Tapering Off Alcohol
Alcohol addiction can be a devastating condition, affecting every aspect of a person’s life and putting their health in harm’s way. When a person has developed a physical dependence on alcohol, quitting can result in withdrawal symptoms that are physically and mentally painful. In some cases, alcohol withdrawal symptoms can be life threatening. Because alcohol withdrawal syndrome is both uncomfortable and potentially fatal, it is often a good idea to gradually lower one’s alcohol intake over a considerable length of time rather than stopping all at once.
What Is Tapering?
Tapering, or weaning off, is an approach to detoxing from alcohol or other drugs that involves gradually reducing one’s consumption over a given length of time. Individuals can taper off alcohol alone, though it is generally safer and more effective to do so under the supervision of addiction professionals. For people with severe alcohol dependence, clinical evidence shows that tapering is a safer alternative to the “cold turkey” method, which involves quitting alcohol entirely all at once.
When people with alcohol addiction decide to stop drinking, their first impulse is generally to simply throw away all of their liquor and never drink again. Most people believe that they can stop through sheer willpower. It is common for people suffering from addiction to believe that they can stop drinking or using drugs if they only try harder and make firmer commitments. While the despair that addicts experience can indeed drive them to make firm promises to themselves, it is hard for people to remain steadfast and resolved once withdrawal symptoms begin.
A variety of factors can determine a person’s withdrawal symptoms and the proper tapering procedure. These include their level of dependence, level of tolerance, the individual biology of the drinker, and the circumstances under which they normally drink. Together, these factors can make people’s addictions more emotionally and physically debilitating. Individuals at all levels of addiction are likely to experience excruciatingly painful withdrawal symptoms, but those with more severe addictions can sometimes even suffer from significant health problems while detoxing from alcohol. Progressively tapering off of alcohol rather than stopping abruptly can mitigate both the discomfort and the dangers of quitting this powerful substance.
However, tapering is not necessarily the best strategy for everyone. Some individuals who are less likely to experience the negative health effects of alcohol withdrawal can benefit from quitting cold turkey, provided they have a strong sober social support system in place and access to recovery resources. Ultimately, whether a person chooses to quit alcohol cold turkey or follow a tapering plan, it is best to work with experts on alcohol withdrawal who can ensure that the detox process succeeds. Addiction professionals can not only help craft an individualized plan for people who are trying to quit alcohol, they can help them develop the skills and tools they need to remain sober over the long term.
Alcohol Withdrawal Syndrome
Alcohol withdrawal syndrome refers to a wide range of physical and psychological events that occur when a person stops drinking alcohol. Individuals generally experience some degree of alcohol withdrawal even after one night of drinking. In fact, a hangover is simply another term for alcohol withdrawal. As most people are aware, hangovers can vary considerably in intensity. For individuals who have abused alcohol in high quantities for prolonged periods of time, alcohol withdrawal syndrome can not only be physically and psychologically painful, but even life threatening.
The symptoms of alcohol withdrawal occur on a spectrum. While people recovering from one night out on the town may be stuck in bed the next day with a splitting headache, individuals with severe physical dependence on alcohol can experience alcohol withdrawal side effects that are fatal or lead to permanent damage.
Individuals experiencing mild alcohol withdrawal syndrome can experience uncomfortable symptoms. These symptoms include shaking, profuse sweating, faster heart rate, insomnia, headaches, feeling wiped out or tired, mood swings, nausea, vomiting, depression, anxiety, irritability, and general mood swings. Most of these symptoms occur after approximately half a day without drinking alcohol.
People with stronger physical dependence on alcohol may initially experience only the above-listed mild symptoms of withdrawal. However, after approximately two days of stopping, they are likely to experience more severe symptoms. These symptoms are often mostly identical to the mild symptoms but are experienced as more powerful or intense. Some people, however, experience some degree of hallucinations.
Individuals with severe physical dependence on alcohol are likely to experience excruciatingly painful and sometimes life threatening alcohol withdrawal symptoms. Withdrawing from alcohol after a person has developed severe physical dependence often requires medical supervision. Those with quit alcohol “cold turkey” despite severe physical dependence can sometimes experience the following symptoms:
- Tremors (shakes). Tremors, often known as “the shakes,” can occur within 5 to 10 hours after a person has had their last drink. They generally reach peak intensity between 24 and 48 hours after a person has stopped drinking. Tremors cause people to physically shake or tremble. This can be not only distracting and painful, but it can make coordinating physical movements more difficult. Tremors also frequently co-occur alongside increased blood pressure, sweating, rapid breathing anxiety, severe anxiety and irritability, nausea and vomiting, nightmares, and insomnia.
