Monthly Archives: February 2014

Sober safety plan

It is standard practice in my day job that if there is a worrying behaviour being demonstrated by a young person or they are involved in a difficult situation we would implement a safety plan to help them manage it and to ensure that we have assessed any risk to them posed by this.

For my drinking I have this ‘safety’ plan in my head but you could easily commit it to paper much like the changing behaviour contract detailed in this post.  This is a plan of action for when the cravings strike.  Obviously the best scenario is that you manage your triggers, as detailed here, so that it doesn’t reach a craving crescendo but sometimes it is just unavoidable.

My safety plan if a craving strikes is:

  1. Use the 15 minute rule which you can find here
  2. If that didn’t working, I’d talk to my husband (who is 6 days ahead of me)
  3. If that didn’t work I’d email my sober penpal Belle
  4. It that didn’t work I’d blog about  it
  5. If that didn’t working go to bed, irrespective of how early it is, and see how it is tomorrow
  6. If that didn’t work I would then find an AA meeting.  I haven’t yet reached this point and know from my fellow bloggers that this can be a saving lifeline and I would use it.

I found it important to try and contingency plan a worse case scenario because I did not want to drink under any circumstances and I knew that wolfie would strike if I wasn’t sure of what my ‘in case of emergency’ action plan was!

Committing to stopping


Like the postcard above I had always made stopping drinking a joke.  That was my defense mechanism to what I knew was a pretty serious problem, even if none of my friends or family saw me as any worse than any of them.  But now I wanted to take it seriously and so I made a contract with myself.

This contract is modelled on the making changes worksheet taken from the centre for smoking cessation and training here in the UK.  It could be used for any change that you are considering making.

It detailed the change I wanted to make to my drinking, and could just as easily be used for moderating for a specified length of time if you are not ready to stop completely.

It considered; how changing/not changing made me feel. how changing/not changing might affect how others viewed me and the consequences to myself and other people

It listed the advantages and disadvantages of both making the change and not making the change and the conclusions that I had come to.

It then listed a ratings scale of how motivated I was about the change and how confident I felt about the change.  Finally at the bottom it had a section for other considerations. So for me previously when I used it to give up smoking I included the risk of drinking alcohol while quitting smoking as for me the two went hand in hand.

Critically I completed it when I was really hungover and my desire to change was at it’s highest. I then posted it up on the front of my fridge so when ever I was tempted to consider having a drink it was there as a reminder of the deal I’d made with myself.

You can use this with yourself progressively as you moderate or stretch your duration of non-drinking to longer and longer time frames.  You can keep former contracts as a record of progress and to see how your motivation and confidence changes over time and what influences them as you learn more skills to manage your drinking.

If you would like a print friendly pdf version it is included in a guest feature article that was published on Soberistas yesterday here 🙂

thank you

Hi Lucy,

I stumbled across your blog, from mumsnet I think, about a month ago, and the first post that I read was this:

I wasn’t thinking about giving up alcohol and was utterly unaware of the phenomenon of “sober blogs” (I don’t normally spend much time online). I was worried about my drinking, have been for years between periods of sticking my head in the sand, so I guess just the title of your blog appealed to me.
As I read your list of how you used to moderate, I felt connection, amused recognition: yes, I’ve tried that, tried that, ooh, haven’t tried that, looks like a good idea. Because I hadn’t seen your blog before I didn’t get the point until the last line – and it’s impact was huge.
I genuinely never thought I could stop – I would always try to moderate because the alternative seemed too horrific for me to even contemplate, but I stopped three days ago and I have no intention of drinking again. I don’t know how things will turn out, I have so many fears and uncertainties, but something has changed inside me over the last month. I see myself and the problem booze differently now and I can’t go back to how it was. Part of that change is down to your blog, to that post – I found it at just the right moment, a moment of true serendipity.
So I wanted to say thank you – thank you.
PS – have signed up for Belle’s 100 day challenge and already have a new addiction – sober blogs!

Thank you for the thank you 🙂  So glad you found the blog helpful and that you have joined Belle’s 100 day challenge.  She was a god-send in the early days for me.  Please feel free to email me too if you would find that beneficial.  I’m at the almost 5 month mark and like you never thought I would be able to stop but I have.  It is possible and if my experience is anything to go by you will not recognise yourself or your life in a few months time.  Keep me posted as to how you’re doing and welcome to the sober blogging community.  They are wonderful and have been pivotal in me staying off the sauce.

Thank you again for emailing me – you have made my day as it makes my blogging feel of value 🙂


(Edited to add: MTM has started her own blog so you could always go visit and say hello :))

I love what sobriety has given me both internally and externally and I owe a huge thank you to the sober blogging community too, so thank you xx

Drinking worries

I have been reading and watching so much stuff online since I stopped drinking.  All the free time I suddenly have has been put to very good use with learning things to help me on my sober journey.

