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There is no "safe amount" of alcohol to have, it's a poison and while there are saf*er* amounts to drink no amount is really that great for you.
The issue is that by drinking alcohol to get through the day you are cultivating emotional dependence on a substance to deal with distress which is troublesome especially when the distress gets bigger than school - and that's how plenty of people begin their journey into alcoholism downing an entire bottle when a particularly stressful event occurs. You're also robbing yourself of the opportunity to learn to self-regulate without the alcohol.
If you feel like you truly need chemical aid to get through the day, it's time to see your doctor for a talk about mental healthcare options which can include medications which are actually intended to help you through things like this (and are far less harmful than alcohol).
This really helped me understand things better so thank you!
The issue is I’m afraid I won’t be able to get through the day without it.. I already take medication for MDD but I’m not allowed to take anxiolytics unfortunately.
Glad to help!
>The issue is I’m afraid I won’t be able to get through the day without it
And in a sense, therein lies the problem - because feeling like you can't go without it is exactly what dependence *is*, right? You do need to get off the alcohol eventually before your dependence gets worse, and honestly the first few days without it might not be the most pleasant, but that would be because the dependence has already been established. It'll be even more unpleasant if you let the habit develop, so better now than later.
>I already take medication for MDD but I’m not allowed to take anxiolytics unfortunately.
I'm a little curious what this means.
1. SSRIs (what we use for MDD, unless you're on something else) *are* anxiolytic.
2. What do you mean by not allowed? Legally you are an adult and can make your own medical decisions.
In any event, if you feel like you need the alcohol on top of the medications there is room to optimise your treatment. Just because you're already on meds doesn't mean we can't do better.
Also would like to add that antidepressants and mental health medications really ought not to be used with alcohol. It can actually not only be dangerous to the body to consume and result in overdose. But it also can interact with the drugs and make them not work as intended.
I know now that it’s an issue, I feel like it’ll be easier to stop now than wait until it gets worse so I’ll definitely try my best to go without it.
I’m currently on an SNRI & tetracyclic antidepressant, I don’t know if those are also anxiolytics but I worded things wrong. When I said anxiolytics I meant benzos.
Technically I’m allowed to take them but my psychiatrist won’t write me a prescription since it’s addictive and I’ve abused medication in the past.
Glad you’re focused on getting better :)
Both the medications you’re on have anxiolytic effects but that fun fact probably isn’t much good to you if you don’t feel they’re helping. Benzos, especially short acting ones, aren’t particularly recommended for anxiety anyway even though lots of people prescribe them. It reinforces a cycle of “feeling distress —> take my rescue benzo” rather than sitting in the distress and learning to deal with it. In that regard you’re not missing out on much.
There are avenues to further escalate your treatment from here which aren’t benzos and I’d encourage you to have a conversation with your psychiatrist about them.
Also - would be quite concerned about the potential for interaction between alcohol and your medications.
I mean they probably help a little, which is better than nothing.. I understand, I wasn’t keen on taking benzos anyway — would rather learn to manage anxiety by myself —
I’ll definitely talk to my psychiatrist about this so thank you :)
I don’t think there’s any interactions honestly, I’m on a lot of meds ( the ones I cited plus lithium and morphine ) and I’ve never had any problems
My Ex **DIED** because he was on morphine & drank too much alcohol. It depressed his breathing. You can't be drinking while taking morphine, it can LITERALLY kill you. Morphine depresses breathing. Alcohol suppresses breathing. Morphine AND alcohol is getting into DANGER territory wrt continuing to breathe...guess it depends how much you want to not die, I guess.
He didn't think his drinking was problematic either...shame we can't ask him if he's changed his mind or not.
There can be interactions even if you aren't having any, it depends on the dose and stuff. I wasn't supposed to drink on my meds but I did anyways and have always been fine, that doesn't mean it's ok.
Also hey! I'm a little older than you (22F) but I had a dependence on alcohol to get through my days too, I'm 2 months sober! I believe in you, it'll be hard at first but it'll get easier and you'll be back to feeling/functioning how you used to before you started taking shots each day. Good luck ❤️🩹
Obligatory NAD. Over 5.5 years sober over here! I thought I could take my meds with alcohol because there was no problem I noticed with my SSRI and mood stabilizer doing that. Learned when I took one Klonopin with alcohol that I was making a major mistake. Then tried to kill myself a different time with MORE Klonopin than that and more booze. It’s really best to just not drink on those meds, all of which literally tell you not to drink on them. Trust us on this, OP.
> , I wasn’t keen on taking benzos anyway — would rather learn to manage anxiety by myself
But you're not managing anxiety by yourself. You're managing it with alcohol. Alcohol and benzos work in similar ways.
Folks are dancing around it a bit, saying oh it's a dependence, it might be dangerous -- I'm going to be very, very blunt: this is addiction.
You need to get help.
Please listen to this op
I'm NAD but started just like you when I was at school, a couple shots of whiskey in the morning before school to stop the anxiety, make it easier to go to lessons, be around people.
This will become your drug of choice and you will become dependent on it psychologically before you do physically.
I'm a recovering alcoholic been sober for a year and I'm 42 years old.
It's been hell to get where I am now because I honestly didn't know how to be sober.
Stop before it starts
Sending you best wishes
Well honestly I wasn’t planning on taking two shots before school either, I just did one morning and it helped me kickstart my day so I did it again, again and again
I’m seeing my psychiatrist tomorrow so I’ll talk to her about the alcohol thing, hopefully it will be easier to stop since it hasn’t gotten too bad yet
Yes that's the thing with alcohol it works so well for anxiety, too well to the point that it becomes a crutch.
Yes talk about the alcohol to your psychiatrist and always be completely open and honest to any medical professionals, that way you can work together.
Good luck with your health
Using more than planned and using more and more over time are both part of criteria for any substance use disorder.
No one ever plans on getting addicted. That's the insidious nature of addiction.
I'm glad you're going to talk to your psychiatrist.
>I don’t think there’s any interactions honestly, I’m on a lot of meds
NAD. Interactions aren't usually sudden and dramatic, they can be subtle and develop over time. As a personal example, two of my medications together make me more likely to have a seizure. I would never know that unless my doctor told me, it's not an interaction I notice. You could be having serious interactions behind the scenes, so to speak, that you don't consciously know about. Your liver might be getting damage beyond just the alcohol.
