How to Taper off Alcohol
By The Orlando Recovery Center
Editor Theresa Valenzky | Medical Reviewer Benjamin Caleb Williams, RN
Last Updated: September 15, 2024
Alcohol addiction is dangerous, and the best way to reduce the risks of drinking is to stop using alcohol. However, quitting cold turkey can be hazardous. Tapering your alcohol intake, or slowly decreasing it over time, can help you avoid severe alcohol withdrawal symptoms.
You should only attempt an alcohol taper while under a doctor’s care. However, learning more about how an alcohol taper works can help you prepare to quit.
Is Quitting Alcohol Cold Turkey Dangerous?
Quitting alcohol cold turkey can be very dangerous. While it is generally the medically recommended method of stopping alcohol, it requires medical supervision to be safe. Quitting cold turkey can shock your system since it has become used to functioning with alcohol.
What Happens to Your Body When You Stop Drinking Alcohol?
Heavy drinking causes changes in your brain. In particular, it alters neurotransmitter gamma-aminobutyric acid (GABA) receptors. When you drink a lot over a long period, your brain reduces sensitivity to GABA. This means that if you quit drinking cold turkey, your brain will not be sensitive enough to GABA. This can cause your brain to become hyper-excitable and leads to withdrawal symptoms.
Alcohol withdrawal symptoms can include:
- Sweating
- Increased heart rate
- Tremors
- Anxiety
- Agitation
- Seizure
- Delirium and hallucinations
Withdrawal symptoms often follow a general timeline. For most people, it will look something like this:
- Six to eight hours after the last drink: Mild withdrawal symptoms like tremors, anxiety and nausea can occur.
- 12–24 hours after the last drink: Hallucinations may start; other symptoms may include tremors, agitation and insomnia.
- 12–48 hours after the last drink: Symptoms may worsen, and seizures may occur.
- Two to five days after the last drink: Delirium tremens, the most dangerous complication of alcohol withdrawal, can occur. A person may experience unstable vital signs, confusion, agitation, fever, rapid heart rate, high blood pressure and sweating.
- One to six months after the last drink: As sobriety is maintained, physical withdrawal symptoms will generally improve within two weeks. However, lingering anxiety and sleep problems may occur.
Can Tapering or Weaning Off Alcohol Reduce Withdrawal Symptoms?
When you slowly taper your alcohol intake over time instead of quitting cold turkey, you reduce the likelihood of withdrawal symptoms. By weaning yourself from drinking, you allow your brain to adjust its sensitivity to GABA.
When you drink heavily, your brain changes its sensitivity to GABA. The imbalance in GABA that occurs when you suddenly stop drinking causes withdrawal symptoms. Slowly reducing your drinking over time instead of suddenly stopping allows your brain to change its response to GABA.
Strategies for Tapering off Alcohol
There are two main strategies for tapering off alcohol: a direct taper and a substitution taper. Depending on what you drink and how much you drink, you may find either one works better to help wean you off alcohol:
- Direct taper: In a direct taper, you continue to drink your regular drink but slowly decrease the amount over time. Direct tapers work best for drinks that contain a low percentage of alcohol, such as beer.
- Substitution taper: You switch your regular drink to a different one in a substitution taper. For example, if your standard drink is a strong liquor, a substitution taper would involve counting your daily drinks and switching to an alternative that contains less alcohol, like beer. You would then slowly reduce the amount of beer you drank over time.
Some drinks, such as liquor or spirits, contain a high percentage of alcohol. If your typical drink has a high alcohol percentage, a substitution taper may be safer than a direct taper for several reasons:
- It can be easier to measure your intake of beer versus spirits.
- It can be harder to binge drink beer versus spirits.
- Because beer contains more water than spirits, it is easier to remain hydrated.
- It can be easier to adapt your body to drinking smaller amounts of alcohol with a substitution taper.
However, it’s important to note that people with moderate to severe alcohol addictions may struggle with sticking to a taper schedule and relapse to heavier alcohol use. In these cases, medical detox may be the best option.
How Long Does It Take to Taper off Alcohol?
It can take different people varying amounts of time to taper off alcohol. How long it takes depends on factors like how much you typically drink. A person who drinks more alcohol will probably have a longer taper than a person who drinks less alcohol.
Another significant factor in how long a taper lasts is alcohol withdrawal symptoms. After all, the point of a taper is to minimize alcohol withdrawal symptoms. If you begin to have withdrawal symptoms during your taper, this is a sign that your taper may be going too fast, and you need to slow it down. Doing so can prolong the duration of your taper.
Alcohol Taper Schedule
Addiction experts have not conducted many studies on alcohol tapering, as tapering is not considered the ideal way to quit alcohol. As a result, little information is available regarding the best way to taper. That said, some independent groups have stepped in, publishing sample tapering schedules to guide people trying to cut back on drinking.
The sample schedules state that if you drink fewer than 20 standard drinks a day before starting the taper, you should reduce your alcohol intake by two drinks a day until you get to zero drinks. The schedule becomes a little more complex if you drink more than that. If you drink 20 or more standard drinks a day before starting the taper:
- Day one: Drink one drink each hour for 16 drinks.
- Day two: Drink one drink each hour and a half for 10 drinks.
- Days three through seven: Reduce your drinking by two drinks each day until you get to zero drinks.
Because tapering can be tricky and alcohol withdrawal can be dangerous, you should never start a taper before talking to your doctor.
Challenges of Quitting Alcohol
Quitting alcohol can be hard, not just because of the withdrawal symptoms. Knowing ahead of time that quitting may be difficult can help you plan the best way to address these challenges. In turn, this increases your confidence and your chances of success. Common challenges include:
- Losing a coping strategy: Many people drink alcohol to cope with mood problems like anxiety, depression and stress. When you stop drinking, you must find a different coping strategy for these problems. Fortunately, this is precisely what rehab programs train you to do after you quit drinking.
- Avoiding triggers: When you drink regularly, you likely have certain rituals for when you drink. For example, you may drink whenever you see your friends or at night before bed. These situations can serve as triggers for you, which may lead to alcohol cravings because you are used to drinking at those times. Learning how to avoid triggers is an important part of maintaining your recovery.
- Finding supportive relationships: If you spend a lot of time with people who drink heavily, your new sober lifestyle may be harder to maintain. Finding new relationships that support your sobriety is important.
- Dealing with relapses: Relapses are common, but they are not the end of the road. Learning to reduce the chances of a relapse and move forward with your sobriety despite a relapse are important parts of recovery.
The Benefit of Medical Detox for Tapering off Alcohol
Because alcohol withdrawal symptoms can be life-threatening in some cases, safety is crucial when you work towards sobriety. Little scientific evidence exists regarding tapers, but medical detox has been proven to be a safe and effective way to quit drinking.
In medical detox, doctors and nurses provide around-the-clock care while helping you detox from alcohol. Inpatient and outpatient rehab follow medical detox to help you maintain your sobriety over the long term, and medication-assisted treatment may be prescribed as medically appropriate.If you or someone you love is struggling with drinking, Orlando Recovery Center can help. We offer a full continuum of care and are an in-network provider for a range of insurance companies, including Aetna, Cigna and America’s Choice. Contact us today to learn more about the insurance we accept and find an alcohol addiction treatment program that can work well for your situation.
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