- Alcohol hallucinosis. Alcohol hallucinosis most frequently begins within 12 to 24 hours after a person has stopped drinking, and it can last up to 2 days once it starts. Alcohol hallucinosis is the medical term for alcohol withdrawal-induced hallucinations. People who suffer from this condition most commonly have visual hallucinations. These often manifest as multiple tiny identical moving objects. One common hallucination is crawling insects. While some people have hallucinations that are abstract, others have hallucinations that are detailed, realistic, and imaginative. These hallucinations can be quite frightening and lead to worsened anxiety and mental health.
- Alcohol withdrawal seizures. Alcohol withdrawal seizures can occur between 6 and 48 hours after a person has stopped drinking. After 24 hours, the risk of alcohol withdrawal seizures peaks. Many people experience not just one, but multiple back to back seizures over the course of several hours. These seizures carry the risk of death.
- Delirium tremens. While many people experience a lessening of alcohol withdrawal symptoms after 48 hours, individuals with severe alcohol dependence often face the greatest risks at this stage of withdrawal. Their alcohol withdrawal symptoms may gradually increase in intensity. In some cases, symptoms advance to delirium tremens. Delirium tremens can occur between two and three days after the last drink, but sometimes it takes more than a week for a person to develop the condition. Delirium tremens affects most major body functions and carries a high risk of death. It alters breathing, circulation, temperature control, heart rate, blood pressure, and can lead to dehydration as well. During delirium tremens, the brain is often starved of oxygenated blood, which can cause permanent neurological damage. Common symptoms of delirium tremens include disorientation, confusion, stupor, nervous or angry behavior, loss of consciousness, profuse sweating, sleep disturbances, hallucinations, and psychosis.
Why Does Alcohol Withdrawal Occur?
When people drink alcohol, the body actually goes into overdrive to fight off the effects. When people drink alcohol regularly, their bodies actually get very good at counteracting the effects of alcohol. Habitual drinkers may have neurotransmitters that are so used to combatting the effects of alcohol that they continue to do so even when a person no longer has alcohol in their system. While the activities of these neurotransmitters may help balance the body while a person is drinking, they can lead to a variety of dangerous conditions when alcohol is removed from the equation.
To understand alcohol withdrawal, it is important to recognize that alcohol is a depressant. This does not mean that alcohol makes people feel depressed — though it often does! Rather, alcohol being classified as a depressant merely means that it achieves its effects by inhibiting the functioning of the body’s central nervous system (CNS). The central nervous system, which consists of the brain and spinal cord, is responsible for coordinating the activity of most of the body’s functions. Alcohol’s central nervous system-inhibiting effects decrease the neural activity, and it is this effect that is responsible for alcohol’s perceived positive side effects. When neural activity shuts down, people are likely to feel more relaxed and less socially inhibited. However, alcohol’s depressant effects are also responsible for many of the dangers of alcohol consumption, such as blackouts and alcohol overdose.
When a person drinks alcohol, the central nervous system compensates for the depressant effects of alcohol by increasing its activity. This counterbalance of activity works in a person’s favor, allowing them to function throughout the day even as they continue to depress their nervous systems by drinking alcohol. However, when a person whose nervous system is accustomed to providing this counterbalance suddenly stops drinking, their brains can be stimulated to a dangerous degree. As a result, they will experience many of the opposite effects of alcohol. Instead of feeling uninhibited and sedated, they will feel anxious, paranoid, and have difficulty sleeping. The only way to rid oneself of these alcohol withdrawal effects, aside from simply waiting them out, is to have another drink of alcohol.
It is no surprise, then, that many people’s physical dependence on alcohol tends to increase. While they may originally turn to alcohol as a way to rid themselves of a hangover, their consistent alcohol consumption gradually worsens these hangovers until alcohol withdrawal syndrome becomes actively dangerous. At this point, stopping alcohol consumption entirely becomes out of the question.