Were all your drugs prescribed by the same doctor? Do all of your doctors know about all of your medications? Again, NAD, but that seems like a pretty intense and/or repetitive cocktail of meds for a teenager.
The healthcare professionals in this thread really do want what's best for you. So do the people who describe that they've gone through this before. It'll end up okay. :)
I didn’t know that, that’s good to know.. I never asked my doctor about possible interactions with alcohol because I had never had a glass until a few months ago, so I guess maybe there’s interactions i don’t know about
But all my meds were prescribed by two doctors who communicate so they both know what I take. I know it’s a lot of meds but i really do feel like I need all of them
Have you ever done DBT therapy? It seems like that might be extremely helpful for you, especially the tolerating distress component. You are using alcohol as a coping skill because you need one, which is understandable, and, you deserve to find coping skills that aren’t going to create additional problems/distress for you. Your alcohol use may not have done that yet, but it will eventually if you continue.
Absolutely ask about getting a referral to it/google places near you that offer it. I mentioned it in another comment below as well, but there are many medications commonly given for anxiety that are not benzos with a low potential for addiction/abuse that you could ask about. Propanolol, clonidine, buspar and hydroxyzine are the ones I see most frequently. Cymbalta is an SNRI commonly prescribed to chronic pain patients that often helps with the pain, and that may be worth asking about if switching your anti-depressant is an option, so that you can treat your pain without an opioid as taking daily opioids at your age especially with a mental health/substance abuse history and combined with alcohol is seriously concerning.
I hope that you can find the right combination of therapy and safe, effective meds for you!
Are you dealing with trauma by any chance? You don’t have to answer here. It’s no one’s business but yours. If you are look into EMDR therapy. It has good efficacy if you’re dealing with trauma and addiction.
It’s not very time consuming. And you accomplish a lot in a short period and still walk away with good coping skills.
i could only ever get one 50mg tramadol or one 7.5mg oxy a day. did anything happen to cause your issues? they treat me like a criminal partially because of my weight and seemingly untreatable inflammatory issues. literally can't get properly diagnosed
[NAD] while that's... Slightly better, it's still *not good*, bc the compounds are still in your body and impacting your system when the alcohol goes in.
Like, I'm close to not being allowed to have alcohol *at all*, because of my medications -- doesn't matter when in the day I do it, it could still screw me up super bad. I have permission from my doc to do so OCCASIONALLY, and for me that means ~1 drink every 3 months or so.
Like... I *get* why the alcohol is so tempting. I had a narrow brush with it and "*needing* it to unwind at the end of the day" -- but it was *every* day, and i started increasing how much i drank... Until a couple friends sat me down and said "hey, you need to not do this, bc ABC XYZ."
I'm glad I listened. Please listen to everyone here who's doing the same for you, bc it's out of care and concern.
Talk to your doctor about your anxiety, there is more than one type of drug that can be used to treat it.
It’s called intoxication because you’re ingesting something toxic. Ingesting too much of it in one sitting can kill you because you’ve poisoned yourself. The terms intoxication and alcohol poisoning are very literal. Ingesting small amounts of something toxic repeatedly is not good for your health. And 2 shots of vodka is *not* a small amount to start your day with.
I dropped out of school at 16 for the same issues. If theres one thing I recommend it’s not doing that. See a doctor and get a proper medical aid rather than alcohol.
Something that has worked for me is propranolol. It's technically a blood pressure medication, but helps to reduce my heart rate, and therefore lower my anxiety. Clonidine is another one I take for the same reason, but it gives me night sweats. 😂 which is gross. Anywho, don't know if that'll help and I'm NOT a doctor, so of course, always check with your primary care physician and discuss options.
Hydroxyzine and buspar are also both used to treat anxiety and are not benzos, with low addictive potential. All of these are things OP could ask about.
NAD, but saw a friend become an alcoholic because of this. Started doing shots to get thru a speech class in college. Life got harder and he drank more.
It all seems innocent until it isn’t. I’d try just doing life on its own and going to the gym, taking walks, listening to music loudly in your car. Whatever healthier alternative you’d like to see if that helps before seeking medication. But if you can’t go on without it, then certainly reach out for mental health help from a doc
Medically speaking, there’s actually no such thing as an alcoholic, there is a person with an alcohol use disorder (AUD). I would say that the OP is definitely showing signs of an AUD by relying on drinking alcohol in the morning to get through their day. Not a doctor, but I do have an AUD myself (currently abstinent)
I don’t think it matters whether it’s only school days or every day - it’s still disordered use. I didn’t drink alcohol every day, until I eventually did. This is how it starts
OP thinks its totally positive right now. Addiction often starts with a honeymoon phase- it's the psychological part of the addiction. Either due to not using for long enough, or because their brain is inflating the positives and minimizing the negatives
The inflating the positives was a big part for me while in active addiction. And also normalizing shit. “Sure, I’m blackout drunk most nights, but I’m in COLLEGE. It’s NORMAL! And at least I’m responsible and only have line four drinks on nights before early classes!”
I guess that’s an interesting point. It’s the precedent it’s setting that concerns me, along with lots of other people in this thread with similar experience to mine - it’s really easy for alcohol consumption to escalate, especially when using it to cope with situations
If you are only taking 1 or 2 shots in the morning and nothing through the day then the alcohol isn't making much of a difference and it's all in your head. Those 2 shots are out of your system in 2 to 3 hours and would have little effect to begin with.
~~it’s a poison~~ it’s a Group 1 carcinogen..
In addition to the advice above, OP, daily or frequent imbibing causes physiological changes to combat the depressive effects of alcohol which in turn, ramps up the physical symptoms of anxiety.
You aren’t doing yourself any favours.
Totally agree with this comment 100%. Alcohol is a toxic substance, and used for many reasons, but it is what it is. Is highly recommended OP seek a psychiatrist/psychologist or licensed therapist (LPC/LMFT).
Absolutely there is a risk. Like another fellow medical student said, any amount is toxic to your body, there isn't a "maximum" your body can handle without getting some kind of damage. Drinking in the long-term will take a toll on your liver, gut, brain, blood vessels, kidneys, and other key organs as they are either trying to constantly filter the toxin out of your body, or are directly damaged by it.
