by RE Helper | Sep 15, 2024 | Alcohol Relapse, Blog, Early Sobriety, Science and alcohol, Uncategorized
Today’s blog entry is from Dan B. Dan has been a member of Café RE since January 2022. He can be found on our zoom chats and supporting fellow members of Café RE.
Experiences in the ER and Detox
By: Dan B (Café RE UP)
Both are Brutal & Dangerous: Drinking to that Level and Detox/Withdrawal by Dan B.
I’m hoping that all my experiences in ER and Detox could both be informative and a motivation not to do what I did. I used to drink enough alcohol in a binge over days to the point I was in a panic and my blood alcohol level was at a dangerous level. Alcohol energized me, raised adrenaline and cortisol, then I probably used more for hair of the dog, and for fear of withdrawal – so it all accumulated to a dangerous level, hence ambulance rides (way too many) initiated by my friend or myself seeking a friend or neighbor.
ER Experiences
In the ER, I usually asked for a benzo like Ativan, because I felt in a panic, but at a certain blood alcohol level, they cannot give you it. One time, I think they waited until my BAC was under 2.5; another time, they didn’t give me anything at all. I think I believed I was in withdrawal, but it was intoxication. Having an anxiety disorder probably factors into this.
They hook you up to IV, and put those round stickers on you, is that for heart eval? I should know by now. I think they had something on my other arm sometimes too. Sometimes they told me to keep my arm straight. One time they told me not to move. In some situations, if I got out of my bed, beeps would go off; other times, they didn’t. I was in telemetry at times, which I guess may be extra monitoring.
Various staff would come in at different times to take vitals and such. Nice, caring nurses make a huge difference in states like these. And I always thank them. They would also do a certain scan putting me into a machine, maybe because I sometimes fell before going in. I was often what they call a fall risk, so that’s why they wanted me to stay in bed.
At certain visits, they would attach something for urination. Others I would have that plastic bottle. When I had some anxious energy, I liked to walk around, but they are extremely attentive when you step an inch outside of your door.
I usually asked for a lot of water, but I think at one visit, they didn’t want me drinking too much because I guess it may eliminate some of the electrolytes via IV.
The “Fight” Out
They eventually have a counselor evaluate me via computer, in which she asks at least 30 questions. Between that and a doctor’s call, that determines if they will keep you in for days, transferred to detox. I’ve been there several times, and it’s a process just to get out.
So, in a very challenged, exhausted state, I gave my best to speak well and answer questions the right way. Because I know the decision is ultimately mine about drinking. And when you are in detox for days, you have access to nothing in terms of phone, shaving, makeup, etc. You are in scrubs. In the process of discharge, they will ask if you have support. I always said, “Oh I’m in an amazing recovery group called Café RE.
I usually have nothing in terms of glasses, my wallet, phone, keys. So there was a fear that my doors would be locked though I leave the sliding glass door unlocked a lot. They call a ride for you, and I often left in scrubs and socks. I hated going back because my neighbor often knew about the episode and is very nosy.
When Transferred to Detox (5-9 Days)
I was always pleased when I had my own room in detox, because you never know what your roommate will be like. In NJ, I had a roommate that said, “If you snore – I’m going to put toothpaste up your nose.” I stayed awake as long as possible.
Some of the hospitals for detox were very challenging environments, but you also create special bonds, and we found a way to laugh together. But it also got pretty “crazy” at times. You also hear some very sad stories. But there are also some good workshops.
Self-Detox
This obviously could be dangerous, especially without a benzo like Librium. When I went through alcohol withdrawal at home without the help of a benzo, even after spending half a day to 2-3 days in the ER, I may have had some alcohol a couple of times. But even with that small amount, the reduction was so significant that I still experienced the full effects of withdrawal. And you also have the possibility to tip back over into dangerous excess.