How to Taper Off Alcohol Successfully
If you or a loved one has decided to taper off alcohol, it is generally a good idea to plan this process well in advance. While tapering can mitigate the severity of alcohol withdrawal symptoms, people can still expect to experience them. In fact, since tapering extends the length of the withdrawal process, they can expect to experience alcohol withdrawal symptoms for a longer period of time than they would if they simply quit “cold turkey.” Having a solid plan in place can help people get through alcohol detoxification successfully. By following a clearly delineated roadmap with an end goal in sight, alcohol withdrawal, while no walk in the park, can seem far more achievable.
Many people benefit from using techniques to increase their motivation as they taper off of alcohol. Breaking down the plan into small achievable goals can make the process seem less formidable. Sometimes it is helpful to reward oneself by replacing alcohol consumption with alternative healthy habits, such as exercise or delicious meals. Keeping a journal or calendar is often recommended. Many people benefit from talking to friends and family members about their goals, or even tapering off of alcohol alongside a close friend or partner. By communicating your goals and struggles, you not only increase your accountability but you obtain valuable support.
Tapering off of alcohol involves making gradual incremental changes. There are a number of ways to do it. Most people begin by assessing how many drinks they generally have. They can measure their quantity of drinks over the course of a day, though for some people it is more helpful to count how many drinks they habitually have per week. Once a person has an accurate understanding of the number of drinks they regularly drink, the next step is implementing a small reduction. Instead of drinking 9 drinks a day, for instance, a person can reduce that number to 7 or 8. After a person has acclimated to this new change, they can lower the number yet again. The goal may be a long way off, but eventually they can get it down to 0 drinks.
It may be helpful as well to drink different kinds of beverages. Instead of drinking pure alcohol, drinking mixed drinks can help one slow down over the course of a night. By gradually reducing the proportion of mixers to alcohol, the tapering process can be greatly aided. Switching from shots to wine or from wine to beer is sometimes a useful strategy. These drinks, which have lower alcohol content and take longer to drink, are by definition more difficult to abuse. Drinking a glass of water between each alcoholic drink can also help people avoid acute intoxication and further slow down their liquor consumption.
While these actions may not seem like huge changes, they are actually huge steps in the right direction for problem drinkers. Even if the tapering process is not ultimately successful, even a short period of time of reduced alcohol consumption can lessen the likelihood of severe harms.
It is important not to be overly harsh with yourself. Alcohol is a highly addictive drug, and if you experience setbacks or find it difficult to cut down on your alcohol consumption by yourself, that is normal. The essential thing is to not get discouraged. If you slip up or return to heavy drinking, try to understand that it is not because you are weak or lack will power. Alcohol use disorder is a legitimate and very serious medical condition, and few people are able to stop drinking entirely on their own.
Building a New Life in Sobriety
Ultimately, it is crucial to understand that quitting alcohol is generally not sufficient to keep a person permanently sober. While physical alcohol dependence can be overcome via the “cold turkey” method or the tapering process, individuals suffering from alcohol addiction often remain helpless to say no to a drink even after they’ve overcome their physical dependence. Alcohol addiction, often known as alcohol use disorder, is a serious medical condition that causes people to lose their freedom to choose whether or not to drink. Individuals who suffer from alcohol use disorder may recognize the devastating consequences of continued alcohol consumption, but they are simply unable to manage their own drinking.
While some people are able to taper off alcohol successfully at home, most people face a continued risk of relapse unless they develop a new set of tools for dealing with the emotions that caused them to turn to alcohol in the first place. Furthermore, after years of alcohol abuse, most people have damaged lives. Suddenly sober, they may look around to discover that they are working dead end jobs, have no friends, suffer from debt, and may even be facing legal consequences. Many people also drank abusively because they were trying to relieve the symptoms of untreated mental health disorders, like depression or anxiety. When alcohol is removed, the symptoms of emotional distress may actually seem stronger!
Design for Recovery, a structured sober living home located in West Los Angeles, works with young men to help them develop a new way of life in sobriety. At Design for Recovery, we understand how alcohol consumption can take over a person’s life, and we believe that the most important aspect to long-term recovery is building a new life from the ground up. Residents work daily with our trained and dedicated staff to develop new values and coping tools. They also have the opportunity to live with and benefit from the experiences of other young men in the house who are equally committed to building new lives. One study on sober living homes showed that, in part because of the sober social support systems that residents build, people who attend sober livings have lower rates of relapse even years after graduation. If you are ready to say goodbye to alcohol and begin to take steps toward new life goals, reach out to us today.
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