Please ensure Javascript is enabled for purposes of website accessibility How to reduce drinking safely – Help With Drinking

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How to reduce drinking safely

If you’re trying to wean yourself off alcohol, it’s important to be aware of the potential risks. If you suddenly stop or cut back on your drinking without a doctor’s help, you could end up with serious or even life-threatening withdrawal symptoms.

Safe withdrawal

When you suddenly stop drinking, your body can have a reaction called “withdrawal”, which is its response to the alcohol leaving your body. Some people call this “going cold turkey”. If you have a strong addiction to alcohol, withdrawal can cause strong symptoms, and some of them can be serious enough that you need emergency medical help.

During alcohol withdrawal, your body can become hyperactive. Some of the most common symptoms of this include:

Faster heart rate

Headaches

Fever

Shaking

Throwing up

Feeling sick

Sweating

You might also experience:

Anxiety

Restlessness

Trouble sleeping or not being able to sleep at all

In severe cases, withdrawal can lead to seizures and a dangerous condition called “delirium tremens” (DTs). DTs can happen when someone stops drinking alcohol suddenly, and it can be life-threatening.

Delirium Tremens (DTs)

The symptoms of DTs include confusion, fever, heavy sweating, fast heart rate, high blood pressure, nightmares and hallucinations. DTs usually starts 2-4 days after someone stops drinking a lot and can last for 1-5 days. If DTs isn’t treated properly, it can be very risky and potentially deadly.

 

“Shakes” or tremors are sometimes confused for DTs. Shaking in one or more areas of the body can also happen because of alcohol withdrawal, but it is not the same as DTs.

 

After you stop drinking alcohol, withdrawal symptoms can begin as soon as 6 to 24 hours later. They usually become the most intense within 24 to 48 hours. Most symptoms improve and then go away within 5 to 7 days.

 

Getting support during withdrawal

If your goal is to quit drinking alcohol, or if you might get severe withdrawal symptoms when you cut back or stop, your health care provider may suggest “withdrawal management”, also known as “detox”. During this process, you will get support to help you go through withdrawal more comfortably and safely. This may include medications and other strategies that help with withdrawal.

The detox day alone simply sobered me up for a day or two: like a mini break from my hell. During these detoxes, I was prescribed lorazepam. This was to stop me from having a seizure, which happens when one stops heavy drinking abruptly.

Heather, person in recovery from alcohol use disorder

What to expect

Before starting the withdrawal management process, the health care provider you see will talk to you about your past experiences with withdrawal. They will ask you questions to understand if you are at low risk or high risk of having severe symptoms. This information will help them determine the best support for you.

If you are at low or medium risk of severe withdrawal

 

If you have a low or medium risk of severe withdrawal symptoms, you can safely go through withdrawal management at home or at an outpatient clinic. To help you feel more comfortable, your health care provider may prescribe medications like gabapentin, carbamazepine or clonidine. See Medications for Withdrawal for information on these medications and what they do.

 

If your symptoms are very mild, you might find relief with common pain medication like Tylenol, or you might choose not to take any medication at all. You and your health care provider will create a plan for check-ins by phone and in-person visits during this process. Online or virtual care is also available as an option for those who cannot or prefer not to see a health care provider in person.

 

If you are at high risk of severe withdrawal

 

If you have a high risk of experiencing severe withdrawal symptoms, you will likely need to stay in a hospital or a treatment centre for some time. While you’re there, your health care provider may give you medications like lorazepam (Ativan) or diazepam (Valium), which belong to a group of medications called “benzodiazepines”. These medications can help manage your symptoms and prevent serious problems such as seizures during withdrawal. See Medications for Withdrawal for information on these medications and what they do.

 

If there are no overnight-stay withdrawal services in your area, you may need to find these services in a larger community or city, or at a nearby hospital.

WARNING: It is not safe to suddenly stop heavy, long-term drinking. Make a plan with your health care provider first, before you stop drinking.

Medications for withdrawal

These are the types of medications that are usually used when treating alcohol withdrawal.

 

Benzodiazepines

 

Benzodiazepines (also known as “benzos”) are a type of medication often prescribed to help people going through alcohol withdrawal. They work by calming the brain and body, reducing anxiety, and preventing seizures that can happen during this time. Examples of benzodiazepines include Valium and Ativan. Benzodiazepines should only be used in the short term as they can be dangerous. They can be addictive, and they can cause problems with memory and coordination.

 

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Phenobarbital

 

In hospitals, phenobarbital is sometimes used to treat alcohol withdrawal. It helps calm the brain and body, reducing the risk of seizures.

 

 

Gabapentin (Neurontin)

 

Gabapentin, also known as Neurontin, is a medication commonly used for alcohol withdrawal. It can help with symptoms like anxiety, not being able to sleep and cravings, without causing sleepiness like other medications.

 

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Carbamazepine (Tegretol)

 

Carbamazepine, also known as Tegretol, is an anticonvulsant medication used to treat mild or moderate symptoms of alcohol withdrawal.

 

 

Clonidine (Catapres)

 

Clonidine, also known as Catapres, may be prescribed for mild withdrawal symptoms, or along with other medications. It can help prevent withdrawal symptoms like high blood pressure and fast heart rate.

Harm reduction

If you don’t want to or aren’t ready to get help for problem drinking—or if you can’t get medical help for whatever reason—there are things you can do to drink more safely or stop dangerous withdrawal symptoms.

