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Providing non-judgmental and non-criticizing support for family and friends of end-stage alcoholics through one-on-one coaching, support groups, blog posts, workshops and public speaking.

Wednesday, November 2, 2011

There's a pill for that...

Back in the 60s, I lived at the edge of Berkeley and many of my friends were students at the university. It was a wild time. Free love whenever and with whomever. Free flowing drugs such as “grass” and “acid”. Wine was consumed at a higher rate than water. Peace rallies and sit-ins. The establishment of disestablismentarianism. Those were the days, my friend.

For me, it was a very short time of reckless abandon. After all, I had a baby and a job. While my friends could simply skip a class, I had responsibilities. So while my friends were tokin’ on whatever, I had a couple glasses of wine and then saw to it everyone got home OK. I was the watchkeeper – the caretaker. I was one of the very few who can say, I was there, I was involved and I never participated in any of the drug experimentation.

It’s a funny thing about drugs. Most are designed to help us get though whatever medical issue we are facing and even cure certain ailments. Others are designed to generate a feeling of living in a different world – much like the “acid” of the 60s. They create a fantasy world and the only one inside the world is the user of the drug. Sometimes that fantasy world is much more desirable than the real one.

Alcohol is a drug. It may not be in pill form, but it is still a drug that gives the user and altered point of view. It can make them feel invincible, intelligent, sexy, strong and in control. The truth is they may already be all those things without the alcohol, but they just don’t believe it. The alcohol makes them feel good. When they become hooked the way out is unpleasant – detox, rehab – and believing the truth that they really are good people without the alcohol and monsters with the alcohol – is sometimes impossible to get the alcoholic to accept.

Over the years, drugs have been developed to aid alcoholics in their quest for a way out of the addiction. I think Riley has tried them all.

After Riley’s first rehab center (compliments of the Navy), he started taking Antabuse. This was the first medication approved by the USFDA in the treatment of alcohol abuse. It creates a negative reaction to drinking alcohol, so in effect it is aversion therapy. If alcohol is consumed while taking Antabuse, the alcoholic will be physically ill. I believe the most common is vomiting.

Riley is a smart guy who hates being sick in any manner. After leaving the rehab center he was required to report back to the center each and every morning for his daily dose of Antabuse. He could then proceed on to his duty station for a regular work day. It all sounded good in theory. But it didn’t take long for Riley to “outwit” the counselors at the center.

After taking his daily dose, Riley would proceed to the bar just outside the base gates. He then downed a couple of shots of scotch, go to the men’s room and vomit it up along with the Antabuse. He was then able to drink the rest of the day without incident.

The next venture into drugs for the cure of alcoholism was Campral. There has been great success with this drug which was approved by the USFDA in 2004. Campral works in the brain to restore a chemical balance. It suppresses the craving for alcohol. I have a reader who has achieved great success with this drug and after several years of use, has no desire for alcohol at all. It isn’t that he’s able to refuse the alcohol – he simply does not want it. Impressive. I say we should spike the water supply with the stuff! But… wait a minute… that may not work.

Riley was at end-stage and a last ditch effort to cure his addiction lay in the hands of an addictionologist that I had found through a family doctor. Riley was told he could continue to drink, but to take the Campral and for me to keep track of how much he was drinking. Over a period of three months, I did see a slight decrease in his consumption. But it was too little too late for Riley. He ended up in ICU and once again just barely avoided the grasp of the grim reaper.

After his release from the hospital and the nursing facility (he chose not to go to rehab), I asked if he wanted to resume the Campral as a safety measure. His answer was an absolute NO. In the most sober mind that I had seen in him in years, he declared that he did not want to be sober and if Campral would make him sober he didn’t want it.

Additionally, during the time he was taking the Campral, he was also taking Lactulose which is used in the treatment of constipation is a manmade sugar that pulls water into the colon. The addicitionologist told me that it would help move the toxins from his brain and make Riley easier to deal with when he was antagonistic. During the three months he took the laxative, Riley was even more antagonistic. He didn’t like the laxative effect because he could not make it to the toilet quick enough. He refused to wear depends and results were unpleasant for everyone. Riley fought taking the liquid and threw temper tantrums when I told him it was time for him to take it.

There are other drugs out there that claim to aid in recovery of alcohol addiction. Such as Naltrexone which blocks that “high” feeling that are obtained from alcohol consumption. USFDA approved a once-a-month injectible form of the drug. The regimine is about  a year long.

