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Suggest Ways To Taper Off Alcohol
Question: mY BROTHER IS AN ALCAHOLIC & AFTER BEING CLEAN FOR 5 YEARS HE LOST HIS FIANCE HE FELL OFF THE WAGON. HIS SPONSER BELIEVES HE HAS BEEN DRINKING FOR 2 WEEKS STRAIGHT AS THEY HAVE NOT BEEN ABLE TO TALK TO HIM FOR THAT LONG. wE WENT TO GET HIM & HE HAS BEEN WITH US SINCE 3AM SUNDAY SO NO BEER SINCE THEN. hE IS 54 & IT LOOKS AS IF HE HAS LOST 20 LBS OR MORE. HE IS STILL HAVING DIFFICULTY WALKING & WITH FINE MOTOR SKILLS.IS THIS NORMAL? WE HYAVE BEEN PUSHING HIM TO DRINK & HE IS TRYING ,GIVING POTASIUM & ASPIRIN
Brief Answer:
several things.
Detailed Answer:
without being there I cannot diagnose, prescribe, nor treat. But that isn't what you want anyway.
Assessment and management of the immediate alcohol withdrawal situation is quite variable. Here's the key point: people withdrawing from alcohol in the first day to 1 week can have seizures and die. OBviously, most people who have gotten drunk don't have this. More likely to be serious if:
more alcohol, for a longer continuous time.
BUT the big predictor is whether people have had any seizures/brain injury/withdrawal psychosis/withdrawal hallucinations. No previous alcohol withdrawal anything, and the risk is lower.
And other medications. If someone is on other drugs of abuse, if someone is on TRAMADOL/ULTRAM/WELLBUTIN/ZYBAN/COCAINE/BUPROPRION these increase seizure risk. Not on them, not increased risk but there is still the same baseline risks.
Management of someone withdrawing from alcohol if NOT at risk. Risk drops after 3-4 days. The main thing is to lower excitation of the nervous system. Dark, quiet room, not a lot of stimulation if it can be avoided. Food. Multivitamin especially b complex. Fluids and potassium (and also coca cola for phosphorus and calories) are another significant issue. If someone is dehydrated, this can be a problem. If someone cannot keep anything down then they need to be in the hospital for IV hydration. If someone has breathing problems, incapacitation, delirum, these are bad and need ER.
Assuming someone does NOT need inpatient monitoring and treatment (which is the safest choice by far), then food, vitamins, hydration, and calm first few days. THen, there is a real question of counseling.
A key point is the loss of a spouse in decompensation. Realization that meaningfulness really is the potential for grief/pain/loss is a key point in transcending the loss. Realization that having a better life is a celebration of the relationship. Tricky, because negative feelings of sadness, guilt, regret are the usual triggers of abuse behavior.
several things.
Detailed Answer:
without being there I cannot diagnose, prescribe, nor treat. But that isn't what you want anyway.
Assessment and management of the immediate alcohol withdrawal situation is quite variable. Here's the key point: people withdrawing from alcohol in the first day to 1 week can have seizures and die. OBviously, most people who have gotten drunk don't have this. More likely to be serious if:
more alcohol, for a longer continuous time.
BUT the big predictor is whether people have had any seizures/brain injury/withdrawal psychosis/withdrawal hallucinations. No previous alcohol withdrawal anything, and the risk is lower.
And other medications. If someone is on other drugs of abuse, if someone is on TRAMADOL/ULTRAM/WELLBUTIN/ZYBAN/COCAINE/BUPROPRION these increase seizure risk. Not on them, not increased risk but there is still the same baseline risks.
Management of someone withdrawing from alcohol if NOT at risk. Risk drops after 3-4 days. The main thing is to lower excitation of the nervous system. Dark, quiet room, not a lot of stimulation if it can be avoided. Food. Multivitamin especially b complex. Fluids and potassium (and also coca cola for phosphorus and calories) are another significant issue. If someone is dehydrated, this can be a problem. If someone cannot keep anything down then they need to be in the hospital for IV hydration. If someone has breathing problems, incapacitation, delirum, these are bad and need ER.
Assuming someone does NOT need inpatient monitoring and treatment (which is the safest choice by far), then food, vitamins, hydration, and calm first few days. THen, there is a real question of counseling.
A key point is the loss of a spouse in decompensation. Realization that meaningfulness really is the potential for grief/pain/loss is a key point in transcending the loss. Realization that having a better life is a celebration of the relationship. Tricky, because negative feelings of sadness, guilt, regret are the usual triggers of abuse behavior.
Note: In case of any other concern or query related to prevention, evaluation, diagnosis, treatment, or the recovery of persons with the any type of addiction or substance use, follow up with our Addiction Medicine Specialist. Click here to book a consultation now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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