How To Taper Off Alcohol

Tapering off alcohol is the act of slowly reducing alcohol intake until a person becomes completely abstinent. Tapering off alcohol to reduces potential withdrawal symptoms and decreases the likelihood of a potentially fatal withdrawal from alcohol in individuals who consume alcohol on a regular basis.

If you start to experience significant withdrawal symptoms when you stop drinking, a taper can provide a much safer method to detox from alcohol. Tapering can be done by using alcohol itself or various medications; however, can only be done safely under the supervision of a physician.

Benzodiazepines are the most common medications physicians use to taper alcohol and reduce withdrawal symptoms. Before a doctor begins a tapering plan with medications, they will assess the medical stability, including vital sign stability, and pattern of withdrawal symptoms in the patient.

With the goal of keeping the patient stable and minimizing withdrawal symptoms, the physician will slowly guide a reduction in benzodiazepines until the patient no longer needs the medication and no longer has alcohol withdrawal symptoms.

Is it Better to Taper Off Alcohol or Quit “Cold Turkey?”

The phrase cold turkey refers to abruptly stopping drug or alcohol use. Typically, when a person thinks about the word tapering they think of tapering off medications like opioids. The same process can be applied to tapering off alcohol. With that being said, tapering is a lot safer than going cold turkey. Although going cold turkey on opioids is dangerous and can cause significant withdrawal symptoms, quitting alcohol cold turkey can be fatal.

The reason for weaning off alcohol instead of quitting cold turkey is to reduce the severity of withdrawal symptoms. If a person abruptly stops drinking alcohol within 6 to 8 hours they will experience hyperactivity, anxiety, tremors, sweating, nausea, and confusion. Seizures are another complication of abruptly quitting alcohol that may occur within the first 12 to 48 hours of stopping.

Also, a severe type of alcohol withdrawal known as delirium tremens (DT) can occur between 4 to 72 hours of stopping alcohol use; without the proper supervision, DT can lead to permanent braind damage or death.

Dangers of Quitting Alcohol Cold Turkey

Stopping alcohol use abruptly can be very dangerous. There are various dangers associated with stopping alcohol use cold turkey. First, DT can lead to a person becoming functionally disabled or even dying. DTs are a sudden and severe mental or nervous system change that alters a person’s breathing, circulation, and temperature control.

DT symptoms are severe and include: autonomic hyperactivity, hand tremor, insomnia, nausea or vomiting, transient hallucinations or illusions, psychomotor agitation, anxiety and generalized tonic–clonic seizures.

Abruptly stopping alcohol intake after prolonged heavy drinking can also result in alcohol withdrawal seizures; these seizures can originate anywhere in the brain  and may be deadly. Seizures typically occur 12 to 48 hours after a person has their last drink. DTs and seizures are usually associated with severe alcohol withdrawal which can occur in individuals who consume high amounts of alcohol.

Further, the severity of withdrawal symptoms can cause a person to resort back to drinking alcohol to relieve any symptoms. However, doing so without the guidance of a physician, can complicate tapering and ultimately delay when, if ever, sobriety is reached.

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Pros and Cons of Tapering Down Alcohol Intake

Even if tapering off alcohol consumption is known to be safer than quitting cold turkey, there are still some considerations you need to understand when trying this method. Below are the pros and cons of tapering off:

Pros of Alcohol Tapering

• A safer method of detoxing from alcohol
• The lesser intensity of withdrawal symptoms
• Better control of cravings
• Potentially smaller chance of relapse

Cons of Alcohol Tapering

• Difficult to execute on your own if you are unsure of your recent alcohol intake
• Risk of relapse when done incorrectly
• The slower process of detoxification
• Not guaranteed to be safe without the supervision of a physician

The best way to taper off alcohol is to find healthcare professionals who can assess one’s current intake. This will be the basis of the protocol to taper off the substance to increase the chances of success.

How To Safely Taper Off Alcohol

How to taper off alcohol? When coming off drugs or alcohol tapering is the best way to prevent severe withdrawal symptoms. Tapering is the act of gradually reducing alcohol use until completely abstinent. By creating a schedule to monitor your alcohol use you can see just how much of the substance you are drinking.

Making a schedule to slowly reduce your alcohol intake is a safe way to taper off the substance. This will ensure that you are not quitting cold turkey which could result in severe and debilitating  withdrawal symptoms or even death. Depending on how much alcohol you’ve been consuming, it can take days or over a week to gradually reduce your dose safely and get off alcohol.

Another strategy for a successful taper is to drink just enough to keep withdrawal symptoms at bay. If you find it is difficult to prevent yourself from drinking too much and getting drunk, locking your alcohol up in a cabinet and giving your friend or family member the key can help. Although with this method, it is important that the friend or family member is accessible when symptoms of withdrawals such as tremors return. Also, learn to cope with and avoid situations that might cause you to want to drink more.

