This was my part of a forum conversation in 2003 with someone who had been drinking very large quantities of beer for several years. In his country there was a long delay in available medical services. So the question was: how to begin quitting alcohol, and what to expect?
I am definitely NOT an expert on the medical aspects of quitting drinking. But IÕm curious: how much are you drinking on a daily basis? Others have posted about the dangers of detoxing abruptly and without supervision, but I canÕt think of any reason you canÕt carefully drink LESS than you are presently doing.
If you are drinking medicinally, as many people do, you may be drinking pretty much the same amount of pure alcohol each day—though possibly in forms of differing strengths (beer, wine, spirits). So if you can measure what your daily ÒdoseÓ is and cut that by 25% itÕll certainly be better for your body than what you are presently doing.
Help me out here, folks; anyone know of any harm from steady reduction in alcohol intake—as opposed to cold turkey?
Identifying how much you find ÒnecessaryÓ each day might also be a good first step in determining what benefit you think it provides you. Then maybe we can talk about other ways to achieve that benefit while tapering down gradually.
When I made a commitment to quit drinking, I chose to cut my daily intake in half for two days first to reduce the discomfort associated with sudden abstinence. But without knowing your typical daily intake, or what the consequences would be, I canÕt tell you whether this is likely to work for you.
The only reason I suggest this, even with all the prior suggestions about medical supervision, is it doesnÕt seem that your doctors are being much help on this! It certainly is interesting how different cultures perceive alcohol use and abuse. Let us know how things are going, and thanks for posting.
Once again, I have no medical background. But here are some rough figures.
By my calculations, you were drinking about 2 gallons of beer a day. In the US, beer is 4% alcohol, which would be about 10 - 11 oz. of ethanol. ThatÕs about the same alcohol thatÕs in a 750 ml. bottle of whiskey, vodka, or brandy @ 80 proof. I certainly drank that amount of alcohol in one day on a regular basis, and I suspect many other folks here have done the same. Without knowing how much you weigh, I canÕt figure out how drunk that was getting you, but at the rate your liver processes alcohol itÕs about enough to keep you feeling the effects of alcohol throughout your waking hours.
Beer in some countries is as much as 6% alcohol, so you can adjust the math accordingly. Replacing one of those gallons with two gallons of water per day is definitely a good plan. Plus, you can consider that youÕve just cut about 1600 calories (20 - 30% less with light beer) out of your daily diet É itÕs pretty easy to see the benefits of that!
IÕd anticipate some sleeplessness, irritability, and perhaps feeling hungry due to the sudden drop in carbohydrates. My eyes felt dry and itchy because there wasnÕt the alcohol evaporating out of them. I found that small, steady amounts of fruit juice helped even things out, and herbal teas helped make me feel sleepy at bedtime. Taking that much fluid containing diuretic out of your body is going to affect your digestion. With the amount of water youÕre drinking you might feel bloated at times. Some coffee or tea around meals helped me with that.
Have you had much physical discomfort from cutting your beer intake in half? Would you be able to cut it in half again within the next day or so? In particular, have you had any of the symptoms mentioned in the other posts, which might warrant a medical consultation? If not, I donÕt see why you couldnÕt taper off more with the goal of being completely free of alcohol in your system in, say, several days.
Some folks here may disagree with me on this, but I think that the stopping part of drinking can actually be the simplest part of the process. You just stop—either cold turkey, or incrementally. There are some discomforts, but they are not unbearable.
ItÕs the staying stopped that can be complicated, primarily because of anxieties we may have about what it will be like to be sober. Inability to cope with stresses, problems breaking the daily patterns that reinforced the drinking, or just dealing with the boredom or restlessness that often comes with early sobriety: those are the things a recovery program can help you with.
Figuring out what benefit alcohol was providing you can be a helpful starting point. Anticipating urges, changing your daily routine, and finding a way to make your commitment to sobriety firm and unshakeable are the keys to success.
