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Day two of my journey in rehabilitation and (hopefully at least) recovery began much like Day One….but worse. A knock on the door, waking me from a fitful sleep, telling me that we would depart for “the meeting” in 20 minutes.
Disoriented, sweaty, and still uncertain of exactly where the hell I was, I stumbled out of bed and threw on the same clothes I had worn the day before. It just did not seem to matter to me what I wore at the time, I had worn the same booze-soaked clothes for days on end before, so why change now?
I was still on a medication regime of Librium and whatever other pills they gave me to take. My body was starting to really break down by day two – the tremors, the dizziness, the beginning of my central nervous system realizing it was no longer getting what it was addicted to – in short, the actual delirium tremens were trying to break through despite the pharmaceutical assistance I was getting.
I’d been through physical withdrawal and detox before, but normally I was medicated to a greater degree. Every time I was in the hospital, they would dope me up with Librium but also had healthy doses of narcotics and sedatives. Maybe not the best choice for an addict to be given, but hospitals are focused on preventing physical or mental breakdowns due to withdrawal. And they successfully got me through that – more than once.
But here, in this rehab facility, they were focused on first preventing my body and/or mind from shattering but they were just as focused on getting me on a path of recovery. So, no dialudin, morphine, oxycodone or the like this time. Damn the luck.
In the morning A.A. meeting, I still was not feeling up to sharing, but I was starting to feel a connection to some of the people there and what they were sharing. Plus there was lots of coffee at the meeting, which was quickly becoming my substitute addiction in lieu of vodka.
After the morning meeting we returned to Detox Mansion, where I promptly collapsed back into bed. Around lunchtime came another knock on the door, but this knock was from the person in charge of the facility. He asked if he could come in and talk with me for a bit. I obligingly said yes, and he came in and sat in one of the chairs provided in my room.
He talked with me about his background, his life, and his experiences. He told me he had never personally suffered from any addictions but that he had worked with addicts for over 25 years. As it turned out, it was his wife who had conducted my intake interview the night I arrived and who had (correctly) surmised that, as she delicately put it, “we might have a detox situation on our hands.”
She could not have been more correct. And so ends my memory of that miserable day two, feeling as though I were plunging into the depths of detox and delirium once more, but this time remembering…remembering and feeling every single minute of it.
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We are up to 23 clients in the rehab facility now. The staff is struggling to keep up. This is the most clients they have ever had at one time. Two of the clients are only in for seven days – they had the choice of seven days in jail or seven days in rehab in a cushy rehab place. Go figure, they picked the luxury spot instead of jail. Those of us who are here for “longer” detest the seven-dayers.
We’re @ outpatient programming right now. We go to outpatient four times a week for two and one-half hours per sessions (10AM to lunch break @ 12:30). On Thursdays such as today, the first hour is structured as an AA meeting (though it is the worst AA meeting I have ever attended).
The morning AA meeting was awesome! Lots of great sharing. One of the “old-timers” approached me afterward and told me he had been through some of the same experiences as me (such as driving our vehicles into ditches on the “way home” at something like 60 or 70 miles per hour and being fucking lucky we didn’t smash into a power pole before righting our vehicles back onto the roadway…good times).
I’m eternally grateful that I never hit anything…or anyone…while driving drunk. It’s a miracle, one of many. I could not live with myself if I had hurt or killed someone in an “accident” – to be honest, I would rather have died myself than hit someone else. Don’t get me wrong, I’m not suicidal, I just couldn’t bear the guilt of damaging someone else’s life that way.
Yesterday I received pictures and a lovely letter from my significant other. I also talked on the phone last night with them for awhile. Things are going well in their life (all things considered) and I am very happy about that. The pictures sent were from their visit during “family visit” day last weekend and they came out great. I am so blessed to have this person in my life, especially after all I have done. I still feel a lot of guilt and shame for hurting them so badly with my drinking and the behavior I exhibited while drinking.
I miss them so much. But as they have said (more than once), I’m where I need to be right now. And as they said as I was packing my bags for rehab, and I noted how far they had come in making some needed changes in their life, “It’s your turn now.”
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Simple tests for complex problems do not work. The disease of alcoholism is recognized and defined by Alcoholics Anyonymous as (among other things) “cunning, baffling, and powerful.” I believe this to be very accurate.