A final strategy to assist with an alcohol taper is to get a good network of peer support. Peer support is beneficial to help you taper off alcohol because it has been proven to increase self-esteem, confidence, positive feelings of accomplishment, increase your ability to cope with challenges that arise as a result of alcohol use, and increase your chances of recovering from alcohol abuse.

Support groups such as Alcoholics Anonymous (AA) or sober living houses can help you get connected with peers who are going through the same journey as you are. This is a 12 step intervention for alcohol abuse and addiction that can help lead to recovery from alcohol abuse; sober living houses provide mutual sobriety support to help you remain alcohol-free.

Challenges of Cutting Down on Alcohol Intake

For some people who consume alcohol, tapering just doesn’t work. Maybe they don’t have peer support or maybe their alcohol addiction is too severe. Being surrounded by triggers can make it extremely difficult to stay on track and avoid overdoing it on alcohol.

There are two types of triggers that can set off a person’s urge to drink. These are internal or external triggers. External triggers are people, places, things, or times that offer opportunities to drink and remind a person of alcohol. Internal triggers are thoughts, emotions, or physical sensations that cause a person to drink. Being exposed to either form of a trigger can result in unwanted relapse.

If a person finds they have been drinking too much alcohol, they may have Alcohol Use Disorder (AUD). If you think you may suffer for AUD, keep an eye on the following criteria, descripted by the Diagnostic and Statistical Manual of Mental Disorders:

• Alcohol is often taken in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to cut down or control alcohol use.
• A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.
• Craving, or a strong desire or urge to use alcohol.
• Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
• Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol.
• Important social, occupational, or recreational activities are given up or reduced because of alcohol use.
• Recurrent alcohol use in situations in which it is physically hazardous.
• Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol.
• Tolerance.
• Withdrawal symptoms (as described previously).

Using these criteria the AUD can be classified into:

• Mild: 2-3 symptoms.
• Moderate: 4-5 symptoms.
• Severe: 6 or more symptoms.

According to the National Institute on Alcohol Abuse and Alcoholims, during 2019, there were14.5 millions of americans suffering from AUD, and according to the Centers for Disease Control and Prevention, 95,000 deaths related to AUD were reported.

Aside from unavoidable triggers, tapering off alcohol can also have side effects which can be difficult to manage at home.

Side Effects of Tapering

• Intermittent alcohol cravings: Since one will not be drinking to the point of intoxication, frequent cravings may be expected during the tapering process.
• Mild to moderate withdrawal symptoms: Although withdrawal symptoms are not as life-threatening as quitting cold turkey, there will still be uncomfortable bodily symptoms that may warrant medical care. The ability to function for day-to-day tasks may also be challenging especially in the earlier days.
• Mental and emotional symptoms: There will also be mental and emotional barricades if one is trying to overcome alcohol addiction. Those who try to taper off alcohol use may feel distressed, anxious, or depressed when they cannot get the amount of relief they need from alcohol especially during the initial stages.

Medications Used When Tapering Off Alcohol

Aside from decreasing alcohol intake, there are some medications that healthcare professionals use during a formal detox. According to The American Psychiatric Association, these are some of them:

Naltrexone or Acamprosate

These are offered to patients with moderate to severe Alcohol Use Disorder, having the goal of reducing alcohol consumption and achieving abstinence, and they can be used in acute withdrawal syndrome treatment.

Disulfiram

This is offered to patients with moderate to severe Alcohol Use Disorder, having the goal of achieving abstinence. Note that Disulfiram it is not a cure to alcoholism, and a full therapy must be used.

Topiramate or Gabapentin

These are offered to patients with moderate to severe Alcohol Use Disorder, having the goal of reducing alcohol comsumption and achieving abstinence. Prefer Topiramate or Gabapentin if patients are intolerant to or have not responded to Naltrexone and Acamprosate.

Antidepressants

Antidepressant medications are not meant to be used for treatment of Alcohol Use Disorder unless there is evidence of a co-occurring disorder for which an antidepressant is an indicated treatment.

Benzodiazepines

Benzodiazepines are not meant to be used in individuals with Alcohol Use Disorder, unless treating acute alcohol withdrawal or unless a co-occurring
disorder exists for which a benzodiazepine is an indicated treatment.

Finding An Alcohol Rehab

In 2019 the Substance Use Disorder and Mental Health Services Administration reported that 14.5 millions of americans suffered from Alcohol Use Disorder. Treatment is the best way to ensure long-term abstinence from alcohol. This is especially true if you are suffering from an alcohol use disorder. Addiction alters the chemical balance in a person’s brain, making it extremely difficult to quit drinking alcohol on one’s own.

A high-quality rehab is well equipped to provide you or a loved one with the tools you need to overcome your addiction; rehab clinics provide medications to ease withdrawal symptoms as well as behavioral therapy to alter a person’s thoughts towards alcohol consumption.

At a rehab clinic, an alcohol withdrawal taper can be provided to slowly get you back to normal life. This form of tapering would likely involve medications to eliminate withdrawal symptoms. Slowly, to reduce the discomfort of withdrawal symptoms, you will come off the medication with the goal being complete abstinence from alcohol.