To preface, many of you know about husband's issues. I'm pretty upfront about it, partly because it's one of those "uncomfortable" areas... something you don't ask about, something "good people" aren't saddled with. I just need to vent a bit. Alcoholism is a b1tch.

So he's been trending downward for some time. He started drinking in college, and we just blamed the fraternity, figuring he'd "grow out of it." Well, he did manage to get a job, but kept drinking. And somewhere along the way developed some pretty severe situational anxiety. I don't know if the anxiety prompted the drinking or the drinking led to the anxiety, but 8 years later, I have a nearly non-functional husband. I uprooted him from his job to move cross country for residency and he never found another. He managed to get sober after getting REALLY sick - pancreatitis, but fell off the wagon. He went to AA but never participated. He has become more and more withdrawn, and it is pulling teeth to get him to commit to anything. Do anything. Go anywhere.

In the last year, since finishing my residency, it is much more prominent to me that this is "the rest of my life" - the part after training, when all those long-delayed dreams come to fruition. And so I'm embracing it. All of it. Traveling, spa days, girlfriends, all of it. And he is completely stuck, stranded in a deep pit of hopelessness and apathy. So I'm going on as best I can, trying to remember my alanon principles. I've been all over the country, I've been taking care of myself, nurturing my personal safety-net of contacts, trying to vent, and needing to go to more al-anon meetings. Yes, I know. But my schedule is weird, and I live in the middle of nowhere. Hence, limited times. But I swear, I will start going again.

It's driving me crazy.

My in-laws are visiting this week. He has been super stressed about this, partly because he's trying to quit, and partly because he's anxious about everything. (He thinks that they don't know he fell off the wagon. Not that he's actually been on it for years.) You name it, he stresses. I wonder if his baseline stress is simply elevated from lacking the powerful depressant of alcohol. He's on benzos, and his PCP is wonderful. (ie not me, because I passed that part a long time ago.) He was supposed to have quit last week, but I keep finding beer. Note that he's never been good at hiding it. But I hate being "bad cop." HATE IT. HE IS THE ONE WITH THE DISEASE! And it's a disease, a powerful, all-encompassing disease that he fails to recognize will kill him. That, or the insulin-dependent diabetes he's developed by killing his pancreas. He had his first real bout of insulin-induced hypoglycemia and collapsed on me yesterday. I put two and two together, and got some OJ in him, but it scared the crap out of him. And he stumbled around like a drunkard the rest of the day. (Note that even in his heaviest drinking days, he wasn't generally falling-down drunk, just relaxed and glassy-eyed. "Just." Ha.)

So tonight, I caught him with a 5th of whiskey. Actually 2 of them, but only one opened. Which explains why he looked so fricking drunk the other day. He's never really turned to whiskey - at least not swigs out of the bottle, as far as I know.

I can't take much more of this. I have only in the last 3 months begun threatening. I only hope that him realizing what he may lose is enough to turn him around. Me, his home, his insurance, his financial stability and his way of life. I just don't think he gets it. Hell, I know he doesn't get it. Because that would be Step 1.

I told him he has to do a 90-90. (Addiction lingo for 90 AA meetings in 90 days.) His therapist has been pushing for ANY meetings, which he has vehemently opposed. Why, I don't know. I used to understand him, but he is so lost in this damn disease that not much makes sense. He agreed. He'll probably try to weasel out. But I really can't put up with this for much longer. I don't know how much longer his body will put up with this. He's only 31 years old. And at the rate we're going, I'll be divorced or widowed (more likely) in the next 10-15 years. He's got pretty crummy luck. (ie not only had multiple bouts of pancreatitis, but managed to grow an obstructing pseudocyst that required an ex-lap). Maybe he needs more tattoos (he has none) and less teeth (I've paid for a LOT of dental work) to make him more resilient like my chronic alcoholic patients.

I'm just really frustrated about this.

God, Grant me the Serenity
To Accept the things I cannot change,
The Courage to change the things I can,
And the Wisdom to know the difference.

Thanks. I just needed to get that out.

Yes, alcoholism is a bitch. All addictions are a bitch.

Don't threaten anything you're not willing to follow through on. It might be about time to start following through now.

Very sad. Hugs to you.

I agree with AnnaM. Sounds like a very difficult situation for you.

I am wondering how things would turn out if he did do this 90-90 and became sober. Would you still want to be with him, knowing that he still has the potential to fall off the wagon? Do you still love him as a husband and life partner? I am not trying to be judgmental -- no "right" answers to these questions -- just trying to clarify what is your ultimate goal. Do you want to be with him forever, hopefully in a healthy state, or do you want him to get healthier so that you can leave him and get on with your own life?