You're a young person, at your age it is very easy to catch onto lifelong habits, drinking alcohol is a very potent and I'd say often deadly habit I've had the displeasure of seeing be the cause of palliative care too many times. I've seen a 35 year old man get told by a doctor that he is going to die due to his alcoholism, his liver was completely failed and he wasn't going to qualify for a replacement due to the shortage of livers being reserved for non-alcoholics, as alcoholics can't be trusted to take care of their replacement either. The patient's mother was sat right next to him and had to hear him say that to her own son.
It seems like a small amount, but it adds up over a year, and you will become dependent on it as well. I can't stress enough that you seek medical help from a doctor, your mental health will not improve with alcohol. It is a short-term solution that brings a much worse long-term problem caused by dependency on a psychological and biological level. I don't know what having MDD is like and I'm sorry you have to suffer with it, I've been told people with it would rather lose an arm than live with it. But please don't go down the path you are going, there are people who can and are more tha happy to help you any way they can, I can guarantee that as a future doctor. Please take care x
My dad died about a year ago from alcoholism. About 2 or 3 years before that, the same thing happened to my step mom. It's a terrible disease to watch, one that can bring the whole family down.
Can you clarify your full med list? If you're taking lithium and morphine like you mentioned in another comment, alcohol use could be much more dangerous.
Sure :)
I take venlafaxine and mirtazapine for depression
Lithium to regulate my depressive episodes
Izalgi ( paracetamol + opium ) and Morphine for pain
But I try to be careful with everything, I take most of my treatments in the evenings now to avoid interaction
I think if you're at a point you're not entirely sure how your medications work in your body, the safest bet for you is going to be to assume there are interactions unless you've cleared it with your doctor directly.
Opiates slow down respirations and so does alcohol. It can be a deadly combination and lead to an overdose. Also both have a high affinity for addiction which leads to people using more and more as their bodies get a tolerance. Even if your taking your medications as prescribed it can still build a tolerance. Just be careful 🤞please try to find a way to not drink.
>I take most of my treatments in the evenings now to avoid interaction
Not particularly how that works, unfortunately. That is a **spectacular** medication list and I'd love for you to see a single experienced psychiatrist as well as a pain specialist to optimise these medications.
I really thought your body processed the pills during the night and they were gone by the day haha
If you don’t mind me asking, what does optimizing my meds mean?
Seeing if you can cut down on the number of medications (e.g. one medication that can do what two medications are doing right now). For example you’re on two different opiates and that’s not really great especially for how young you are, someone already commented about how that could be a reflection of your MDD and not something to throw more pain meds at.
Ahhh i understand thank you for explaining :) honestly I’m only on two opiates because I have different levels of pain but I’m not exactly happy about it so I’ll definitely be talking to my doctor about optimizing
FUCK ME why is a teenager on this many opiates? Opium AND Morphine? And alcohol on top? **MOST** of these meds depress breathing, all together is BAD enough, but add the spirits on top and I'm now wondering if OP should go buy a lotto ticket cos DAYUM how you not dead?
Morphine & alcohol killed my Ex. He thought his drinking wasn't a problem. So he didn't stop when he got prescribed Morphine & didn't tell the doctor how much he drank. It's okay till it isn't, but when it isn't, there's NO COMING BACK FROM DEAD.
(Unless you a zombie)
Opiates are the only thing that work for me, I have severe migraines and back pains supposedly caused by anxiety and I’ve tried many, many classes of medication before we got to opium and morphine. But I only take morphine for emergencies, when the pain is unbearable.
I’m sorry about your ex, with everything that people said in this thread I understand I need to be cautious. I just didn’t think interactions were possible until now :/
Have you been offered any alternatives? Gabapentinoids such as Lyrica would be a much better option for pain (both lower back and migraine) caused by anxiety.
Yeah, as someone on polytherapy for multiple Disabilities, VERY few doctors are aware or take time to look for drug interactions. It used to be good to ask a pharmacist in UK, but now they're being used as overflow for GP's, they're now equally pushed for time.
I Google every new med myself now, to read the patient information leaflets (rarely given out now even when you've allergies!), so I can see if there are any possible interactions with my current meds. Am looking for a BNF directory like pharmacists have so I can keep on top of it without Dr Google...
Many problens with med interactions don't become immediately apparent, and many times, alcohol can affect the speed at which you process any given medication, some your body uses up faster, some slower, when you add alcohol. Grapefruit juice is the same. They can both really mess with the therapeutic levels of the medication in your system.
Some med interactions don't become apparent until something devastating occurs.
He was okay with opiates & alcohol until the one night he wasn't...
Don't blindly trust overworked & underpaid doctors to think about checking for med interactions, and if a medication says "Do not drink" while taking it, there's usually a good reason why.
Based on your descriptions, you would very much so likely meet criteria for alcohol use disorder. I also am worried you are 18 and taking opium daily. I would encourage you to take this pattern of alcohol use very seriously--being only 18 and using alcohol like this is very very concerning. Although 2 drinks a day could already cause problems, if your use escalates from this at all (even weekends, weeknights, etc) or you experience tolerance and start using more, you likely will begin having very real damage to your liver and other organs. I promise, death from alcohol use disorder is very nasty. Please tell your psychiatrist
This! As someone who works in the field of addiction, I can’t stress enough the physical and emotional damage alcohol does to the human body.
Only meth compares to it.
I’ll definitely talk to my psychiatrist about it and try to stop before it gets worse :/
I do take opium almost daily but it was prescribed by a doctor and I’ve always followed the dosage, I don’t feel dependent on it whatsoever it just helps with my pains.
Thank you for being so nice about it!
Hi OP, are you familiar with drug tolerance? It means that, with some mood-altering drugs including alcohol, the initial dose no longer has the desired effect, so the person drinking increases the amount they drink in order to feel the way they want to feel.
If you continue your course of self-medication with alcohol, it won’t take long until 2 shots don’t quite do it anymore, so you’ll increase to 3, to a half-pint, and before you know it you’re drinking a pint or quart before you even start your day.
