Alcohol detoxification...

Most of us who recovered with AA's program did so with the help of a "sponsor". But what is sponsorship? How do I get one? Who can be a sponsor? What makes a good sponsor?
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Tosh
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Alcohol detoxification...

Post by Tosh » Thu Jul 28, 2011 7:38 am

Just recently, I've had a spate of guys who're physically addicted to alcohol (or appear to be so) and require detoxification. Two of them are back out drinking, but the one remaining guy I'm working with seems to be determined to kick the booze; he seems to really like A.A. and we both get on well with each other. Now I've read some of the history of A.A. and know how they used to do it, but I try to get these guys to see their doctor, and go with them, to hear what the doctor says; and they say different things.

My doctor told me not to stop drinking (I took her advice and continued for another two years) and referred me to alcohol counselling, which didn't work for me.

One doctor said to taper off at the rate of 1 can of lager per day (the guy was a vodka drinker); he's back out drinking.

Another doctor said to take the diazapam and to just stop drinking; the doc said the daizapam would prevent fitting. (he took the diazampam washed down with alcohol, and is still out drinking).

And today, for the guy I'm currently working with, the doctor prescribed diazapam and said to 'cut down' on the alcohol. I pushed for a clearer course of action, and even explained how we crave for alcohol even more once we start drinking it, but she still insisted that the guy I'm helping has two-or-three cans of lager per day.

Sigh!

It's not easy is it. I'll phone my sponsor tomorrow morning (he gets to work an hour early to read e-mails and take phone calls from sponsees) to see what advice he can offer, but if anyone can share some experience of getting guys - who really seem determined to stop drinking - stopped safely so that we can start working with them, I'd be grateful. The guy in question does really seem to have a desire to stop drinking (but I also know how quick this can change too), but he's going to all the meetings he can, he has been trying to cut down (with the exception of yesturday), he answers his phone when I phone him, and he listens too; he knows I understand the problem from my own experience.

But when I stopped drinking, in the end, I just STOPPED. I'd tried the tapering off thing, and just couldn't do it; I'd taper straight back on drinking even more as if to make up for what I'd denied myself on previous days. But I also understand the risks of stopping drinking the way I did it.

As I say, any experience of getting guys of alcohol would be much appreciated.

(P.S. If the mods deem this post to be too 'medical' you're welcome to delete or move it into the Registered Discussion area; I'm no doctor and have just regurgitated the advice the doctors have given from my visits with alkies).
Come, come, whoever you are. Wanderer, worshiper, lover of leaving. It doesn't matter. Ours is not a caravan of despair. Come, even if you have broken your vows a thousand times. Come, yet again, come, come.” Rumi (No sniggering from the sex addicts)

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Re: Alcohol detoxification...

Post by leejosepho » Thu Jul 28, 2011 7:58 am

In my own overall experience, there is no "one size fits all" here ... and of course, I know you already understand that, Tosh.

In my own case, my detoxification was "self-inflicted 'cold turkey'" by having myself locked up in a city jail so I could sober up and hopefully remain that way at least just long enough to go see a man who had sent a message to me via my ex-wife saying he was sober. Looking back after working in a detox unit several years later, it is fortunate I did not actually experience full-boat DTs. Many of us might shake a bit when we first sober up, but many alcoholics actually die during actual delirium tremens.

Personally, I "make the call" in each case based upon my best effort to "read" the sufferer. If s/he does not want medical help for detoxification, I will check for some willingness to allow me to "supervise" the tapering-off process ... but I absolutely will not serve as a nurse-maid for someone just trying to get over a bad drunk with no real desire to truly stop "for good and all" and accept some real help to actually make that possible.

Funny story: In Key West many years ago, a call once came in at the meeting hall during a meeting ... and the guy behind the coffee counter called me to the phone. I quickly grabbed my book from my chair and got in my car and drove to where the caller was sitting on the steps in front of the Post Office ... and then the next thing you know, some cop is giving me grief for stopping and getting out of my car in a loading zone there after dark! At the time, I figured he just did not understand someone being on "a mission from God!" In any case ...

