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Practical Advice About Detox and Getting Sober

Specific emotional or mental health problems, like anxiety, depression, insomnia, confidence etc. Along with bodily health, exercise, nutrition.
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caroline95
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Re: Practicle Advice About Detox and Getting Sober

Post by caroline95 » 29 Dec 2012 20:45

This is a great idea for a thread :D

I couldn't work out how to link to an individual post, so apologies if this is a bit lengthy.It's a post by our own Smudge, which covers a lot of the basic information about detox and withdrawal and gives some useful links too:

"One of the things that would help you to give up drinking is to think about exactly how you do your drinking and how you get your supplies. Think about the answers to the following questions :

1) What do you drink?
2) When do you drink?
3) When do you buy your drink?
4) Do you go out for more drink late at night when you are already drunk?
5) Do you always have drink in the house because other adults in your house drink?
6) Where do you drink?
7) Do you drink alone in your house, alone in the pub, or in company in the pub?
8) When you drink and you had planned not to, at what stage did things go wrong?
9) Do you have plenty of easily-cooked, easily-digested food in the house?
10) Do you have a good selection of hot and cold alcohol-free drinks in the house?

When deciding you want to give up drink it is important to realise that it doesn't happen just by magic or just by wishing. It really has to be planned carefully to maximise your chances of success. Look at your own habits and see where your desire to stop drinking breaks down and you find yourself caving in to the lure of booze. And having identified where things break down try and work out how to reduce the chance of it happening in the same way again. Also, ask us for advice. We might make suggestions to help you improve your chances of success that you hadn't thought of.

It helps if you learn as much as possible about what to expect during detox, and in the weeks and months following detox. If people are unprepared they are more likely to succumb to the lure of booze. So, ask questions. Lots and lots of questions. I doubt there is anything you can say about alcohol recovery that somebody on the forum hasn't also gone through already.

When I was still drinking I was an evening drinker. If I had to go to the shops in the late afternoon or evening I could guarantee I would buy booze. I had to stop that somehow, and I did it by buying all the food and alcohol-free drink I needed as early in the day as I could possibly manage it. And I tried to arrange things so that I didn't need to go to the shops more than once a week if possible. Apart from planned shopping trips I tried to make sure I didn't need to leave the house with money. After I had walked the dog in the early evening I would go home and get pyjamas on. I also accepted that socialising would have to be hugely curtailed, but it was a price worth paying. I was prepared to be bored. (Have plenty of books, computer games and DVDs available. Some people start knitting or sewing or painting.) I knew it wouldn't be forever.

One other thing... It is a good idea to take high dose thiamine (Vitamin B1) pills for the first three months or so of getting sober.

For various links on the subject of thiamine supplementation in alcoholics take a look at the post I made here

The first link I give in that post is the easiest to understand. For heavy drinkers it is important to take thiamine if they want to have a working memory after getting sober.

Good luck!

P.S. If you develop the shakes or hallucinations then call NHS Direct (0845 4647) or dial 999. Alcohol withdrawal in heavy drinkers can induce a fit which can be fatal. It is best if someone can be with you to monitor you while you go through withdrawal. If you already know that these things might happen to you, then don't even start withdrawing on your own, go and see a doctor and be honest about your drinking. It could save your life!
Last edited by caroline95 on 30 Dec 2012 14:24, edited 1 time in total.

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Jake.
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Re: Practical Advice About Detox and Getting Sober

Post by Jake. » 29 Dec 2012 21:37

Great idea. Here's some from me. I'll have another think soon

1. Eat a healthy diet with complex carbohydrates, proteins and veg to keep your blood sugar levels stable. A dip in blood sugar can cause a craving!

2. Drink plenty of fluids, anything non alcoholic! Try and avoid too much caffeine

3. Keep full! If you are full alcohol will tempt you less

4. If you're tired, go to bed!

5. If you can't sleep keep busy! Consult your doctor about sleeping tablets if insomnia's a problem, anything's better than drinking again!

6. Avoid places that prompt an urge to drink at first

7. If you're angry escape the situation if you can, have some large deep breaths

8. Exercise. It uses up stress hormones healthily and boosts energy levels

9. Take a good B vitamin supplement. I use Berocca for a multivitamin aswell

10. Don't be afraid to treat yourself now and again

I like the word HALT from the AA aswell. Don't be Hungry, Angry, Lonely, or Tired.
Last edited by Jake. on 29 Dec 2012 23:19, edited 4 times in total.

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Re: Practical Advice About Detox and Getting Sober

Post by grendeldave » 29 Dec 2012 21:38

Yes, I fully endorse all of that. I don't want to scare anybody but alcohol really is dangerous. Please do not let your pride put you in danger. It is not worth it. You may feel worthless right now but trust me. You are most certainly not.
Desire is an illusion unless it is a streetcar. Don't get run over.

