My descent into alcohol dependency and what to do about it?

General health and lifestyle
1

Well, I feared it would happen - and am afraid it has.

A taste for alcohol (that was not dangerous for over 25 years) finally bcame toxic due toa series of seriousluy negative life events in close succession over the past year, resulting in several admissions to hospital (some necessary, some due to others' anxiety), at least one seizure, rib injuries, and me damaging my house superficially.

At the behest of others, I tried a locally, religiously-based rehab, but they were a law onto themselves and, to be honest, most of those there had been there many times before and got worse each time.

I have now referred myselkf to the NHS Community Addictions Team and am determined to access anti-cravings medication.  In fact, I have told them that, if they won't prescribe it to me, I will buy it myself.  I did actuallly manage to speak with an Alcohol Liaison Nurse during the week, and she was at least realistic enough to see that, while it would be idral to stop drinking altogether, much less would be much better than a continuation of regular heavy binges that are, sooner or later, bound to cause gradual physical health deterioration (which I have so far avoided) or a serious accident.

It relly does seem as if the rehab industry is built on a proposition of failure for repeat business.  Spiritual mumbo-jumbo and scary DVDs about the curses of alcohol (and nicotine, gambling, illegal or prescription drugs) really don't work (IMHO).  In fact, they would drive you to drink/nicotine/gambling/drugs.

The question is: which is the best of these anti-cravings drugs?

I honestly never saw myself in this position, but it has happened, and I just hope I can get out of the fix I'm in.

2

Hi Gavin,

Here is a list of the medications available on the NHS.

Campral - Prescribed to those who are abstinent and are attemtping to remain abstinent.

Naltrexone - As above, but can be used for The Sinclair Method which I will give you a link to below.

Nalmefene - Prescribed to those who are currently drinking and to help them reduce their drinking.

The above three are anti-craving medications.  There is a fourth medication called Antabuse that does nothing for cravings, but will make you very sick, and potential hospital/death situation if you drink on it.  For some reason, this type of old-fashioned 'aversion' style, punishment medication is still often prescribed on the NHS so do not be surprised if this is what they try to suggest to you.  In the long term, it does nothing to actually weaken the pathways in your brain that associate alcohol with reward and strengthen each time they are reinforced by drinking.

I mentioned The Sinclair Method, which is not often known by that name by doctors or addiction specialists, but it involves taking either naltrexone 1 hour prior to drinking, or nalmefene 2 hours prior to drinking.  With compliance and awareness when you drink, this is an extremely successful method of weakening those strengthened pathways in your brain and therefore reducing your cravings, which in turn will reduce how much you drink over a period of months - right down to abstinence if you wish.

Here is a link to another page on this website that gives you a brief overview of the method:

https://patient.info/health/sinclair-method-for-alcohol-use-disorder

3

The only thing that works is "readiness" of an individual.

I was always told when entering detoxes...rehabs...that a very low percentage of individuals are really ready to stop.  Many people go for vacations from home life, kids, work responsibilities (or work is forcing people to go or they won't have jobs), jail (prisoners are forced to go to show they want to get better to enter the community)....etc...etc..

gav....you sound like you are "ready" to cut down but not quit all together....and there are ways to manage your drinking.

I'm sure you have read about the Naltraxone.

25 years is a long time....and that just means you are about my age...and the more we drink...the sicker we get at this age.

Keep posting.

4

That sounds like a very poor excuse from the rehab places Missy. I accept that a person needs to really want to resolve their alcohol problem but I find it appalling that treatment facilities can blame their clients for ALL failures of treatment and never consider their methods of treatment. If, indeed, the key element is 'being ready' and those that are will mostly succeed, then rehab facilities should do better assessments and only take money from those they believe fulfil their 'ready' criteria. In reality, many don't mind their less than 10% success rate because it is very profitable.

AA takes a similar approach. AA CANNOT POSSIBLY be wrong. If it doesn't work (as it doesn't for more than 90% of people), then they say it is the fault of the drinker, NOT the fault of AA. There are people who find AA helps them and they should continue to use it, but too many people are just made to feel worse and worse about themselves when treatment methods, which don't work for the vast majority of people, don't work for them.

Can you imagine any other medical disorder where people are blamed when treatment doesn't work? Imagine if 90% of people who had heart attacks died and it was said 'well, it's because the patients failed' rather than 'our response was not fast enough, or good enough or our treatment was inadequate.' It just wouldn't happen, would it?

