Tapering off Alcohol: What You Need To Know

For a safe recovery from heavy drinking, have a plan in place. Quitting abruptly can be dangerous without medical supervision due to potential withdrawal symptoms. Gradually decreasing alcohol intake through supervised tapering can make quitting safer and ease withdrawal severity.

Tapering off Alcohol vs. Going Cold Turkey

People looking to quit drinking may consider either tapering or going cold turkey, meaning they abruptly stop all alcohol consumption without weaning.

Taper Method

An alcohol taper is a way to wean yourself off alcohol and avoid withdrawal symptoms. Although all forms of alcohol cessation should be done with medical guidance, tapering your alcohol intake may allow you to self-wean from drinking at home. 

When you taper your alcohol, you slowly reduce your alcohol intake over time. By gradually drinking less instead of stopping cold turkey, your body has a chance to adapt to smaller and less frequent drinks. In turn, your risk of undergoing alcohol withdrawal may be lower.

Cold Turkey Method

Quitting alcohol cold turkey is not recommended and can be dangerous. Alcohol is a central nervous system depressant that leads to an increase in brain neurotransmitters that slow down your brain’s functions, such as gamma-aminobutyric acid (GABA). When you drink heavily over a long period, your brain and body adapt to expect this.

If you suddenly quit drinking, your brain can start to make more of an excitatory substance called glutamate. This excessive glutamate level can lead to alcohol withdrawal symptoms, which can be dangerous.

What Happens to the Body When You Stop Drinking?

Prolonged and excessive alcohol consumption can impact your brain, causing changes to the neurotransmitter gamma-aminobutyric acid (GABA) receptors. Heavy drinking can lead to a reduction in the sensitivity of your brain to the amount of GABA produced. If you abruptly stop consuming alcohol, your brain may not have enough sensitivity to GABA, which can result in hyper-excitability and withdrawal symptoms.

Alcohol withdrawal symptoms often start anywhere from six hours to a few days after a person’s last drink. Alcohol withdrawal symptoms generally peak within 24 to 72 hours but may continue longer. Symptoms include:

• Sweating
• Fast heart rate
• Tremors or shaking
• Insomnia
• Nausea or vomiting
• Hallucinations
• Agitation
• Anxiety
• Seizures

Delirium tremens is the most severe complication of alcohol withdrawal, and its symptoms can start as soon as 48 hours after the last drink. Delirium tremens is a medical emergency, and you should contact 911 if you suspect someone may be experiencing this complication. Symptoms of delirium tremens include:

• Fever
• Hallucinations
• Seizures
• Extreme agitation
• Extreme confusion
• Tremors

Benefits of Tapering off Alcohol

Tapering alcohol is beneficial because you can avoid alcohol withdrawal symptoms. This is because when you drink heavily for months or years, your body can start to depend on alcohol to function normally. This phenomenon is called physical dependence. When you are physically dependent on a substance like alcohol, your body adapts accordingly. 

When you quit drinking cold turkey, your body suffers from a cascade of changes caused by the sudden shift. This can be dangerous. Since alcohol depresses central nervous system activity, quitting drinking can cause an imbalance of an excitatory neurotransmitter called glutamate. This excess glutamate triggers alcohol withdrawal symptoms, which can sometimes be dangerous. Tapering alcohol helps to avoid this scenario.

Cons of Tapering off Alcohol

When done under medical supervision, tapering off alcohol has few downsides. However, tapering can sometimes be unsafe if you attempt to do so on your own without a doctor’s knowledge. For example, if you start to suffer from alcohol withdrawal symptoms despite an attempt to taper, your symptoms may worsen before you have the chance to seek medical attention. For this reason, even at-home tapers should be done under a doctor’s care.

Alcohol Tapering Strategies 

The safest way to taper off alcohol is with a doctor’s help. By looking at your medical history and alcohol intake, your doctor can determine whether you need to taper in a medical detox facility or can safely detox at home. 