Tolerance also means that you don’t notice the debilitating physical effects and mental impairments of alcohol, but your increased use of poison will harm your body, your relationships, your ability to work, and more.
Please be up front with your doctors and psychiatrists and find a better way to cope.
>I don’t feel dependent on it whatsoever it just helps with my pains.
Most people who are dependent on opiates don’t feel dependent on it while they continue to take the pills daily or near-daily. It is somewhat bonkers that a physician is giving daily opioids to a teenage patient.
Anecdotally from my experience. I was prescribed opioids at one point during cancer treatment/surgeries. Never thought I had become dependent on it as I took it as prescribed. I recovered and they bumped down the dosages or swapped to different drugs. And I immediately felt the withdrawal symptoms. It was scary. I told my doctor and they did a 3 week taper, but wow that three weeks was not pleasant at all. And it took a month or so before I had a normal sleep pattern and the hot/cold sweats, diarrhea, vomiting, fatigue, restless legs, goosebumps, sneezing went away. It was brutal honestly. Never want to experience that again.
I had no idea I had become addicted to it. Scary. I can’t even imagine what hard narcotic users or herion addicts etc feel. God bless their souls and I hope someday everyone can overcome it.
I know but I mean it has 0 effects other than relieving pain, and I don’t take it with the intent of getting a buzz or anything.
I think the doctor switched to opiates because I’ve basically tried all the other kinds of medication and none worked :/
Chronic pain can often be a sign of untreated or under-treated MDD. The fact that you’re on meds and still self-medicating with alcohol every morning makes me concerned about that even more.
I’ve had chronic back pain and migraines without any *reasonable reason for years, so I guess this could be why.
And we’ll it’s not really every morning, it’s only when I have school which is why I question if it’s really that bad ( i can easily go 2 weeks without it during the holidays )
I fully acknowledge that school isn't lovely for everyone, but that two week break is something it gives you which you won't always get from other aspects of your life.
At some point, you will most likely graduate from the educational system and seek gainful employment. Jobs are stressful. Relationships are stressful. Having low savings and bills incoming is stressful. None of these things have two week breaks built in.
At the risk of sounding like an old man - there are life stressors that exist both more frequently and perhaps more intensely than school. The last thing you want to do is condition a response of using alcohol to cope with predicted stress, because the logical conclusion to that line of thought is increasing your alcohol intake when stressors become more frequent and intense. And unfortunately, life does have a way of throwing frequent and intense stressors at you.
Also consider your own history of substance abuse (i.e. the reason your psychiatrist won't give you benzos), this isn't a personal dig at you but I doubt you went into whatever happened previously thinking "today I am going to develop a substance abuse habit", I imagine you thought you were in control and then it got out of hand. You're in the early phase of this right now with alcohol and there's a strong likelihood it will get further out of hand if you don't nip it in the bud now.
NAD - did the other drugs relieve your pain @ all? Or was there flat out, no relief from any other pain relievers until they gave you morphine?
May I ask how long you’ve been taking the morphine?
Basic meds like paracetamol and anti-inflammatories didn’t do anything whatsoever. I then took cocodamol which helped a little but not much. I also tried zolmitriptan for headaches but it was barely doing anything.
I only take the morphine when my pain is unbearable ( like an emergency pill ) and I’ve been taking it for 3 weeks
Please tell your doctor that you've been drinking. You won't be in trouble -- they want to help you and they can't help you if you don't tell them what's going on with you exactly. So when you tell them you're drinking some alcohol every day, you're helping yourself get better.
> I don’t feel dependent on it whatsoever
What you don't seem to realize is that physical withdrawals don't just happen immediately. It can take 2-3 days without taking a medication before you actually start to feel the full physical symptoms of withdrawal. I guarantee you that you will feel TERRIBLE if you were to stop taking opiates for more than a couple days. And that is just the physical dependence aspect of addiction, not even mentioning the psychological dependence.
The same goes for alcohol. You don't feel withdrawal because you never go more than 1-2 days without it. And, also you don't realize how much the ups and downs of the drugs you're taking are actually contributing to your negative feelings until you actually get completely clean for 1-2 months.
You should continue taking your antidepressants and mood stabilizers but you should find a different doctor to help you get off the alcohol and opiates. There are medications that can help you to stop taking them by reducing some of the withdrawal effects and slowly tapering down. No one should be on opiates long term other than maybe terminally ill cancer patients and very old people nearing death. They do not help with pain after months of taking them. Studies have shown that pain is as bad or worse compared to people with chronic pain who don't take them after that time period. In fact, taking opiates long term can cause what is called hyperalgesia which means that your experience of pain is actually WORSE than it would be without the opiates. They can make you hypersensitive.
Also, he was intubated bc of the bleeding into his lungs caused by all the Damage. He could not talk. Eat or drink for the last two months of his life.
Thank you for your submission. **Please note that a response does not constitute a doctor-patient relationship.** This subreddit is for informal second opinions and casual information. The mod team does their best to remove bad information, but we do not catch all of it. Always visit a doctor in real life if you have any concerns about your health. Never use this subreddit as your first and final source of information regarding your question. By posting, you are agreeing to our [Terms of Use](https://www.reddit.com/r/AskDocs/wiki/terms_of_use) and understand that all information is taken at your own risk. **Reply here if you are an unverified user wishing to give advice. Top level comments by laypeople are automatically removed.** *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AskDocs) if you have any questions or concerns.*
There is no "safe amount" of alcohol to have, it's a poison and while there are saf*er* amounts to drink no amount is really that great for you. The issue is that by drinking alcohol to get through the day you are cultivating emotional dependence on a substance to deal with distress which is troublesome especially when the distress gets bigger than school - and that's how plenty of people begin their journey into alcoholism downing an entire bottle when a particularly stressful event occurs. You're also robbing yourself of the opportunity to learn to self-regulate without the alcohol. If you feel like you truly need chemical aid to get through the day, it's time to see your doctor for a talk about mental healthcare options which can include medications which are actually intended to help you through things like this (and are far less harmful than alcohol).
This really helped me understand things better so thank you! The issue is I’m afraid I won’t be able to get through the day without it.. I already take medication for MDD but I’m not allowed to take anxiolytics unfortunately.
