I have regularly drank 1.5 - 2 bottles of wine a night for years. I quit cold turkey several times and never had withdrawal symptoms, at least not any requiring any kind of medical supervision. I only drank at night though. That being said I guess everybody is different, and your circumstances could be different even if ours sound the same.

The treatment under TSM for withdrawal symptoms would be having another drink. This is something you couldn't do if you took antabuse. I'd say it'd be safe to start antabuse 24 hours after your last drink because that's the longest time it takes for withdrawal symptoms to start to kick in. But to be safe I'd go 3 days abstinent before taking antabuse if medical supervision weren't a possibility.

D2M

http://alcoholism.about.com/od/withdraw ... 040604.htm

Serendipitously, it appears that the Valium you were on before was just what was required!

Regarding your question above - people cured using TSM are effectively 'tapering' - i.e. gradually reducing their consumption until they are no longer physically (or psychologically) dependent on alcohol - at which point there can be no withdrawal.

If you are determined to quit cold turkey, then I strongly urge you to get medical help. In the meantime - maybe you can try some 'tricks' to help reduce your consumption - e.g. have a soft drink every second or third drink, or drink a large amount of water to fill you up a little.

I'm not sure about that Lo0p, in my detoxes I have always been told that 72 hours (three days) is the riskiest time for life-threatening seizures. If you take antabuse you won't be able to stop the seizures by doing the one thing that would stop them (aside from large doses of sedatives, which you almost certainly wouldn't have on hand) - which is having a drink.

This is just what I understand from what I have been told.

That's why I italicized "start." You're not gonna have seizures at 72 hours if you don't have the shakes and anxiety and 24 hours.

Are you sure? Do you have a link to research about that?

D2M, I didn't read all of this but pm'd you first so most of that is moot! I would be afraid to go cold turkey without doctor's supervision at the amount of wine that you have been at. Hopefully you can reduce your units somewhat and continue with TSM as we are all trying to do. Good luck! There are quite a few of us in this boat!

Do I have research?

The Alcohol Withdrawal Syndrome
[Brown CG: The alcohol withdrawal syndrome. Ann Emerg Med 11:276- Charles G. Brown, MD 280, May 1982.] Baltimore, Maryland


"Stage One occurs approximately six to eight hours after the reduction or cessation of ethanol intake. At this point, patients begin to experience mild tremulousness, anxiety, nausea, vomiting, and insomnia. There is often a craving for alcohol or other sedatives. On examination the patient is easily startled, is often diaphoretic, and has an obvious tremor. The tremor characteristically oscillates at about six to eight cycles per second and is made worse by agitation. Depending on the amount and duration of ethanol consumption, the patient may be tachycardic, mildly hypertensive, and hyperreflexic. 1°,11 The symptoms and signs of this stage are often shortlived, most resolving in about 24 hours.

Although the second stage may take up to six to eight days to become manifest, it usually begins within the first 24 hours following the cessation or reduction of ethanol intake. 1° The hallmark of this stage is the development of hallucinations which are often heralded by illusions. Symptoms of disordered perception occur in only about one-quarter of all tremulous patients. 12 The autonomic hyperactivity of Stage One continues through this stage and becomes even more pronounced. The hallucinations are usually auditory, but may be visual, tactile, olfactory, or mixed. Visual hallucinations are usually less unpleasant and less threatening to the patient than are the auditory hallucinations. Between hallucinations the patient is lucid and will have partial or complete amnesia for the hallucination.

The characteristic feature of Stage Three is the occurrence of grand mal seizures. Three to four percent of untreated patients progress to Stage Three. More than 90% of the seizures occur from 7 to 48 hours after discontinuation of ethanol. 13 From one to several seizures usually occur over the course of a few hours. More than half these patients will have multiple seizures during withdrawal. 5 Thirty to forty percent of those who develop withdrawal seizures go on to develop delirium tremens if untreated. Onefourth of these patients with seizures progress directly into delirium tremens without a lucid interval.

The last and most serious manifestation of the withdrawal syndrome is delirium tremens (Stage Four). This stage usually begins three to five days after ethanol withdrawal, but may be seen as late as 14 days. TM The majority of patients who develop delirium tremens following withdrawal seizures do so after a lucid interval of between 12 hours and 5 days. This stage is characterized by marked autonomic hyperactivity (tremors, diaphoresis, fever, hypertension, and tachycardia), illusions, hallucinations, and global confusion. Seizures rarely occur after the development of delirium tremens. Only 5% to 6% of the patients who withdraw from ethanol, if untreated, go on to develop delirium tremens. 6 In approximately 15% of the patients, the delirium resolves in less than 24 hours; in more than 80% it resolves in less than three days."

Despite what I have stated in other posts to you before, I see we are alike in this regard. Pre-"cure", when I was with my chosen social group, I would drink a lot less or not at all. In fact, it was the cause of my early AF days before TSM week 16/17 where things started to change. I could NEVER have a voluntary AF day before then, without external influences. Where we differed is that I have a highly unstructured job and social life and since I was/am a lone drinker, the circumstances often allowed me to drink anytime I was alone or at home. So I now understand your Sunday situation. It is not the day, it is the circumstance. If that circumstance were on a different day or days, you would likely be abstinent on those days too.

The thought occurred to me that you sound more like an alcohol abuser and not an alcoholic. We can debate the terms. Some say they are the same, some say they are different. I am still not sure what to believe, although I tend to think they are different. Pure abusers may not be addicted. I am sure if there is in fact a difference that there are many shades between the two (e.g. 30% addicted, 70% abuser). I think I may have been a combination of the two, if there is even a difference.

Is it possible to change your circumstances? That seems likely to have a very strong positive improvement on your life.

Bob

Thanks for that, Evan. I learned something. There were a few times when I quit drinking after huge binges where I got the shakes, racing heart, high blood pressure, was sweating, thought I was going to die, etc. I thought that was the DTs but it wasn't -- it happened within 24 hours so it must just have been a withdrawal.

NP nick. I've got this cool new thing now. I've got this VPN set up that goes from my computer through Johns Hopkins University's network to Google Scholar. So I can just go to Google Scholar and google anything I want and I get results which are full texts of any research studies that have been done on whatever I googled. I don't have to crawl through the individual journals looking for the study I want anymore I can just google it. Badass!

Does this make me a geek?