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One anecdote to another: Naltrexone isn't all that different from what you're describing Disulfiram as here - it's an opiod blocker so when you drink you get th

by teirce 4y ago

One anecdote to another: Naltrexone isn't all that different from what you're describing Disulfiram as here - it's an opiod blocker so when you drink you get the poison and not the happy chemicals. That doesn't help with addiction, it's subjecting yourself to negative effects / conditioning for drinking. Naltrexone doesn't work for me. It is not very effective for some people.

anon9001 4y ago
- eurasiantiger 4y ago
  As long as it’s actual medicine and not street pills laced with fentanyl.
- xanaxagoras 4y ago
  Xanax is about the worst choice for this because the half life is so short. Most often people receive ativan or librium for the taper you describe.
  - anon9001 4y ago
    Any of them work, and it probably depends how deep you're in. If you can't fall asleep without a drink, xanax would be a good choice. If you need a drink in your hand all day, I'd guess librium. If you're drinking from shift end until you pass out, probably ativan. Alcoholism takes a lot of different forms, and obviously a doctor should come up with a taper plan. But I think the reason these drugs (which actually work) aren't first line treatments is puritanical. They feel good, so giving them to alcoholics to feel just as good (or better) than they did with their drinks feels uneasy. But it really works, and it can be much more easily tapered and controlled. It's frustrating to watch after having seen multiple people successfully taper themselves off booze with other drugs (without doctor's supervision, sadly).
    - deleted 4y ago
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- deleted 4y ago
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- sab24 4y ago
  Even with drugs that are supposed to stop addiction, many people are still addicted after the treatment stops. Continuing with the drugs over a long time can lead to health problems, thus not solving the issue. Many studies show that a change in environment has a major influence on the change in behavior of patient.
- robbiep 4y ago
  Yes, there’s a protocol and it’s called the alcohol withdrawal scale. Advocating for people to switch from alcohol to xanax to quit drinking… this is utter madness and I strongly advise anyone who reads this to completely disregard this advice.
  - nickjj 4y ago
    > Advocating for people to switch from alcohol to xanax to quit drinking… this is utter madness and I strongly advise anyone who reads this to completely disregard this advice. Yeah, absolutely. This recently happened to someone I knew who was addicted to alcohol, 9 months later they died from a combo of alcohol, Xanax and Fentanyl. Let me preface this with I'm not a doctor, I also never tried Xanax / Fentanyl and I don't "really" drink alcohol. The air quotes mean I drink about a handful of beers a year at assorted family events and occasionally when socializing. I'm not saying that to brag or be like "look at me, I'm above that!", I just want to paint the picture here that I don't have first hand experience on how easily it is to get addicted to this stuff, know what it feels like or how hard it must be to quit. Anyways, here's 1 potential formula for how someone ends up dying after being prescribed Xanax when a doctor knows the patient has addictive behaviors and drinks a lot: 1. They're addicted to alcohol to the point where they feel compelled to drink very often. Not just a beer a day, but more like lots and lots of Vodka. 2. They try going to rehab multiple times and it fails every time within a month or 2 after returning. 3. They get prescribed Xanax by a doctor. 4. They have an addictive personality in general and get addicted to Xanax. 5. This helps for a brief amount of time (weeks or months perhaps). 6. They end up drinking again. 