What happens when a high-functioning alcoholic in denial gets hospitalized for an unrelated condition?
Say Barbara gets hit by a car and has to stay in the hospital for a few weeks. Barbara is also a highly functional but acute alcoholic (in that she has no problem affording her habit or keeping her life together, but is a trembling wreck before her first drink of the day). Say Barbara is also in denial and doesn’t let on to her dependency before withdrawal symptoms present themselves. What happens then? Does she undergo involuntary detox? Are enablers sneaking in booze during visiting hours a common problem?
I don’t see how this will have a factual answer, as every case will be different.
I can describe a best-case scenario: me. All through my 20s, and well into my 30s, I drank 15 or 16 12-oz beers every night. Never had any problems with my job or the law. In 2003, I was diagnosed with very high blood pressure (due to my drinking, of course). Rather than admit the truth to myself or my doctor, I put myself on a very low-sodium diet. In 2005, I landed myself in the hospital with a sodium deficiency. So not directly related to drinking, but I wouldn’t have been there otherwise. My memory of the whole incident is hazy, but in the ER I wound up admitting my consumption to the doctor. I stayed in the hospital for a few days, and they detoxed me.
The result? It stuck, and I’ve been sober ever since, for 12 and a half years now.
On the flip side… I had a cousin who was much like me - drank a lot, daily, but held his career together. in 2000, he fell off a cliff and broke his neck and his back in two places. For the rest of his life he was paraplegic (and damn lucky he wasn’t quad). Again, technically unrelated to drinking, but he was drunk when he fell…
Anyway, he spent six months in the hospital. I suspect there were a few occasions where he managed to sneak out and get some booze, but for the most part he was alcohol-free. As soon as he got out, he went right back to his old ways. Various things in his life over the next few years led to him killing himself in 2004.
In the case of my son, who is an active alcoholic, he wound up in the hospital last month in his most recent event because he fell down the basement stairs, breaking several ribs and a humerus and incurring a light concussion. While in the hospital, he had his usual withdrawal siezures and was detoxed in order to save his life. I think we’re now at the point of no return with him, as a continued quart-a-day vodka consumption is going to kill him in short order. It’s not the happiest of Christmases.
Patients go through unexpected (by staff) withdrawal from alcohol, opioids, benzos, barbiturates rather often. They also get supplied with alcohol, opioids, benzos and barbs and other drugs by their buddies. IVs make convenient places for friends to give them a quick pick me up shot of heroin.
Usually the withdrawal is detected quickly by staff and treated appropriately. Sometimes the symptoms are masked by whatever else is going on. Each case is different.
Nothing worse than walking past the entrance to the local hospital and seeing someone on a drip in a gown with obvious symptoms of jaundice cracking open a can of “Special Brew” brought by their mates.
I’ve seen it more than once.
He’s been in and out of the hospital several times in the past year or two, was in kidney failure once, had fluid pumped out of him several times, has had seizures in public and in front of his kids, has lost three jobs, and is now out of work with only the state insurance to cover him. None of the long-term rehab centers will take that insurance, even if he was inclined to give it a go, and are prohibitively expensive if you pay your own way. He’s only 41, and we’re bracing for the worst.
I’ve seen people recover from lower bottoms than that. It can be done. Frankly it will take a complete commitment on his part, though. I failed to sober up pretty repeatedly and very disastrously from 1984 until 1990 before something clicked with me, and I’ve been a productive citizen since, and quite happy about that outcome.
So there’s always hope. Meanwhile detach with love, live your own life. And my wife says to tell you to go to Al-anon and find a compatible group. That’s where she learned to find sanity and happiness, a couple of years before I managed to get clean and sober.
Depends on the problem and the hospital. Around here, St V’s had a pretty relaxed attitude towards alcohol and indigent people. Assuming she was going straight out again and was normally functional in her station of life, they’d give hee a glass of low-strength beer every couple of hours to keep her stable, then let her go.
RM had a stricter attitude to both alcohol and indigent people. They’d give her something else to control the DT’s, but they too would treat the presenting problem and discharge her.
Incidentally, it may have been directly related to your beer drinking. Beer is significantly hypotonic (much lower than isotonic salt concentration), and excessive beer drinking can lead to hyponatremia. The condition even has a name:
I have a relative who didn’t realize he was physically addicted to alcohol until he was admitted to the hospital for open heart surgery, and had a seizure after a couple days with no alcohol. :eek: IDR if the seizure happened before or after his surgery; he was given massive doses of Valium and kept in an artificial coma for a few days, and has to my knowledge not had any alcohol since.
D’oh - “one drink a day” means a shot glass of hard liquor and not a drinking glass, which was what he would have every evening.
The treatment of an active alcoholic who’s in the hospital for a reason other than detox depends on multiple factors. Usually, the doctor would order diazepam or chlordiazepoxide, or maybe clonopin, but in some cases, they would indeed order alcoholic beverages. We kept them in the narcotic cabinet and catalogued them the way we would any other Schedule II drug, and the nurses charted it the same way.
Not alcoholism, in this case, but my mother was addicted to prescription painkillers when she got admitted for something else. The doctors diagnosed the addiction and treated it along with the other issues. I’ve got this memory of Mom barking “I’m nutanaddict gimme ma pills!” while Dad looked real, real scared… In that case and legal system, the doctors were allowed to treat the addiction without her personal consent since the addiction itself made her non compos mentis, mentally incapable; after that scene there was no problem obtaining Dad’s consent (as her next of kin and therefore automatic guardian while temporarily incapacitated).
The Spanish medical system generally involves the family as much as possible; this includes whenever a new diagnosis crops up, which does include previously-undiagnosed addictions.
From what my SO (who works in a residental facility for formerly homeless men, who almost all have been alcoholics for decades and are veterans of numerous detox tretments and several long-term therapies, all to no avail), hospitals mostly seem to take it in their stride.
A lot of her her clients are frequent flyers in the city’s hospital (falling down a lot, complications from diabetes, some are entering the age where you need hip or knee implants). Doctors are aware of the condition from the start of treatment (German charts and reports seem to coyly note it as C2-Abusus, C2 being short for C2H6O), and the wards have beer in stock, or they are treated with medication as warranted. More of a worry is that they sometimes get bored and self-discharge without notice.
Indeed. In Juan Thompson’s (son of Hunter Thompson) book “Stories I Tell Myself”, he details how when HST was hospitalized for hip replacement that he was such a raging alcoholic that they were giving him alcohol to keep him from going into severe DT’s/coma.
I mentioned this in a thread a while back. I have a friend that is (was*) an alcoholic. One of those guys you could find falling off a bar stool at 6am. Still shitfaced at 10pm. In fact, I don’t think I ever saw him not drunk. However, he held down a job, raised a family, put several kids through college etc.
A few years ago he had knee replacement surgery. The doctor doing the surgery told him the hospital they were doing it at didn’t have the ability to deal with him going into detox while he was there and asked him to bring some booze in with his overnight bag. IIRC, they explained that they didn’t want him falling down drunk all day, but they actually did want him getting a few beers/shots into him throughout the day or two that he was there so he didn’t have a seizure.
*Was an alcoholic as in he doesn’t drink anymore, not that something happened to him.
I had meant to type clonidine (and maybe it autocorrected) but Klonopin is also used for detox even though it’s highly addictive itself. You do have to weigh various plusses and minuses.