 

Harm reduction is all about making sure people who use substances stay as safe as possible by giving them resources to protect themselves and reduce the risk of worst-case problems. Harm reduction focuses on what people need and supports their well-being, independence and choices.

Managed alcohol programs

 

Managed alcohol programs (MAPs) are an option to help people who have a goal to drink more safely. In these programs, individuals get a specific amount of alcohol at times throughout the day that is right for them. This helps prevent withdrawal symptoms for those who struggle to get the amount of alcohol they need.

 

MAPs not only help control drinking, but they also provide support from others and the community. These programs help people stay stable and avoid using unsafe alcohol, like hand sanitizers or mouthwash that has alcohol in it.

 

MAPs are often run by non-profit organizations in the community, and some are found in hospitals. To join, people usually need to have a serious problem with alcohol and face other challenges like mental health problems, not having enough money or not having stable housing. Some MAPs are available in public housing places, especially for people who don’t have a home and have problems with alcohol. The requirements for each program can be different, and you usually don’t need a referral from a doctor to join.

Find managed alcohol programs (MAPs) across Canada.

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Tips for safer drinking

Whether you are getting treatment or aren’t ready to stop drinking alcohol yet, there are ways for you to be a little safer while drinking. These tips come from a community group in Vancouver called EIDGE (Eastside Illicit Drinkers Group for Education).

  • 1

    Be prepared before drinking.

    • This may include taking medication, eating something or drinking a meal replacement, having a big glass of water before or after the first drink of the day, and telling friends or family where you will be.
  • 2

    Mix and dilute drinks.

    • Pre-mix non-alcoholic drinks (e.g., juice or cola) with alcohol to lower the percentage and to make your drinks last longer. This is especially important when drinking “hard liquor” or spirits.
  • 3

    Hydrate before and during drinking.

    • Keep water nearby and drink as much water as your alcoholic beverage.
  • 4

    Know and pay attention to your limits whenever possible.

    • This could include counting cans and bottles and writing down how long you have been drinking for.
    • People may also have better or worse experiences with certain types of alcohol. Avoid the types of alcohol that are not a good fit for you.
  • 5

    Drink in safe(r) places.

    • In the summer, stay in the shade and keep cool. In the winter, try to stay warm and dry.
    • Drink with others when possible. If drinking alone, pick a place that is well known to your friends.
  • 6

    Start cutting back.

    • Get a sense of how much you normally drink in a day (for example, 8 cans of beer). Make small goals, like cutting out 1 beer a day for several weeks.
    • Before stopping all at once, make sure you talk to a health care provider to help manage withdrawal.
  • 7

    Tips for tracking how much you drink.

    • Keep your cans or can tabs to count the total.
    • Mark your bottles, especially if diluting or mixing.

Tips for cutting down on drinking

Use these tips and strategies to help you avoid situations where drinking is happening and to help you drink less when you do drink.

  • Give yourself several drink-free days, when you don’t drink at all.
  • When you do drink, set yourself a limit and stick to it.
  • Quench your thirst with alcohol-free drinks (e.g., soda, sparkling water, mocktails) before and between alcoholic drinks.
  • Avoid drinking in rounds or in large groups.
  • Eat something before you have your first drink.
  • Switch to a lower alcohol beer.
  • Avoid going to the bar or pub after work.
  • Plan activities and tasks at times when you would usually drink.
  • When you’re bored or stressed, do something physical instead of drinking.
  • Avoid or limit the time you spend with friends who drink heavily.

It helped to know I could just reduce my drinking without quitting completely.

Ken, person in recovery from alcohol use disorder

Avoiding injuries and accidents

When you drink alcohol, it can make your brain slower, which makes it hard to react quickly. This means it’s unsafe to do things like driving or operating machinery. Drinking also increases the risk of getting injured from falling or being in other accidents. It’s important to be aware of these risks.

Alcohol and driving

 

In Canada, it is against the law to drive if your blood alcohol concentration (BAC) is higher than the legal limit. The legal limit is 0.08, which means having more than 80 milligrams of alcohol in every 100 millilitres of blood. It’s important to know that even if you are below the legal limit, alcohol can still affect your ability to drive safely. This is why it’s best to avoid drinking and driving altogether to stay safe.

Can you drink and still be safe to drive?

 

The safest option is to avoid driving after drinking any amount of alcohol. Even just 1 drink can make it harder to drive safely. Without a Breathalyzer, it’s difficult to know how each drink will affect your blood alcohol concentration (BAC).
 
Generally, it’s recommended to have no more than 2 drinks within a 2-hour period. But it’s important to understand that what is okay for one person may put another person over the legal limit. How quickly you feel the effects of one drink can depend on factors like your body type, weight, whether you’ve eaten or had water while drinking, and how much sleep you’ve had.

Common myths about “sobering up”

Myth

“Drinking coffee or water will sober me up quicker.”

Myth

“Maybe I can have a quick nap—that sobers people up.”

Myth

“If I exercise, that will help sober me up.”

Myth

“I’ll have a cold shower. That will definitely help sober me up.”

Fact

The only way to sober up is time. It takes about six hours for the body to get rid of all the alcohol.

 

While eating food and drinking water can help to slow down how quickly you get drunk, it cannot sober you up.