Trying to stick with the doctor's plan
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Trying to stick with the doctor's plan
I always knew it was going to be tough to quit alcohol, but I'm really only just learning how tough. Through my attempts to stop I've been struggling with (and being defeated by) sweats, shakes, anxiety, depression and cravings. I've now been to speak to my psychiatrist. My wife came too.
What my psychiatrist told me I found surprising.
After listening to me describe the situation and the problems, she asked what my alcohol intake was. I worked out it was approaching one hundred units per week in three or four nights of twenty-plus unit binges. I felt it had been at that level for a few months, but that it was particularly heavy as more normally I drank perhaps thirty to fifty units a week. My wife said she felt I had always drunk more than thirty to fifty units.
My psychiatrist said that she would refer me to the alcohol recovery team, but, and this was the surprising thing, that in the meantime I should not stop drinking. My blood pressure and various other observations were worrying, and she felt I needed to wait until I had specialist support in place.
So, she divided my week's units by seven, and said that I should limit myself to that amount of units per night. She said I should only have that amount of alcohol in the house at the time I started to drink. I should drink this amount for two weeks, then reduce it by one can. Again, after two weeks, remove one can. I should continue with this until either I had stopped drinking or my referal to the alcohol support team came through.
That was last week, on Thursday I think. I've tried to follow the advice, but my God, it's been a complete nightmare.
I managed the first night to stick to the six can limit. The next night, I almost didn't drink at all, but then I did. I stuck to the limit, but I found myself feeling really angry. The following night, for reasons I really can't remember, I didn't drink. I remember I was irritable as hell. The night after this, there were six cans in the fridge (my "ration") but I knew there were two more cans somewhere in the house. My wife had hidden them. I asked her where they were, but she wouldn't tell me.
What did I make of this? Well, would you believe that in a dumb temper I went out to the shop and bought another eight cans? Yup. Then, intending to "show her" and stick to my six can limit despite these extra cans being available, I of course drank twelve.
The following night (last night) I didn't drink, though I was extremely depressed and anxious, and that brings me to today - when I should have six cans for the evening but there are only three in the fridge and cans are much cheaper in eight packs...
And the other thing is, I'm starting drinking as late as I can hoping I'll be sleepy when I finish the last can. It doesn't work. I just end up having almost all my head time day and night given over to freaking out about beer and getting by.
Clearly, I'm driving myself round the bend. It feels as though I should just carry on regardless until the alcohol referal team gets in touch. But then, should I persist, so maybe I'll have a head start when they do get to me? Or maybe I'll have no head left at all. After all, it's been a while since I really flipped out loco...
Sigh. Why can't I follow a simple plan? Why in the hell can't I just think straight? Act straight? Be just a ****** regular frickin' guy?
What my psychiatrist told me I found surprising.
After listening to me describe the situation and the problems, she asked what my alcohol intake was. I worked out it was approaching one hundred units per week in three or four nights of twenty-plus unit binges. I felt it had been at that level for a few months, but that it was particularly heavy as more normally I drank perhaps thirty to fifty units a week. My wife said she felt I had always drunk more than thirty to fifty units.
My psychiatrist said that she would refer me to the alcohol recovery team, but, and this was the surprising thing, that in the meantime I should not stop drinking. My blood pressure and various other observations were worrying, and she felt I needed to wait until I had specialist support in place.
So, she divided my week's units by seven, and said that I should limit myself to that amount of units per night. She said I should only have that amount of alcohol in the house at the time I started to drink. I should drink this amount for two weeks, then reduce it by one can. Again, after two weeks, remove one can. I should continue with this until either I had stopped drinking or my referal to the alcohol support team came through.
That was last week, on Thursday I think. I've tried to follow the advice, but my God, it's been a complete nightmare.
I managed the first night to stick to the six can limit. The next night, I almost didn't drink at all, but then I did. I stuck to the limit, but I found myself feeling really angry. The following night, for reasons I really can't remember, I didn't drink. I remember I was irritable as hell. The night after this, there were six cans in the fridge (my "ration") but I knew there were two more cans somewhere in the house. My wife had hidden them. I asked her where they were, but she wouldn't tell me.
What did I make of this? Well, would you believe that in a dumb temper I went out to the shop and bought another eight cans? Yup. Then, intending to "show her" and stick to my six can limit despite these extra cans being available, I of course drank twelve.