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Re: Practical Advice About Detox and Getting Sober

Post by loosebanana » 29 Dec 2012 23:17

When I was really on my knees and could hardly walk or eat my doctor recommended complan. So I drank a pint of that every day with milk and it helped rebuild my physical strength.

Once the hard part is done eating becomes easier and not a chore.

Also strong b-vitamin compound and thiamine tablets. Just keep taking them for a long time, tell the doctor about your drinking and they should give you a repeat prescription.

I've done a few detoxes now.

I found combating stress was an important part, lots of rest, some gentle activity, accepting that you might be quite fragile for a while.

Then look for a programme of support.
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caroline95
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Re: Practical Advice About Detox and Getting Sober

Post by caroline95 » 30 Dec 2012 14:42

A lot of us use this Drinking Diary as a really useful motivational tool.

It's easy to use, and you get a lovely turquoise square for every day you stay sober.It's such a good feeling when you start to see those turquoise squares adding up :D .

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Re: Practical Advice About Detox and Getting Sober

Post by DannyD » 31 Dec 2012 07:07

There's a boredom plateau that we all appear to hit at about the 2 month goal - though this will vary for people. I coped by knitting constantly. Other activities are available.
be selfish in your sobriety.

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Re: Practical Advice About Detox and Getting Sober

Post by PandaGirl » 31 Dec 2012 08:40

Vitamins and mineral supplements help. Alcohol takes its toll on the body, so replenishing the stocks is important during recovery.

I use Magnesium-B, which I take at night, and I find it helps restful sleep. Probiotics are also good to help settle the stomach, especially the nausea that can hit in the early days, and they recolonise the gut with good bacteria, which alcohol kills off, hence why IBS frequently goes with excess alcohol intake. Best ones are a probiotic with added prebiotic, like Optibac or Bimuno. Some people also find Intest-aid IB helpful, if the irritable bowel type symptoms are really bad initially - they're expensive, but worth it if you're plagued by stomach problems because they settle things down.
I also take Omega 3's, which are meant to have a beneficial effect on mood and brain function, extra Vitamin C, and Sea kelp for iodine and calcium. I found that calcium supplements ahem, blocked me up, but the sea kelp doesn't seem to.

The other thing that I found helped was switching to Lo-Salt because it contains potassium, alcohol can play havoc with your electrolyte levels and potassium deficiency can cause fatigue, mood swings, anxiety, heart palpitations, muscle weakness, spasms and cramps. Other good sources of potassium are bananas, milk, dates, apricots, green veg, peas and beans.
“In order to succeed, your desire for success should be greater than your fear of failure.” – Bill Cosby

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caroline95
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Re: Practical Advice About Detox and Getting Sober

Post by caroline95 » 31 Dec 2012 14:36

A guy named John Cheese made a series of videos called 9 Videos That Prove Anyone Can Get Sober and posted them on You Tube.

I can't recommend them highly enough.Again, I think the original link came from Smudge - thanks Smudge! :D

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 31 Dec 2012 18:11

A bit of useless info for you, Caroline - I found out recently (from wikipedia) that John Cheese's real name is Mack Leighty. I wondered what it was like to grow up with a surname like "Cheese", and I'm rather pleased he didn't have to. Glad you liked the links! :D
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 31 Dec 2012 23:23

It's New Year's Eve and over the next two or three days the site is likely to have a larger than usual supply of new members, so I thought it was a good time to post some links about quitting booze.

You need to know that giving up alcohol cold-turkey without medical supervision may lead to permanent memory problems, brain damage, seizures (fits), stroke, heart attack, DTs (delirium tremens), and death.

If you involve your doctor before you have stopped drinking then they can arrange the appropriate level of care you need or (more likely) refer you to an alcohol support agency to help you detox safely. Many doctors are reluctant to deal with people with alcohol problems because they (the doctors) don't have the appropriate knowledge or training they need. So being referred to an addiction agency is quite common.

The following are some links you can read to help you determine your level of risk in giving up alcohol :

Alcohol withdrawal - an article from the main BE site

Alcohol withdrawal syndrome (a wikipedia article)

Symptoms of Alcohol Withdrawal

Alcohol Withdrawal Syndrome

How do I withdraw from alcohol safely?

Amy Winehouse and the perils of alcohol withdrawal - a New York Times blog article

Alcohol withdrawal (from the webmd site)

+++++++++++++++++++++++++++++++++

It really helps to make an informed decision about how you can withdraw from alcohol safely if you can work out the number of units you are drinking each week.