If your doctor decides it is safe to taper at home, it is still best to be prepared. Some tips for having a safe alcohol taper at home include:

• Calculate your daily alcohol intake before starting the taper. This allows you to better track your progress over time.
• Consider drinking beer or drinks with comparatively low alcohol content.
• Support your nutrition by having a healthy diet with lots of B vitamins, especially thiamine (vitamin B1).
• Stay hydrated with sports drinks like Gatorade to replenish your electrolytes.

Direct Taper

Reducing the amount of the chosen substance consumed daily is known as a direct taper, but it may not be effective for everyone. It is only advisable to direct taper if the preferred drink is beer with a low alcohol percentage. 

Direct tapering is not recommended for liquor drinkers as it is challenging to measure amounts and can result in binge drinking. Additionally, mixed drinks may contain sugar or other additives that could exacerbate withdrawal symptoms and should be avoided during the taper.

Substitution Taper

Gradually reducing alcohol consumption can be achieved through a substitution taper. This can involve switching to a different alcoholic beverage or replacing alcohol with a prescription drug, but the latter should only be done under the guidance of a medical professional. 

It is important to note that prescription medication should not be used for a substitution taper unless it has been prescribed as part of a medical detox program. In the case of switching to a different beverage, it is recommended to count the number of drinks consumed daily and gradually replace them with a beverage that contains less alcohol, such as beer. 

This method is safer than abruptly stopping alcohol consumption, especially when switching from hard liquor to beer. Drinking beer can also help maintain hydration throughout the taper.

Alcohol Tapering Schedule

Unfortunately, alcohol tapering has not been extensively studied. This means that there is little data about the best way to taper your drinking. However, some groups have published tapering examples to assist those trying to quit drinking. 

According to the examples, if you drink fewer than 20 standard drinks a day before beginning the taper:

• Lower your intake by two drinks a day until you get to zero.

If you drink 20 or more standard drinks a day before beginning the taper:

• Day one: Have one drink per hour for a total of 16 drinks.
• Day two: Have one drink every hour and a half for a total of 10 drinks.
• Days three through seven: Lower your intake by two drinks per day until you get to zero.

You should not begin a tapering plan before talking to your doctor. Based on your medical history, your doctor can advise you about the safety of the taper.

Challenges of Quitting Alcohol

Quitting alcohol can be extremely hard, especially without medical support. Alcohol cravings can make it difficult to stay sober. Further, mental health disorders like anxiety and depression are extremely common in those who struggle with drinking, and these disorders can make it even harder to stay sober.

In addition, social pressures can make it hard to quit drinking, especially if your friends or family also drink heavily. Quitting drinking can feel very isolating, making it even more difficult to do alone at home without medical support.

What Is the Kindling Effect?

The kindling effect is an aspect of alcohol withdrawal that makes repeated attempts at withdrawal less safe. If you go through alcohol withdrawal multiple times, a kindling effect can occur. With kindling, the brain becomes increasingly sensitized to stopping alcohol. In turn, you can suffer from increasingly severe withdrawal symptoms every time you try to stop drinking.

This is dangerous because if you have unsuccessfully tried to stop drinking in the past with only mild withdrawal symptoms, you may assume you can handle another attempt on your own without help. Unfortunately, your brain may be sensitized to withdrawal due to kindling, which can set you up for unexpectedly severe withdrawal symptoms.

How To Taper off Alcohol Safely and Effectively

Little data is available about the safety and effectiveness of alcohol tapers. This is because tapers have not been extensively studied. In contrast, robust evidence supports quitting alcohol while under medical supervision. 
If you struggle with drinking, the safest way to quit is under a doctor’s care. If you drink heavily, your doctor may recommend quitting with the help of a medical detox center. In medical detox, you receive around-the-clock care from doctors and nurses to help prevent and treat alcohol withdrawal symptoms and their complications. This can set you up for a safe and effective detox and put you in a good position to continue your recovery in rehab.