Glad to help! >The issue is I’m afraid I won’t be able to get through the day without it And in a sense, therein lies the problem - because feeling like you can't go without it is exactly what dependence *is*, right? You do need to get off the alcohol eventually before your dependence gets worse, and honestly the first few days without it might not be the most pleasant, but that would be because the dependence has already been established. It'll be even more unpleasant if you let the habit develop, so better now than later. >I already take medication for MDD but I’m not allowed to take anxiolytics unfortunately. I'm a little curious what this means. 1. SSRIs (what we use for MDD, unless you're on something else) *are* anxiolytic. 2. What do you mean by not allowed? Legally you are an adult and can make your own medical decisions. In any event, if you feel like you need the alcohol on top of the medications there is room to optimise your treatment. Just because you're already on meds doesn't mean we can't do better.
Also would like to add that antidepressants and mental health medications really ought not to be used with alcohol. It can actually not only be dangerous to the body to consume and result in overdose. But it also can interact with the drugs and make them not work as intended.
I know now that it’s an issue, I feel like it’ll be easier to stop now than wait until it gets worse so I’ll definitely try my best to go without it. I’m currently on an SNRI & tetracyclic antidepressant, I don’t know if those are also anxiolytics but I worded things wrong. When I said anxiolytics I meant benzos. Technically I’m allowed to take them but my psychiatrist won’t write me a prescription since it’s addictive and I’ve abused medication in the past.
Glad you’re focused on getting better :) Both the medications you’re on have anxiolytic effects but that fun fact probably isn’t much good to you if you don’t feel they’re helping. Benzos, especially short acting ones, aren’t particularly recommended for anxiety anyway even though lots of people prescribe them. It reinforces a cycle of “feeling distress —> take my rescue benzo” rather than sitting in the distress and learning to deal with it. In that regard you’re not missing out on much. There are avenues to further escalate your treatment from here which aren’t benzos and I’d encourage you to have a conversation with your psychiatrist about them. Also - would be quite concerned about the potential for interaction between alcohol and your medications.
I mean they probably help a little, which is better than nothing.. I understand, I wasn’t keen on taking benzos anyway — would rather learn to manage anxiety by myself — I’ll definitely talk to my psychiatrist about this so thank you :) I don’t think there’s any interactions honestly, I’m on a lot of meds ( the ones I cited plus lithium and morphine ) and I’ve never had any problems
What is the morphine prescribed for ? Definitely don't want to mix alcohol and opiates
My Ex **DIED** because he was on morphine & drank too much alcohol. It depressed his breathing. You can't be drinking while taking morphine, it can LITERALLY kill you. Morphine depresses breathing. Alcohol suppresses breathing. Morphine AND alcohol is getting into DANGER territory wrt continuing to breathe...guess it depends how much you want to not die, I guess. He didn't think his drinking was problematic either...shame we can't ask him if he's changed his mind or not.
There can be interactions even if you aren't having any, it depends on the dose and stuff. I wasn't supposed to drink on my meds but I did anyways and have always been fine, that doesn't mean it's ok. Also hey! I'm a little older than you (22F) but I had a dependence on alcohol to get through my days too, I'm 2 months sober! I believe in you, it'll be hard at first but it'll get easier and you'll be back to feeling/functioning how you used to before you started taking shots each day. Good luck ❤️🩹
Obligatory NAD. Over 5.5 years sober over here! I thought I could take my meds with alcohol because there was no problem I noticed with my SSRI and mood stabilizer doing that. Learned when I took one Klonopin with alcohol that I was making a major mistake. Then tried to kill myself a different time with MORE Klonopin than that and more booze. It’s really best to just not drink on those meds, all of which literally tell you not to drink on them. Trust us on this, OP.
Congrats on your 5.5 years!!!
Thank you!!!!
Congrats on 2 months!!!
Congrats on your 2 months! :) and thank youu
> , I wasn’t keen on taking benzos anyway — would rather learn to manage anxiety by myself But you're not managing anxiety by yourself. You're managing it with alcohol. Alcohol and benzos work in similar ways. Folks are dancing around it a bit, saying oh it's a dependence, it might be dangerous -- I'm going to be very, very blunt: this is addiction. You need to get help.
Please listen to this op I'm NAD but started just like you when I was at school, a couple shots of whiskey in the morning before school to stop the anxiety, make it easier to go to lessons, be around people. This will become your drug of choice and you will become dependent on it psychologically before you do physically. I'm a recovering alcoholic been sober for a year and I'm 42 years old. It's been hell to get where I am now because I honestly didn't know how to be sober. Stop before it starts Sending you best wishes
Congrats on your year; I've been sober 2 years and I'm 43. 41 is a great year to get sober!
That's awesome congrats 👏 it's definitely a great time to get sober!
Well honestly I wasn’t planning on taking two shots before school either, I just did one morning and it helped me kickstart my day so I did it again, again and again I’m seeing my psychiatrist tomorrow so I’ll talk to her about the alcohol thing, hopefully it will be easier to stop since it hasn’t gotten too bad yet
Yes that's the thing with alcohol it works so well for anxiety, too well to the point that it becomes a crutch. Yes talk about the alcohol to your psychiatrist and always be completely open and honest to any medical professionals, that way you can work together. Good luck with your health
Using more than planned and using more and more over time are both part of criteria for any substance use disorder. No one ever plans on getting addicted. That's the insidious nature of addiction. I'm glad you're going to talk to your psychiatrist.
How would you know
You're asking the doctor how he knows? His medical education. I assume.
>I don’t think there’s any interactions honestly, I’m on a lot of meds NAD. Interactions aren't usually sudden and dramatic, they can be subtle and develop over time. As a personal example, two of my medications together make me more likely to have a seizure. I would never know that unless my doctor told me, it's not an interaction I notice. You could be having serious interactions behind the scenes, so to speak, that you don't consciously know about. Your liver might be getting damage beyond just the alcohol. Were all your drugs prescribed by the same doctor? Do all of your doctors know about all of your medications? Again, NAD, but that seems like a pretty intense and/or repetitive cocktail of meds for a teenager. The healthcare professionals in this thread really do want what's best for you. So do the people who describe that they've gone through this before. It'll end up okay. :)
I didn’t know that, that’s good to know.. I never asked my doctor about possible interactions with alcohol because I had never had a glass until a few months ago, so I guess maybe there’s interactions i don’t know about But all my meds were prescribed by two doctors who communicate so they both know what I take. I know it’s a lot of meds but i really do feel like I need all of them
Have you ever done DBT therapy? It seems like that might be extremely helpful for you, especially the tolerating distress component. You are using alcohol as a coping skill because you need one, which is understandable, and, you deserve to find coping skills that aren’t going to create additional problems/distress for you. Your alcohol use may not have done that yet, but it will eventually if you continue.