I not only read sober blogs but other blogs too as so much can be gleaned and applied to the sober path.  I was watching a video interview between Marie Forleo and Dr Ned Hallowell about why smart people under-perform.  And one of the points that was made really resonated with me.  They were talking about worry and how stuck you can get in the worry space.  They gave 3 handy tips to avoid the worry trap:

  1. Never worry alone
  2. Get the facts
  3. Make a plan

When I think about how much time I spent worrying about my drinking and not doing anything about it.  How I was alone in my drinking problem.  How I didn’t know how to go about changing it.  How I didn’t know what to do to go about changing it.  These three simple steps would have helped me immensely in moving me from worrying about it to doing something and therefore easing my concerns and ultimately solving the problem.

As soon as I found the sober blogging community I knew I wasn’t alone as I read their blogs and could see that they had experienced very similar things to me when they drank.  I knew the facts about alcoholism from my time nursing alcoholics but I didn’t see myself as an alcoholic and wasn’t aware of any alternative view or way forward.  Again I found the answers online and that knowledge of how to change things enabled me to make a plan to move from dependent drinker to non-drinker.  It is said so often within this community that the best thing you can do is reach out and comment or ask or blog and it is so true.  A drinking problem shared is a drinking problem halved 🙂

Dying for a drink

I read this with interest recently:

Russian men losing years to vodka

Russian men who down large amounts of vodka have an “extraordinarily” high risk of an early death, a new study says.

Researchers tracked about 151,000 adult men in the Russian cities of Barnaul, Byisk and Tomsk from 1999 to 2010. They interviewed them about their drinking habits and, when about 8,000 later died, followed up to monitor their causes of death.  The risk of dying before age 55 for those who said they drank three or more half-litre bottles of vodka a week was shocking 35%.

Overall, a quarter of Russian men die before reaching 55, compared with 7% of men in the UK and fewer than 1% in the United States. The life expectancy for men in Russia is 64 years, placing it among the lowest 50 countries in the world in that category.

Alcohol has long been a top killer in Russia and vodka is often the drink of choice, available cheaply and often homemade in small villages. Previous studies have estimated that more than 40% of working-age men in Russia die because they drink too much, including using alcohol that is not meant to be consumed, like that in colognes and antiseptics.

Drinking is so engrained in Russian culture there’s a word that describes a drinking binge that lasts several days: zapoi.

You can read the full article here.  This matches my experience on an alcoholic liver disease ward that the majority of patients were male, late 40’s to early 50’s, who were drinking primarily spirits.  The average male life expectancy in the UK is 80 so drinking knocks an enormous 25 years off their life.

I thought I’d end this post on a more cheery note by wishing you a Happy Valentine’s Day. The biggest gift that Mr Hangoverfree and I have given ourselves today is sobriety and choosing not to celebrate with champagne but with chocolate.  In the eponymous words of Renton in Trainspotting ‘Choose your future, choose life’.

NekNominations and alcohol poisoning

I read with sadness in the news yesterday that another person has died as a result of completing a neknominate challenge.

NekNominations are an online drinking game that encourages the participant to drink a pint of alcohol whilst filming themselves doing it and then posting it up.  The participant then nominates two others to do the same, although a third nomination has become commonplace. The nominated person has to complete the task within 24 hours.  As the game spread it escalated with nominees performing the challenge in more extreme circumstances by drinking more potent beverages or engaging in dangerous activities either during or immediately after consuming their beverage. This has resulted in four confirmed deaths of participants, two in the UK and two in Ireland since the craze surfaced less than 2 weeks ago (source).  And now the game has claimed it’s third in the UK  who allegedly attempted to drink a pint of vodka.

Drinking a pint of vodka in one go will give you alcoholic poisoning.  Alcohol poisoning is a dangerous and often deadly occurrence and is caused by an excessive, rapid intake of alcohol, far beyond what the body can process.  This leads to your blood alcohol concentration (BAC) rising and a BAC of over 400mg per dl can result in severe breathing difficulties, coma and death.  At very high levels, alcohol affects the nerves that control automatic actions, like breathing, your heartbeat, and your gag reflex (which stops you from choking).   Excessive alcohol consumption can slow or even shut down these functions, causing you to stop breathing and become unconscious (source).

People need to understand that these neknominations can be fatal because alcohol is not a benign substance that you can drink in endless amounts without  harm.  It is a toxic poison that excessive ingestion of will kill you as it tragically has in the case of these young people.

Craze’s and foolish dares come and go but this one needs to be addressed quickly before it claims another life.