5

There is a huge percentage of failure rates for rehabs due to the examples above...I know as an alcoholic that I have been there many times for some of those reasons...and I never got better because I wasn't ready.

If an alcoholic isn't ready to quit...the best rehab, counselor, Dr...is useless.

6

ps..my X had a heart attack and quard heart surgery....and he did NOT listen to what they told him...he was in huge denial and under a car pulling out a motor after quad...surgery on his heart.

He is lucky to be alive...but he had good Drs...and he just wasn't ready to change his lifestyle.

 

7

Sorry for your troubles, but thanks for delivering a dose of reality to the NHS! Really, your POV on this is quite refreshing, as the mumbo jumbo is what's offered over 90% of the time. For the rehab industry, it's almost better than a seat on the Supreme Court. 

I have used the Sinclair Method that Joanna mentions. I was a daily drinker for over 30 years and before TSM was drinking 12 beers a day (9 pints) every day. I started TSM in January and as of the last 60 days I've had 14 beers. A six pack of my favorite pints sits in the fridge and that same six pack has been there for going on two months now. Using TSM has largely erased the compulsion to drink. It's as if the addicted and compulsive part of my brain has largely forgotten what beer is for.

8

Missy, I don't doubt that some people are not ready and have no real desire to stop drinking. However, it is all too convenient to blame drinkers for their treatment not working. This is over 90% failure rate we are talking about.

9

Thanks for all the replies, folks.

The Alcohol Liaison Nurse who I spoke to a few times last week was actually a breath of fresh air and quite realistic in her approach.

Of course she said that it would be better if I did not drink at all, but said she realised how hard it is to kick the habit.

She also didn't 't doubt me when I told her that my problem was lonely, solitary drinking.  I don't know any of you personally, but I I am being completely honest when I tell you that if I was in your company, in a pub, chatting, I could quite happily sit with you and have 3-4 pints over 3-4 hours and sit and chat, prererably with food.  I would feel no compulsion whatsoever to 'neck' the drink or have spirits.  In fact, I'm sure I'd be behind others when it came to consumption.

The ALN concerned also said to me that, if I must drink, I should avoid spirits, eat, have a couple of days off per week, and be moderate of course.  She was aso sensible enough to concede that it is infinitely preferable to take medication that is highly likely to substantially reduce alcohol intake, compared to continuing to drink at dangerously high levels.

Am  I ready to quit?  Boredom is at the root of a lot of this, but of course there is at least an element of addiction.

Rehab?  When  I went to the local, religiously based one (which is a charity and not expensive - it was £60 per week), most of those there had been there before at least once and often many timesmore than once, so the evidence was that it didn't work.

That's why I am determinded to try one of the medication methods, though it does seem unjust that ba GP or psychiatrist (in Northern Ireland anyway) cannot presribe such treatment - it has o be via the Community Addictions Team.

But, as I have said, if they won't prescribe such treatment, I hsve the means and will (somehow) buy the drugs myself.

I'll speak to the Addictions' people (in the NHS) tomorrow and mention 'The Sinclair Method' and these various drugs.  I assume that, besides me buying the drugs myself, there is also the option of having private treatment and accessing them that way?

By the way, I won't be touching Antibuse with a barge pole.  I want to recover and either stop or seriously reduce my drinking - not risk death by other means.

Cheers,

Gavin.

10

The person who was explaining the statistics of his facility was not making excuses.  He was stating facts...and many in the room were nodding heads in agreement.

People shared that they were there for wives, jobs, prison...

My message for gav...which he states himself in his own original post...is it is clear he is not ready...he is speaking "much less will be better".

His post in contrast to the posts recently by lori....are strikingly different in the desire to remain sober...and therefore I stated he was not ready.  And tried to let him know that he is not alone and that most people that enter rehabs are not entirely ready.

And not that it is the "drinkers" fault that they are not ready....when you are not "ready" and an alcoholic the fact is the statistics are bad that you will remain sober.

Until the "gift" of sobriety is there...there is little hope for sobriety regardless of having the best Dr., rehab or counselor in the world.

I know...I've been to many detoxes, rehabs, counseling sessions...and there was nothing wrong with them or their programs...it was all my desire to stop drinking was never totally there...until 11 years ago....and now....I pray for that desire daily....to return.