So, in general, here’s what withdrawal was like when drinking vodka at the massive level I did:
There are various alcohol withdrawal symptoms one can get. The first two days are the scariest. Sometimes I vomited throughout the day, from 2 up to 20 times. The dreams on day 2 and 3 (or similar) were vivid and weird in a scary way. And I’m not one to ever get this unless I’m going through this process. Trying to take vitamins caused me to vomit also. It’s strange because you are very tired but have anxious energy. So as a fall risk, I would lay on the couch and move my legs/feet because of the anxious energy.
I would sleep on my side in case I vomited. You don’t want to sleep on your back during this. I often said, “God, please help me.” Then read Matthew Perry also said that. I often did the heart hold with affirmations like, “Daniel, you are going to be OK.” And did deep breathing. I remember in some episodes, I felt like deep breathing a lot still wasn’t enough.
In one episode, I was trying to hydrate but vomiting as well, so I don’t think I was hydrating. I drank Powerade Zero for electrolytes. I sometimes put on the Insight Timer app which has relaxing sleep music. Sometimes I kept playing “Be Not Afraid”, which my long-time friend did during hard times. He’s one of my smartest, biggest hearted friends.
I was weak walking to the bathroom, and would sometimes hold the rail of the shower. Thank God for Google. I would look up things. When I eventually could hold food and vitamins down, I had blueberries and strawberries out. Perhaps broccoli at times. And of course B1 (Thiamine) and Folic Acid. This is standard in this process. The amount they prescribed me for folic acid was 1 mg, B1 varied from 50-100mg according to the notes I’m looking at from two visits.
After 3 days, things get better. After 5 days even better. And after 7 or 8, for me, it was a major transformation. So, this was my experience with and without alcohol after a binge.
It was brutal.
by Kerri MacFarlane | Mar 15, 2023 | Alcohol Free, Helpful Tips, Science and alcohol
Let’s talk about dopamine!
If we are to properly discuss alcohol addiction we will soon come to the molecule dopamine. Dopamine is a neurotransmitter commonly coined as the pleasure molecule, but that’s not entirely correct. Dopamine is more accurately described as the learning molecule. However, it’s definitely a combination of both. Dopamine is the molecule that has kept us alive for thousands of years. It’s the chemical that drives us to eat, to find warmth, shelter, to find a mate, and puts a smile on our faces when we high five or hug another human being.
Another neat fact about dopamine is once we take action towards a goal, we get a little blast of dopamine. The human dopamine system is like a see-saw, as a dopamine hit brings about pleasure, and then is quickly followed by pain or a lack of dopamine. What goes up, must come down. This is to keep us motivated and it worked great when we were hunters and gatherers and we had to constantly search for our basic needs – food, water, and shelter.
But, in the modern world we live in a world of abundance rather than scarcity, and our brains have not evolved for the “fire hose of dopamine” of sugar, social media, TV, sex, drugs, ALCOHOL, or any number of dopamine-triggering stimuli so easily available.
In short, it could be said that in the modern era, we are all addicts running from fix to fix, which is a reason why on average people open their smartphones around 100 times per day averaging 2,600 swipes, taps, or touches.
Many of us reached a phase in our drinking when we no longer drank to feel good, instead we drank to feel “normal”. I know there are some heads nodding right now.
This is 100% tied to dopamine.
When we drink we open the flood gates to the dopamine system, and then the dopamine system tries to reset itself by creating a deficit the next day, or next couple of days. We then are even more motivated to reach for that drink to offset the treacherous feelings of the dopamine deficit. Think merry-go-round. ?
When people do cold plunges, or ice baths, it has the same effect on the dopamine system..but backwards. You experience the pain of the cold water first, then you get a rush of feel good dopamine. Cold plungers are chasing dopamine just like alcoholics.