The following night (last night) I didn't drink, though I was extremely depressed and anxious, and that brings me to today - when I should have six cans for the evening but there are only three in the fridge and cans are much cheaper in eight packs...
And the other thing is, I'm starting drinking as late as I can hoping I'll be sleepy when I finish the last can. It doesn't work. I just end up having almost all my head time day and night given over to freaking out about beer and getting by.
Clearly, I'm driving myself round the bend. It feels as though I should just carry on regardless until the alcohol referal team gets in touch. But then, should I persist, so maybe I'll have a head start when they do get to me? Or maybe I'll have no head left at all. After all, it's been a while since I really flipped out loco...
Sigh. Why can't I follow a simple plan? Why in the hell can't I just think straight? Act straight? Be just a ****** regular frickin' guy?
Last edited by CarolD; 01-26-2009 at 04:16 AM.
Om, Aum, Ohm...
Join Date: Jul 2005
Location: Punxsutawney/Pittsburgh
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Maybe you're alcoholic? Limits didn't work for me, either. All or nothing, and if it was available, it was all.
How long, do you think, until you have medical supervision to detox?
Peace & Love,
Sugah
How long, do you think, until you have medical supervision to detox?
Peace & Love,
Sugah
but perhaps you should call her back
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"perhaps you should call her back and discuss your mental situation"
I guess... but she seems very reticent about treating the alcoholism - even associated anxiety and other symptoms - until I have the specialist team available.
I guess... but she seems very reticent about treating the alcoholism - even associated anxiety and other symptoms - until I have the specialist team available.
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First welcome to SR BovinePieBear, it is a darn shame that you have to wait 6-8 weeks......... I have to assume that your psychiatrist is not very familiar with alcoholism, to tell an alcoholic to control thier drinking is kind of like telling some one with a real bad case of diareah to wait an hour before going to the bathroom!!!!!
I know when I was drinking if I had one I was going to continue to drink until it was all gone, I passed out, or went to sleep!!!!!
Is there any way they can get you in earlier? Try calling the psychiatrist back and telling him you can not control it, tell your psychiatrist the whole truth and that you need to get in as soon as possible. Here in the states I know some folks who have gone to the emergency room to get detoxed!!!
Do the best you can for now, I will have you in my prayers.
I know when I was drinking if I had one I was going to continue to drink until it was all gone, I passed out, or went to sleep!!!!!
Is there any way they can get you in earlier? Try calling the psychiatrist back and telling him you can not control it, tell your psychiatrist the whole truth and that you need to get in as soon as possible. Here in the states I know some folks who have gone to the emergency room to get detoxed!!!
Do the best you can for now, I will have you in my prayers.
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Hi Tazman. 
I discussed the idea of quitting completely and immediately with my psychiatrist, but for many reasons (that she outlined) she felt it would be dangerous for me to do that without close, comprehensive, expert support. I have absolutely no idea whether she thought I'd be able to cope with the cutting down plan - perhaps it was an experiment, I don't know! - but I had the strong impression that she was au fait with alcoholism, at least from a psychiatric perspective.
Hmmm... yes. 
I've already been assured that I will be treated as a "high priority." Whatever that means. 
I discussed the idea of quitting completely and immediately with my psychiatrist, but for many reasons (that she outlined) she felt it would be dangerous for me to do that without close, comprehensive, expert support. I have absolutely no idea whether she thought I'd be able to cope with the cutting down plan - perhaps it was an experiment, I don't know! - but I had the strong impression that she was au fait with alcoholism, at least from a psychiatric perspective.
"I know when I was drinking if I had one I was going to continue to drink until it was all gone, I passed out, or went to sleep!!!!!"
Is there any way they can get you in earlier?
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Uh...
Maybe you should talk to your primary care physician...trying to moderate intake can result in disaster, and I have a hard time understanding why she told you to moderate in order to stop.
If your psychiatrist is worried about physical withdrawal and your general physical health, she should refer you to a hospital or clinic where you can detox SAFELY.
Maybe you should talk to your primary care physician...trying to moderate intake can result in disaster, and I have a hard time understanding why she told you to moderate in order to stop.
If your psychiatrist is worried about physical withdrawal and your general physical health, she should refer you to a hospital or clinic where you can detox SAFELY.
I got nothin'
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Originally Posted by bovinePieBear 
Hi Tazman.
