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 Post subject: Feeling Conflicted. Am I Doing This Right?
PostPosted: Sat Jul 11, 2020 4:36 pm 
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Joined: Sat Jul 11, 2020 4:27 pm
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Tl;dr, ended up needing to go to detox for alcohol withdrawals pre-TSM. Family is pressuring me into 12-step AA meetings. I'm attending meetings, but I am doing TSM / drinking as well, which seems to defeat the purpose. I'm not binge drinking or drinking every day like I used to. (Week 1 post-detox, 11.1 drinks, week 2, 12.5 drinks). It's early days to tell if TSM is making this difference vs the freshness of the alcohol withdrawals in my mind, but should I go ahead and try to "white knuckle" it a bit and totally quit at this point?

Super Long Version

I tried to leave out irrelevant details, but I wanted to give some background leading up to what led me to take a serious look at medication for AUD, and what's making me feel conflicted about what the best approach is. I gave titles for each of the sections, so feel free to skip ahead / skim to the parts you're interested in :)

My backstory of problem drinking

I've been out of the range of what would be considered a "safe" amount of drinks per week for the past several years. Usually I would have at least 3 drinks per evening during the weekdays, and then binge drink with my friends during the weekends. I would guess this had me around 35 drinks per week in the beginning. If I powered on through "Sunday funday" I was increasingly finding that Monday hangovers included elevated blood pressure and heart palpitations. Towards the end, I had to leave work a couple of times to come home and throw up. And sometimes on Monday mornings I would wake up and feel like I needed a morning "hair of the dog" to fight the rebound anxiety and shakiness. I disclosed my usage with my doctor, and he confirmed that this was indeed an issue, but didn't offer much guidance other than encouraging me to cut down. I brushed it off somewhat, but I did stumble upon The Sinclair Method. While I was definitely intrigued and interested in giving it a try, especially to reduce the binge drinking, I wasn't motivated enough to make a second appointment with my doctor to discuss it and attempt to get a prescription. Oh how I wish I'd tried it sooner now.

Things get worse

Fast forward to quarantine, and the weekly average started to spike. Among the stress of the pandemic (and accompanying insomnia), the widespread riots and police brutality, the ability to pretty much drink whenever I wanted to, and the loneliness and boredom from social distancing, it was easy to slip into a habit of heavy drinking. I was probably up to 7 drinks per day during the week, and maybe 12 drinks during the weekend, sometimes starting as early as Thursday. I started to recognize this as a problem, especially the day-drinking during the work week, and decided to make tea in the mornings to give myself caffeine and something interesting to sip on other than alcohol during the day. This was effective, but as soon as the workday finished I would crave my evening drink.

About a month and a half ago things took a turn for the worse after a trip to the beach with a couple friends, when the drinks during the day made a comeback. Unfortunately, this habit stuck with me once I returned home. In the very back of my mind, I knew that I may have been in serious trouble at this point, but this was covered up with enough layers of denial and dismissal that the habit continued. Interestingly, I found that I wasn't getting as many hangovers at this point, but this may have been because I was at least a little buzzed fairly regularly.

Sh*t hits the fan

Fast forward even more to about three weeks ago, I was hanging out with the same friends on a lake trip. I got a good full night's rest that Friday. Saturday morning I initially felt fine. I was chatting with a friend when suddenly an extreme wave of anxiety washed over me. I tried to keep a straight face while the friend chatted with me, but I felt like if I didn't get a drink soon, things were about to get a lot worse. I immediately grabbed a beer out of the fridge and chugged it, and the symptoms went away. This was very concerning, but I thought "**** it, I'm not going to worry about this right now," and continued to drink for the rest of the day, putting off the symptoms until I could return home and deal with them then. That night when trying to go to sleep, the symptoms returned, with the classic hallmarks of alcohol w/d: sweats, shakes, extreme anxiety, nausea, elevated heart rate, etc. I drank just enough to where I managed to get two hours of sleep, then immediately left the following morning.

By the time I got back home, I really wanted to get more sleep. I was six drinks in, laying in my bed, and while I felt relatively normal, I was totally unable to sleep. A couple hours later, those drinks started to wear off. The symptoms started to get bad, then really bad, then nightmarishly, scary bad. The shakes started to get out of control, my blood pressure felt like it was shooting through the roof, and words could not describe the anxiety I was enduring. It felt like my brain was on fire, or melting, and all the synapses were firing at once. I felt like I might be on the brink of a seizure, and also felt like death was imminent. I looked back on my choices and could not believe I'd let myself get to this point. I was also shocked given that usually w/d symptoms are supposed to happen a few hours after the last drink (it was only about 3 hours after my last drink by the time things got severe), and I hadn't had any of these symptoms in the weeks prior to this point. In any case, I read up on the HAMS guide to tapering off of alcohol, and calculated the number of hours per drink my current habit equated to. From there, I started the taper, slowly sipping on the drink to last me the allotted time, to keep the worst of the symptoms at bay. Overnight, I went from 15 drinks/day equivalent, to 12 drinks/day equivalent, and had gotten no sleep. I was in pretty bad shape by this point, and was supposed to work that morning. Finally, even though I had no health insurance, I gave in and found a detox clinic to check into to avoid incurring any further damage to my brain and body.