Regrettably, alcoholism is not a disease that can be easily “tested for” or proven or dis-proven. If you, a loved one, or anyone else you know believe you may have a problem or feel that you or they drink too much, it is certainly worth examining further. However, in my own experiences and the experience of others, I have seen a variety of tempting but ultimately unproductive ways to approach that examination.
The first and most frequently-used simple test is, I believe, among the worst because it is so inaccurate: “Do you ever drink alone?” This is far too black and white a question, yet is considered by many laypeople to be a good jumping-off point for deciding that an intervention is in order for anyone who answers “Yes.”
The most simple rebuttal I have to that is the scenario of a single person who wishes to occasionally have a drink but does not drive after having even a drop of alcohol (a very good policy, by the way). If they go home and have one or two drinks after work by themselves, they would answer “Yes” to the question of whether they ever drink alone. Are they an alcoholic? Not necessarily.
A friend of mine who is aware of the fact that I am a recovering alcoholic and I were talking the other day, and he said, “Man, what a day I had! I felt like I really could use a drink after I got off work.” He then sheepishly apologized for saying that to me. I told him no apology was necessary – alcohol is in our society, for better or worse, and you have to get used to that.
He then asked me if feeling the “need” for a drink after a stressful day at work was a sign that he had a problem. It took me a minute to really process that and formulate a helpful answer. In the end, I replied:
I don’t think it’s that simple. Many people have days like that from time to time, and sometimes a drink is a nice little treat for someone after such a day. If you find yourself feeling that way quite often, or if you have more than one after a stressful day, you might have a problem. But it’s a cunning and complex disease, not one that is prone to simple tests. It’s good to ask yourself questions like that, but from what I know of you, you do not have a problem.
There are many other “basic” tests that people try to use. In the end, I think they are at best overly simplistic and, at worst, are used by some people to rationalize the outcome they want – “I don’t do x” (where x is a basic test), so “I do not have a drinking problem.” Alcoholics are masters of rationalization, often attempting to apply rules to limit their drinking (such as “I will not have a drink until 8 p.m.” or “I will only drink beer from now on”) to “prove” they don’t have a problem.
Would you like some simple tests? The first one is quite basic but requires honest, thoughtful reflection in responding to be of any use:
Are you concerned about the impact of your alcohol consumption?
If you have reason to ask this, whether you are asking it of yourself or with regard to a loved on, I would encourage you to spend some time reflecting on why you are asking the question.
Another simple test is:
Do your hands shake uncontrollably when you wake up? Do they stop shaking after you have had one or more drinks?
Aside from neurological conditions, the “morning shakes” are often a sign of physical dependence on alcohol. If they “clear up” after you drink, you need help. Now.
Other signs of alcohol dependence include:
- waking up one or more times during the night to have a drink to “help you sleep”
- profuse sweating when not drinking and/or while sleeping
- periods of time that you cannot remember
- obviously, a strong odor of alcohol (or even rubbing alcohol if you drink vodka because “it doesn’t have an odor”)
- aside from an odor of alcohol, many heavy drinkers will have a very strong odor of vinegar in their perspiration; if you smell vinegar when you wake up, your body is going into a state in which it cannot process the alcohol properly; again, get help – immediately
Alcoholism is indeed a very cunning, baffling, and powerful disease. It is progressive – without help, it will continue to get worse and worse. It is also fatal if untreated. If you get nothing else from reading this article, please get this. I have friends who drank themselves to death. I nearly drank myself to death. It is a painful, lonely, slow way to die.
There is help. There is light at the end of the tunnel. And there is no shame in it. Because we are anonymous, there are far more people who have struggled in similar ways than you know. You can get help. Just ask.
Please feel free to contact me anonymously if you don’t know where else to turn.
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Hi my name is Jack and I am a stage 4 alcoholic.
I don’t want to focus too much in this article on the different stages of alcoholism – not because I think information about the other stages is unimportant, but because the fourth stage is so unique among drug usage that there are some critical factors I want to discuss for anyone in need of help or knowing of someone who might need help.
Stage four alcoholism’s primary indicator is a physical addiction to alcohol. Put another way, a person at stage four actually has to do one of two things – drink or detoxify under medical supervision – or they run a serious risk of death.
When I say they must drink, I do not mean the psychological craving many indicate by saying or thinking “I could really use a drink” or “I NEED a drink.” I mean that their body’s central nervous system will begin to break down during withdrawal, causing high risks of:
- seizures
- hallucinations
- profuse sweating and dehydration
- severe shaking or tremors
- alcoholic psychosis
- decrease in tolerance to alcohol
- further and severe loss of motor control skills
If you believe you may be physically addicted to alcohol, do not attempt to “quit cold turkey” or to otherwise do it on your own. You would be needlessly risking your life.
