Flash Says…

Toxic January

Posted on: 2013-01-27

I didn’t drink alcohol last night. As a result, I found my pain almost unbearable. I lay awake in bed all night, in agony despite being cushioned by two double duvets, wishing I could sleep, wishing the pain would ease. I had no solution.

A good friend, Beth, an alcohol worker, has not been drinking in January. Instead she’s been raising money for Alcohol Concern, and been blogging about her journey. Her blog has reminded me that I drink to “harmful” levels, and made me think about alternatives. But so far, I haven’t found a solution.

I have good reasons to cut back on my drinking. As well as knowing Beth who is an alcohol worker, another friend is an alcoholic (now two years sober) and I have seen how not drinking has changed his life. Most crucially, I saw my dad get ill and then die of liver failure aged just 60. So I know first-hand about the damage that alcohol can do – to your social life, and to your body. If that doesn’t put me off, what will?

But it isn’t that simple. I have a chronic pain condition, and no medicines seem to provide me with adequate pain relief. In order to cope, I drink nearly every evening. I rarely get drunk, or feel particularly intoxicated, nor do I want to be: but I do exceed recommended limits. I just need to have a certain level of alcohol in my bloodstream so that I can sleep at the end of the day.

A friend with the same condition as me, David G, said: “When I did my Pain Management course, one question the medics asked was “Who supplements their painkillers with alcohol?” When half the class stuck their hand up, the only comment was “That’s about average.” In teaching us to be expert patients in control of our own conditions, alcohol was completely accepted as one of the tools available for responsible use.” So it is more or less expected that patients will use alcohol to help their pain levels. But at what cost?

I have tried stronger painkillers; buprenorphine, and oxycodone. They were good in that I didn’t feel a wish for alcohol when I was taking either medication, but unfortunately they each turned me into a zombie and I couldn’t take either on a permanent basis. I haven’t found anything else that I can take instead. So it was helpful to know that medics expect patients to use alcohol as a pain killer, but sad nonetheless.

I’ve seen the way that alcohol can destroy your body. Everything from yellow skin and needing regular blood transfusions, through to limbs seeping liquid from oedema; a midriff swollen by many litres of ascitic fluid, tight as a drum; regular gastroscopies to check for veins about to burst; and ultimately confusion, coma, then death. It is utterly horrid. It was a cruel thing to happen to my dad in the last few years of his life, taking him when he was barely 60. People whispered “it was no age” and they were right; and it upsets me to think that if I go the same way, I might only have another 20 years with my husband, who I love beyond compare. I have liver profile tests on a regular basis, but you don’t tend to see signs of damage until it has already been done. I just hope that I am luckier than my father.

I drink almost every night. By NHS standards, I drink heavily and I drink too much. For example I will drink a pint of Pimms (5 units) over a few hours, and then a Pina Colada (2.5 units) over another hour or so. That’s a quiet evening; I’ll often have something else as well. This is what I need in order to bring my pain to a manageable level, so I can sleep. The NHS thinks this is a “binge”.

Bearing this in mind, and inspired by Beth’s blog, I didn’t drink alcohol last night. As a result, I found my pain almost unbearable. The first night of not drinking is just about doable, but a second night would be impossible. You see, when I don’t drink for a night I am in agony. Every time I try to sleep, the stabbing pain jolts me awake again. I lie there trying to sleep, but whichever way I lie, it hurts. If it’s not my knees or hips shouting, it’s my pelvis or my ribs; they take it in turns to disturb me. I also flick between being too hot and too cold. My body is hypersensitive and my pain levels are up to 11. When my husband reaches an arm around me, I have to move him away, because it is even painful to be touched.

It took me until morning before exhaustion overwhelmed me and I finally got some kip. I slept from 8am until afternoon. When I woke up, I was in agony again. This doesn’t happen the morning after a night of drinking. That’s so unfair, it’s like being penalised for doing the right thing! So if I want to give up alcohol, I first need to find another way to handle pain.

I have asked my medics. I can’t take stronger painkillers because the patches damage my skin and tablets turn me into a zombie. They have said I shouldn’t take anything more than codeine. But to me, that is like a sticking plaster on a gaping wound; better than nothing, but only just.

