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A drug that cures alcoholism may be the next anti-anxiety medication

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Re: A drug that cures alcoholism may be the next anti-anxiety medication

#181
post #179

Earlier quoted context omitted.

> 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.

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 goo…

Well, I've known a lot of ex-everythings (over the last 40 years). I have never personally known anyone that has died from detox of alcohol, or anything else.

However, I have listened to many, many horror stories (and seen them, acted out, in front of me). In all cases, the benzo withdrawals took forever (like months and years), and included seizures, hallucinations, and neverending insomnia.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#182
post #179

Earlier quoted context omitted.

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 goo…

Well, I've known a lot of ex-everythings (over the last 40 years). I have never personally known anyone that has died from detox of alcohol, or anything else. However, I have listened to many, many horror stories (and seen them, acted out, in front of me). In all cases, the benzo withdrawals took forever (like months and years), and included seizures, hallucinations, and neverending insomnia.

Ok. I think we are on the same page. I have never seen a detox death either. I have heard that benzo's are the hardest to withdraw from, and it does sound pretty frightening. For a lot of alcoholics the hardest thing to quit is nicotine. The really scary cases are the folks who start taking Valium to keep from shaking until they start drinking.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#183
post #182

Earlier quoted context omitted.

Well, I've known a lot of ex-everythings (over the last 40 years). I have never personally known anyone that has died from detox of alcohol, or anything else. However, I have listened to many, many horror stories (and seen them, acted out, in front of me). In all cases, the benzo withdrawals took forever (like months and years), and included seizures, hallucinations, and neverending insomnia.

Ok. I think we are on the same page. I have never seen a detox death either. I have heard that benzo's are the hardest to withdraw from, and it does sound pretty frightening. For a lot of alcoholics the hardest thing to quit is nicotine. The really scary cases are the folks who start taking Valium to keep from shaking until they start drinking.

> The really scary cases are the folks who start taking Valium to keep from shaking until they start drinking.

Knew someone that came off a 17-year Valium addiction.

Took them a year and a half to stop hallucinating, and three years, to get a full night's sleep.

They're still around (40 years later), and doing great.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#184

Earlier quoted context omitted.

I use Disulfiram and it has been a godsend for me. It takes away the choice, I am physically unable to drink, my mind makes this easy for me, it's simply not an option so I don't even consider it. I realize it's not for everyone but it has saved me. I had to go out of country for it, doctors do not like to prescribe it. I hoard it.

I'm truly glad it works for you and nothing that I or others say should distract you from that course. I know it works for some people and I knew that before I posted that comment. Again, that's truly great for them. However, it's my understanding that all too many do not have your level of self-perception nor do they have the same level of self-control that you do and so they end up on a horrible carousel ride until…

I did not mean to dismiss it's negative side effects , this is a dangerous drug. For a general purpose anti anxiety it's a down right terrible choice, even to suggest it feels irresponsible. Chugging a bunch of alcohol while on this ( if say you forgot your anti-anxiety meds were also an anti alcohol drug ), might literally kill you.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#185

Earlier quoted context omitted.

I know, this is the utter tragedy of it. Like others I've no additional wisdom to add except to say we need science to urgently find a less dangerous psychotropic substitute for ethanol - if such a substitute is actually possible.

Alcohol acts a lot like benzodiazepines in the brain, and it inhibits the serotonin transporter like SSRIs do, and it has NDRI-like action, as well. Personally, I think a lot of alcohol consumption is self-medicating to treat symptoms that could be treated with drugs with better safety profiles. Of course, self-medication with addictive substances leads to physical dependence, making it harder to substitute other dru…

I think there's little doubt that those who consume excessive alcohol regularly over long periods are self medicating. I'm almost certain this was so with my aforementioned friend and colleague who died from the effects of alcohol.

Decades earlier he'd been hooked on benzodiazepines and could never seem to get enough of them. He was always concerned about being caught short without them and that his supply might run out before he could get a renewal of his prescription (supply became a problem in the '70s/'80's when doctors became aware that they were addictive and that too many people were abusing them). As he was an organic chemist by training, I used to joke with him that he should concoct up a supply in his kitchen.

For him, benzodiazepines where highly effective (at least so over the short term). I've seen him in a jittering state of nervous anxiety and being totally unable to function yet an hour or so after swallowing a couple of 5mg Valium tablets he'd be as normal and calm as everyone else around him. Of course, by then, it was impossible for me to determine how much of his anxiety etc. was part of his condition and how much was attributable to benzodiazepine withdrawal.