If you know someone who may be physically addicted, do not attempt to be the sole or primary facilitator of a physical withdrawal. It will be tempting to try to help your friend or loved one - especially for people who like to help “fix things for other people.” But in reality, there is little you can directly do for a stage four alcoholic until they have completed a medically-supervised physical detoxification.
Alcohol is the only drug where withdrawal from it can kill you. Someone I know who has worked in substance abuse recovery for decades once said:
Alcohol is the worst when it comes to hardcore addictions. I’ve worked with heroin junkies while they went cold turkey, and they wished they were fuckin’ dead but they didn’t die. I’ve seen stage four drunks in withdrawal have seizures and not make it out.”
I know first-hand what stage four alcoholism feels like. I reached a point while I was drinking where I literally was drinking to avoid a withdrawal that I knew was very likely to be permanently physically and mentally damaging if not directly fatal.
Some key indicators that someone may be physically include:
- very shaky hands after waking up in the morning
- needing at least one drink first thing in the morning to calm those shakes
- waking up two or three times during the night to get a drink
- profuse sweating and/or disorientation after a few hours without a drink
- extremely blurry vision, very bloodshot and/or watery eyes
When attempting to diagnose physical addiction, it is important to also remember a few myths or misconceptions.
A stage four alcoholic may still be somewhat functional. Their acquired tolerance to alcohol will, for a time, remain quite high. The stage four will not always appear drunk at first glance. Many stage four alcoholics begin to lose their tolerance in the latter part of stage four, and at this point their ability to conceal their drinking will diminish correspondingly.
The good news is that there are effective protocols and treatments to physically detox a stage four alcoholic. Librium and Ativan are two of the primary medications used to keep the body from seizing up during the process.
Stage four is the terminal point of the progressive disease of alcoholism. Once a person has reached stage four, they must choose between a certain and premature death or a comprehensive treatment program that begins with physical detox.
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Hi, my name is Gretchen, and I am an alcoholic.
I really shouldn’t have so much to bitch about.
Born an only child, and growing up as something of a “military brat,” I have always been an introvert who learned to play the role of an extrovert. Moving across the States (and the world) frequently as a younger person, I learned early on how to “fake it to make it.”
Ironically, decades after learning myriad techniques for getting by, it all came crashing down around me and I lost my ability to cope, my house, my job, my car, and most of the people who I always suspected – who I knew deep-down inside, in the dark of night where my tears were the only sound to drown out those nagging voices of doubt, fear, and self-loathing inside my head – I was sure they would abandon me once they figured out the faker underneath it all. Whoever the hell that faker had become.
I started drinking at a fairly young age by American standards. Of course, people have commented that I looked and behaved as though as I was older than my chronological age for all of my life. That used to feel like a compliment – I was quite the “popular” teenager, although strangely most of my so-called friends turned into hoodlum Houdini’s once I doled out the booze I had acquired with my fake ID and deep voice.
As a teenager I was curious, and was often told how smart I was. One day a friend and I decided that smart+curious=trip to a parent’s basement to scope out anything of interest. Among the treasures we found was The Bartender’s Guide to Mixology. Not just any guide, nor just for any bartender, but THE Bartender’s Guide to Mixology! Naturally the bookshelf it was in had very few other books, but the bottles in the shelves combined with this book of magic potions was all we needed.
So there we were, two curious, allegedly smart nerds, about to have our first drink. The choice was made – something called “a Manhattan.” The first one was wonderful. So was the second. Shortly thereafter we were the two nerdiest 14-year-old drunks in town. And so began my career as a professional alcoholic.
Throughout most of my adult life I lived a “traditional” life in public and a rather different one in my own head. I thought of myself as a social drinker, never having more than two drinks in public. As tears went by and life got more complex, I continued to use wine as a “social lubricant.” What could be the harm in that? It was just wine. I never consumed more than two glasses of wine in public. And I was the belle of the ball, the person whose table people rotated around so they could share in witty bon mots about the shallowness of others, refreshing small talk wholly reflective of the total nothingness that is suburbia, mindless chitter chatter for we, the upper-middle-class masses, to pass the time in between PTA meetings, mowing the lawn, polishing our nails, and otherwise giving the Brits a damned good run for use of the title “Lives of Quiet Desperation.”