The next thing you know, three or four of us have this guy on the couch in the vestibule of the meeting hall, and Morris ("Five-Time Loser Wins") is calling a doctor friend of his and getting us some kind of pills from a dispensary somewhere ... but first we must all get permission from the board to even have those pills inside the meeting hall ...

... and a few minutes later, the guy on the couch looks us at me and winks and says, "God bless you, Joe" ...

... and then I quickly came to understand why so many of the other long-timers there had been chuckling all the way through.

Bottom line? If the suffering alcoholic's ideas/plans/demands are so great, then why is s/he even suffering?

Never let the suffer call the shots, and best of luck to you in actually finding a *good* doctor (as mentioned in our Basic Text).
=======================
"We A.A.s do not *stay* away from drinking [one day at a
time] -- we *grow* away from drinking [one day at a time]."
("Lois Remembers", page 168, quoting Bill, emphasis added)
=======================

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Re: Alcohol detoxification...

Post by PaigeB » Thu Jul 28, 2011 8:28 am

I was familiar with AA and knew that it was the only way to STAY sober. My family wasn't pushing - I wanted to quit - but I refused to go to a treatment facility for many "reasons". When I went to the doc, knowing I was going to "try and quit" the doc gave me Valium. I knew this to be like booze in solid form. I took the script knowing this doc had little or no knowledge of my condition. Around the same time, I had an appointment with a shrink who said, "It might help" (the pill) but when asked her opinion on AA she was not familiar. I had a gut feeling I was on my own and called the AA hotline.

2 weeks later, I returned to both with AA literature. And with the help of a sponsor (then & now) I have not had a drink since. It is OUR RESPONSIBILITY to carry the message & maybe the literature! Good luck with your new sponsee - I hope he finds something here he wants and goes to any length to get it.
Step 6 is "AA's way of stating, the best possible attitude one can take in order to make a beginning on this lifetime job... with most of them we shall have to be content with patient improvement." 12&12 Step Six, p.65

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Re: Alcohol detoxification...

Post by jakpar » Thu Jul 28, 2011 11:55 am

Tosh, I wish I could offer more than info you probably already know, and
I wouldnt recommend my way to others, as in my case, I was arrested again and this time refused being released. I made the courts aware of this and asked them to not to let anyone get me released, knowing my family had the influence to do so.
I knew that if I got out immediately, I would go right back to drinking on the way home.
They asked me at booking if I thought I would detox, and I said yes, from alcohol.
The nurse said if I started with DT's she would get me medication to ease it. The dt's were severe, and the meds seeemed to eventually help with the shaking, sweats and physical illnesses, but not sure if helped with them mental part.
I wish I knew what the medication was to tell you.
I remained in jail for 6 days, until I felt both physically and mentally I was ready to be released.
I had my dr contacted prior, so could stop on way home to be seen. I stated clearly my problems with alcohol, and what my dt's had been like.
The dr. prescribed me Lorazepam, which I believe is for nerves/anxiety. The shakes and sweats became less frequent, but occasionally occurred
I went to my first AA meeting that evening, and began to read the BB, and attend meetings daily, but it was more than I could handle.
After just 6 days, I checked myself into a local rehab unit for alcohol and drug abuse. They kept the medication the same, and added group and individual counseling while there. While there I read the BB and other AA lit. and focued on what to do once I got out.
I remained in house rehab for only 7 days, before checking myself out against their reccommendation.
I continued immediately to attend meetings, and all other things mentioned and shown to do.
I continued to take the meds faithfully for about 3 months, gradually reducing the frequency, and today I keep a prescribed bottle at home, but havent had the need to take one in over a month.
I believe that if I hadnt been confined or in the rehab unit most of the first 20 some days, I would have drank, and probably not stayed on the meds.
It takes time and work with or without the meds, alot of work.
I wish I had more to help you with than this.
Jack

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Re: Alcohol detoxification...