7. They very quickly discover drinking while taking Xanax has a whole new effect. 8. They run out of prescribed Xanax. 9. They attempt to find it on the street and do. 10. They enter a world of street drugs and now Xanax turns into Xanax plus Fentanyl (intentional or not, I don't know how it becomes laced, etc.). 11. They do this combo for a bit and one day they go-to sleep and never wake up from heart failure. The question I ask myself all the time now is if step 3 didn't happen, would the outcome have been the same? My gut tells me no way, being introduced to Xanax started the chain of events that lead to death.
- ransom1538 4y ago
  "Also anecdote: the easiest way to quit alcohol is with xanax." Ugh. Replacing addiction with addiction. Go this route if you have extreme medical conditions requiring it. EG. You are an alcoholic with serious liver issues, then by all means substitue xanax. Rehabs are full of people with xanax issues.
  - ChrisMarshallNY 4y ago
    But we seem to have no issue, with Suboxone. That is, quite literally, replacing one addiction with another. Opiate/oid withdrawal is pretty awful. You feel like you will die, but that seldom happens (unless you have other issues). Withdrawal from alcohol, on the other hand, is, quite frequently, deadly (that's why medical alcohol detox is recommended). Benzo withdrawals make alcohol withdrawals look like a case of the sniffles. I think that we are best off, with no addiction to anything, but I also know that many folks can't seem to achieve that. But deliberately addicting to benzos is crazy. They do use drugs like Librium to medically detox folks from alcohol, but that is quite short term, and is meant to keep you from dying.
    - zafka 4y ago
      Benzos are often given short term- 3-5 days on a taper schedule to someone in detox. It is not recommended to give a script to an alky. Benzos are not as dangerous to withdraw from as alcohol but are horrible to detox from as they are fat soluble.
      - ChrisMarshallNY 4y ago
        > Benzos are not as dangerous to withdraw from as alcohol That's not been my experience (and I've seen this play out for quite a while). I'm interested to know why this is the case.
        zafka 4y ago
        Hi Chris, Not sure if you are asking a question or not. To clarify, my understanding is that there is a greater risk of death when detoxing from alcohol,although it is possible to die from benzo withdrawal it is not as common. My information comes from registered nurses who worked in Rehabs, and years of interaction with a lot of ex-drunks. I did a very light search last night, but did not find anything that gave good comparisons.
- cue_the_strings 4y ago
  I knew a guy who swapped his World of Warcraft addiction with heroin. It worked surprisingly well, he never played WoW again. Last time I saw him, he tried 'borrowing' some money from me for 'medicine for his mom'.
  - xanaxagoras 4y ago
    There's a case to be made that he's better off.
sithadmin 4y ago
Naltrexone and disulfram are incredibly different, both in terms of pharmacology and subjective experience. Naltrexone hangovers are an awful experience, but that's due to neurochemistry. It doesn't short citcuit metabolic pathways so you literally poison yourself when you drink alcohol.
- teirce 4y ago
  Oh sure the process with how they work is very different. My point was more towards the 'this is unethical treatment' sentiment. I don't have experience with disulfram, but I'm familiar with a few different methods to treat addiction. Most of them make you feel like shit when you drink as a sort of skinner-style negative conditioning. So yes, taking the one that doesn't actually make the poison _more toxic_ - just a less pleasant experience - is probably the preferred route so you don't endanger yourself. But it's still forcing yourself to extreme negative consequences and conditioning your brain to associate alcohol with misery.