17/02/2014 Edited to add: Neknomination craze claims fifth victim Bradley Eames who mixed two pints of gin with teabags and died four days later (source)  🙁

21/02/2014 Edited further to add: Neknominate craze spreads to primary schools (source)

Recollections of nursing alcoholics

I am a nurse who for 4 years worked on a Digestive Diseases Unit which included the care of alcoholic liver disease patients.  This was almost 10 years ago so these recollections are based on my experiences at that time.

If I was to recount a day in the life of a nurse on this ward then this is how it would have been.  After receiving hand-over from the night staff our first duty would be to do the drug round.  Drugs played an important role in the management of liver disease whether we were managing initial withdrawal from alcohol, trying to correct vitamin and mineral levels with intravenous thiamine, folic acid and multivitamins or whether we were administering opiate based pain medication.

We had two types of alcoholic liver disease patients, the acute and the chronic.  Though their disease was at different stages the life-threatening nature of it remained the same.  The acute would include patients with pancreatitis.  This is excruciatingly painful and because it is caused by inflammation of the pancreas has the additional risk to blood sugar management and therefore diabetes risk.  Other acute patients included those who were just beginning the detoxification process and were at risk of epileptic fits, patients who were actively bleeding from gastric ulceration which meant they would vomit or defecate fresh blood or those whose blood pressure around their liver had become so raised that they would burst veins around their oesophagus and bleed out profusely, effectively internally drowning in their own blood.  These patients would require intensive monitoring and blood transfusions if bleeding was extensive.  Drinking affects the clotting mechanism within the blood and we would be vigilant for signs of additional clotting and bleeding.  Observations of temperature, pulse, blood pressure and blood sugar was extremely regular as was monitoring and management of fluid balance, that is what we were infusing intravenously, or they were drinking, and what was being excreted either urine or other fluid loss, such as bleeding or removal of ascites.

Our chronic patients were those whose liver disease was more advanced.   This would include patients with re-feeding syndrome, where they would need intravenous electrolytes and tube feeding as their digestive system was so disordered that they could not eat normally.  Patients whose liver had stopped working and so fluid would collect in their abdominal cavity and would require drainage, called an ascitc tap.  Patients who would come in comatose from toxicity and would require bowel management medication to clear the toxins from their gut.  Patients who were confused, due to Wernicke-Korsakoff’s syndrome, or wet brain, where vitamin deficiency causes dementia.  Finally we had terminal liver disease patients who were admitted for care and management in their death.

After the drug rounds, we would attend to the Dr’s round where management, progress and further treatment regimes would be discussed and implemented.  From there we would help the patients to wash and dress if needed, provide food and drink if they were able to eat, although many could not.  We would manage the tube feeds, drain their ascites replacing any fluid removed with albumin to rebalance their low protein levels.  They would often be emaciated, with skinny arms and legs from muscle wastage with large rotund bellies from swollen livers and fluid collection.  Many were profoundly yellow from jaundice and dehydrated and rehydration was a crucial part of their treatment.

There would be another drug round at lunch time and we would ensure that all our paperwork was accurate and up-to-date before handing over our patients to the next shift of nursing staff.

This was an exceptionally busy ward and we would have responsibility of between 2 and 7 patients depending on how acutely ill they were.  Transfers and escorts to other units, such as endoscopy or intensive care were routine.  Cardiac arrests were common and a shift would fly by as we were so rushed off our feet.  It could be a depressingly sad place to work as many patients would be admitted repeatedly and it felt like a ‘revolving door’ much of the time with ‘frequent fliers’ who were unable to address their drinking becoming increasingly ill with each admission.  Every patient was offered drug and alcohol counselling and support whilst they were in-patients with out-patient follow up but disappointingly many did not engage with this once they were discharged.

I felt very honoured to work on this ward and care for these patients but it left me with no illusions as to the harm that alcohol does both in the short term and the long term.  I also wrote a guest post for Veronica Valli, which was published yesterday, that is my account of caring for a dying alcoholic that you can read here.

Drinking, sleep and dreams

I didn’t use to go to sleep after drinking but more often than not passed out cold into a disappointingly pathetic version of restorative sleep.  I would wake feeling like not only had I not slept but that I could sleep another full night again then and there.  It was shockingly poor quality sleep and for a girl, who after years of doing shift work, could sleep standing up in broad daylight this was unhappy making indeed.  Having a drink to help you sleep is the biggest misnomer on the planet!

In those days I didn’t really dream as have nightmares and these were vivid and frightening with periods of sleep paralysis. This is because what I was experiencing was a waking dream condition called the hypnagogic state induced by a night of heavy drinking.  This was a compensatory REM period to replace the normal stages of sleep, including normal REM sleep which dreaming is a by-product of.

