Pros and Cons of Tapering Down Alcohol Intake


Published On: March 22, 2023

Realising that you might need to stop drinking or cut down is the first step in the right direction. If you start to feel that you ‘have’ to drink, or your drinking is starting to cause problems (socially, mentally, physically), then it is time to talk to a professional and do something about it. [1]

Alcoholism is defined as the most severe form of alcohol abuse, a stage of drinking that causes harm. This is characterised by an uncontrollable urge and desire to drink.

This is also known as alcohol dependence or alcohol addiction, recognised recently as an ‘alcohol-use disorder’.

This is harmful drinking, and people who are dependent on alcohol will place it above any other responsibilities, including loved ones. They will also build up a tolerance to alcohol, meaning they will need more alcohol, more often to experience the effects it once had.

However, most people get to the point where they are just drinking to reduce or prevent withdrawal symptoms. People addicted to alcohol often conceal their drinking habits, becoming socially isolated and introverted.

Quitting alcohol is strongly advised if: [2]

  • You have impaired control over alcohol intake: this may involve the length of time per drinking session, the amount of alcohol drunk during these sessions, and how frequent these sessions are. If you are unable to stop drinking once you have started, or drink during inappropriate occasions or places, this is an indication of alcohol addiction.
  • You give alcohol priority over everything else and everyone else: drinking may become more important to someone than health, negative consequences, activities, and responsibilities.
  • Physical and mental effects directly caused by alcohol: this may involve withdrawal symptoms, physical conditions such as alcoholic gastritis, or mental health conditions such as depression and anxiety.
  • Your behaviour is anti-social and harmful when drinking

Doctors and professionals might diagnose alcoholism and addiction based on the symptoms presented at the clinic, along with the patient’s history. This will involve looking at behaviour and the development of symptoms, along with whether you have tried to cut down or quit drinking before.

Medical professionals will advise you to stop drinking. They will likely advise you to taper off alcohol rather than stopping suddenly. Quitting immediately is called going ‘cold turkey’. If you go cold turkey, you are likely to experience severe withdrawal symptoms.

The severity of the withdrawal symptoms experienced during abstinence is dependent on the severity of the addiction in question.

Risks of Going ‘Cold Turkey’

pain

Cold turkey is defined as “abrupt complete cessation of the use of an addictive drug”. [3] This carries medical risk when immediately discontinuing alcohol or drugs.

This is never advised after using a substance for a long time, as your body and mind have become accustomed to the added substance.

You will suffer from extreme withdrawal symptoms if you quit suddenly without tapering off.

However, quitting cold turkey is appealing to those who have abused substances for a long time. People believe it makes it easy to quit when you avoid something completely, rather than use it in moderation.

Some people learn of an effect the substance has on the mind or body and are immediately put off the substance. They aim to stop using the substance suddenly to reduce the damage and harm that has unfortunately already started.

This does not mean that the body and mind are not going to crave alcohol. If you have been drinking heavily for a long time, the neurological circuits in the brain rewire themselves.

The nervous system has also adapted to its high dependency on alcohol, so cutting yourself off can lead to life-threatening medical conditions. [4]

The Idea Behind Tapering Down Alcohol Intake

sober

Quitting alcohol ‘cold turkey’ on your own can lead to severe medical consequences if you:

  • Have drunk for many years
  • Drink daily
  • Are a heavy drinker
  • Binge drinker
  • Suddenly stop drinking

Tapering off substances is standard medical practice. Even for patients on antidepressants, their medication will be reduced until it runs out. [5]

Products on the shelf second this idea; nicotine patches and nicotine gum vary in strength to help people reduce their nicotine over time until they quit long-term and practice sobriety.

It is obvious that quitting immediately will cause more mental and physical stress than reducing intake slowly. A home detox including the cold turkey method might be efficient for some people, but that is only appropriate for those with an extremely mild addiction who haven’t been drinking alcohol for a long period of time.

The easiest way to taper your alcohol consumption is to increase the time between drinks, and either drink less or reduce the alcohol percentage of the drinks. For example, if you drink around 7 beers per night, try drinking around 5 beers a night or beers that are weaker in strength.

Then try to increase the gap between drinks, maybe taking a night off between evenings you know you will consume alcohol.

You can also try to lengthen the time between each drink during the evening. If you were drinking one beer every 30 minutes, try one beer an hour. The alternative is that you could substitute every second or third drink with water or a non-alcoholic beverage.

It may help to drink an alcoholic drink that you do not usually drink or one that you don’t particularly enjoy, such as wine if you are a beer drinker. You are less likely to drink it quickly or much of it at all if it is one you do not like.

It may also be a good idea to keep less of your favourite drink in the house. However, do not be tempted to drive to get more once you start drinking the beverage you do not like – make your favourite alcoholic drink inaccessible or less accessible.

Tapering down must be consistent – this will not work if you are sober one day and go to a party the next evening. You must taper your alcohol intake consistently for it to work, so aim to avoid fluctuating your intake.