You really can do all this before you ever get to your first meeting. And starting out sober will just make the next steps that much easier.
Congratulations on cutting your drinking in half, W_____. I admire your perseverance in the face of the apparent indifference of the professionals who are supposed to be helping you! Thanks for posting.
W_____, you mentioned that your daughter would really like your sobriety.
My kids were (are) a huge motivating factor for me. Two young teenagers needed their dad to be sober. I made them a promise in writing, and recited it word for word until I could simply say it anytime I was tempted to buy a bottle:
ÒThere will be no alcohol in my house or in my body.Ó
Many times those bottles (of wine, in my case) looked very tempting. I could start to rationalize: Òwell, one bottle would be ok; I need it for a recipe; I can drink a glass and stop there....Ó
But that absolute rule kept the bottle on the shelf.
The only change IÕve made to that rule is to add the word ÒdrinkableÓ in front of alcohol. So I do own Listerine and cooking sherry, and when I was given a bottle of good-quality red wine I just poured 3 tablespoons of salt into the bottle as soon as I opened it.
By the way, my (14 year old) son walked into the kitchen while I was doing that and said Òwhat on earth are you doing?Ó
ÒIÕm making this wine undrinkable.Ó
He gave me a BIG hug. They care a lot more than they let on.
Since youÕve successfully cut your drinking in half and gotten your body used to about 5, instead of 10, oz. of ethanol—why not try a day without any beer? IÕd go back and read PeterÕs post about possible side-effects first, and if you can talk to a doctor that would be great. As they say in AA, Òone day at a time.Ó One day without beer?
If you do quit tonight, IÕd suggest making specific plans for:
á what to do with the time you usually spent drinking. ItÕs a pretty passive activity, and most of us found ourselves pretty restless at first. I found myself stopping at a local bookstore or magazine store almost every day, looking for reading material, and the folks at Blockbuster got to know me on a first-name basis.
á the possibility of negative reactions from those around you. You might be a little antsy or snappish. Your drinking friends might be a little threatened by your change. Some might show relief when you decide to drink, that youÕre Òback to normal.Ó Those are big factors in how we deal with urges.
á how to quiet your rumbling stomach. This might be a good evening for a high-carbohydrate dinner. Make lasagna! It takes time, is fun to make at home, and fills you up. Plus, people will really be impressed.
á how to get to sleep. Herbal teas and a good, slightly boring book have helped me many nights. Or, just donÕt worry about the fact that youÕre up late. I have found I can function just fine on much less sleep than when I was drinking, probably because the quality of sober sleep is more restful.
Again, the next step might be to try and figure out what it is that alcohol was providing you with so that once you have stopped you can stay stopped. Right now, while youÕre reducing your intake, would be a good opportunity to observe and describe what youÕre missing. That can be helpful in building the tools to combat urges.
Writing those ÒbenefitsÓ down and posting them here can elicit suggestions from others about how they filled the void once alcohol was out of their system. Part of it is practical—tools and techniques—and part of it is philosophical—learning to NOT think of it as a void.
I distinctly remember my first night in over 20 years without alcohol. The restlessness seemed pretty overwhelming, and I kept looking at the clock and realizing how little sleep I was getting. That is a particular symptom of ÒdetoxingÓ that can really be an obstacle for many people: ÒI canÕt sleep without a drink.Ó
There are a couple of simple ways to dispute that. One is to do things that will help you relax—warm bath, book, hot milk, massage, candles, soft music...uh oh, IÕm getting carried away here.
Another is to realize that you may be fixating on, and becoming anxious about, your sleeplessness. So stay awake! All night, if that happens. Big deal. Heck, you used to do it in college, right? And you can nap when your body tells you to. Besides, sober sunrises are beautiful. You may be a little less on top of your job tomorrow, but probably not as impaired as if you were drunk. Besides, taking a Òsick dayÓ to achieve sobriety isnÕt unreasonable. After all, you are dealing with a medical condition.