I don’t know how to end this article. You see, I am frustrated that I end up drinking to help manage my pain, but I don’t know any other method, so I will continue to do so… even though I know it is probably harming my liver, and I really don’t want to end up like my father.

I can’t find an alternative. My immediate, day to day need is to minimise pain. My long term aim is to minimise damage to my body and to plan for my future. But until I find a way to replace alcohol as a painkiller, I am just running on the spot, and hoping not to do myself harm in the process.

Beth’s blog is http://bethanfisher.wordpress.com. Please read about her experiences of a month lived sober, and consider sponsoring her for Alcohol Concern.


13 Responses to "Toxic January"

It seems to me that you are a responsible drinker – you know why you do it and you monitor it. You drink to the point of risk, but it seems to me to be a risk you understand.

Thank you, Steve. I hope you know why your comment means a lot to me; certainly I know you have insight. It hadnt occurred to me that my medics might also think it is a risk but that when they weigh things up, it is reasonable. I had thought I would send a copy of this blog to my rheumatologist (who influences my pain treatment), but now I wonder if he would just tell me to carry on. Or, if I didn’t have the experience of seeing my dad suffer, whether I would care quite as much. As usual, you’ve given me food for thought. Thank you.

I would definitely send a copy of the blog. All this information will help!

First I’d like to say thank you for writing this. It cannot have been easy for so many reasons. But it is a subject which perhaps should be addressed more often.

I suffer from chronic pain too and relate to so much here. Sleepless nights are quite common, as is being in too much pain to be touched. When I had a kidney stone a few years back I stuck it out for 48 hours because it wasn’t that different to my normal pain and I didn’t realise anything was wrong! When I went into hospital they gave me morphine. Yet on a day to day basis I am supposed to cope with codeine and tramadol. While that works well for my joint pain, it doesn’t do much for my muscle pain and that is what is excruciating.

I have considered using alcohol to help, to the point of going out in my wheelchair and sitting in front of the local mini supermarket before trundling home again empty handed. So far I have resisted. I know that once started down that road there may be no turning back. I think it will be a slippery slope. Recently it has been more difficult. But reading your blog has strengthened my resolve. That voice saying “how bad can it be?” now has a very definite answer.

I wish I could help you, but all I can say is that in fact it is the opposite and that you have helped me. I just wanted to say thank you.

I’m glad to have helped, truly; one size doesnt fit all. And looking at it the other way, supposing my blog had encouraged you to drink and now you were an alcoholic? And perhaps still in pain regardless. I’d feel awful!

I know your response doesn’t help me, but I am glad to have made you think. Do read my friend Beth’s blog too; if you need reassurance not to drink, Im sure you can find it in there!

Im sorry that you, too, know how it is to be in such pain or to avoid being touched, even… it has helped me a lot to know that you and other friends on twitter can relate to how Im feeling. I live in hope that there will be a solution out there. I just don’t know what it is yet.

All the best, and thanks for commenting.

Wow, a really tough read and a really tricky dilemma. I’m in a similar situation myself – on codeine but still in a lot of pain. I drink regularly too. I might have a couple of large spirits most nights and then more at the weekend. The amount I’m drinking doesn’t worry me but the need to does. I guess until you find something else that satisfactorily addresses the pain you have no choice. One option might be to see a traditional Chinese medicine herbalist and get some support for your liver.

Thanks for raising this – it is something I’ve been thinking about at the back of my mind but reluctant to bring it in to full consciousness.

Thanks for your comment, it is helpful to know I’m not alone even if we don’t have better answers right now. I do take milk thistle tablets when I remember; studies seem to be undecided about whether it does help the liver but it won’t hurt.

I sympathise, Flash. I know I was drinking too much towards the end of last year what with Christmas and everything. I’m not drinking at the moment and I am enjoying being clear-headed every morning and not having that nagging guilt going on that I’m over the ‘allowed’ limits.

What I would say is that there are risks associated with all drugs and I wouldn’t have thought any more so with alcohol than with other drugs such as opiate-based ones or whatever. As others have said, you know the risks but it’s something you need to do for your own wellbeing. If it works for you, that’s great. I wouldn’t stress it too much – plenty of people do drink more than that every day and are absolutely fine.