I discussed the idea of quitting completely and immediately with my psychiatrist, but for many reasons (that she outlined) she felt it would be dangerous for me to do that without close, comprehensive, expert support.
I discussed the idea of quitting completely and immediately with my psychiatrist, but for many reasons (that she outlined) she felt it would be dangerous for me to do that without close, comprehensive, expert support.
That's why many people check into a hospital to detox. She should have told you that...
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Hi Bamboozle.
Well, I don't know. Evening out my intake seemed to be important since my binges led to such dangerous levels of intoxication. Getting me thinking about control? A test? I just don't know.
Yup, she did tell me that, but there's a procedure. She has to refer me to the alcohol team, and only they can decide on my rehab/detox plan.
She said that the options certainly will include hospital as a detox location, but that there is a preference for community detox. (I have a strong suspicion that this is a funding issue, but that's just the way it is.) Either way, she said, I'd have 24 hour care... though I really don't see how this could happen in my home. Hmm.
hard time understanding why she told you to moderate in order to stop
That's why many people check into a hospital to detox. She should have told you that...
She said that the options certainly will include hospital as a detox location, but that there is a preference for community detox. (I have a strong suspicion that this is a funding issue, but that's just the way it is.) Either way, she said, I'd have 24 hour care... though I really don't see how this could happen in my home. Hmm.
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Originally Posted by bovinePieBear
Yup, she did tell me that, but there's a procedure. She has to refer me to the alcohol team, and only they can decide on my rehab/detox plan.
Hello.
Wow...you can't just walk into an Emergency Room? I'm sorry, bPB...hang in there.
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Join Date: Jul 2008
Location: Los Angeles, California
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BpR,
The Salvation Army most certainly can help! Give them a call or stop by. And let us know what happens. In my city, they have a detox program and I believe it's free.
Love,
Lenina
The Salvation Army most certainly can help! Give them a call or stop by. And let us know what happens. In my city, they have a detox program and I believe it's free.
Love,
Lenina
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Join Date: Oct 2008
Posts: 57
This sounds like an urgent care/emergency to me. 6-8 weeks is ridiculous. You need more immediate attention. Your primary care physician is probably in a better position to get a more immediate referral. You need to be persistent until you find someone who will get you the care you need. Tell them you need help today. Don't accept 6-8 weeks as their answer. Tell them that is unacceptable, and speak with a manager/supervisor at your health insurance company or whoever is telling you that.
When I wanted an appointment at a neurologist, they tried to give me the run around. I just kept calling them and told them to either see me or I was going to an emergency room. My primary care doctor made room to see me that same day and was able to get me a referral/appointment to the neurologist 4 days later. But I had to be very persistent to get this done. If I had done things their way, I would probably still be waiting to see the neurologist.
When I wanted an appointment at a neurologist, they tried to give me the run around. I just kept calling them and told them to either see me or I was going to an emergency room. My primary care doctor made room to see me that same day and was able to get me a referral/appointment to the neurologist 4 days later. But I had to be very persistent to get this done. If I had done things their way, I would probably still be waiting to see the neurologist.
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You say (in your first sentence) that quitting is tough. That's true, but in my opinion, your psych. is making it tougher than it needs to be. Alcoholics like us cannot control or cut down our drinking. That's pretty much a definition of alcoholism.
You say that there are a number of reasons you are being told not to quit. I'm not a medical professional (just a humble alcoholic of many years experience) but as far as I know the only reason professionals normally tell alcoholics not to quit is fear of DT's with seizures. In that case you could talk to your GP about doing a home detox using librium or similar. Tell him/her that the moderation plan isn't working. Home detox still needs a degree of discipline, but your wife could take control of the meds and it's a lot easier than trying to moderate alcohol intake. You could then even consider taking in an AA meeting or two (which I never liked to do if I'd been drinking).
If you're concerned about "going behind the back" of your psych. or jeopardising your appointment with the alcohol team, please remember that your health comes first. Call your psych. if necessary and tell her that the plan isn't working.
Simon
You say that there are a number of reasons you are being told not to quit. I'm not a medical professional (just a humble alcoholic of many years experience) but as far as I know the only reason professionals normally tell alcoholics not to quit is fear of DT's with seizures. In that case you could talk to your GP about doing a home detox using librium or similar. Tell him/her that the moderation plan isn't working. Home detox still needs a degree of discipline, but your wife could take control of the meds and it's a lot easier than trying to moderate alcohol intake. You could then even consider taking in an AA meeting or two (which I never liked to do if I'd been drinking).
