Dealing with alcohol withdrawals
April 27, 2010 7:07 AM   Subscribe

What can I expect dealing with alcohol withdrawals?

I'm a moderate drinker -- 3-6 drinks a night, every night -- but I want to stop or cut back drastically. I'd rather not see a doctor about this. I'm American and don't want insurance companies to know about the alcohol dependency.

I stopped drinking over the weekend and made it 3 days with no cravings or side effects. On the 3rd night, I had vomiting and diarrhea. The next day I couldn't really wake up, my skin was itchy, etc. It felt like a mild flu. That night (last night) I had a single drink and felt immediately better.

So, I know every case is different, but what can I expect with this? How long will a single drink keep the withdrawals at bay? Will the symptoms come back tonight or in another few days? Will I need a drink less often as time goes by, or more often? Assuming I don't fall into the "I'll just have one more" trap, is this a reasonable way to quit drinking?
posted by mad bomber what bombs at midnight to Health & Fitness (15 answers total) 1 user marked this as a favorite
Just as an FYI, the CDC defines 'moderate drinker' as having no more than 2 drinks per day for men. You're a heavy drinker.
posted by Jairus at 7:17 AM on April 27, 2010

I used to drink a lot. Friend urged me to keep M and Ms in pocket when I tried to stop and pop them in my mouth as needed to quell this and that. Seems the sugar substituted for the stuff in worked. I took about a week , stopped feeling strange, a bit shaky etc and now I can be in a bar, buy drinks for my wife at restaurant, bring home wine for her and never feel the urge or need to have a drink myself. Figure that since I do ok without, why try one or two...stay ahead of the game this way...sure do drink lots of mineral water though when at a restaurant.
posted by Postroad at 7:32 AM on April 27, 2010 [1 favorite]

There are medications that ease the symptoms of alcohol withdrawal considerably. You should talk to your doctor about them.
posted by The Straightener at 7:36 AM on April 27, 2010 [1 favorite]

Sugar is definitely your friend. My experience is that ice cream was a pretty spectacular treatment for alcohol withdrawal.

I would categorize your withdrawal symptoms, so far, as moderate. (I won't offer an opinion about your drinking, having never seen you drink.) If you are not hallucinating or the like, that's pretty good.

You can expect, I would say, to feel up and down over the course of a few weeks or even a month. You may actually feel quite great for a while! And you may not experience anything but slight temporary relief (and possibly a prolonging of symptoms) with an occasional drink. Or maybe that will work for you.

By now, you may actually be through the worst of it. Your bloating, if you have any, should disappear pretty quickly over the next week or so.

If you wanted to, you could try not drinking for 15 days, or 30 days, so as to judge if you have a problem.

You may find that after even a brief period of abstinence, you feel like totally poisoned the next day if you have just three drinks.

Also, if you have a good doctor, she or he needn't record any information in your chart about your alcohol usage. You can have a conversation about keeping that confidential with your doctor.
posted by RJ Reynolds at 7:50 AM on April 27, 2010

You'll need to drink less and less often as the alcohol addiction subsides.

It's addiction, like heroin, coffee, or cigarettes. Your body develops a physical tolerance to alcohol and adapts to it. When the alcohol is removed, you feel unwell.

Over 10,000 people a year die from unsupervised alcohol withdrawal. You probably aren't at risk of anything serious, or you'd have been very, very ill in the first 24 hours of withdrawal.

Just drink less. Despite what the CDC might say, 3-6 drinks a night is not that heavy. A half a gallon a day is heavy. It's all relative, especially to drinkers.

One drink a day or even less should keep the symptoms abated for you. After a few weeks of that, you can quit entirely, if you are so inclined.

Don't equate drinking functionally or only having a couple of drinks a day with not being an alcoholic. Alcoholism is like autism, it's hard to define, and there are many varieties of it. On the other hand, one or two drinks a day is not a problem if it's not a problem. The risk for many alcoholics is that once every so often, two drinks turns into many, many drinks, without really thinking too much about it.

Personally I define alcoholism as an attitude towards alcohol, or a relationship with it, that non-alcoholics don't have (Yes, I know that is circular logic). My ex-wife probably drank as much or more than me; I am alcoholic, she isn't. Yeah, weird.
posted by Xoebe at 7:58 AM on April 27, 2010 [3 favorites]

I am not a doctor, I am not a nurse, do not take this as medical advice. This is simply a recount of what I've seen in my days working in a psych hospital.