I found this calculator which makes the job an easy one (at least for people using UK measurements) :

http://www.cleavebooks.co.uk/scol/ccalcoh2.htm" onclick="window.open(this.href);return false;

All you need to know is the Alcohol by Volume (AbV) and the amount of alcoholic liquid you are drinking. The AbV is the strength of the alcohol in the liquid. For example, a standard bottle of wine in the UK often has an AbV of 12% and contains 750 ml. of wine. Stick those figures in to the calculator and it tells you that if you drink the entire bottle of wine you will have consumed 9 units of alcohol in total.

If you decide to record your consumption of alcohol on a daily basis then the Drinking Diary that Caroline linked to earlier does a similar job and is very popular.

+++++++++++++++++++++++++++++++++

Despite my comments about how dangerous it can be to go cold-turkey as a way of giving up alcohol, please be aware that with the correct support from the medical profession or addiction agencies the risks can be reduced to almost zero.
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 01 Jan 2013 00:17

Some terms people use :

Detox, PAWS & Rehab

Detox (short for detoxification) is the acute withdrawal phase of getting sober - generally covers the first 5 - 7 days of withdrawing from alcohol, although in severe cases it can last longer. For people at risk of suffering severe withdrawal symptoms, a supervised detox is essential. Supervised detoxes can be done at home, in residential care or in hospital.

PAWS (Post acute withdrawal syndrome) describes what happens to some people after going through detox. There is a separate thread about PAWS on BE which can be found here.

Rehab ( short for rehabilitation) is an optional phase that people can go through after detox. Sometimes people say "I'm going into rehab". What they usually mean is that they will go through a supervised detox either in residential care or in hospital and then they will have a period in residential care where they get counselling and assistance in learning how to live a sober life. There are some unsatisfactory situations where detox and rehab are organised completely separately and there might be a delay after detox before rehab can begin.

Edit : One thing I should have mentioned - many people get help to go through detox, either through the NHS or by paying privately. Rehab can be more problematical. Some people stay in rehab for months and obviously the costs mount up. I've heard anecdotal evidence suggesting that it is much harder to get rehab help than it is to get detox help on the NHS - rehab places are scarce and waiting lists can be long. When dealing with professionals it is important to be precise about exactly what help you are asking for. And ask about rehab early on - don't leave it until after you have been through detox.
Last edited by smudge on 01 Jan 2013 22:12, edited 1 time in total.
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 01 Jan 2013 17:59

Sorry about this, but I'm just going to post information as it occurs to me, so it will be a bit haphazard.

One thing I discovered when talking to doctors is that they don't know of any alternatives to AA when it comes to getting support. If AA is a good fit for you then that's fair enough. It didn't suit me at all, mainly because I couldn't deal with the "I am powerless over alcohol" ethos. I don't believe I am powerless at all! Also, I could never get my head around the "higher power" stuff. But there are many other ways and means of getting support for alcohol addiction issues. To find your local alcohol support services try doing a web search for "your town/city/county name" plus :

"alcohol support services"

"community alcohol support"

"alcohol addiction support"

or similar phrases.

Some helpful links :

An NHS search page for addiction support services around the country

Alternatives to AA

Alcoholism help - with or without AA

I got sober solely with online support from BE and (in the early days) I also attended meetings once a week run by my local Alcohol Support Service. I know that some BE members do use AA and get on well with it. People have to find what works for them.
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by Topcat » 01 Jan 2013 19:16

Wow Smudge - take a bow for all these great links you've dug out. Fantastic Smudge (::) (::) (::) (::)
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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 01 Jan 2013 22:02

Thanks Topcat! :D I'm trying to put together the kind of information I wish I had known just before I took the plunge with getting sober. I know now that I was dangerously ignorant and didn't even realise it!

And I still have a fair amount of info to post. But it will take time.
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 02 Jan 2013 12:26

In my earlier post - this one - I mentioned the dangers of giving up alcohol cold turkey and also stressed that seeking medical advice is strongly recommended.

There is another way to give up alcohol which is less dangerous than giving up cold turkey, and that is tapering off or weaning yourself off alcohol over a period of time. It isn't a subject I know much about so I'll just give a very few links about it.

Detoxing Safely (Tapering Off) - a thread here on BE

How To Taper Off Alcohol

More on tapering off alcohol

I want to stress that tapering off is not an easy option and can still be extremely dangerous!
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 06 Jan 2013 23:22

Thiamine / Thiamin / Vitamin B1

If you drink heavily or alcoholically (or have done in the recent past), there is an extremely good chance that you are suffering from vitamin and mineral deficiencies. Even if you consider your diet to be good, many drinkers have digestion problems - diarrhoea, indigestion, gastritis - and these can affect absorption of vitamins and minerals. Also, just metabolising all the alcohol that we drink depletes some vitamins and minerals. One of the vitamins that drinkers may be very low in is thiamine (also spelled thiamin, and also known as vitamin B1). The consequences of thiamine deficiency are severe (and can be fatal).