As the mundane drone of life went on, I began to find that two glasses of wine was not enough to get me through the various social outings that I felt obliged to go for fear that the other attendees would all talk about me in my absence. So I learned the delicate art of “pre-drinking” – consuming as much wine as possible as quickly as possible in the alloted time when no-one else was home.
Even while engaging in pre-drinking, I rigidly maintained my two glasses in public rule. Not once did I break that limit. After all, I told myself, I had the “post-drinking” to look forward to. And of course, it was still just wine. once I was home, safely ensconced in my private chamber of alcoholism, I could and did drink until I passed out. I even started adding in an occasional nostalgic Manhattan.
Eventually the blackouts started arriving, along with the mornings of discovering new bumps, bruises, and scrapes (always accidentally self-inflicted, to the best of my knowledge). Hangovers were a thing of the past. If I woke up with a headache, or shaking hands, or just thinking I could use a drink, that would mark the start of that day’s pre-drinking.
Days become weeks, weeks became months, and months became years. Over time, the few people I had not totally isolated myself would periodically try their best to help. Some asked if I was trying to kill myself. My answer to them was always “No, of course not.” But inside I knew I was choosing a very slow, very painful, and very selfish form of suicide.
At times I even thought of taking a quicker way out.
At other times, the best of intentions from some people actually made things worse. But today, looking back, I am grateful. I walked the line and got a chance to start over.
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Hi, my name is Ted, and I am an alcoholic.
It’s very hard to know where to start writing in this blog. The subject matter is intensely personal and will at times be very painful for both authors and readers.
In reality, it was even difficult to decide on a name for the blog itself. The current name (LearnAboutRehab.com) makes the site matter sound much more narrow in focus than the reality of what we write about here.
Another complicating set of factors in writing here is our intense need for our own – and our respect for others’ – anonymity. Many bottles of ink have been spilled and many heated discussions have occurred regarding this topic. The founders and charter members of Alcoholics Anonymous considered it so vital that they named the group accordingly; each A.A. meeting begins with reminders of the importance of respecting the anonymity of the group and the individuals in it; and each meeting is closed with another reminder about leaving what is said and who see in the room.
My own need to maintain my anonymity and to respect that of others’ is not borne simply from “respecting the Elders” of A.A. It is also driven by my own experiences of small-town living, of having heard how others felt when their privacy was violated, and my own feelings when well-intentioned people did not maintain my own anonymity and took it upon themselves to share information about my situation with others.
I do not doubt the motives of the people who did that – I sincerely believe them to have been well-intentioned at the time. That, however, does not erase the feelings it engendered in me:
- a sense of loss of control in a situation where so many other aspects of my life had spiralled out of control
- feelings of betrayal or “being used” as some sort of example (again, with good intentions; but there is a certain road that is paved with good intentions)
- self-isolation out of concern for further betrayals of confidences
The final, and perhaps the greatest challenge to writing this, is the intense swirl of emotions, the complicated inter-personal relationships between those involved, and the simple fact that I was a “blackout drunk” for quite some time.
The feelings and the relationships between the people writing here will obviously colour some of what is discussed. That is human nature.
But put quite simply, I could not construct any sort of cohesive history of what happened. I do not remember parts of it, and other memories are distorted. A frequent exercise in rehab programs is to ask the person how much they drank per day, week or month; or, worse yet, how much they spent on booze in a given time frame.
There is simply no way I could answer the first question – I had no idea. Near the end I drank enough to prevent myself from going into physical withdrawal. And the amount of money spent? I guess I’d sum that one up by saying two things:
- It doesn’t matter if you’re drinking Mad Dog 20/20, “just beer”, or Dom Perignon and Remy Martin – you can develop a problem with any of these
- In my experience, I slowly moved down the “food chain”, progressively buying cheaper brands to maximise quantity purchased
The term “blackout” is actually quite misleading. Blackout drunks aren’t just passed out. Those periods of actual loss of consciousness are the ones that are relatively easy to figure out; the person is passed out, “asleep” in a place they normally might not sleep. For example, a dumpster.
But the blackout drunks’ more natural state is to appear largely functional. They may slur their words a bit (or maybe not). They may sweat profusely, but they will always have an excuse as to why. The blackout drunk can (as I have done) have a Blood Alcohol Content of .30, .40, or higher, and still be largely functional. That’s just one glimpse into the fun world of being a blackout drunk.
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