by teirce 4y ago

anon9001 4y ago

eurasiantiger 4y ago
As long as it’s actual medicine and not street pills laced with fentanyl.
xanaxagoras 4y ago
Xanax is about the worst choice for this because the half life is so short. Most often people receive ativan or librium for the taper you describe.
- anon9001 4y ago
  Any of them work, and it probably depends how deep you're in. If you can't fall asleep without a drink, xanax would be a good choice. If you need a drink in your hand all day, I'd guess librium. If you're drinking from shift end until you pass out, probably ativan. Alcoholism takes a lot of different forms, and obviously a doctor should come up with a taper plan. But I think the reason these drugs (which actually work) aren't first line treatments is puritanical. They feel good, so giving them to alcoholics to feel just as good (or better) than they did with their drinks feels uneasy. But it really works, and it can be much more easily tapered and controlled. It's frustrating to watch after having seen multiple people successfully taper themselves off booze with other drugs (without doctor's supervision, sadly).
  - deleted 4y ago
    [deleted]
deleted 4y ago
[deleted]
sab24 4y ago
Even with drugs that are supposed to stop addiction, many people are still addicted after the treatment stops. Continuing with the drugs over a long time can lead to health problems, thus not solving the issue. Many studies show that a change in environment has a major influence on the change in behavior of patient.
robbiep 4y ago
Yes, there’s a protocol and it’s called the alcohol withdrawal scale. Advocating for people to switch from alcohol to xanax to quit drinking… this is utter madness and I strongly advise anyone who reads this to completely disregard this advice.
- nickjj 4y ago
  > Advocating for people to switch from alcohol to xanax to quit drinking… this is utter madness and I strongly advise anyone who reads this to completely disregard this advice. Yeah, absolutely. This recently happened to someone I knew who was addicted to alcohol, 9 months later they died from a combo of alcohol, Xanax and Fentanyl. Let me preface this with I'm not a doctor, I also never tried Xanax / Fentanyl and I don't "really" drink alcohol. The air quotes mean I drink about a handful of beers a year at assorted family events and occasionally when socializing. I'm not saying that to brag or be like "look at me, I'm above that!", I just want to paint the picture here that I don't have first hand experience on how easily it is to get addicted to this stuff, know what it feels like or how hard it must be to quit. Anyways, here's 1 potential formula for how someone ends up dying after being prescribed Xanax when a doctor knows the patient has addictive behaviors and drinks a lot: 1. They're addicted to alcohol to the point where they feel compelled to drink very often. Not just a beer a day, but more like lots and lots of Vodka. 2. They try going to rehab multiple times and it fails every time within a month or 2 after returning. 3. They get prescribed Xanax by a doctor. 4. They have an addictive personality in general and get addicted to Xanax. 5. This helps for a brief amount of time (weeks or months perhaps). 6. They end up drinking again. 7. They very quickly discover drinking while taking Xanax has a whole new effect. 8. They run out of prescribed Xanax. 9. They attempt to find it on the street and do. 10. They enter a world of street drugs and now Xanax turns into Xanax plus Fentanyl (intentional or not, I don't know how it becomes laced, etc.). 11. They do this combo for a bit and one day they go-to sleep and never wake up from heart failure. The question I ask myself all the time now is if step 3 didn't happen, would the outcome have been the same? My gut tells me no way, being introduced to Xanax started the chain of events that lead to death.
ransom1538 4y ago
"Also anecdote: the easiest way to quit alcohol is with xanax." Ugh. Replacing addiction with addiction. Go this route if you have extreme medical conditions requiring it. EG. You are an alcoholic with serious liver issues, then by all means substitue xanax. Rehabs are full of people with xanax issues.
- ChrisMarshallNY 4y ago
  But we seem to have no issue, with Suboxone. That is, quite literally, replacing one addiction with another. Opiate/oid withdrawal is pretty awful. You feel like you will die, but that seldom happens (unless you have other issues). Withdrawal from alcohol, on the other hand, is, quite frequently, deadly (that's why medical alcohol detox is recommended). Benzo withdrawals make alcohol withdrawals look like a case of the sniffles. I think that we are best off, with no addiction to anything, but I also know that many folks can't seem to achieve that. But deliberately addicting to benzos is crazy. They do use drugs like Librium to medically detox folks from alcohol, but that is quite short term, and is meant to keep you from dying.
  - zafka 4y ago
    Benzos are often given short term- 3-5 days on a taper schedule to someone in detox. It is not recommended to give a script to an alky. Benzos are not as dangerous to withdraw from as alcohol but are horrible to detox from as they are fat soluble.
    - ChrisMarshallNY 4y ago
      > Benzos are not as dangerous to withdraw from as alcohol That's not been my experience (and I've seen this play out for quite a while). I'm interested to know why this is the case.
      - zafka 4y ago
        Hi Chris, Not sure if you are asking a question or not. To clarify, my understanding is that there is a greater risk of death when detoxing from alcohol,although it is possible to die from benzo withdrawal it is not as common. My information comes from registered nurses who worked in Rehabs, and years of interaction with a lot of ex-drunks. I did a very light search last night, but did not find anything that gave good comparisons.
cue_the_strings 4y ago
I knew a guy who swapped his World of Warcraft addiction with heroin. It worked surprisingly well, he never played WoW again. Last time I saw him, he tried 'borrowing' some money from me for 'medicine for his mom'.
- xanaxagoras 4y ago
  There's a case to be made that he's better off.

sithadmin 4y ago

Naltrexone and disulfram are incredibly different, both in terms of pharmacology and subjective experience. Naltrexone hangovers are an awful experience, but that's due to neurochemistry. It doesn't short citcuit metabolic pathways so you literally poison yourself when you drink alcohol.

teirce 4y ago
Oh sure the process with how they work is very different. My point was more towards the 'this is unethical treatment' sentiment. I don't have experience with disulfram, but I'm familiar with a few different methods to treat addiction. Most of them make you feel like shit when you drink as a sort of skinner-style negative conditioning. So yes, taking the one that doesn't actually make the poison _more toxic_ - just a less pleasant experience - is probably the preferred route so you don't endanger yourself. But it's still forcing yourself to extreme negative consequences and conditioning your brain to associate alcohol with misery.