Forced Sobriety and Falling off the Wagon

[tayberhecate]

I have a few questions about alcohol withdrawal and relapsing - I have some of the basic facts but have little idea what some of the effects will be. Hopefully someone here can help me out?

Comments

[beauty_forashes]

Oh boy, do I have experience with this one myself during my drinking days. He'll have all the symptoms you listed, probably, and his disorientation won't be slight, it'll be pretty extreme. You can't even cross a street because you can't guess how far a car coming on is away. He'll also have severe insomnia for days...many days (I was once awake for nine straight days, which is one thing that causes hallucinations. Once you sleep again, those get better).

As to drugs, long-acting drugs, such as chlordiazepoxide (Libritabs, Librium), oxazepam (Serax), and halazepam (Paxipam) are usually the better choice, but in a hospital you're usually given valium and/or haldol, intravenously since you'll be puking your guts out. You also want him on an anti-convulsant (I got half a pill, so I assume it's half the dose, but I don't know what it was, sorry). I don't think drinking again would interfere with that medication, but I'm not a doctor, so I don't know.

Will they simply cease once he's got alcohol in his system again, or will they more

[tayberhecate]

The slight disorientation was from when he sought medical attention, I sort of figured it would get progressively worse. And insomnia was already something he struggled with, so that will be extra entertaining.

augh, I knew I forgot something while giving my rundown. >.< His drink of choice is Midori. I'm not certain where that falls on a scale of beer to vodka. He does have other drinks too, but at the point where he starts drinking again? Midori, likely straight from the bottle.

Yeah, I didn't think it would help his mental state any. Not much is, at present, which is frustrating. His recovery is a loooong sloooow work in progress.

I'll be sure to ask, if I can think of anything else. Thanks so much for all your help! :)

[beauty_forashes]

I'm not certain where that falls on a scale of beer to vodka.

That has an alcohol volume of 20% according to Wikipedia, so it basically falls in the middle. He'd be drunk again pretty fast depending on how fast he drinks it (and alcoholics tend to drink very fast, since you drink for effect rather than enjoying the taste of the beverage, so you're seldom just sipping the way non-addicts do).

His recovery is a loooong sloooow work in progress.

Yep, it often is that.

Most welcome - ask away! :)

[marycatelli]

The question is whether they would really let him out after keeping him overnight. Remember that alcohol withdrawal can kill. Not just from itself, though that's possible, but also because they can suffer terrifying hallucinations that cause them to leap out of windows.

[tayberhecate]

The private medical clinic he went to is in the same building as his apartment, just downstairs, and he was accompanied the entire time he was in withdrawal. So he does have easy access to more medical attention if necessary. Furthermore, that aspect of it is (unfortunately) out of my hands; this is for an RPG. The treatment described and the release for outpatient care was what the doctor characters' players offered. To be honest, I already suspected at least two of the doctor characters of malpractice anyways, so that would just play right into that more.

Thank you for bringing that up, though! You raised some good points.

[beauty_forashes]

Sorry to jump in, but here (Germany) they let you out after 24 hours even if the police bring you in...not sure what it's like in the US, but here it's that way. You sign a paper that you're leaving on your own responsibility and that's it.

But you're right, alcohol withdrawal is one of the types of withdrawal that can be deadly because of seizures, as far as I know it's even the only drug that can cause deadly seizures because the GABA receptors in the brain futz out (the receptors that control stuff like electrical impulses vital to the body, such as heart function...but then I'm not a doctor). When and if delirium sets in, you usually know what's going on, and that it's hallucinations. He'd have to have a secondary mental condition if he jumped out the window because of that. But yes, they're terrifying all the same. You may know you're hallucinating, but it's a very scary experience.

[marycatelli]

Theodore Dalrymple reported that attempting to jump out the window was so frequently among them that he tried to persude the hospital to put the ward with the detoxing alcoholics on the ground floor.

[tayberhecate]

You pretty much confirmed everything I'd already been thinking about on that subject. :) Caffeine withdrawal, I am familiar with, but I'm not a drinker by any means. But from what research I did, this is about what I figured would happen. Thank you!