medication I came across what is useful is Chlormethiazole.

https://en.m.wikipedia.org/wiki/Clomethiazole

The last alternative I could think of would be getting medications to alleviate the symptoms such as an antisiezure med, a blood pressure med, etc but doing it that way may be more damaging than just waiting for treatment.

 

[strity1994]

.

*As far as organs go, typically if a person is so heavily dependent that they hallucinate and seize from CT alcohol withdrawal, it means they've been at it for years. So as far as that goes, a few more months won't be a killer (unless she already has life-threatening stage of liver disease). The same cannot be said for other aspects of her life. Excessive drinking usually entails monetary loss, possible job loss (or at least failure to work properly), relationship problems, and so on. I would not want to continue the cycle for a few more months if I knew that I was getting myself into that again. But health-wise, yes, it's more advisable to drink than not.

In other words, if her organs are already damaged, she's screwed. At this point, a few months more of drinking won't really make a difference.

 

[belligerent drunk]

What I'm saying is, if her organs are not already damaged, a few months more months won't make a difference. Unless she is in a death/life position, in which case a month or two of drinking would cause death. But I doubt she is.

@Moreaux: other GABA agonists like phenibut or baclofen might be useful. They're GABA-B agonists, not GABA-A, but I think it should be fine still.

 

[nuttynutskin]

Jesus H Christ. Apparently everyone in this thread magically knows exactly in what shape her organs are. And suggesting that drinking for a few more months would be ok? You've gotta be fucking kidding me. In the name of harm reduction I'm seriously disgusted. About a year ago I'd been told that if I kept on drinking like I had been for another month I would have irreversible liver damage but let's just throw that out the window. I stand by every goddamn thing I've said and suggested in this thread. Doctors DO NOT always have your best interest at heart. If you have to exaggerate your symptoms because you're not being taken seriously do so. Either way, Jenny I hope you can get the help you need and you do whatever you can to get it.

 

[belligerent drunk]

Calm down, nutty. Nobody would suggest drinking for a few more months if there were better options available to the person. And I think I made myself very clear, that there are cases in which the drinking would cause irreversible damage to organs, but it's not always the case - she would need to get herself checked out to know, of course, but that's not so hard to figure out, is it? Nobody knows what the perfect answer is, which is why we're speculating here and trying to support our ideas with coherent reasoning. The reality is that a lot of people drink for years and don't suffer irreversible organ damage, which would indicate that unless she is in danger right now, it would be unlikely to cause anything serious if she continued for a month or two.

Of course, medical staff have some rules that are ultimately counterproductive to the health of some people, Jenny for example. Doing what you suggested might work, it might not (medical workers are not retards too) - I'm more inclined to agree with you that in her case it would be worth a try. However, Moreaux brought up a very good point: there are a lot of other readers, lurkers, who might see this as a means to get drugs like benzos, when they don't need them; and we need to be careful with what we suggest on a public forum. You can always use the personal messaging system to let her know what you think.

E: I seem to have missed something earlier. The question was "if her organs are already damaged, she's screwed either way and drinking for a couple more months is OK". No, it's not. If they're already damaged, then it will only make matters worse. That is the case in which continuing to drink is not an option.

 

[nuttynutskin]

Fair enough... I suppose I have a bit of a personal stake in this issue. I just hate seeing people not getting the medical help they need by incompetent doctors/nurses. Normally I would fully advocate playing by the rules, but in certain situations I think you gotta do what you gotta do to get the help you need. But I guess I've pretty much made my point. Good luck Jenny.

 

[Moreaux]

What I'm saying is, if her organs are not already damaged, a few months more months won't make a difference. Unless she is in a death/life position, in which case a month or two of drinking would cause death. But I doubt she is.

@Moreaux: other GABA agonists like phenibut or baclofen might useful. They're GABA-B agonists, not GABA-A, but I think it should be fine still.

Other GABA agonist won't really improve her situation, and may not stave off siezures. I had thought about them and checked as they would be easier to obtain. I also know from personal experience that nonbenzodiazepines, the Z drugs, do nothing for withdrawal, at least high doses of Ambien. I think they would have to be GABA-A. I do wonder how a GABA-B agonist along with an antisiezure med and possibly a beta blocker would do?

 

[belligerent drunk]

Nonbenzos and benzos act in the same way though, as in they're also GABA-A positive allosteric modulators.

Nonbenzodiazepine pharmacodynamics are almost entirely the same as benzodiazepine drugs and therefore employ similar benefits, side-effects, and risks.

I was rather mildly dependent on GABA-A drugs (nonbenzos - zopiclone, and benzos - nifoxipam, diazepam) for a little over a month, and stopped a week ago or so, and now switched to 1,4-butanediol (prodrug to GHB, a GABA-B agonist), and I have to say, it does alleviate what little withdrawal symptoms I have.

 

[Moreaux]

Fair enough... I suppose I have a bit of a personal stake in this issue. I just hate seeing people not getting the medical help they need by incompetent doctors/nurses. Normally I would fully advocate playing by the rules, but in certain situations I think you gotta do what you gotta do to get the help you need. But I guess I've pretty much made my point. Good luck Jenny.

Nutty - I loath seeing alcoholics and other addicts get poor treatment from medical staff. My heart breaks for alcoholics who are still active and struggle - I understand how insidious the condition is and how desperate it makes us. To be honest I have cried several times over Jenny's situation, I can relate to that feeling of needing help and it seems the world turns its collective back on you. Many of us in this thread get it. If it were in my power I would help every single addict who suffers as nobody deserves to have to live that way, but realistically it's not and Jenny is no exception. I get what you're saying - You're heart is in the right place.

 

[Moreaux]

Nonbenzos and benzos act in the same way though, as in they're also GABA-A positive allosteric modulators.



I was rather mildly dependent on GABA-A drugs (nonbenzos - zopiclone, and benzos - nifoxipam, diazepam) for a little over a month, and stopped a week ago or so, and now switched to 1,4-butanediol (prodrug to GHB, a GABA-B agonist), and I have to say, it does alleviate what little withdrawal symptoms I have.

I was really interested in Phenibut but all the experiences that I read regarding Phenibut and alcohol withdrawal state that it wasn't completely effective in eliminating siezures, though it may be effective in bringing then blood pressure down and helping with heart palpitations and producing a more relaxed sensation. I also wonder how Phenibut would behave when combined with high levels of magnesium and some of the B-vitamins, if that would get symptoms manageable? My only other concern with Phenibut is withdrawal from that, and the fact that it seems quite addictive in and of itself.

GHB may be a better choice for her situation, but that is not as readily available

 

[nuttynutskin]

Librium has been my godsend on more than one occasion.

 

[polymath]

I finally got Antabuse again, after it being unavailable for 4 months. Makes the risk of relapses a lot smaller.