askchapo

Hard to say without knowing more but if it's that severe, either mental health-wise or alcohol withdrawal-wise, then hospital is gonna be the safest bet.

I get why you don't want to do the hospital thing but if she's going through severe alcohol withdrawal then she risks seizures and in the worst case scenario even death. Alcohol and benzo withdrawal are the two withdrawals that are known to kill people. It ain't worth the risk. A hospital can manage the withdrawal and if shit goes sideways, being in hospital means they can respond immediately.

If she's not at the point of risking seizures or death from DTs but she's hallucinating for some other reasons then you're looking at the possibility of a psychotic break. And hospital is where a person needs to be in that situation so that the psychosis can be managed while mitigating the risk.

In all honesty though, it sounds like delirium tremens based off of your description. The mortality rate for untreated DTs is between 15-40% and those are not odds that anyone should gamble a life on.

With those symptoms I strongly recommend going to a hospital or at minimum getting a telehealth visit from a doctor. Tremors and hallucinations may indicate some very serious and harmful withdrawal symptoms that need to be managed by a doctor with carefully-controlled drug dosages as the other commenter mentioned.

Also while I am not recommending giving her alcohol, it sounds to me like this is a cold turkey situation, yes? Tapering is usually safer if carefully planned and, if it is at all possible, done in a controlled environment like a clinical detox context (in which case they might also just use carefully-controlled drugs). Please consider asking doctors about this as well or at least providing them with a history of her drinking, quitting strategy, time of last drink, and recent and current symptoms. See if they have any thoughts. Ideally get a few opinions. This is something that is very difficult to evaluate remotely.

Also, overall, thank you for doing your best. Quitting an addictive substance usually takes several attempts, meaning several failures and then trying again. It is difficult on everyone involved. I just want to mention this in case there is a relapse, which is not necessarily unlikely if she doesn't get proper treatment.

And sorry you have to deal with this. I'm sure it's really difficult and scary.

benzodiapenes are the firstline treatment for DTs in clinical settings, though safe supply without insurance is likely to be difficult.

Definitely just go into a hospital, I have been through it myself and it’s so much better to do it with the meds they give you at the hospital, cold turkey can result in seizures and even death in the worst case .

I had a roommate who barged into my room in the middle of the night because he was sure that one of my other roommates was blasting rap music whos lyrics were all about him, and that there were a bunch of other people in her room with her laughing along with it. I went upstairs and there was silence. I had to calmly tell him he was hearing things, and that nothing of the sort was happening. I knew he had recently decided to quit drinking because he'd slept through an alarm and his job threatened him. Thankfully, I had another roommate awakened by the hub bub and the two of us talked him down and the next morning he checked into a hospital. He was there for five days, over Thanksgiving. He told me he didn't even realize what day it was and was just pleasantly surprised they gave him turkey. It's scary but hopefully you can find a way to get them resources to get over the initial withdrawals and stay clean.

Just remember Amy Winehouse didn't die from an OD, she died from alcohol withdrawal

My dad supposedly hasn't had symptoms of psychosis, but he very recently decided to dry out on his own without medical treatment, and it was bad. He came out of it fine (supposedly) and I can share with you what happened but it's pretty scary and I don't wanna freak you out.

If she is quitting alcohol, besides inpatient detox there may be places near you that do outpatient treatment with medications and trained staff, possibly with peer support options.

Ideal Option has clinics in multiple states and are an agency that provides this kind of care, if she would be more open to outpatient support.

Also, to address the psychosis in the moment: sometimes telling someone that what they are experiencing is imaginary can do more harm than good, especially depending on how severe the psychosis is. It sounds to me like you did an awesome job of reality testing with her to try and get her to maybe believe that there is something else going on. At this point, I would personally tell her that even if no one else experiences it, it must be frustrating/scary/etc. and validate her feelings. Because it IS real for her right now and probably really distressing. That might be able to break through some of her resistance if she just feels like she's being listened to. Sometimes I'll ask questions, like when did you start hearing this? How does it make you feel? Why do you think you can hear it if no one else can hear it?" And maybe make ypur concerns a bit more about you. "I care about you and I'm worried, if anything for my sake can we just go talk to a doctor or just try this thing that might help? And if it doesn't, we can try something else". Could be good for her to hear about how it works from a clinical standpoint too depending on what kind of person the is/how cogent she is at the moment

Her tremors were down but still there. She said she was starting to visibly hallucinate and trying to understand what the triggers were.

If her hallucinations are worsening she needs hospital now. She doesn't have triggers, her brain is malfunctioning because it's abruptly being deprived of something it relied on for normal function.

If she's in deep enough to be getting dts she's in deep enough to need controlled tapering. This isn't something to fuck around with unless she really wants to find out. Seek help from a professional asap. The mortality rate from untreated dts is up to 40%.

https://en.m.wikipedia.org/wiki/Delirium_tremens