This is part of a broader anxiety about quitting drinking. People are often scared of what life will be like without it. The threads on this forum board reflect fears of boredom, coping with stress, dealing with how other people will react (just wait until we get close to the holidays!), etc. It WILL be uncomfortable, but all of those things are bearable. Dealing with them as separate issues, and ruling out alcohol as the solution to any of them, is an important step.
How much beer did you drink when you finally did? The reason this is important is that you may have found what your body and mind consider to be your dosage. Anything after that is probably maintenance, although for many people the first drink simply starts another long ingestion that doesnÕt stop until theyÕre asleep in one form or another.
Taking a close look at when you drank and why may be useful to you in identifying what triggers you to start drinking. If you can stop the starting part, you can stop for good. That means recognizing urges and triggers and disputing them until they pass.
Congratulations on your first day, W_____. Keep in mind that after about 72 hours without alcohol most of the physiological changes of early sobriety have passed and you are mostly dealing with psychological things. So a 72 hour goal can be an important first step.
At the risk of repeating myself, there are three things that people who succeed at sobriety have in common:
a commitment to sobriety;
a change in lifestyle;
they plan for urges and practice dealing with them.
This post shows me that you are building the commitment to sobriety and are making steps towards changing the lifestyle. You mention Ògoing in that directionÓ of the store; that is a case of an urge manifesting itself, seemingly unconsciously, and is something you can plan for. Our daily shopping patterns are a big part of the behavior, and NOT buying alcohol was, for me, the key to NOT drinking in the first few days. Yeah, I can get a drink elsewhere if I really want to, but I might as well not make it easier by having it in the house!
ÒThere will be no alcohol in my body or in my house.Ó I actually said this out loud as I went to the grocery store, until it became a fact rather than just a hope.
While the 90 day milestone was significant, I didnÕt really notice it at the time. The most significant one for me was the 72 hour one. When you get there youÕve really broken a physiological cycle in your body. YouÕve changed your blood sugar patterns, youÕve started a new sleep cycle, and your body is no longer producing the various enzymes and such that have been required to process a continuous stream of alcohol and carbohydrates. 24 hours is a huge step, and 72 hours is when sobriety really ÒclickedÓ for me.
By the way, five days after my 72 hours I decided to have a beer. I consciously focused on how it made me feel as alcohol reentered my body. My IMMEDIATE reaction was that I wanted another one. So my rational mind kicked in and said Òyou obviously like alcohol TOO much for just one.ÓModeration was obviously not for me, and that was the last drink IÕve had.
Stopping drinking can seem hard, but itÕs not TOO hard. Just some discomfort. With a little planning most of the discomfort can be reduced. In my case it was mostly figuring out when I was likely to really want a drink, and changing my dayÕs plans so IÕd be doing something else then. Plus eating and drinking carefully so that hunger wasnÕt a factor in my desire for a drink.
Planning for urges—what youÕre going to say to the folks who have beer waiting for you, how to get dinner going earlier when you get home instead of sitting down with a drink—is an important part of breaking the pattern.
Commitment to abstinence, change in lifestyle, and planning and practicing for urges are the three components of successful sobriety. And we all do it one day at a time.
IÕm not sure about the Òrock bottomÓ part. I think most of us can just redefine rock bottom as needed. IÕm sure there are plenty of folks on this board who had bad physical and mental effects of alcohol abuse but never, say, ended up on the streets panhandling for their next bottle. I used to measure the morning by whether or not I was throwing up bile. No bile was a good day. George C. Scott once described himself as a Òfunctional alcoholic,Ó meaning he drank heavily but functioned fine at work and on a day-to-day basis. We donÕt necessarily have to have a life-changing physical (or legal) event in order to find the motivation and make the commitment to get sober.
That gets to some of the principles of REBT/CBT which could be useful to you and others. The simplest principle is that our behavior is based on our emotions and beliefs, and if we can change those beliefs we can change our behavior. This seems simple, but it can be a challenge to change the beliefs on which long-established behavior patterns are based.
