booze as analgesia

we know a lot of the reasons chronic alcohol abuse causes damage to the body. We understand the mechanisms that go haywire in the liver (at least enough to counteract them).

So why not use ethanol drips for some hospital patients? Seems like it’d be remarkably cheap. And pretty effective, at least for low level pain.

Is it more addictive than morphine or percocets? Would the withdrawl symptoms after a week of pain-relieving doses of alcohol be too great (e.g., d.t.'s)? Is it not in fact cheaper?

What gives?
jb

I’ve tried to fight pain with alcohol before (a toothache), and I personally don’t like to get as drunk as it takes to have any effect on the pain - the aftereffects are worse.

right, but under correct supervision of the right amounts of drugs, you’d be fine.

a steady drip of ethanol, saline, and glucose, with maybe a potassium thrown in for good measure. At such a rate that you are a little over slightly buzzed.

What’s not to love?
jb

right, but under correct supervision of the right amounts of drugs, you’d be fine.

a steady drip of ethanol, saline, and glucose, with maybe a potassium thrown in for good measure. At such a rate that you are a little over slightly buzzed.

What’s not to love?
jb

the fuck? this is like the third time in two days!

jb

Most emergency departments keep a bottle of whiskey around for alcohol withdrawal seizures, but it doesn’t do much for the longer term problems. Usually PO (oral) alcohol is used rather than an IV drip. Benzodiazepines (such as Ativan) are usually given. SInce alcoholics can be deficient in thiamine, this is usually given too.

what is it about alcohol that makes it a less-than-ideal pain-killer?

jb

  1. There are too many exceptions as to who could use it. Anyone with existing liver damage, anyone using medications that could cause damage combined with alcohol, women who were or might be pregnant, nursing mothers, alcoholics, people with religious objections, etc.

  2. I doubt that it would be very effective agains serious pain, and there are already a lot of safe alternatives for nonserious pain–even babies can take acetominophen or ibuprophen.

  3. You’d have to know every person’s drinking history to know how much to give them and even then, it has unpredictable effects on people’s behavior.

Another problem is that alcohol dilates peripheral blood vessels, and (IIRC) interferes with clotting. For that matter, my WAG would be that the drip would have to be fairly concentrated to deliver an effective dose, and might be irritating to the vein.

Very narrow therapeutic window, that is the dose necessary to really relieve significant pain better than aspirin is close to the dose able to kill off the patient. Not to mention the array of sappy, weepy, belligerant, and nostalgic drunks you’d get rampaging thru the wards. So it really sucks as a painkiller, for that and many other reasons.

Qadgop, MD

thank you one and all for the responses. Very well-reasoned.

later,

jb