Everyone withdraws from alcohol differently. It depends on how much they drink per day (including the size of each drink) and how long they've been drinking. There are also a ton of symptoms ranging in severity. Medical detox monitors and treats the symptoms, so while there is a usual protocol of treatment, not everyone responds the same way. It's about managing the symptoms and physical distress. Most people coming off alcohol have sleep disturbances (either sleeplessness or feeling tired all the time), shakes, sweats, and irritability. Some will run a fever. Vomiting and diarrhea are definite symptoms, and tend to hit about the 2nd or 3rd day. Patients also tend to get dehydrated (partially because of the vomiting, partially because most of the liquid they consumed was liquor and they aren't used to drinking water), so we gave them lots and lots of Gatorade, which helped them feel better than plain water. The dangerous symptoms to watch out for are high blood pressure (which could cause stroke or heart attack) or any change in your heart rhythm, seizures, or psychosis/hallucinations. I'd say most alcohol withdrawals last anywhere from 5 to 7 days, but you could feel bad for a while after that (tired, restless, etc). The major medical symptoms tend to stay within that 5-7 day window unless someone is a very long term, heavy drinker with other medical problems. If that was the case we kept them on medications to alleviate the symptoms.

Alcoholics would also be low on vitamins, so everyone got a Thiamine (B1) shot upon admission. It probably doesn't help symptoms, but a shortage of B vitamins causes other problems, so consider taking a B vitamin complex or a good multivitamin.

Since each person is different, it's hard to tell when your symptoms will come back. If your intent is to stop drinking, the goal is to "need" a drink less and less often. Yes, having a drink will lessen your symptoms because you are giving your body what it is craving, but it won't ever really get you off of the alcohol. However, quitting cold turkey can be dangerous as well, depending on the symptoms. Since I am not a trained medical professional, I cannot advise you on what to do next. I will tell you that withdrawing from alcohol sucks, but it is manageable. If you feel like you are having any serious symptoms (high blood pressure, can't keep anything down due to vomiting, dehydration, heart issues, hallucinations, delirious thinking, etc) seek medical help ASAP.

I also want to encourage you to consider a support group (AA or another group of your choosing). Alcohol dependence has a medical/physical component, but it also has a psychological component that doesn't go away after detox.

Take good care of yourself, and I wish you the best.
posted by MultiFaceted at 7:59 AM on April 27, 2010

This is a personal anecdote, not medical advice. I'm an office manager, not a doctor.

I drank 3-5 drinks every night, with 1.5-2oz of liquor per drink. It was "the only way" I could relax after work. At the first of the year I decided to quit. I was immediately more irritable and shaky. I felt more sensitive to changes in temperature and would sweat more easily. I slept hard and woke up feeling exhausted. After about a week of this, the shakes/sweats subsided but I was moody for another month before that leveled as well. I'm sleeping much better, even started to wake feeling refreshed.

It's been 5 months, and I've relapsed a few times. Do not fall into 'it's just one drink' because it never is. One drink, and I feel the need to have another. I can't stop or reason my way out of it. It is the strangest thing I've ever felt. The cravings are definitely still there, and I don't think they'll go anywhere anytime soon. I haven't found a good way to combat them, but I do have a glass of milk every evening - I could never drink milk with alcohol, so it's an effective way to keep out of the bottle.

I have the full support of my partner, and he won't so much as drink a beer in my presence because it triggers a craving. We don't go out to bars, no wine with dinner - nothing. If you're not planning on going to treatment (and I feel the same you do in regards to that) then you may find it useful to cut out all bars and places where alcohol consumption is high.

I feel wonderful now. The times I did fall off the wagon, there was no additional week of detox or anything... although this last time, I had 5 glasses of wine and woke up with the most wicked hangover, when I used to clear a half bottle of vodka without much trouble.

So, there's that. Good luck. :)
posted by caveat at 8:46 AM on April 27, 2010 [1 favorite]

Multi is right, alcohol is not a 'cold turkey' substance. Check this Wikipedia entry on Alcohol Withdrawal Syndrome. Please don't misinterpret what I'm saying... you should quit and quit completely, but there is really only one way to quit without endangering yourself: Supervision by a professional. If you were to go to an AA meeting I'm sure you could find anonymous resources to help your cause. Good luck.
posted by Gainesvillain at 9:13 AM on April 27, 2010

It's fairly normal. Under medically supervised detox (withdrawal management center), they have experience in treating the assorted symptoms. As mentioned above people react differently. Vomiting, nausea, heartburn, loss of appetite, rough sleep, the shakes, elevated blood pressure, whatever.

