Tripod Home | New | TriTeca | Work/Money | Politics/Community | Living/Travel | Planet T | Daily Scoop
You can try your hand at Past Puzzlers, too!
The Scenario:
Craig is a third year medical student at Duke, and he's in the middle of a two month rotation in psychiatry. That means that he is learning for the first time what it means to take care of people suffering from depression, anxiety, addictions, schizophrenia, and other maladies. It's pretty overwhelming.
Part of Craig's rotation time is spent at an inner city crisis center. One day, a man came in who had a problem with alcohol abuse. He really wanted to quit drinking and was asking for help. His life was a mess. He had been separated from his wife for the past six months, and she was taking him to court in order to prevent him from getting access to their eight year old son. He was living temporarily with a friend, and had just about used up his sick time at work. Beyond this, he was feeling extremely depressed and anxious. He had a terrible time sleeping and often drank at night just so he could get a couple of hours of sleep. He felt constantly shaky, as if he could never calm down.
He asked for a sedative to help him sleep better. With enough rest, he felt he could tackle the job of attaining sobriety much better. It sounded like a reasonable request, and he seemed like a sincere man desperate to turn his life around.
Question:
Answer:
The request for a sleeping pill from an alcoholic is a very tricky one. When someone comes to us asking for help, asking us to put aside any prejudice we may feel about their addictions, their life, and their circumstances, when we can see that they are suffering under the burdens of a life addicted to alcohol, our instinct is to provide that help. With better sleep, the lack of which can cause endless days of fatigue and despair, perhaps he will have the strength and determination to see his way through his alcohol cravings.
About 90% of people who responded to the Puzzler felt that this man should not be given a sedative. Nearly everyone was aware of the dangers posed by mixing alcohol with other sedatives. One of the tenets of helping alcoholics amounts to a stern decision not to help them too much. That in order to have any hope of recovery they must fully feel the consequences of their addiction, the effects on their families, their livelihoods, their self esteem. Too much comfort may allow him to stay within his cocoon. If sedatives are provided, the effect mimics alcohol. Feelings are numbed; decision-making lacks clarity. Dependency on a substance from outside oneself is continued. Furthermore, many of his symptoms are apt to be the direct result of his drinking. The way to deal with that is simply to stop. Odds are, he won't want to hear that, and will look for an easier way to cope with his symptoms.
Some people mentioned using valerian root, mint tea, or melatonin for sleep. Others felt that a some rigorous daily exercise would help. Another trick sometimes used is to offer an anti-depressant (such as Elavil) that has sedation as a side-effect. These are not addictive medications, and the drowsiness is not perceived as pleasurable.
Without pretending to be an expert in addictions, I would suggest that the best thing to do is to provide comfort and support, help in getting into substance abuse counseling, help in making connections with Alcoholics Anonymous, everything but provide him with sedatives. Many spouses and children, and many doctors have made the mistake of trying to provide too much help to an alcoholic.
Map | Search | Help | Send Us Comments