It sounds like Al-Anon has been very helpful to you and maybe there is some way you can still participate, even from out in the middle of nowhere. Do they have online meetings? Forums like this where you don't have to meet at a specific time?

Good luck with this very difficult situation.

So sorry to hear about this Popcorn - alcoholism is such a devastating disease with both physical and psychological components that make it so difficult to treat. The emotional effects on spouses and other relatives are horrendous too.

It sounds like your husband is in real trouble. His health is in serious jeopardy. He has suffered major and life threatening complications from his continued drinking and as difficult as it is for me to say this, if he doesn't stop soon, his disease will likely take his life. You are right, his ongoing denial is going to kill him eventually. Chronic pancreatitis with IDDM from alcoholism at age 31 is not a good prognosis. From a medical perspective, he should not drink again.

I am not saying that to be cold, but to be honest. I think you are aware of how sick he is too.

I think he really needs help - at the very least the 90 - 90 you mentioned but maybe even an inpatient detox program where he can get the medical and behavioral treatment he needs. His medical situation is getting complex and he might be at risk for DTs. He also sounds tremendously depressed, which may be due to the drinking or in part leading to it.

Inpatient treatment for him will also give you some space and time to decompress and assess what your goals are with him - the issues SAHMD brought up.

It may really be time for an ultimatum - either he gets treatment or you leave. You have to be ready to follow through though, and maybe only when everything he has is taken away from him will he finally be ready to get treatment, when he's got nothing else to lose. Watching someone you love slowly kill himself is a burden no one should have to carry. Obviously walking away is immensely hard too, but I don't see how things can continue on indefinitely the way they are now. You both deserve a better life than this.

Hang in there - looks like you have some tough choices ahead of you, and we are all wishing you well.

I'm so sorry...alcoholism really is a terrible disease.

Would he consider in-patient treatment?

Kris

I'm just dropping in to say that appreciate your honesty. And to also say that you'd be VERY suprised ( or maybe not) the number of people who in the same situation as you, dealing with an "addict" of some sort.....................

Thanks guys. And yeah, I know it's common. But it's not something people generally bring up.

And yes, I know that this is going to kill him. I know that the M&M of diabetes is going to land him on dialysis before cardiac disease likely gets him, and not until he's suffered a lot of vascular complications. He doesn't actually have chronic pancreatitis... yet - has always spiked a lipase/amylase. I fully realize in all the doctor ways how bad this is. Maybe I'm splitting it, but I can see him clinically from a distance, which is mostly what I've been doing lately.

I've known him since we were kids - waaay back in elementary school. I have seen him get sober, and then he's the "old self." It's really rather amazing. He's the guy who sent me mushy love letters, and takes the trash out, and surprises me with flowers.

I have only recently gotten to the point where I am threatening to leave, partly because up until now, I was in training and really needed someone at home. And really, for an alcoholic, he's been a fairly reliable guy... feed the dogs, etc. But he's really in a freefall now. It's been worse since we've moved, and he's really cut off. (He used to be very functional - he worked and we lived off his salary in med school.

So anyway, I don't really have a plan, because, well, I'm an ER doc and the situation is always changing. But it's on the radar now. I'll admit that I'd have a lot to lose too, so I am hopeful that he will get better. As in, sober. I can deal with the rest. The lying is what gets to me the most.

He really can't go on the way he is. We've talked about inpatient or even intensive outpatient, and he isn't "there" yet. Maybe I should ship him to Hazelden. I don't know...

I do take those vows seriously. And I have lots of other fulfillment... and how would I forgive myself for letting him succeed in throwing it all away? (I know that sounds very codependent. But it's something I don't know if I could deal with very well. I do save people for a living, after all.)

For the record, I know he's very, very depressed, which complicates the matter further. He's not suicidal, at least not last time I asked.

Oh, and just how does one go about arranging inpatient treatment? I figured only celebrities did that. He's been in once for "detox" but it was 3 days on the psych ward, and he swore he wasn't going to do that again.

Not just celebrities. There is probably a phone number on the back of your insurance card to call for mental health issues. I would start there, or call the local alcohol rehab unit directly. They can arrange an intake interview and evaluation if your husband is willing.

You could ask your faculty at your training program if they know of any good programs near you, or find out if there is an addiction medicine specialist at your medical center who may be able to guide you. Also, there is a American Society for Addiction Medicine (ASAM) website that has a Resources Link tab that takes you to a list of programs as well as a program finder.

Hope you are taking care of yourself in this difficult situation. I fear I may be guilty of what I always accuse my husband of - giving advice when all I really want him to do is listen to me vent. But your situation does seem quite serious and therefore it is hard for me to refrain from offering some advice.

I am hoping you both get through this. You said it well - alcoholism is a bitch.