Post by Lali » Thu Jul 28, 2011 2:07 pm

Take him/her to the emergency room. They will not be given alcohol there. They will be given a mild tranquilizer type medication to avoid life threatening seizures. They will also be re-hydrated with an IV. Usually this procedure does not take more than a few hours, though some patients may be kept overnight. Even if you don't have insurance, most e.r.'s have to treat you.
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Re: Alcohol detoxification...

Post by Mike O » Thu Jul 28, 2011 2:16 pm

My opinion is that detox should be under medical supervision. Whether or not the degree of toxicity is such that, upon withdrawal, seizures may be a possibility is an assessment best made by a medical professional.

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Re: Alcohol detoxification...

Post by Tosh » Thu Jul 28, 2011 2:27 pm

Thanks for your info guys; it just goes to confirm my thoughts that there's no simple answer, so I'll pray and hope it all turns out well. I spoke to him this afternoon and he was off to a local meeting this evening and I'll take him to a meeting tomorrow.

@Lali; he's been given a weeks worth of diazapam which will protect him from fitting; it's a commonly prescribed drug for alcohol withdrawal according to wikipedia. And I don't 'think' he's that bad he needs hospitalisation; he's 26, a fit looking lad. When he wakes up the first thing he does is an exercise regime (it helps with his anxiety apparantly) and the second thing he does (hopefully 'did') is drink. But I've taken a lad to a hospital before, but he was in a far worse condition.

@Mike; in an ideal world that would be the best course of action, but he's already had one rehab and if he wanted another, he'd end up on a long long waiting list. I've another guy I worked with for a time dying, while he's waiting for a detox at a rehab; but he's had two already; and the docs prefer to prioritise those who've not had one yet, rather than giving the places away to those who've already had one. And I guess given the current financial climate, funding is tighter these days.
Come, come, whoever you are. Wanderer, worshiper, lover of leaving. It doesn't matter. Ours is not a caravan of despair. Come, even if you have broken your vows a thousand times. Come, yet again, come, come.” Rumi (No sniggering from the sex addicts)

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Re: Alcohol detoxification...

Post by Mike O » Fri Jul 29, 2011 12:45 am

Tosh wrote:
@Mike; in an ideal world that would be the best course of action, but he's already had one rehab and if he wanted another, he'd end up on a long long waiting list. I've another guy I worked with for a time dying, while he's waiting for a detox at a rehab; but he's had two already; and the docs prefer to prioritise those who've not had one yet, rather than giving the places away to those who've already had one. And I guess given the current financial climate, funding is tighter these days.
I understand that but even an initial visit to a GP, your examples above notwithstanding, so that a medical professional is aware of what is going on with the alcoholic in question is vital I feel.
Sorry to labour the point but it's my opinion that medical conditions are best handled by medical professionals.

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Re: Alcohol detoxification...

Post by leejosepho » Fri Jul 29, 2011 4:03 am

Mike O'R wrote:... so that a medical professional is aware of what is going on with the alcoholic in question is vital I feel.
I tend to agree, and at least "just in case" things might become complicated. I no longer recall the name of the medication used, but in the detox where I used to work they gave everyone who came in a "double shot" of something via syringe, and that stabilized vital signs as well as helping to filter out a few people who were really only looking for a place to get off the street for a few days! Overall, I think an ER is best for detox since they are only going to do what is actually medically necessary without getting caught up in a story problem and presuming to also begin some kind of treatment for alcoholism while picking and choosing who might get the next shot at a nice little vacation in a rehab center this month ... and then they leave the suffer alone so we can do what only we can actually do best.
=======================
"We A.A.s do not *stay* away from drinking [one day at a
time] -- we *grow* away from drinking [one day at a time]."
("Lois Remembers", page 168, quoting Bill, emphasis added)
=======================

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Re: Alcohol detoxification...