During his “sober” period, I suggested that Riley might want to give this drug a try. But, once again, he told me that if it would prevent him from “feeling” the way he feels when drinking – he would not want to take it. Riley drinks for the effect of the alcohol. He doesn’t want to stop and lose that effect.

In my opinion, these drugs probably DO work for people who truly want them to work. But there is always the same caveat – they MUST WANT to stop drinking. Riley gets some reward from staying drunk. It doesn’t matter what the reward is, it exists for him. To live without that reward is not acceptable for him. He does not WANT to stop drinking. It is very difficult to argue with his logic especially when the logic is expressed during a time when his brain is the least alcohol saturated.

Just as I did in the 60s, I am the watchman – the caretaker. I watch Riley deteriorate. I take care that he does not cause outsiders any harm. This is my role. I know it well. I don’t live in Riley’s fantasy world. Even if I were invited in, I would decline the invitation.


jo said...

hey guys! just a couple comments. the dr you talked to, linda, was misinformed about lactulose. yes, its a sugar to cause bowel movements. BUT..it removes ammonia from the intestine and binds to it. not toxins FROM the brain. since mine has crohns, all i need is him crapping on everything even worse! lol..

the antabuse works as mines lack of the gene we talked about before on facebook. the asian syndrome of a lack of a gene to metabolize alcohol into other metabolites. since it poisons them, they throw up. mine drinks anyways..so antabuse would not help.

campral im not familiar with.

but addiction is a complicated genetic as well as life style choice. no pill will magically stop or fix that. they need the desire to live,,along with intense therapy.

interesting post! but yet another pipe dream of pop a pill and fix yourself. wont work.

ahhhh the 60's. what a wonderful time of my life also.

Syd said...

Linda, my father-in-law who has cirrhosis was on Lactulose. It is used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body. If ammonia builds up in the brain, it can cause a coma and death. Just a bit of clarification for those with cirrhosis.

Linda (Immortal Alcoholic's Wife) said...

Jo and Syd -- Thanks for the info. Your explanations make more sense to me than mine does. --Linda

Anonymous said...

Have any of you heard of a drug/medicine called Librium, my alcoholic is currently being assesed to see if he is strong enough to start a 2 week detox. Last time he tried to stop drinking was over a year ago and after 2 days he lay in the snow screaming, arms flailing convinced the neighbour had posted thousands of fleas through the letter box! Im guessing this was the start of DTs? He started drinking again that night. Anyway our Doctor and counsellor says as he is agraphobic the detox will happen at home with a doctor visiting daily to give him the Librium. Ive read the post (The truth about detox) and obviously detox at home is scaring me to death. Does anyone have any advice etc regarding coping with him detoxing at home? My name is Wendy by the way. I live in the UK

jo said...

librium,.here in the usa, is a anti anxiety med, also addictive. i dont blame ya, i would think he needs far more attention --and precautions--than he could get at home. (please know we have diff names for drugs than you do over there)

it would scare me too!

i dont think ,unless he is sedated and watched closely for seizures, the librium will do more than take off the edge.

i think expecting you to handle this is terribly unfair.

good luck!

jo said...

for anonymous...


this is about librium...its a benzodiazpine...with a long half life. i hope his liver can handle it.

Eli said...

Hey everybody! I've got a few comments to share as well. I took Campral and found it to be amazingly effective. I agree with Linda that the A has to WANT to be sober in order to make it work. One also has to be seeking outside support (psychiatrist/counselor and AA meetings) rather than just taking the Campral and believing that all will be fixed thanks to a round, white pill. Campral isn't a cure. Unfortunately, we live in a society that thinks we can just take a prescribed medication, and we'll be fixed. This mindset won't work for someone who really wants to be sober. Also, Campral is very expensive, even with insurance, so it would be a huge waste of money to buy/try it if the A isn't determined to give it his/her best shot.

Wendy (Anonymous)... if you have the resources for your A to NOT detox at home, by all means, take advantage of them. Librium issue aside, your A isn't going to remember anything while detoxing; however YOU will. It's not pretty and can take a toll on you as well. Also, it seems quite odd that if your A is agoraphobic, why on earth wouldn't the doctor want to have your A in a controlled setting? (I'm not a doctor, so it's just my opinion from personal knowledge and experience.)

I, too, agree with Jo.. The Librium seems like an all-around bad idea. :-(

Colleen said...

Mine took Naltrexone for a while, and it was/is effective in both reducing cravings and blocking the drunk.
He was unwilling to keep his dr appts, though..and now says he does not want to stop.
I really and truly do not understand how he is keeping his job.
He drinks 24/7 on weekends and as soon as he gets off of work.