Alcoholic dad

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Hi I really need some advice as I am struggling to cope with my dad's drinking he's been to rehab twice and had a home detox a few months ago he stopped drinking for a few weeks then started again since then he has a few days of the week drinking then stops mainly because money runs out i am also his carer and control all his money I used to give him  £10 a day but he continued to buy alcoholic with it then lying to me to get more money so I had enough and gave him  £70 for the week and said don't ask me for another penny till following week witch he was happy with then yesterday he's beginning me to take all his money away so he can't buy alcohol he says if he has no money drinking doesn't bother him but I've been here so many times he's also on two baclofen four times a day and 15mg of mirtazapine will he ever stop drinking and sorry my writing/grammar I am dyslexic x

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  • Posted

    I should add that when he begged me to take all his money he still had some vodka so I said if you tip the vodka away i will take your money and help you and he said no x
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  • Posted

    Hello Mac,

    What a horrible situation for you to be in, I am so sorry to hear this.

    Unfortunately, rehab and detox do not have great long-term success rates as you have unfortunately found out.  I think stats from the US show that around 90% will relapse within the first four years.

    This is, in part, because alcohol changes our brain so it isn't that your father is a bad person, it is that he has experienced a neurological change in the way the pathways in his brain respond to alcohol, and the longer he tries to stay away from alcohol, the more his those changed pathways in his brain demand it.  His brain has learned that alcohol provides it with a chemical reward and now associates alcohol with that reward.  Unless that change is reversed (there is medication available in the UK that will do this and should really be prescribed long before a relapse is going to happen, it will be extremely difficult to continually resist the demand for alcohol.  He might be able to manage for a little while, but that demand builds to levels that chip away at his resolve.

    Is he currently under the care of a doctor for his drinking issues, or maybe your local alcohol recovery centre? 

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    • Posted

      Okay, thank you for that info, Mac.  Whilst I was waiting for your reply, I just went back over your previous posts here about 6 or 7 months ago and I suspected they had prescribed the Baclofen.

      AA is good for some BUT it doesn't deal with the change in the brain.  What AA does is try help someone find a way to deal with not taking the first drink by following their program.  After over 10 years in AA with continual relapses, my personal opinion is that medication should be offered in order to gradually help weaken those pathways in the brain that have grown so strong over the years, and then if someone wishes to also attend additional support then that is fine, too.

      I am not a doctor so I can't say for sure, but it appears that your father is unlikely to be taking the required dosage of Baclofen to reach the point where the desire switches off.  I am not sure if you remember but in a previous post you made, some replies came back to you that indicated the dosage should be gradually increased up by the doctor until the switch flicks - but most doctors either don't understand this, or just don't like the idea of prescribing in such high doses.

      If this is the case, then taking not enough Baclofen is about the same as only half puttng the plug in the bath!  It isn't enough medication in his brain to actually do what it is intended to do.

      I really think the next step would be to ask him to attend another appointment with his prescribing doctor and ask about this.  If the doctor is not willing to increase the dosage further, then there are other medications that are also effective:  Naltrexone, Acamprosate and the one that potentially can be approved whilst he is still drinking, nalmefene.  Naltrexone and Acamprosate are usually the preferred choice following a detox.  I am really surprised that a UK doctor prescribed Baclofen over either of these, that is very rare.  There is also Disulfiram, but its a terrible medication that could potentially kill your father if he caved in and drank on that one!

      Assuming you are in Liverpool (?), your local NHS guidelines actually state:

      'Acamprosate or naltrexone [unlicensed indication], in combination with an individual psychological intervention, are treatment options for maintaining abstinence in people with alcohol dependence following successful withdrawal. Disulfiram is also effective but should only be used under specialist supervision when acamprosate and naltrexone are not suitable, or if the patient prefers it and there are no contraindications. Nalmefene in combination with psychosocial support is licensed for the reduction of alcohol consumption in patients with alcohol dependence who have a high drinking risk level, without physical withdrawal symptoms, and who do not require immediate detoxification.'

      And PS.  I forgot to say in my first reply, that your writing is perfectly good!

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    • Posted

      Aww thank you joanna he's been on other medications in the past but didn't work and he taking the maximum does of baclofen but I'm not sure he always takes it i just worry about his drinking while taking baclofen and mirtazapine plus what angers me is that he says if he's got no money it doesn't bother him so when he's got money he's acting like a child and runs to the off licence x

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    • Posted

      Adherence to any medication is always vital, yes.

      Some studies I have seen indicate that many needed 200mg and sometimes higher before things started to happen.  Has the doctor really prescribed him anywhere near as high as that?

      I will send you the link privately since I can't post it on here.

      Ignore most of the complicated text, but scan down the page and it gives a paragraph on 12 patients, their age, what their drinking was link and what dosage of baclofen they needed to hit indifference to alcohol.

      Based on my (admittedly) limited knowledge of Baclofen, I would be almost 100% certain that your father is not being prescribed anywhere near these doses.....

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    • Posted

      Baclofen needs to be titrated up until it activates the process of making the patient ambivalent to alcohol. This can be as high as 300mg and retitrated down to a maintenance level of say 100mg.

      In this country it is unheard of for doctors to prescribe those levels and in the first phase of titration, it often makes the patient feel unwell. As Joanna has said, it is off label for combatting alcohol abuse. It still means it is okay to be given, just there is guidance/research on its use in alcohol.

      I suspect however much he is being given is no where near enough.

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  • Posted

    Hey MacLiverpool, Can I ask did a Doctor prescribe those meds because I don't see how they would  affect his drinking, especially in these doses. Ones and anti depressiant, the other is an Antispatic. Mirtazipine does take a few week before you find it working at its best, but then again if your puting a anti Depressiant into your Body, then pour Alcohol on top of it (a Depressiant) he can't expect a fantastic result. It sounds like a tough spot your in there Mate, there are so many different conflicts of interest. If your father still has capacity, and you activly stop him from getting drink, thats abuse. If he lacks capacity and you are giving him Drink, it's assault. So you have the Carer and the son role....thats the hardest part. There are a few ways you can activly help him control and reduce his Drink, which may be a slightly easier task at the moment? What's he drinking? You say he has time off from the drink, if he can do this with ease, you Don't have to worry so much about having withdrawals or fitting so much. Maybe if you designate a timetable to differ your "working hours" then hours where you can speak frank "As a Son" to make the stance you take a little easier to deal with. Sounds a little weird perhaps, but it would be driving me crazy.  

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    • Posted

      Thank you the hospital give him the baclofen to help with the cravings and the doctor gave him mirtazapine when he was dry after I did home detox with him he started off on a quarter bottle of vodka a few weeks ago but it's gone up to half a bottle now x

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    • Posted

      Yeah, the last thing you want is it creeping up. It does sound like you have been dealing with this for a while and certainly been doing the right thing so far. You could try a bit of tough love I suppose. Say his Drinking bores you and you don't want anything to do with it anymore. Agree on a certain amount once a week (do this when he is in one of his better moods) and Strickly stick to that. Make it clear that your not buying it, pouring it and you don't even want to see it. Unless he wants to do something about it,......you don't care.  Say you have better things to do than go round and round in these circles. If he wants to Die a horrible slow painful Death from Liver disease, whilst you deplore it, is his choice. (Obviously you know your Dad, so you know how far to push the tough love thing, you don't want someone to think you don't love them, on the contuary, make sure you let them know your reasons behind trying to help them, or else they could just end up wondering your motives and why you are making the situation your problem. smile

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