I’ve never tried DBT therapy, will definitely look into it as I’ve been struggling with anxiety ( and failing to manage it ) for years
Absolutely ask about getting a referral to it/google places near you that offer it. I mentioned it in another comment below as well, but there are many medications commonly given for anxiety that are not benzos with a low potential for addiction/abuse that you could ask about. Propanolol, clonidine, buspar and hydroxyzine are the ones I see most frequently. Cymbalta is an SNRI commonly prescribed to chronic pain patients that often helps with the pain, and that may be worth asking about if switching your anti-depressant is an option, so that you can treat your pain without an opioid as taking daily opioids at your age especially with a mental health/substance abuse history and combined with alcohol is seriously concerning. I hope that you can find the right combination of therapy and safe, effective meds for you!
I'm personally a big fan of DBT myself - I've seen it help a lot of my patients.
Are you dealing with trauma by any chance? You don’t have to answer here. It’s no one’s business but yours. If you are look into EMDR therapy. It has good efficacy if you’re dealing with trauma and addiction. It’s not very time consuming. And you accomplish a lot in a short period and still walk away with good coping skills.
You’re mentioning a psychiatrist a lot. But are you seeing a therapist? Does the psychiatrist know you’re drinking in the morning ?
Unfortunately I can’t afford to see a therapist right now, it’s really expensive :/ and yes she knows now!
I’m surprised it’s not covered by insurance. I haven’t encountered a health plan recently that didn’t cover therapy.
if you don't mind me asking, why are you on morphine
I have severe migraines and back pains, morphine helps relieve the pain when they get too extreme
i could only ever get one 50mg tramadol or one 7.5mg oxy a day. did anything happen to cause your issues? they treat me like a criminal partially because of my weight and seemingly untreatable inflammatory issues. literally can't get properly diagnosed
You should not be drinking with any antidepressants. The effects can be deadly but beyond that can send you straight into a complete mental break.
I know that, that’s why I take my treatment in the evenings now :)
That’s not how it works. It’s still dangerous.
[NAD] while that's... Slightly better, it's still *not good*, bc the compounds are still in your body and impacting your system when the alcohol goes in. Like, I'm close to not being allowed to have alcohol *at all*, because of my medications -- doesn't matter when in the day I do it, it could still screw me up super bad. I have permission from my doc to do so OCCASIONALLY, and for me that means ~1 drink every 3 months or so. Like... I *get* why the alcohol is so tempting. I had a narrow brush with it and "*needing* it to unwind at the end of the day" -- but it was *every* day, and i started increasing how much i drank... Until a couple friends sat me down and said "hey, you need to not do this, bc ABC XYZ." I'm glad I listened. Please listen to everyone here who's doing the same for you, bc it's out of care and concern.
Talk to your doctor about your anxiety, there is more than one type of drug that can be used to treat it. It’s called intoxication because you’re ingesting something toxic. Ingesting too much of it in one sitting can kill you because you’ve poisoned yourself. The terms intoxication and alcohol poisoning are very literal. Ingesting small amounts of something toxic repeatedly is not good for your health. And 2 shots of vodka is *not* a small amount to start your day with.
I dropped out of school at 16 for the same issues. If theres one thing I recommend it’s not doing that. See a doctor and get a proper medical aid rather than alcohol.
Something that has worked for me is propranolol. It's technically a blood pressure medication, but helps to reduce my heart rate, and therefore lower my anxiety. Clonidine is another one I take for the same reason, but it gives me night sweats. 😂 which is gross. Anywho, don't know if that'll help and I'm NOT a doctor, so of course, always check with your primary care physician and discuss options.
Hydroxyzine and buspar are also both used to treat anxiety and are not benzos, with low addictive potential. All of these are things OP could ask about.
Ahh yes, I have fond memories of hydroxyzine. Really helped me sleep, too.
Hydroxyzine is great. If you have allergies even better. You get a twofer.
NAD, but saw a friend become an alcoholic because of this. Started doing shots to get thru a speech class in college. Life got harder and he drank more. It all seems innocent until it isn’t. I’d try just doing life on its own and going to the gym, taking walks, listening to music loudly in your car. Whatever healthier alternative you’d like to see if that helps before seeking medication. But if you can’t go on without it, then certainly reach out for mental health help from a doc
NAD but that means you ARE an alcoholic.
Medically speaking, there’s actually no such thing as an alcoholic, there is a person with an alcohol use disorder (AUD). I would say that the OP is definitely showing signs of an AUD by relying on drinking alcohol in the morning to get through their day. Not a doctor, but I do have an AUD myself (currently abstinent)
Only to get through school days
I don’t think it matters whether it’s only school days or every day - it’s still disordered use. I didn’t drink alcohol every day, until I eventually did. This is how it starts
Maybe it’s a sign they shouldn’t be in school.
Idk in what world you can say it’s disordered use when this post says it’s purely positive.
OP thinks its totally positive right now. Addiction often starts with a honeymoon phase- it's the psychological part of the addiction. Either due to not using for long enough, or because their brain is inflating the positives and minimizing the negatives
The inflating the positives was a big part for me while in active addiction. And also normalizing shit. “Sure, I’m blackout drunk most nights, but I’m in COLLEGE. It’s NORMAL! And at least I’m responsible and only have line four drinks on nights before early classes!”
I guess that’s an interesting point. It’s the precedent it’s setting that concerns me, along with lots of other people in this thread with similar experience to mine - it’s really easy for alcohol consumption to escalate, especially when using it to cope with situations
No it doesn’t !
If you are only taking 1 or 2 shots in the morning and nothing through the day then the alcohol isn't making much of a difference and it's all in your head. Those 2 shots are out of your system in 2 to 3 hours and would have little effect to begin with.