 

11

LOL..yes, i have had a serious reaction to Antabuse and it is no fun.

And Antabuse is not a drug to curb cravings...as you know it is ONLY to make you sick if you drink (a deturent that doesn't work for most alcoholics).

I hope you get to use the Sinclair method if you want to...it sounds like the "desire" to use this method is stronger than the desire for you to quit altogether..which in my mind...means you will have a really strong chance of success with this method.

I HATE that your area is so difficult when it comes to helping people live healthier/happier lives....what a JOKE....

Would buying the drugs online yourself be illegal?  I am not sure about buying drugs on line...I did read a little bit about it once and I interpreted the deal to be...if you are not ordering a "controlled substance" than  you would not be prosecuted if caught.

Is that true?

 

12

I agree, and the problem is, that many who are involved in the industry, do not understand the physical addiction, the mental addiction (neural pathways semi-permanently affected) and most importantly, the psychological addiction which is at the root of most people's problems.

If people were actually properly qualified counsellors that didn't have some NVQ or whatever it is, but actually understood the whole process, they would have a far higher success rate.

Once you can understand the whole process, you can explain it to someone with an alcohol problem. Once they understand what it is that drives them to drink, then they have the tools to help  themselves.

But, we are stuck with this whole moral fibre attitude. That pervades the whole 'support' process that are available to people. The fact that they still think, moral fibre or Antabuse is the answer, shows their complete lack of knowledge on the subject.

13

I told e medical practitioner that I would buy the drugs if I had to.  I would see that conversation as practitioner/patient confidentiality, would only be using the medication for my own use/benefit, gain no profit from same, and not be supplying them to anybody else.  Illegal or not, I doubt if I would be prosecuted - the defence of protecting my own life would be a strong one.

Anyway, we'll see what happens.

14

If you are in the UK, and buy medication like, Campral, nalmefene and naltrexone and import it, that is totally legal.

If you buy benzos like diazepam, that is a C class controlled drug, then that is illegal. Not likley to be punished if it is very small quantities for personal use, but it is illegal.

15

Unfortunately, it seems few are aware of Natrexone or Selincro, let alone TSM. NICE guidelines lay out what's appropriate for when, but it seems community guidelines can override that. 

16

Ready seems to be a variable, relative state, based on the demands and efficacy of the treatment. By this measure one may not be "ready" for one treatment though they are for another, that is that their ability to respond favorably to the treatment depends on the particulars for that person. So, this isn't an absolute state and the treatment itself can capture more levels of "readiness" that show up in the alcoholic population at large. I do think that people can be ready/not ready for a given method of treatment, i.e., not ready for strict abstinence, but ready for TSM, baclofen, or ready for abstinence when combined with something like Campral or Topamax. 

Sobriety is also a word that can mean moderate. Saying someone is sober doesn't not always mean that they are abstinent. You woudn't look at someone that has a couple of glasses of wine over the weekend and accurately say that they aren't sober. You could say that they aren't abstinent. A person that is moderate or temperate in their alcohol use is also sober.

17

I wholeheartedly do not agree that you can say someone is sober without being abstinent.  But, everyone has their own opinion.

I just looked up the definition....although sober can mean other things in various context...in relation to alcohol...it means "without alcohol".

18

The people selling are more likely to be in trouble when it comes to benzos. I think the police would be more interested in where they came from than who had bought some. Having said that, it's crazy to buy benzos online because if somebody is selling those, they are clearly not reputable and you never know what you will actually get.

19

The word 'sober' means 'without alcohol in the body' at any particular point in time. So a person who doesn't have an alcohol problem but does sometimes drink alcohol will be sober most of the time, but occasionally not sober.

Legally, you can drink a small amount of alcohol and drive a vehicle. If you passed the breathalyser test, you would be considered 'sober' by the law,

The word has been adopted by organisations like AA to mean 'totally abstinent all of the time.' So it really depends on the context smile

20

When you put it that way...I can agree that there are sober people...like my mother that doesn't have an alcohol problem...and can have a drink, be under the legal limit...and still live a "sober' life.

My mother does not need to take a pill to have a drink.  That said, I have NEVER put down the Sinclair method because I do see positive results with some people.

However, I will never agree that an alcoholic can consider themselves sober if they are drinking (at all).

I have lived both "sober" and with alcohol in my system.

I'm an alcoholic...alcohol in my system is BAD at any level.