Wernicke's encephalopathy (WE) is an extremely serious condition that can arise as a result of an acute lack of thiamine in the brain. The symptoms include eye movement problems, gait ataxia (staggering and lack of coordination even when sober), confusion, confabulation (making things up without realising you are doing it), and short-term memory loss. According to wikipedia only about 10% of sufferers will display ALL the classic signs - eye problems, confusion and ataxia.

One of the problems for alcoholics is that they may already be extremely short of thiamine but show no signs of WE. Then when they begin a cold-turkey detox without any medical help, the process of detox itself depletes thiamine stores even further. So, detox itself could precipitate WE. If any of the symptoms occur then get yourself to an A&E department immediately, tell the doctors that you are a heavy drinker/alcoholic and you have begun a cold turkey detox. They should give you intravenous injections which can help to replace the missing vitamins. There is no guarantee, even if treatment is begun quickly, that a full recovery will happen.

If WE is left untreated (or treatment is begun too late) it may lead to Korsakoff's Psychosis (KP). The combination of both WE and KP is known as Wernicke-Korsakoff Syndrome [WKS}. The most noticeable long-term effect of WKS for the sufferer is problems with memory. In severe cases it can lead to people needing permanent long-term care.

So, what does all this mean? If people get medical help to go through detox they are likely to be treated with something called Pabrinex which is a vitamin cocktail (containing thiamine and also vitamins B2, B3, B6 and C) injected intravenously. But if detox is done without medical support it is essential that people help themselves and take appropriate vitamins. In the case of thiamine this consists of 3 x 100mg tablets spread throughout the day for at least three months and possibly for as long as a year. For anyone who continues to drink it should be taken indefinitely.

Paragraph added on 31st Jan 2013 : WE/KP/WKS is most likely to happen in the very early weeks of detox and sobriety. If you have escaped all the symptoms of WKS by the 4th week of sobriety (that is just an educated guess by the way, not a fixed-in-stone number) then the chances of you developing it must be quite small. If you continue to drink large quantities of alcohol then your risk obviously remains high and taking high-dose thiamine should become part of your daily routine.

[This whole subject of vitamin supplementation is very important to me because I didn't know this stuff when I went through a cold turkey detox in April 2010 without medical help. I was diagnosed with WKS last month (December 2012) - far too late for any form of meaningful treatment to have any effect. I'll write about it in another post on this thread at some point.]

I have a lot of links and sources for this information. Some of them are heavy going (sorry!) :

Guidance For The Prescribing Of Vitamin And Mineral Supplements For Hospitalised Patients With A History Of Excess Alcohol Consumption

DETOXIFICATION FROM ALCOHOL

Pabrinex Intravenous High Potency Injection

The Role of Thiamine Deficiency in Alcoholic Brain Disease

The Royal College Of Physicians Report On Alcohol : Guidelines For Managing Wenicke's Encephalopathy In The Accident And Emergency Department

Alcoholism and Nutrition

Acute Thiamine (Vitamin B1) Deficiency

THIAMINE ADMINISTRATION IN ALCOHOL-DEPENDENT PATIENTS

THE TREATMENT OF PATIENTS AT RISK OF DEVELOPING WERNICKE’S ENCEPHALOPATHY IN THE COMMUNITY

B VITAMIN DEFICIENCY AND NEUROPSYCHIATRIC SYNDROMES IN ALCOHOL MISUSE
Last edited by smudge on 31 Jan 2013 14:39, edited 1 time in total.
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by Jake. » 10 Jan 2013 08:17

I just took berocca. Hope I'm ok

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Re: Practical Advice About Detox and Getting Sober

Post by smudge » 10 Jan 2013 13:05

You would have known a long time ago if you weren't going to be okay, Jake. Problems usually occur in the first few weeks of sobriety if they are going to arise at all. ;)?
"I would rather be a non-drinker with the occasional desire to drink, than a drinker with the constant desire to quit."

Learn from other's mistakes, you won't live long enough to make them all by yourself.

I'm not a doctor!

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Re: Practical Advice About Detox and Getting Sober

Post by Jake. » 10 Jan 2013 14:28

Oh good :-)

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Re: Practical Advice About Detox and Getting Sober

Post by Sandy » 13 Jan 2013 08:41

Bumping this thread for Jude

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