The sleep cycle progresses through four stages, starting with stage one or alpha sleep.  If undisturbed sleep then moves through stage two and three to delta or slow-wave sleep at stage four.  Both REM and slow-wave sleep are believed to be necessary for the brain and body to recuperate and function at optimal levels the next day and the average person spends about 25% of the night in this restorative sleep.  Because I was anaethetising myself rather than falling asleep I was missing the normal stages of sleep and hence the not feeling rested.

Nowadays I sleep like a baby and have only just experienced a drinking dream that was close enough to waking as to be remembered.  My dream involved me drinking cider even though I knew that I had stopped and not only did I feel awful in the dream for doing so I awoke with this strange sense of guilt.  The relief of knowing that it was only a dream was huge and it is the first nightmare that I have experienced in almost 5 months.  Funny that as it is almost 5 months since I quit 😉

Alcohol and depression

I had several bouts of depression during my drinking years, mainly reactive depressions caused by bereavements or being bullied.  As I self-medicated with alcohol that was usually my first line treatment.  I also referred myself to the GP practice for counselling to overcome it but on one occasion this was not enough to help me and I was prescribed anti-depressants.  I took the course of anti-depressants and my low mood improved but in hindsight I realise that my drinking was probably not helping things at the time.  I was prescribed a selective serotonin re-uptake inhibitor (SSRI) and it is recommended that you do not drink whilst taking this medication.  I roundly ignored this advice washing down my tablet every day with a glass of wine.  I mentioned in another post recently how much better my mood had been since I quit and this got me thinking and researching.

Last year a newspaper article reported the results of a survey of tens of thousands of GP’s sick notes and found that 35 per cent of illnesses were linked to stress, anxiety or depression. In the United Kingdom, the use of antidepressants increased by 234% in the 10 years up to 2002 and the number of antidepressants prescribed by the NHS in the UK almost doubled during one decade, authorities reported in 2010. Furthermore the number increased sharply in 2009 when 39.1 million prescriptions were issued, compared to 20.1 million issued in 1999. Also, physicians issued 3.18 million more prescriptions in 2009 than in 2008 (source).  This is an alarming statistic in itself and I began to wonder how many other people were like me and had continued to drink whilst taking them?

A meta-analysis of depression and substance use among individuals with alcohol use disorder found that high rates of depression are common among individuals with alcohol use disorders (AUD), particularly alcohol dependence. Data from the National Comorbidity Survey estimated the lifetime prevalence of major depression to be nearly one quarter (24.3%) among alcohol-dependent men and nearly one half (48.5%) among alcohol-dependent women, exceeding the prevalence rates among individuals without AUD. In clinical samples, the lifetime rates of co-occurrence are greater still, ranging from 50% to 70%.

Research has shown that the pharmacological effects of alcohol may produce symptoms of depression more or less directly during periods of intoxication and/or withdrawal.  Relatedly, laboratory studies have shown that depressive symptoms can spontaneously emerge in the context of heavy drinking and abate with abstinence.

So my thinking has become how much of my depressive symptomatology was caused by, or certainly exacerbated by, my drinking? And also how many other people may be being prescribed anti-depressants for depression that is caused or exacerbated by drinking and yet they do not know this link between drinking and depression and continue to drink?

Edited to add: 29th April 2016

Drinking Alcohol While Taking Antidepressants Could Exacerbate Depression, Increase Drug’s Side Effects

The Drinkers Paradigm

If you have longstanding friendships that had previously focused on drinking as the main recreational activity it may be wise to avoid both the people and the places for a bit.  Although you may be very pleased with your new way of living they may not be quite so welcoming or appreciative and they may feel that the status quo has been threatened.

Here are a couple of examples of our experiences:

  • You may be excluded; group of friends drinking alcohol and because you no longer drink you are not only not offered any, you are not offered anything at all.  As a non-drinker you are effectively ignored.
  • You may be become the butt of jokes; meal at friends house with group of drinking friends.  Wine and water glasses provided for all guests except you who is provided with nothing.  This is then joked about at the table with the comment ‘we were going to provide you with plastic toddler beakers with the word rehab on the side’.
  • You may attract pity; late in an evening when much drinking has been done by everyone but you is met with pity by the other drinkers as in ‘you must really want a drink by now and it must be really tough for you to have to sit here and watch all of us get sh*tfaced’.

These experiences weren’t much fun and it can be hard not to take them personally.   It can also result in the desire to drink as a way of fitting back in if you aren’t solid in your resolve.

It is best to avoid the dangers of the drinkers paradigm in the early days and you may come to the conclusion that if this is their way of dealing with the change that you have made that you need to sadly re-assess the value of some friendships.