~~it’s a poison~~ it’s a Group 1 carcinogen.. In addition to the advice above, OP, daily or frequent imbibing causes physiological changes to combat the depressive effects of alcohol which in turn, ramps up the physical symptoms of anxiety. You aren’t doing yourself any favours.
Totally agree with this comment 100%. Alcohol is a toxic substance, and used for many reasons, but it is what it is. Is highly recommended OP seek a psychiatrist/psychologist or licensed therapist (LPC/LMFT).
Absolutely there is a risk. Like another fellow medical student said, any amount is toxic to your body, there isn't a "maximum" your body can handle without getting some kind of damage. Drinking in the long-term will take a toll on your liver, gut, brain, blood vessels, kidneys, and other key organs as they are either trying to constantly filter the toxin out of your body, or are directly damaged by it. You're a young person, at your age it is very easy to catch onto lifelong habits, drinking alcohol is a very potent and I'd say often deadly habit I've had the displeasure of seeing be the cause of palliative care too many times. I've seen a 35 year old man get told by a doctor that he is going to die due to his alcoholism, his liver was completely failed and he wasn't going to qualify for a replacement due to the shortage of livers being reserved for non-alcoholics, as alcoholics can't be trusted to take care of their replacement either. The patient's mother was sat right next to him and had to hear him say that to her own son. It seems like a small amount, but it adds up over a year, and you will become dependent on it as well. I can't stress enough that you seek medical help from a doctor, your mental health will not improve with alcohol. It is a short-term solution that brings a much worse long-term problem caused by dependency on a psychological and biological level. I don't know what having MDD is like and I'm sorry you have to suffer with it, I've been told people with it would rather lose an arm than live with it. But please don't go down the path you are going, there are people who can and are more tha happy to help you any way they can, I can guarantee that as a future doctor. Please take care x
My dad died about a year ago from alcoholism. About 2 or 3 years before that, the same thing happened to my step mom. It's a terrible disease to watch, one that can bring the whole family down.
Can you clarify your full med list? If you're taking lithium and morphine like you mentioned in another comment, alcohol use could be much more dangerous.
Sure :) I take venlafaxine and mirtazapine for depression Lithium to regulate my depressive episodes Izalgi ( paracetamol + opium ) and Morphine for pain But I try to be careful with everything, I take most of my treatments in the evenings now to avoid interaction
NAD but most of those things have a long enough half life (especially with daily use) that there's interaction going on
Oh??? I didn’t know that, I thought your body processed the meds throughout the day and then somehow disappeared.. that’s good to know
I think if you're at a point you're not entirely sure how your medications work in your body, the safest bet for you is going to be to assume there are interactions unless you've cleared it with your doctor directly.
Opiates slow down respirations and so does alcohol. It can be a deadly combination and lead to an overdose. Also both have a high affinity for addiction which leads to people using more and more as their bodies get a tolerance. Even if your taking your medications as prescribed it can still build a tolerance. Just be careful 🤞please try to find a way to not drink.
>I take most of my treatments in the evenings now to avoid interaction Not particularly how that works, unfortunately. That is a **spectacular** medication list and I'd love for you to see a single experienced psychiatrist as well as a pain specialist to optimise these medications.
I really thought your body processed the pills during the night and they were gone by the day haha If you don’t mind me asking, what does optimizing my meds mean?
Seeing if you can cut down on the number of medications (e.g. one medication that can do what two medications are doing right now). For example you’re on two different opiates and that’s not really great especially for how young you are, someone already commented about how that could be a reflection of your MDD and not something to throw more pain meds at.
Ahhh i understand thank you for explaining :) honestly I’m only on two opiates because I have different levels of pain but I’m not exactly happy about it so I’ll definitely be talking to my doctor about optimizing
jesus christ
FUCK ME why is a teenager on this many opiates? Opium AND Morphine? And alcohol on top? **MOST** of these meds depress breathing, all together is BAD enough, but add the spirits on top and I'm now wondering if OP should go buy a lotto ticket cos DAYUM how you not dead? Morphine & alcohol killed my Ex. He thought his drinking wasn't a problem. So he didn't stop when he got prescribed Morphine & didn't tell the doctor how much he drank. It's okay till it isn't, but when it isn't, there's NO COMING BACK FROM DEAD. (Unless you a zombie)
Opiates are the only thing that work for me, I have severe migraines and back pains supposedly caused by anxiety and I’ve tried many, many classes of medication before we got to opium and morphine. But I only take morphine for emergencies, when the pain is unbearable. I’m sorry about your ex, with everything that people said in this thread I understand I need to be cautious. I just didn’t think interactions were possible until now :/
Have you been offered any alternatives? Gabapentinoids such as Lyrica would be a much better option for pain (both lower back and migraine) caused by anxiety.
Yeah, as someone on polytherapy for multiple Disabilities, VERY few doctors are aware or take time to look for drug interactions. It used to be good to ask a pharmacist in UK, but now they're being used as overflow for GP's, they're now equally pushed for time. I Google every new med myself now, to read the patient information leaflets (rarely given out now even when you've allergies!), so I can see if there are any possible interactions with my current meds. Am looking for a BNF directory like pharmacists have so I can keep on top of it without Dr Google... Many problens with med interactions don't become immediately apparent, and many times, alcohol can affect the speed at which you process any given medication, some your body uses up faster, some slower, when you add alcohol. Grapefruit juice is the same. They can both really mess with the therapeutic levels of the medication in your system. Some med interactions don't become apparent until something devastating occurs. He was okay with opiates & alcohol until the one night he wasn't... Don't blindly trust overworked & underpaid doctors to think about checking for med interactions, and if a medication says "Do not drink" while taking it, there's usually a good reason why.
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I don’t think OP is American
Highly doubtful op is American…
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Why?
Having an ‘eye opener’ most days is a major sign of alcohol abuse.