Countless books have been written on what addition is and its causes. Most would agree it isn’t any one thing, but many things. One reason why some are more susceptible for addiction is based on the makeup of their dopamine system. We have nearly 8 billion humans on the planet and there are 8 billion different dopamine systems. We don’t all experience pleasure and pain the same. When we put our hands in front of a fire, we don’t all feel the warmth equally
It’s quite possible that those who struggle with addiction have enhanced dopamine receptors. Does everyone have the same experience when they take their first drink? Absolutely not. But one commonality that Paul has noticed after interviewing hundreds on the Recovery Elevator podcast is that when those of us that struggle with alcohol take our first drink there’s a light show going off in our dopamine system.
On the flip side, Paul has asked many normal drinkers what their first drink was like, and the common response was eh, it was okay.
This lends truth to the idea that those with enhanced dopamine receptors are more prone to addiction.
Let’s get real. We need that dopamine hit. As human beings after all, it’s what keeps us going, it’s what keeps us alive.
So what are healthy, or healthier, ways to get that dopamine hit? What is the best form of dopamine? Or perhaps the safest?
Well here’s a couple of ideas…
Intimate connection with other human beings. “We know that when we make intimate human connections, oxytocin binds dopamine, releasing neurons in the reward pathway and dopamine is released and it feels really good.”
The opposite of addiction is connection.
Radical honesty – Dopamine is released when we are radically honest with ourselves and others. Studies show that when we are honest about who we are, what we can and can’t control, a healthy amount of dopamine is released. (To be fair, dopamine is also released when we are dishonest.)
Here’s another thing to remember with dopamine. Neurologically, neurons that fire together wire together. When we drink we reinforce dopamine pathways related to alcohol making it harder for us to release dopamine in healthier ways.
If you’re looking for more info on Dopamine, I highly recommend the book Dopamine Nation, by Anna Lembke.
***Taken from Recovery Elevator Podcast, episode 415, host Paul Churchill***
by Kerri MacFarlane | Oct 15, 2022 | Alcohol Free, Blog, Helpful Tips, Resources, Science and alcohol
Let’s talk about science and alcohol. It’s a pretty interesting and popular subject when the topic of recovery and sobriety gets brought up.
But let’s keep in mind that it’s not enough to rely on science and information to ditch the booze. Yes, it’s interesting and knowledge is power, but please don’t solely rely on knowledge, science and information alone to quit drinking. If we could read or listen ourselves out of a drinking problem, well, the problem would be solved. ??
Paul loves the science part of addiction and recently did a podcast intro on just that. (RE Episode 396)
Paul got most of his info from a fantastic podcast episode from the Huberman Lab Podcast, What Alcohol Does to Your Brain, Body & Health| Episode 86. I highly recommend you check it out and listen when you get a chance…Dr. Huberman goes into great detail in this 2 hour episode and even those without a drinking problem will find it interesting and beneficial.
Andrew Huberman, Ph.D., is a neuroscientist and tenured Professor in the Department of Neurobiology at the Stanford University School of Medicine.
Alcohol and the brain. ??
Alcohol has many biochemical and neurochemical effects on the brain. There are dramatic changes in the neurons that control the release of serotonin when we consume alcohol. Serotonin is the feel good chemical and 80% of it is created in the gut. When we mix alcohol and serotonin it gets converted into acetaldehyde. Acetaldehyde damages your DNA and prevents your body from repairing the damage. A toxic buildup of acetaldehyde can increase your cancer risk.
This acetaldehyde acts as a toxin at the very synapses and the connections between the serotonergic neurons and lots of other neurons. In other words, when we ingest alcohol, the toxic effects of alcohol disrupt those mood circuitries.
It does this first ☝?by making them hyper active.
This is why people become happy or more talkative after a couple of sips of alcohol. But when the alcohol wears off the serotonin levels and the activity of brain circuits really start to drop and this is why most people head to the bar for a second round. Now typically what happens when people ingest their 3rd, 4th or 5th drink, there is an absolute zero chance of them recovering that energized mood they experienced on the first drink. Most people, when they drink more and more, begin to feel suppressed ?. The front part of the brain, the frontal cortex, is starting to shut down. The motor areas of the brain that control motion and basic functions begin to slow.