Dealing with it: Ginger Ale, ginger gravol, thiamine, antacid, fruit, lots of sleep, ativan prescription if you get the shakes, lots of water to flush out the system, some people like crushed ice, if you've got an appetite which may not occur for a few days eat as healthy as you can, find things to do to distract yourself.

It's been said that the 3rd day is the worst. I disagree, but depends on the drinking level and how your body is capable of handling it. Bear in mind that paced drinking such as one per hour is different than overloading the liver on a binge.

I'd say, and I'm not a doctor, just experienced in this area, somewhere around 6 days you might feel 'sober'. 9-13 days should be the max.

Once sober, do NOT have a drink ever again. You'll be back at the start. If you go through withdrawal a few times...

I drink more than that, but you still fall into the alcoholic category, and you know it. At least get a blood test targeted for your liver function. Once you have cirrhosis, the damage is done. Liver failure isn't fun. Chain reaction of pretty much all the other organs shutting down, long visit to the ICU (which I imagine won't be cheap in the US), long recovery if at all.
posted by hungrysquirrels at 9:30 AM on April 27, 2010

The problem with alcohol withdrawal is that it can be not only life-threatening but unpredictable. If you wait until you develop a seizure followed by a massive aspiration event or head trauma, it will be too late. Delirium tremens can occur well after your last drink.

Please do this the right way, under professional supervision. Whatever the downside of that may be, the complications are easily preventable and not worth risking, in my opinion as a physician who's guided lots of people through detox. Just my two cents.
posted by drpynchon at 11:48 AM on April 27, 2010

Just drink a little less every couple of days and slowly wean yourself.

Afterwards, If you have no self-control, then never drink again. If you are able to restrain yourself from reverting to habit, only drink 2 days a week, and limit it to 2-3 drinks.

In North America, everyone buys into AA orthodoxy about drinking, but I don't. Take a look at how Europe deals with alcoholism; they are all about moderation and counselling, if I remember right. Alcohol is wonderful and life-amplifying in moderation, so don't deny yourself it if you don't have to.
posted by teedee2000 at 12:11 PM on April 27, 2010

Evidence based alcohol treatment not based on 12 Step recovery modeling still suggests that most who are addicted to alcohol remain abstinent, they simply feel that abstinence is best obtained through medication assistance and maintained through cognitive behavioral therapy as opposed to spirituality and ongoing peer support.
posted by The Straightener at 12:47 PM on April 27, 2010

For what it's worth, I used the Sinclair Method to gradually and fairly effortlessly cut back from a bottle of wine (or more) per night to two drinks a week or even per fortnight. Supposedly cutting back in a gradual process reduces the threat of harm from sudden withdrawal. If going cold turkey, I'd surely pay close attention to the good doctor's advice above.
posted by cairnish at 2:04 PM on April 27, 2010

Hello, I am not a doctor. However, I worked part time in a detox ward in college for a year.

Alcohol has the side effects of being a depressant and muscle relaxant. Your body has adapted to a regular "dosage" of alcohol. Without that "dosage", you can expect to see antagonistic symptoms: elevated heart rate, high blood pressure (hypertension), muscle tremors, headeaches, agitation, nervousness and tremors.

Depending on your past "dosage" and your body's reaction, you can get into severe reactions such as heart arrythmias and seizures. Seizures were a common occurence in the "gallon-a-day" vodka drinkers who came in off the street into the detox ward and stopped drinking "cold turkey".

If you do stop your "dosage" suddenly then keep an eye on your pulse and blood pressure. See a doctor if you have persistent high blood pressure, rapid and/or irregular pulse.

Vitamin supplements can help ease withdrawal symptoms, especially magnesium, folic acid and thiamine.

Hopefully you won't experience any of these symptoms to a severe degree and will simply be able to reduce your drinking to a level you're more comfortable with.
posted by de void at 2:09 PM on April 27, 2010

Thanks for the advice, everybody, although I feel like I know less than I did before.

Personally, I doubt I'm at risk for serious complications. In the past, when quitting something, I always went cold-turkey. I might fail a few times, but eventually everything would fall into place and it would be the easiest thing in the world. This time felt like that.

But I guess it wasn't. I'll work more from an attitude of cutting back than quitting completely. If I can't cut back reliably, I'll follow the prevailing advice and work with a doctor.
posted by mad bomber what bombs at midnight at 4:01 PM on April 27, 2010

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