If you're concerned about "going behind the back" of your psych. or jeopardising your appointment with the alcohol team, please remember that your health comes first. Call your psych. if necessary and tell her that the plan isn't working.
Simon
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Lenina - thanks, I might just give them a call, and if I do I'll let you know what they say.
Jessie911 - Well, I hope I've kind of started to "get proactive" about it, joining here and looking for medical support, but I really am beginning to realise the enormity of what's in front of me.
Ralph9898 - Well, sadly in my experience public and health services here in the UK don't respond to being hounded. The systems are... somewhat inflexible. Queues are defined on a certain basis, you are given your place in them, and that is that. However, I will get back in touch with my psychiatrist - it's clear that most people think I really need to stress my case. Thanks for your help.
Slimey - Thanks for your thoughts. As it happens I'm seeing my GP tomorrow regarding my BP, blood tests for lithium and various other health issues. However, because I am in the mental health services now ALL my mental health care needs are deferred by my GP to them.
I have spoken about my alcoholism with my GP, and she is certainly interested in monitoring my physical health because of it, but my addiction care per se is to be handled by the psychiatric team, at least once I have been taken on by the recovery team...!!! The recovery team are the ones who will decide whether I detox at home or in hospital, with or without whatever medication and in what measure. That is what my psychiatrist has told me, and that is what my GP will tell me. That is the system!
Sara9009 - Thank you for that. I will talk to my GP and psychiatrist about the possibility of moving things faster, and hopefully they'll be able to help. I'll also try to talk to the Salvation Army, so maybe I won't be completely without help. And thankfully I also have everyone here...!
Jessie911 - Well, I hope I've kind of started to "get proactive" about it, joining here and looking for medical support, but I really am beginning to realise the enormity of what's in front of me.
Ralph9898 - Well, sadly in my experience public and health services here in the UK don't respond to being hounded. The systems are... somewhat inflexible. Queues are defined on a certain basis, you are given your place in them, and that is that. However, I will get back in touch with my psychiatrist - it's clear that most people think I really need to stress my case. Thanks for your help.
Slimey - Thanks for your thoughts. As it happens I'm seeing my GP tomorrow regarding my BP, blood tests for lithium and various other health issues. However, because I am in the mental health services now ALL my mental health care needs are deferred by my GP to them.
I have spoken about my alcoholism with my GP, and she is certainly interested in monitoring my physical health because of it, but my addiction care per se is to be handled by the psychiatric team, at least once I have been taken on by the recovery team...!!! The recovery team are the ones who will decide whether I detox at home or in hospital, with or without whatever medication and in what measure. That is what my psychiatrist has told me, and that is what my GP will tell me. That is the system!
Sara9009 - Thank you for that. I will talk to my GP and psychiatrist about the possibility of moving things faster, and hopefully they'll be able to help. I'll also try to talk to the Salvation Army, so maybe I won't be completely without help. And thankfully I also have everyone here...!
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How about a local AA meeting? I am sure there are some in your area who have had to medically detox and they could probably suggest alternatives. That universal health care doesn't look too promising for alcoholics - I mean, it was not possible for me to slowly wean down to zero, or just a few drinks.
When I drink and try to control it - eventually I just drink more...happens time and again.
When I drink and try to control it - eventually I just drink more...happens time and again.
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When I drink and try to control it - eventually I just drink more...happens time and again.
I wonder about attending AA meetings. The thing is, I'm wary of conflicting advice adding to my difficulties. I was worried about it when I posted these experiences here, but so far nobody has said the thing that I most feared: ignore the psychiatrist and just stop, NOW.
From my experience of people in AA in the past there was a fairly clear antagonism felt towards the medical approach to alcohol treatment. But I have to trust my GP, and I have to trust my psychiatist, and I have to trust the alcohol recovery team. I have to trust that they know what they're doing, and that they really can help me to overcome this addiction and achieve a rich, full and most of all sober life.
So, I would find it impossible to deal with some kind of split loyalty thing where I was being told that this way to recover was better than that way to recover... Maybe it wouldn't happen. I hope it wouldn't. But I know it might.
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