You are lucky that your friend was saved from multiple organ failure just in time with proper care, but that wasn't to be with him. Two or three years ago it would have still been so technically, but in the end his medicos, psychiatrist and his friends were unable to help—as essentially he refused to help himself.

Obviously, good medical care often helps but it seems to me we've still a long way to go before we've alcoholism licked for good.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#186

Earlier quoted context omitted.

I'm truly glad it works for you and nothing that I or others say should distract you from that course. I know it works for some people and I knew that before I posted that comment. Again, that's truly great for them. However, it's my understanding that all too many do not have your level of self-perception nor do they have the same level of self-control that you do and so they end up on a horrible carousel ride until…

I did not mean to dismiss it's negative side effects , this is a dangerous drug. For a general purpose anti anxiety it's a down right terrible choice, even to suggest it feels irresponsible. Chugging a bunch of alcohol while on this ( if say you forgot your anti-anxiety meds were also an anti alcohol drug ), might literally kill you.

Right, clearly you're on top of the info and that's what counts. Trouble is, most aren't which is most unfortunate.

Re: A drug that cures alcoholism may be the next anti-anxiety medication

#187

Earlier quoted context omitted.

> My recollection is that accumulation of aldehyde is also the danger of consuming methanol. I assume you mean ethanol, because methanol is highly poisonous (even a fraction of a shot will make you go blind). But yes, alcohol is broken down into acetaldehyde.

No, my recollection was that methanol is metabolized into something which “pickles” you but I may well be wrong.

No, you're not wrong if you're referring to methanol, you could well say methanol 'pickles' the liver and you'd be correct. With ethanol it's somewhat different, chimeracoder is correct when he says alcohol (i.e.: ethanol) is metabolized into acetaldehyde. Here's a slightly more detailed account:

From my understanding acetaldehyde is formed in the body by the partial oxidation of ethanol—if one's body oxidized it completely then I guess there would be little problem (but it doesn't)! Instead, the body has two goes at 'neutralizing' ethanol, acetaldehyde being the first metabolite and the second is that acetaldehyde is converted into vinegar (acetic acid) which is essentially harmless.

Methanol is worse—much more so. It's first-pass metabolite is formaldehyde (right, it's an excellent 'pickling' preservative), and the second-pass metabolite is formic acid (that's the stuff ants sting you with). Thus methanol double-whammies you and unfortunately it does it par excellence.

Methanol is damn horrible stuff really, less than 100ml can kill one outright and if you survive then, as chimeracoder says correctly, you'll likely be left permanently blind not to mention ending up with other serious problems. In fact, one of the emergency procedures for methanol poisoning is to repeatedly give copious quantities of ethanol for quite some length of time—as in the first instance it substitutes for methanol, ethanol's delaying action then gives the body much longer to metabolize methanol and this delay has the effect of ameliorating some of the damage it causes. Here, ethanol is much the lesser of two evils.

That said, acetaldehyde is more toxic than ethanol and it's far from being benign (for starters it's what gives you your hangover but that's not the end of it). Whilst it doesn't have the immediate punch of formaldehyde, acetaldehyde is nevertheless still dangerous for several reasons, first the body is capable of metabolizing ethanol in the liver with the enzyme acetaldehyde dehydrogenase however this process is not exactly straightforward nor is the metabolism of ethanol completely benign; second, the dangerous aspects of acetaldehyde dehydrogenase's metabolism of ethanol is that it often results in cumulative damage to the liver over the long-term, especially so when ethanol is taken in large amounts.

There's a few Wikis on this but they're a bit complicated for a quick understanding, nevertheless the second link on alcoholic liver disease has a nice diagram that illustrates how long-term liver damage happens:

https://en.wikipedia.org/wiki/Acetaldehyde_dehydrogenase

https://en.wikipedia.org/wiki/Alcoholic_liver_disease

Right, I shouldn't have used the word 'pickling' but I was using it in the vernacular and, as here, I did actually use it in inverted commas.

Another way of looking at it is that long-term ethanol/acetaldehyde damage to the liver leads to cirrhosis of the liver—and cirrhosis is in effect the death of liver cells which are then replaced by scar tissue (that's close enough to 'pickling' methinks).

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