Alcohol Dependence: First Steps Out of a Binge

When a person can no longer cope on their own and "has to somehow be brought out of the binge," the first phase begins — exiting the binge. Dr. Saulitis stresses these are concrete steps, not general talk. What matters here is understanding the logic: what we do, how, and why — without self-treatment and without setting doses outside professional care.

First phase: detoxification

The first task is to bring the person out of the binge. To the question "to hair-of-the-dog or not," the doctor answers unequivocally: yes, we ease them off — because once the problem has appeared and the person can't cope alone, they need to be brought out. The main goal of this phase is detoxification: restoring the body's salts, vitamins and fluids.

Vitamins: replenishing the deficit

By the doctor's logic, prolonged drinking "washes out" the B-vitamin group — and it is precisely these vitamins that support neuronal growth. So he emphasizes vitamin C and the B group (especially B1, B6, B12), as well as cellular oxygen for the neurons. The doctor notes: if a person can drink on their own, there's no need for "pumping tricks" — those merely "pump money out of your pocket."

Fluids and the load on the heart

The main risk of giving fluids is the load on the heart. So first we check the basic markers: are there edemas, the pulse, tachycardia, heart problems, blood pressure. The doctor's principle is simple and important: "first we check that they're urinating, then we give them to drink." We need balance: as much as leaves the body, that much we give, so as not "to overload, not to put too great a strain on the heart" and not cause edemas. A little salt can be added to the fluid so it "stays inside."

Sleep — the key to leaving the phase

Once vitamins and fluids are restored and we've confirmed the person is urinating normally, the next mandatory step is to restore sleep. As the doctor says, this is "vitally important": the person must be helped to fall asleep. Once they've slept it off, "the bridge has switched over," and things get easier.

Why a person drinks at all

The doctor looks beyond the first phase: behind alcohol there is often a disorder — depression, anxiety, bipolar, post-traumatic and other conditions. Then "alcohol causes toxicity, damage to the brain," and the person is essentially "treating themselves with a remedy worse than the illness itself." So the overall logic is: first remove the toxic episode, then restore homeostasis, and only afterward work on the disorder for which the person was drinking.

Practice: a first-steps checklist (under specialist supervision)

1. Restore salts, vitamins and fluids — detoxification.
2. Replenish vitamin C and the B group (especially B1, B6, B12); care for cellular oxygen.
3. Before fluids, assess edemas, pulse, tachycardia, blood pressure — the heart's condition.
4. Keep fluid balance: "first check they're urinating, then give them to drink."
5. Restore sleep — make sure the person sleeps it off.

The doctor deliberately does not name doses or specific drugs on air: these are selected individually and professionally.