This is the slurred speech, the swaying back and forth, the classic drunk shuffle. People begin to lean on things, uncomfortable benches seem like a good place to spend the night. There is a great depression, not of the psychiatry sort, but a depression of alertness and arousal, and eventually people begin to pass out. ?
Here’s one big way that alcohol changes your brain chemistry.
Alcohol changes the relationship between the hypothalamus, the pituitary gland and the adrenals. The hypothalamus, which is about the size of a gumball and sits above the roof of the mouth, provides a specific set of signals for the pituitary gland…which then releases hormones into the bloodstream that go and talk to you adrenals which sit right above your kidneys in your lower back. The adrenals release a chemical called epinephrine and cortisol which is involved in the longer term stress response.
The hypothalamus, the pituitary gland and the adrenals maintain the physiological balance of what you perceive as stressful. People who consistently drink are more stressed out at baseline then sober peeps. They have more cortisol released from their adrenal glands even when they are not drinking. And a consequence of this is they feel more stressed and feel more anxiety when they are not drinking. Most medical professionals will agree that stress is the number one contributor to disease.
Let’s talk about blackouts for a second. Blacking out is not passing out. When we overload the brain with alcohol, it’s almost too much to process and the activity of neurons in the hippocampus, which is involved with memory formation, are strained and then they completely shut off. As in you no longer form memories. You are still awake and can still be functioning, some high functioning, but the memory forming part of your brain, the hippocampus, clocks out.
Now…to genetic predisposition…
Side note, Paul doesn’t believe in genetic predisposition to alcoholism. He used to, but now he doesn’t.
Addiction guru Dr. Gabor Mate’s teaching rebukes the genetic myth. Dr. Mate feels all addictions are trauma responses. What helped Dr. Mate reach this conclusion was his studying of twins who have the same genetic makeup. He also studies twins with the same genetic makeup who are separated at birth. His conclusion is that all addictions are environmental responses, or coping behaviors that allow people to survive in unhealthy environments.
Dr. Bruce Lipton, who is coined the father of Epigenetics in the 90’s, would also agree with this. Epigenetics says it’s the environment that controls the expression of genes and gene mutations. In addition, it’s the environment that cues anxiety, depression, addiction, auto immune responses, cancers, inflammations, and not genetics. The classic Rat Park experiment by Bruce Alexander in the 70’s also shows addictions are environmental.
Paul says, “I am on board with this approach and even in the past 8 years doing Recovery Elevator, I’ve seen the pendulum slightly shift in this direction.” What we’re seeing now, is our biological makeup is much more adaptive and reflexive to environments than previously thought. Again, Paul feels, most addictions are trauma based. They are adaptive behaviors. Another reason he doesn’t think alcoholism is genetic is because alcoholism is rapidly on the rise. Gene’s take thousands, millions of years to evolve. Gene’s can’t explain the ten fold increase in alcoholism we’ve seen in the last couple centuries.
That being said, we do want to share different perspectives on alcoholism.
Dr. Huberman feels alcoholism is genetic. He does mention that there is no blood test, fingerprint test, or bio marker to indicate this addiction gene. Dr. Huberman says the best way to “identify” alcoholics and non alcoholics is by putting drinkers in two bins. One bin is the group of people who have a couple of drinks and then get tired with a nodding head, or they feel sedated. The other bin of people is the group that has a couple of drinks and gets energized and are not sedated. The drowsy group after a couple drinks are your normal drinkers. The let’s go streaking in the quad and bring your green hat group are the future alcoholics.
Is it genetic based, or trauma based. Most likely it isn’t 100% one or the other. It’s most likely a combination of 57,680 different things.
Again, we don’t recommend getting too caught up in all this. At the end of the day, you’ve got a drinking problem. Knowing what alcohol does to your prefrontal cortex isn’t going to keep you sober in the long run.
Find what works for you…and go with that!
***Taken from Recovery Elevator Podcast, episode 396, host Paul Churchill***
