For alcohol dependent individuals, self-detoxing alcohol at home without medical support isn’t advised. There is much uncertainty in the alcohol detox process, including the symptoms of alcohol withdrawal.
If you experience withdrawal symptoms such as shaking, sweating, nausea or headache after several hours without a drink, please do not stop drinking suddenly as these signs mean that you are likely to be physiologically dependent and you will go into alcohol withdrawal. Withdrawal from alcohol should never be underestimated, as it can become a serious medical situation with potentially fatal consequences.
However, given the current climate, we are aware that people with an alcohol problem may be struggling whilst self-isolating. With this in mind, we have created a harm reduction guide for self-reducing alcohol intake at home. Your goal should be to cut down and gain some control of your drinking by moving to treating alcohol as a medicine. What this means is spacing out your drinks to manage withdrawal symptoms. We expect the benefits of this to be:
having a lower risk of running out of alcohol and going into untreated withdrawal.
reducing the damage alcohol does to your body, as this is dose-related.
Please do not attempt this if you have a history of seizures or seeing things when you come off alcohol.
Steps to reduce your alcohol intake
Step 1 -Start with a drinking diary Write down each drink you have when you have it and find out how many units it has in it. Start measuring your drinks if you are drinking from a bottle of spirits or wine. Unit calculators are easily available on the Internet or via phone apps, the Drinkaware calculator is one example. Alternatively the % alcohol on the side of the bottle or can represents the amount of units in a litre. Step 2 - Try to space out your drinking across the whole day for 1 week. Try to space out your drinks, particularly in the middle of the day while keeping your drinking at the start and the end stable. Step 3 - Stabilise at the lowest comfortable amount Once you have stabilised your daily intake for one week, start to cut down slowly. Cut down by no more than 10% of your total units per day: tot up your total amount drunk in units per day. Then work out how much less you need to drink each day to cut down by no more than 10% per day. Ideally, cut down by 10% every four days, particularly those drinking more than 25 units per day. If you start to experience withdrawal symptoms, this means you are cutting down too rapidly. Stabilise for one week and then cut down by 5-10% each week.
DO NOT attempt to just suddenly stop drinking or to reduce your alcohol intake in bigger steps as this can cause significant withdrawal symptoms.
Tips for helping you to taper your alcohol intake:
Enlist the help of loved ones – if they can help to measure or monitor, and keep the alcohol, it will be easier for you.
Transition to a lower strength drink: e.g. replace one can of your high strength lager with a standard strength lager.
Measure out your drinks.
Add water or a mixer to drinks or alternate soft drinks with alcohol.
Pay attention to your diet – limit sugar intake, eat brown rice and wholemeal bread as your thiamine requirements are likely to increase.
Make sure you are taking your thiamine three times a day every day
Keep well-hydrated.
Seek support e.g. via online AA meetings, telephone 1:1s with keyworker.
Possible Side Effects and How to Cope
Disturbed Sleep & Anxiety You may wake up several times during the night, and may suffer heavy nocturnal sweats, or may have problems getting to sleep. This is to be expected, and your sleep pattern should return to normal within a month.
How to cope
Try downloading Mindfulness or meditations apps, (Headspace and Calm are two we recommend), and you will also find lots on YouTube.
Drink plenty of non-alcoholic fluids to stay hydrated. This is very important as the body will lose lots of fluids through perspiration. Avoid drinking large amounts of caffeinated drinks, including tea and coffee, because they can make your sleep problems worse and cause feelings of anxiety. Water, squash or fruit juice are better choices.
Food little and often, even if you have no appetite, attempt to make yourself eat small amounts regularly to give you more strength and energy. Multi vitamins and Minerals, Make sure you take your prescribed Thiamine 100mg twice daily. If this is not prescribed, please contact your GP and ask for this to be prescribed. You could supplement this with an over the counter Multivitamin complex, for example Sanatogen one tablet daily.
Attempt activities to divert thoughts from frustration/cravings etc, such as crosswords, Sudoku’s, adult colouring, playing music, reading, taking baths, cooking, baking, gardening, separating yourself into a different room away from annoyances.
Online Resources
Free online CBT resource aimed at reduction: https://www.downyourdrink.org.uk/
AA are running online support groups: https://www.alcoholics-anonymous.org.uk/Members/Coronavirus-News
NHS website with information and support regarding alcohol misuse: https://www.nhs.uk/conditions/alcohol-misuse/
Alcohol Change have created a “Coronavirus Information and Advice Hub”: https://alcoholchange.org.uk/help-and-support/get-help-now/coronavirus-information-and-advice-hub
Important
Please tell people you live with that if you experience a seizure, become confused, start to see or hear things which others cannot hear, develop double vision or become unsteady on your feet, they should call an ambulance. If you reach a stage where you are drinking less than 10 units a day, you could try to cut down further and stop, with telephone advice from your addictions team. Please do not attempt this if you have a history of seizures or seeing things when you come off alcohol.