Detox

I really don't have much to say about detox other than it worked like a charm. It totally removed all symptoms, and I was able to get a full night's rest each night. Strangely, during the check-in, I had to about an hour and a half between my last drink and the medication. If I had gone an hour and a half during my taper at home, the worst of the symptoms would have returned, but I felt totally fine at the clinic, even right up until they gave me my first pill. I also blew a .03 BAC, which I was expecting to be much higher. Thankfully this meant that they were able to medicate me as soon as I was done with the checkin process, but it made me wonder, would I have been ok if I had just stayed home and toughed it out?

In any case, I'd already made my choice. This detox facility was, as I assume most US-based facilities are, heavily oriented towards 12-step recovery. They had daily AA meetings, the patient booklet had the 12 steps in it, and the counselors were all pushing me to check myself into 12-step based inpatient rehab once I left (which I had no plans of doing, because, again, no insurance). It felt like things had gone from 0 to 100 in terms of all these drastic measures everyone was encouraging me to do to address this issue. None of my friends or family realized I had a problem, and they were all totally shocked. But now that they knew, I was getting pressured (mostly from my parents) to change all my life plans, check into a sober house, attend daily AA meetings, etc. Meanwhile, I felt like I'd learned my lesson. It was my first time in detox, and I had no intention of going back.

After—Present Day

My dad, who is a recovering alcoholic of 25 years and is heavily into AA, drove down to meet me and discuss what he felt was the best path forward for me. To my surprise, he told me that he wasn't sure if I was an alcoholic. His definition of an alcoholic is someone who has lost their ability to choose whether or not to drink. That said, his vision of the path forward for me, either way, was no more alcohol, ever again. After all, it was alcohol that had gotten me here. What sane person would want to continue drinking after reaching this point? My counterargument was, while at that time I had no desire to run out and buy a 6-pack, it was over-indulgence that had gotten me here—not just drinking, but drinking too much. I mentioned The Sinclair Method to him, and he was totally against it, and felt that this was "evidence" that I was indeed an alcoholic trying to become a normal drinker. I don't blame him given his success with AA, but he relapsed 4 times, spending time in a sober house each time, before he was able to get sober, and hit absolute rock bottom. This seems to be the story with most people in AA. I think you need that level of motivation in order to really stick to the program, but I digress.

Anyway, in a nutshell he pressured me into agreeing to attend 90 meetings in 90 days, and to agree to stop drinking completely. But not long after, I called MD Proactive (bless this online service during a pandemic) and within probably 1 hour I had a bottle of Naltrexone in my hand. The following evening, I took one of the pills, curious just to see how I felt. An hour later, my head felt a little bit tingly, and I felt maybe slightly stimulated, but that was about it. I had planned on taking the pill alone, but once it was in my system, and with two beers left in the cooler from my lake trip, I decided to try the beers with the naltrexone. The effect was interesting. It was almost like I felt a little slowed down, but I perceived a definitive lack of a feel-good buzz. I didn't feel a strong urge to drink the second beer after finishing the first, but I did anyway just to see if it felt any different with more alcohol. The answer was no, not really.

I didn't drink for the next 5 days (and didn't really want to) until a friend offered me a mimosa at brunch. I made the mistake of drinking this without the pill, before I'd read about the importance of 100% adherence. Even though I stuck to just that one mimosa, by that evening I was feeling a pretty strong craving for more alcohol. I proceeded to take the pill, bought a bottle of wine, and, careful to wait the full hour before drinking, proceeded to have four glasses before going to sleep.

That brings me to this past week, where I've continued to drink at a truly moderate pace. I'm taking the 100% adherence very seriously now, making sure to take a pill each and every time I plan on drinking. I've had at least one AF day in between each drinking day, and have been logging each drink in my TSM app. I'm up to 12.5 drinks this week, but have no desire to have any drinks today or tomorrow (Sunday). My last drinks were Thursday night, and I had these mostly because I couldn't sleep (I'd already taken a melatonin & valerian supplement which didn't help). I found, though, that this didn't help much either, and decided to use an OTC sleep aid the following night.

The point of this long-ass post & my questions:

It feels like I'm close to extinction already, even though it's only been two weeks since I even started this. Is it possible that going a full week AF in detox accelerated this process? Should I try and white-knuckle it a bit at this point and go for full sobriety, forever? I've been feeling guilty for having any alcohol post-detox since I told my family my plan was to go fully sober for the next 90 days, and I have no idea what I'm going to tell my dad if (when) he asks for an update on how things are going. I think he's going to be really disappointed that I drank this soon after getting out of detox, but it feels like things are going really well right now.

I'm also feeling a bit like an outlier compared to a lot of these stories I'm seeing, where people are starting at 50 drinks+ per week (seemingly without the need for detox and no w/d symptoms, those lucky duckies) and slowly trending downward over the course of 9-ish months. And if it's ok for me to continue drinking, is it ethical for me to continue attending AA meetings when the only requirement for membership is a desire to stop drinking? Even though things seem to be heading in the right direction, I'm feeling a bit lost as to what the best approach is.


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