This will be helped by making yourself a tapering schedule with a set end date as this is not an open-ended process.

Why is it Hard to Taper my Alcohol Intake?

Alcohol

For some people, cutting down slowly is very difficult. Some people find it easy to cut back in the safety of their own home, but as soon as temptation and opportunity arise, they will slip back into old habits.

This will not be helped if usual heavy drinkers are surrounded by an environment full of triggers and a lack of encouragement to cut down.

This will often lead back to square one; heavy drinkers and alcoholics find it incredibly hard to cut back when alcohol is readily available, and they remain engaged in old habits.

People that have developed an alcohol use disorder require support and an encouraging environment. Simply cutting down will result in withdrawal symptoms.

You must weigh the pros and cons of tapering alcohol intake and decide what the best route of sobriety is for you, taking into account the nature of your addiction. The safest form of abstinence regarding alcohol is tapering your intake.

If you know from past experience or from your old habits that you will find this hard, seek medical attention.

Educate yourself on withdrawals and how to reduce their effects. In most cases, a medical detox assisted by medical or medical supervision is the safest option. Medical professionals can help patients withdraw from alcohol safely, providing nutrition, medication, and important hydrations. [6]

Tapering alcohol intake is classed as reducing the amount of alcohol in your system over time until you are not consuming any alcohol at all. The main aim of tapering is to reduce the risk of withdrawal symptoms, by getting the body and mind used to lower alcohol levels one step at a time.

The medication offered to you during tapering may include:

  1. Benzodiazepines: ‘benzos’ such as diazepam, chloridiazepoxide, oxazepam, and lorazepam, have been FDA-approved to treat the withdrawal symptoms of alcohol. This medication has a sedative effect, making them all ideal to treat anxiety and the convulsant effects of alcohol withdrawal.
  2. Barbiturates: barbiturates have a strong track-record of treating delirium tremens, a life-threatening side effect of alcohol withdrawal.
  3. Anticonvulsants: anticonvulsants are usually the first type of medication prescribed during alcohol withdrawals. Medication such as carbamazepine and gabapentin are sedatives that are effective at treating most of the withdrawal symptoms.

This is a slow detoxification process and is usually self-managed.

The Pros of Tapering:

  • Cost-effective
  • Can be done from home
  • Safer than cold turkey
  • Lower risk of relapse
  • More control over your own life

The Cons of Tapering:

  • Difficult to remain focused and easy to lapse into old habits
  • Easy to rush to reach an earlier date for sobriety
  • Harder to resist alcohol at home
  • Not ideal for those with medical conditions
  • Slow process of detoxification leads to impatience

In order to experience the right detoxification process for you, seek medical advice before making any drastic decisions to cut down. This page is general advice and information about tapering off alcohol, but your decision is dependent on your drinking habits and general health.

Tapering alcohol consumption is the safer method, but this is aimed at mild and moderate drinkers. Heavy drinkers who are suffering from issues such as alcohol withdrawal seizures must seek medical professional help.

Alcohol withdrawal symptoms from heavy drinking and excessive alcohol consumption can pose a significant risk to life if not treated sufficiently. Severe withdrawal symptoms require medical assistance, where you may be advised to enter inpatient treatment or behavioural therapy.

It is entirely possible to taper off alcohol misuse, but make sure you educate yourself on alcohol treatment programmes or seek an addiction counsellor.

Before you consider tapering off alcohol:

  • Educate yourself on withdrawals and different forms of treatment available
  • Understand your intentions and the reason you want to cut down – what is your motivation?
  • Plan effectively and remain realistic – don’t set the end date too close or too far
  • Plan ahead, planning for temptations as well as unexpected symptoms
  • Be honest about consumption and how well you will stay on track
  • Take into account pre-existing medical conditions

References

[1] https://www.rethinkingdrinking.niaaa.nih.gov/thinking-about-a-change/Its-up-to-you/To-Cut-Down-Or-To-Quit.aspx#:~:text=Quitting%20is%20strongly%20advised%20if,or%20being%20worsened%20by%20drinking.

[2] Royal College of Psychiatrists webpage. World Health Organisation, Global Clinical Practice network. Disorders due to Substance Use in ICD-11: diagnostic guidelines and key changes (Accessed 2 December 2021)

[3] https://www.merriam-webster.com/dictionary/cold%20turkey

[4] Lerner A, Klein M. Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs developmentBrain Communic. 2019;1(1):fcz025. doi:10.1093/braincomms/fcz025

[5] Wilson E, Lader M. A review of the management of antidepressant discontinuation symptomsTher Adv Psychopharmacol. 2015;5(6):357-68. doi:10.1177/2045125315612334

[6] Jesse S, Bråthen G, Ferrara M, et al. Alcohol withdrawal syndrome: mechanisms, manifestations, and managementActa Neurolog Scandinavica. 2016;135(1):4-16. doi:10.1111/ane.12671

 

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