Thanks! I’ve been addicted to not-alcohol before, so I wasn’t sure of the difference.
It’s what I mentioned close to Page 1. I’d say the only reason NOT to do it our way (tapering) would be a lack of complete understanding of the process. Anything that could conceivably end in seizures or even death— the possibilities of which are no matter how vanishingly remote—should not be tried by anyone without a near-medical understanding of the process.
And most people will not have a near-medical understanding of the process.
Thus: the professionals.
It might be compared, albeit clumsily, to taking your first skydiving jump solo, instead of availing yourself of a tandem jump instructor.
We had a lovely chat in this thread about alcohol withdrawal where a few posters tried to argue that the dangers were hyped and overblown, but were rebutted by myself and others.
Botton line: Delerium Tremens can occur in about 5-12% of people who are physiologically alcohol-dependent, and the mortality rate for untreated DTs can go as high as 40%.
Isn’t cutting 1-2 drinks out a day considered the go to method of detox at home? if you are drinking 20 drinks a day, cut 1-2 out a day until you are down to 0. It’ll take 10-20 days, but it should make it much easier.
Also I know detoxing w/o treatment carries a real risk of death (something in the 1-5% range, I can’t recall). However, realistically, what % of the human race has access to the best medical treatment when quitting alcohol? Maybe 10-20%? If that?
Has the step down method been studied as a way to reduce mortality among people who, for whatever reason, cannot get proper medical care? If so what are the results?
Studies of the step down method have shown that people who drink alcoholically (i.e. the people who need to ‘step down’) are seldom able to adhere to it due to their alcoholism.
If it’s done under constraint/medical supervision so it’s adhered to, mortality and morbidity are reduced significantly, but not as much as by using benzodiazepines instead of alcohol.
Thanks
I don’t think I’d be able to stick to it on my own, honestly. There’ve been times I’ve tried to tell myself “I’m only drinking so much today and that’s it”, but I never can keep to that and I just sort of end up “chain-drinking” until either it’s time for me to stop and go to bed, or I realize that I’ve drunk more than I can handle (which usually happens about halfway into the drink after the one that should have been my last). I’m pretty confident that the only way I’m going to break this habit is in a situation where I don’t have access to alcohol - and once I get there, I think it’s going to be easier for me to stay that way.
I’m not seeing my GP until next Tuesday, but I’m seeing my gastroenterologist on Monday to follow up on an endoscopy I had last month, and I plan on bringing this up with her also. I’ve been having heartburn/nausea issues for years that meds haven’t resolved, and I thought it was acid reflux, but looking back on things now it occurs to me that the pain is worst when I’m sober and maybe that’s connected to my drinking as well.
So is a person in African or southeast asia, who probably cannot get an in-patient detox, going to see meaningful reductions in mortality by going to a physician and getting an Rx for benzodiazepines and told to use the step down method?
Why is stepping down with benzo more effective than stepping down with alcohol?
What kills people with DT?
How should I know? I doubt such a study has been done.
But any treatment which gives control of the alcohol/benzo to the patient who is withdrawing is set up to fail, as such a patient is unlikely to use the substances as prescribed. if they did, they wouldn’t be addicts.
Benzos are much safer drugs than alcohol is. Alcohol is toxic to neurons and to the liver, even in healthy individuals. And benzos are much more calming for excited neurons than reduced levels of alcohol. Benzos are not stepped down either, at least not until the withdrawal has been managed. THEN benzos are tapered.
Fluids and electrolytes are badly disordered. Dehydration, low potassium and magnesium can lead to seizures and fatal dysrhythmias, low phosphorus can contribute to breakdown of muscle tissues, respiratory alkylosis from hyperventilating further screws up the ability of the body to keep blood flowing to the brain and electrolytes like sodium, potassium, chloride in balance. To name a few amongst the many mechanisms that go wrong.
I don’t see any mention of African or southeast Asian patients and availability/lack thereof of inpatient detox units in those locations in your cites. :rolleyes:
Thats nice. The mention of Africa or Asia was about people who probably cannot get proper medical care.
There’s tons of folks in the US who can’t get it either. I see a lot of them. It’s maddeningly frustrating. But it actually is improving somewhat with ACA and other reforms.
My point is that benzodiazepines are the drug of choice for alcohol withdrawal therapy, and that the chances for success are far far greater if the patient does not control the dosing/intervals for the medication. Whether control is in the hands of a treatment team in an inpatient setting or those of a family member or trusted friend or hired nurse, the control should reside with someone else.
I’d use gradually reduced doses of alcohol to treat alcohol withdrawal only if more appropriate drugs were unavailable. Because it’s less safe to taper off alcohol.
I’ve been taking care of alcoholics and addicts since 1980, and I’ve seen and done a lot of detox; I’ve had to cut corners, make compromises to get patients to engage at all and for harm reduction, etc. I’ve seen people die from it too, when they came in too late, or just got unlucky.
This is a funny conversation. I’m trying to imagine being sent home from the detox unit/doctor’s office with a fistful of benzos under my control.
Sounds great!! Just not so good for sobriety.
I was given a refillable script for Ativan and sent home.
Of course, I had been using one benzo or another for 5 or so years at the time for sleep.
I think I may still have a few of the sleepers which didn’t work.
If you just show up in the ER as many people do, they don’t really consider anything beyond keeping you from dying from complications of alcohol detox to be their responsibility. Staying clean and sober is your problem.
Had a seizure in bed this afternoon. Called 911. ER doctor says it looks like DTs. Being admitted to hospital now.
I had hoped to do this on my terms, but it looks like it’s happening.