(But really, Pimms and Pina Coladas? Yuck and yuck!)

Heh, what can I say, I like sweet(ish) drinks. Seriously tho, wine antagonises my reflux and I have to be in the mood for beer. But I digress.

I suppose my main concern is whether I’ve inherited my dad’s susceptibility for liver damage. Yes, some people drink much more and it doesn’t harm them, but it is a gamble.

I’m glad you’re enjoying not drinking. I guess parents of young children can’t drink much anyway, as they are responsible for care?

Hi Flash, I really am so sorry to hear how much your pain is affecting your daily life, and that the medication isn’t as effective as you would like (need) it to be.

I know from Ali how frustrating it is to live with chronic pain, and how it gets you down as you feel trapped.in a seemingly hopeless situation. She very rarely drinks alcohol these days because it does not mix with her medication (pregabaline, solpadeine i.e. codeine and paracetamol, sertraline, metaclopramide, clonazepam) and makes her feel sick, though she will occasionally use it to get through a situation like a wedding or something, and agrees it is a very effective painkiller/anaesthetic.

You’re talking about self-medicating, and I’ve certainly known loads of people whose drug or alcohol use started because of the need to relieve pain – with depressants like alcohol, heroin and benzodiazepines, as well as cannabis and over the counter/prescription drugs all with habit-forming potential.

I guess you could think of alcohol as being a drug like any other with possible side effects, and have to make a decision based on weighing up the risks (possible long-term damage to your health, interaction with your medication) against the benefit (reduced pain in the short/medium term).

If you want my advice, I would of course encourage you to discuss your alcohol use with your doctor or specialist, so they can advise you and factor it in to your treatment. I’m not sure what experience you’ve had with other non-medical approaches, e.g. counselling, complementary therapies such as acupuncture, relaxation, mindfulness, meditation etc, but there are many evidence-based holistic therapies which could help you cope.

In terms of self-management, you are the expert on your pain and your life and I know you practice pacing yourself. If you wanted to try cutting down your alcohol use, you could try gradually reducing e.g. from 7.5 units a day to 7, for one week, and monitor your symptoms to see if you can reduce further by any amount. If you have your alcohol when the pain gets too much, rather than routinely, you may be able to reduce your tolerance and need less to get the effects, and stop it increasing any more. It’s certainly complicated though with the medication you’re on, and your existing health condition, so again I would have to stress getting medical advice.

I’m so sorry you lost your wonderful dad and watched his health deteriorate towards the end of his life. There’s nothing that can ease that pain except time, and I know you have loads of happy memories of him (I have some too) as well as the sadness. I’m here if you want to talk.

Finally thanks again for your support and promotion of my Dry January endeavours, and for sharing your thoughts and perspective on my blog – I’ve written replies to your comments there as well as here.

I wish I had a magic wand but recovery (from physical or mental health issues, and alcohol/drug issues) is a long process. I hope your life will get easier in future, and also that you realise how many people really care about you. Much love to you and Mike X

Hi Beth, thanks for your long and thoughtful reply, it is appreciated. I’ve been pondering it, but don’t think I have much more to add.

One thing though, my GP and consultants do know how much I drink. They always have, I am completely up front about this, as they need to know that I will be drinking alcohol while taking whatever they may prescribe. I have also explained to my rheumatologist that I am not happy drinking, because of how my dad died, and that I want to find alternatives. But we have tried strong painkillers and although I didnt want to drink while on them (as my pain was reduced) they did make me a zombie so I had to stop. The search goes on. I’m on the waiting list to see a psychologist for help managing my pain, and I hope it helps as I think that may be the last option open to me. Anyway, long story short, of course all my medics know how much I drink, and that I would rather have an alternative pain relief. I think it would be irresponsible if I wasn’t up front about it, and might affect how they treat me.

Thanks for your kind comments about my dad. I miss him so much.

I’m reminded, every so often, of how my diabetes has reduced my life expectancy. When that happens I find myself of a mind not to try to extend my life, but to try to live it well.
I see your alcohol use in that light; it’s not consequence free, but it allows you to have a life you can enjoy and share with others. For that, I’m grateful.

Thank you, that’s a good way of looking at it. That was a lovely comment.

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