Some of those beliefs can arise from deeper-seated problems such as self-esteem issues, anxiety, and depression, so sometimes counseling can help. But just focusing on why you drink and what you believe about drinking, and determining which of those beliefs are irrational, enables you to start disputing them.
Early sobriety (in all programs that I know of) focuses on techniques for changing the behavior. Go to meetings (real or face-to-face), change your diet, start exercising, practice how youÕll deal with urges, do some role-playing, etc. But the change in beliefs is happening. In AA, I assume, you come to BELIEVE that you have a disease, and you accept (or reaffirm) a BELIEF in a higher power which will help you develop your motivation and commitment. You accept that your life had become unmanageable, and so on. These are things you didnÕt believe just a few weeks prior. Anyone who has come to a recovery forum board is already making a change in their beliefs about drinking.
So here are some simple beliefs I once held, which I now acknowledge were irrational:
I can drink a small amount of alcohol and stop.
I can moderate my drinking.
Drinking isnÕt really affecting my health.
If there is alcohol in the house, I wonÕt necessarily drink it, so itÕs okay to buy extra bottles.
People donÕt really notice or mind when IÕve been drinking.
All of those beliefs were just untrue, and disputing them proved to be pretty easy because they are specific. But itÕs amazing how long we can hold onto them! Getting an outside perspective—your doctor, your girlfriend, a counselor—can help you realize that beliefs such as these are irrational.
Getting a little Òdeeper,Ó I believed:
Daily drinking helps reduce my anxiety and depression.
Our sex life is better when weÕve been drinking.
I am more creative/sociable/accomplished when IÕve had some alcohol (or pot, or...)
Drinking relaxes the part of my brain that worries about work, finances, etc.
I couldnÕt spend an evening without at least some alcohol.
It will be very uncomfortable to quit drinking.
These are more general, and there may be some truth to each belief. So disputing them becomes a matter of finding and believing a rebuttal to the statement. Avoiding absolute and demanding words like Òshould, must, couldnÕt, canÕtÓ can be a useful tool. Avoiding overstating how awful things are or will be is another.
So while it may be uncomfortable to quit drinking, it wonÕt be TOO uncomfortable and I CAN bear it. Daily drinking temporarily reduces the symptoms of my anxiety, but increases it in the long run. An accurate appraisal of my piano playing when sober is that it is sharper and there are fewer errors.
If youÕre having trouble figuring out what you believe about alcohol, a simple technique is to do a cost-benefit analysis (CBA). Take a sheet of paper and make a line down the middle. Write down the things you know alcohol ÒcostsÓ you on one side—money, health, etc. Write down the benefits you get on the other.
People often get stumped here, because theyÕve decided drinking isnÕt good for them so itÕs hard to focus on what you LIKE about alcohol. But even if the behavior has become almost a mechanical process, there is (or was) some benefit we perceive. Finding other ways to achieve those benefits is what we mean when we say that changing your lifestyle is part of achieving sobriety.
Another tool used in REBT is called an ABC. Some people drink in response to specific triggers, or because of emotional upsets. If you can identify the activating event (A) which led to your condition (C), then you can identify the irrational belief (B) which you need to dispute (D). For daily, medicinal drinkers like myself this didnÕt seem that practical—after all, I drank every day, the same amount, so how can I find an activating event?
But you can apply it to specific drinking events. YouÕve described someone bringing a bag of beer, or a customer having it when you arrive to do work. Why do you open the can when he hands it to you? Do you believe he wonÕt accept that you are now sober? So the condition © may be anxiety about the response, and the social situation is the activating event (A). It is surprising how often this comes up; just check the different forum board around the holidays! What am I going to do when --- offers me a drink? How will I explain it? What will people think? So, is it true that someone will be offended when you decline a beer? Probably not, so that belief (B) is irrational. You can do some roleplaying, practicing what youÕre going to say when the beer is put in front of you. But first you can dispute(D) the belief.