Post by John Boy » Fri Jul 29, 2011 8:49 am

I'm no doctor but in my experience in a actual detox they will give you Librium for for 3 days and that is it. After 3 days the chance of a seizure is rare. With other things like opium the detox process is much longer.

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Re: Alcohol detoxification...

Post by Lali » Fri Jul 29, 2011 10:49 am

Yes, Librium is the medication I was trying to think of. Like someone said, long term care isn't needed for detox, just emergency care as it is a short term problem. On the other hand, I would go to the doctor at some point and have bloodwork done to find out what kind of shape my liver and pancreas are in. Long term treatment may be needed for that.
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Re: Alcohol detoxification...

Post by Tosh » Fri Jul 29, 2011 1:49 pm

I picked up the guy I've been working with to take to a meeting and asked him how much he'd drank today, and he said 'nothing'! Howzat! His first 24 sober hours; and all his choice. I took him to a brilliant program orientated meeting, that had quite a few other young alkies in, and on the drive back home we had a good laugh swapping drinking and bed wetting stories.

He's got a weeks worth of diazapam (and vitamins) at a fairly low dosage; he was a bit shaky and sweaty; but so far he's making the effort and doing really well.

I've left him a load of speaker tapes (Clancy I, Chris R and Sandy B); I told him when I first stopped drinking, these tapes were a great help in that whenever I felt like I was about to 'snap' and drink, I told myself I could, but first I had to listen to a speaker tape first. Funnily enough, by the end of the tape, the 'moment' had passed. So I hope they work for him in the short term.

Very pleased for him, here! :mrgreen:
Come, come, whoever you are. Wanderer, worshiper, lover of leaving. It doesn't matter. Ours is not a caravan of despair. Come, even if you have broken your vows a thousand times. Come, yet again, come, come.” Rumi (No sniggering from the sex addicts)

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Re: Alcohol detoxification...

Post by Karl R » Fri Jul 29, 2011 4:27 pm

It's sort of ironic looking back on myself and my experience with sponsees.....that to stop drinking using the step taking program Alcoholics Anonymous suggests for relief from the mental obsession; one has to stop drinking briefly without the full benefit of the step taking program of alcoholics anonymous, (if that makes any sense....:-) )

Unfortunately (personal opinion).....this brief period sometimes stretches for years. Frustrating at times.

regards
Karl

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Re: Alcohol detoxification...

Post by leejosepho » Fri Jul 29, 2011 5:36 pm

Karl R wrote:It's sort of ironic looking back on myself and my experience with sponsees.....that to stop drinking using the step taking program Alcoholics Anonymous suggests for relief from the mental obsession; one has to stop drinking briefly without the full benefit of the step taking program of alcoholics anonymous, (if that makes any sense....:-) )

Unfortunately (personal opinion).....this brief period sometimes stretches for years. Frustrating at times.

regards
Karl
There is some insight along that line in the personal story "Anonymous Number Three" (right after "Dr. Bob's Nightmare") in our book's third edition. On page 186, we can read Bill D.'s account of Bill and Bob questioning him about whether or not he could "just walk out of the hospital and never take another drink", and then on page 188 we see them somewhat rhetorically asking him whether he can quit for twenty-four hours ...

... but then on the next page, we can see where he took Step Three "in the next two or three days" ... and we can then reasonably assume the remainder of the Steps followed right along.

Point: The idea of not drinking one-day-at-a-time cannot be found anywhere within our Basic Text, and yet a man being certain he actually can quit altogether for twenty-four hours can buy him just enough time to get from detox to permanent recovery.
=======================
"We A.A.s do not *stay* away from drinking [one day at a
time] -- we *grow* away from drinking [one day at a time]."
("Lois Remembers", page 168, quoting Bill, emphasis added)
=======================

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Re: Alcohol detoxification...

Post by someoneinaa » Fri Jul 29, 2011 6:00 pm

Isn't that the day I Surrender to the Truth about me?
Admit Step One to myself, and stop fighting it.

From then on, it all happens in just One Day.
knowing I'm powerless, I don't have to struggle...

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