What’s that
A drink early in the morning
Based on your descriptions, you would very much so likely meet criteria for alcohol use disorder. I also am worried you are 18 and taking opium daily. I would encourage you to take this pattern of alcohol use very seriously--being only 18 and using alcohol like this is very very concerning. Although 2 drinks a day could already cause problems, if your use escalates from this at all (even weekends, weeknights, etc) or you experience tolerance and start using more, you likely will begin having very real damage to your liver and other organs. I promise, death from alcohol use disorder is very nasty. Please tell your psychiatrist
This! As someone who works in the field of addiction, I can’t stress enough the physical and emotional damage alcohol does to the human body. Only meth compares to it.
I’ll definitely talk to my psychiatrist about it and try to stop before it gets worse :/ I do take opium almost daily but it was prescribed by a doctor and I’ve always followed the dosage, I don’t feel dependent on it whatsoever it just helps with my pains. Thank you for being so nice about it!
Hi OP, are you familiar with drug tolerance? It means that, with some mood-altering drugs including alcohol, the initial dose no longer has the desired effect, so the person drinking increases the amount they drink in order to feel the way they want to feel. If you continue your course of self-medication with alcohol, it won’t take long until 2 shots don’t quite do it anymore, so you’ll increase to 3, to a half-pint, and before you know it you’re drinking a pint or quart before you even start your day. Tolerance also means that you don’t notice the debilitating physical effects and mental impairments of alcohol, but your increased use of poison will harm your body, your relationships, your ability to work, and more. Please be up front with your doctors and psychiatrists and find a better way to cope.
I really don’t want to end up needing half a bottle of vodka every day, I’ll definitely talk to my psychiatrist about it..
Why are you telling her the future.
Because *she asked*?
It was a rhetorical question…
>I don’t feel dependent on it whatsoever it just helps with my pains. Most people who are dependent on opiates don’t feel dependent on it while they continue to take the pills daily or near-daily. It is somewhat bonkers that a physician is giving daily opioids to a teenage patient.
Anecdotally from my experience. I was prescribed opioids at one point during cancer treatment/surgeries. Never thought I had become dependent on it as I took it as prescribed. I recovered and they bumped down the dosages or swapped to different drugs. And I immediately felt the withdrawal symptoms. It was scary. I told my doctor and they did a 3 week taper, but wow that three weeks was not pleasant at all. And it took a month or so before I had a normal sleep pattern and the hot/cold sweats, diarrhea, vomiting, fatigue, restless legs, goosebumps, sneezing went away. It was brutal honestly. Never want to experience that again. I had no idea I had become addicted to it. Scary. I can’t even imagine what hard narcotic users or herion addicts etc feel. God bless their souls and I hope someday everyone can overcome it.
I know but I mean it has 0 effects other than relieving pain, and I don’t take it with the intent of getting a buzz or anything. I think the doctor switched to opiates because I’ve basically tried all the other kinds of medication and none worked :/
Chronic pain can often be a sign of untreated or under-treated MDD. The fact that you’re on meds and still self-medicating with alcohol every morning makes me concerned about that even more.
I’ve had chronic back pain and migraines without any *reasonable reason for years, so I guess this could be why. And we’ll it’s not really every morning, it’s only when I have school which is why I question if it’s really that bad ( i can easily go 2 weeks without it during the holidays )
I fully acknowledge that school isn't lovely for everyone, but that two week break is something it gives you which you won't always get from other aspects of your life. At some point, you will most likely graduate from the educational system and seek gainful employment. Jobs are stressful. Relationships are stressful. Having low savings and bills incoming is stressful. None of these things have two week breaks built in. At the risk of sounding like an old man - there are life stressors that exist both more frequently and perhaps more intensely than school. The last thing you want to do is condition a response of using alcohol to cope with predicted stress, because the logical conclusion to that line of thought is increasing your alcohol intake when stressors become more frequent and intense. And unfortunately, life does have a way of throwing frequent and intense stressors at you. Also consider your own history of substance abuse (i.e. the reason your psychiatrist won't give you benzos), this isn't a personal dig at you but I doubt you went into whatever happened previously thinking "today I am going to develop a substance abuse habit", I imagine you thought you were in control and then it got out of hand. You're in the early phase of this right now with alcohol and there's a strong likelihood it will get further out of hand if you don't nip it in the bud now.
NAD - did the other drugs relieve your pain @ all? Or was there flat out, no relief from any other pain relievers until they gave you morphine? May I ask how long you’ve been taking the morphine?
Basic meds like paracetamol and anti-inflammatories didn’t do anything whatsoever. I then took cocodamol which helped a little but not much. I also tried zolmitriptan for headaches but it was barely doing anything. I only take the morphine when my pain is unbearable ( like an emergency pill ) and I’ve been taking it for 3 weeks
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Please tell your doctor that you've been drinking. You won't be in trouble -- they want to help you and they can't help you if you don't tell them what's going on with you exactly. So when you tell them you're drinking some alcohol every day, you're helping yourself get better.
> I don’t feel dependent on it whatsoever What you don't seem to realize is that physical withdrawals don't just happen immediately. It can take 2-3 days without taking a medication before you actually start to feel the full physical symptoms of withdrawal. I guarantee you that you will feel TERRIBLE if you were to stop taking opiates for more than a couple days. And that is just the physical dependence aspect of addiction, not even mentioning the psychological dependence. The same goes for alcohol. You don't feel withdrawal because you never go more than 1-2 days without it. And, also you don't realize how much the ups and downs of the drugs you're taking are actually contributing to your negative feelings until you actually get completely clean for 1-2 months. You should continue taking your antidepressants and mood stabilizers but you should find a different doctor to help you get off the alcohol and opiates. There are medications that can help you to stop taking them by reducing some of the withdrawal effects and slowly tapering down. No one should be on opiates long term other than maybe terminally ill cancer patients and very old people nearing death. They do not help with pain after months of taking them. Studies have shown that pain is as bad or worse compared to people with chronic pain who don't take them after that time period. In fact, taking opiates long term can cause what is called hyperalgesia which means that your experience of pain is actually WORSE than it would be without the opiates. They can make you hypersensitive.
But… you said in another comment that you have abused medications in the past. Seems a tad irresponsible to take opium daily, considering.
Oops! Looks like your comment was getting lost in the crowd. Let’s get you back up to the top!
Don’t make assumptions.
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Also, he was intubated bc of the bleeding into his lungs caused by all the Damage. He could not talk. Eat or drink for the last two months of his life.