Those are some tools you can add to your arsenal. Probably the best one to close with is PPP, which applies to ANY recovery program: practice, patience, and persistence.
One of the first things I did when I quit was to make a daily note of the money I would have spent that day on alcohol. Then I took the savings and spent them on some simple treats for myself and my kids—good ice cream, dinner out, or some really good coffee. Check out the Sulawesi or Garuda coffees at your local retailer...theyÕve become favorites of mine. You didnÕt buy one of those fancy expresso makers, did you?
I made a point of trying to stop and notice the things I hadnÕt noticed for a long time. I try to get outside early in the morning, just to remind myself what a great time of the day it is when youÕre sober. In my case, since IÕm a nurseryman and gardener, I literally stop and smell the roses! Or the lilies, almond blossoms, or tomatoes. Appreciating good coffee as a pleasure, rather than a way of jump-starting my fogged brain, is definitely one of those perks (pun intended) of sobriety.
It sounds as though youÕre tapering down steadily and doing well at it. Identifying the habitual drinking times and shaking them up was very effective for me. The next step was identifying what drinking did for me, and trying to find more effective ways of getting those purported benefits—or disputing whether they are really benefits at all! (Example: alcohol helps me sleep? Wrong! Passing out isnÕt very effective sleep...).
ItÕs interesting how few benefits we can come up with for drinking! So, why on earth did we ever start? For most of us, by the time we decide we should quit drinking it has become such a firmly imprinted behavior that we do it automatically. So it can be hard to take a step back and look at what this drug is doing to our brain.
It is a depressant which relaxes certain parts of your brain functions. For some people it reduces anxiety, which can make them feel more effective in social situations. For others (business people like myself, for example) it allows us to stop ÒworryingÓ temporarily about all the many things we juggle at work and in our lives. On another forum board one individual frequently links her drinking to her anger. You mentioned life events over the last few years which I would describe as emotionally distressing, and I suspect it may be a way of coping with that.
The mechanical part of stopping drinking is pretty simple—you can stop cold turkey, or you can reduce gradually. For people who never drink, or who can drink moderately, it must seem like weÕre making a big deal out of that ÒsimpleÓ process. Get rid of whatÕs in the house, donÕt buy any more, and stay out of places where it might be served. Support from others obviously enhances your commitment—meetings, forum boards, family and friends can all support your new decision. ThatÕs the stopping part. ItÕs the staying stopped that defines long-term sobriety.
A lot of people—even long-time, heavy drinkers—can quit for a while. But folks in every recovery program often report lapses after days or weeks or months sober. So something has undermined the commitment. Some might say that itÕs because you let down your guard. In my opinion it is partly because you perceived, whether consciously or not, a benefit from drinking, and partly because you didnÕt plan for and practice for the urge.
When youÕve developed alternative ways of relaxing, or dealing with anxious situations, or whatever it is that alcohol ÒhelpsÓ you cope with, those urges can be easier to deal with. If youÕve changed your daily routine, the temptation is less likely to face you at familiar times. An hour on the forum board can replace an hour drinking in front of the TV!
The way youÕre doing it is very rational physiologically. It takes a lot of willpower—more, I think, than quitting cold turkey, because youÕre continuing to ÒdoseÓ yourself with your medicine every day.
So thatÕs why I keep asking what the benefit is—what is it that youÕre getting from the beer youÕre still drinking? Part of it is that your body wants it. Scientists would tell you that your dopamine receptors are still clamoring for it, so giving them (the receptors, that is) less and less can be an effective way to prepare them for abstinence. But I believe there must still be a psychological or emotional benefit to deal with.
Drinking is kind of like a love affair that you know you should end, but you keep going back for a little more....So perhaps itÕs time to say goodbye for good. No more last flings, not even just being friends....just a clean break, a firm goodbye, and no looking back....