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In an earlier post, https://www.sjdpsych.com/post/cut-down-your-alcohol-now I talked about some things that you can do to cut down on your alcohol use.
Not everyone has to stop drinking. Some just need to cut down.
Maybe they’re waking up in the morning feeling slowed down or not as on top of things. Or maybe they notice their waistlines are expanding and the only new calories they’re taking in are from drinking more beer.
For whatever reason, many people need to cut down on their drinking but don’t have to completely stop.
And then there are the others…
These are the people who, once they start drinking, don’t stop. They get shaky in the morning if they don’t have a drink or two. Maybe they’re drinking earlier and earlier in the day and accomplishing less and less in their lives.
Again, for whatever reason, there are people who have to stop drinking. Cutting down isn’t enough. For these people, I have some different suggestions.
Assuming makes an ASS of…
…U and ME, so the saying goes. (I always liked that one. It’s pretty clever). But for those people who think they might have to stop drinking altogether, I’m going to make some assumptions right off the bat.
I assume that the person has tried the advice I gave about cutting down. If they haven't, they should. And then if that doesn't help... Below are some of the assumptions.
a. You made a drinking diary as described in https://www.sjdpsych.com/post/cut-down-your-alcohol-now. You were very honest about it, so you know how much you really drink (not what you want to think is the amount).
b. You made a plan for cutting down
c. You worked your plan for cutting down, but it didn’t help you slow down, or you didn’t stick with it.
d. You tried apps, calling friends, hid your bottles from yourself or tried other tricks, but you’re still drinking as much or more.
e. You notice that alcohol is causing problems in one or more aspects of your life. Could be legal, professional, family, health, etc.
f. You now accept the fact that you have to quit drinking all together.
Some of these assumptions might not apply to you. What’s most important, though, is ‘f.’ You know you are a person who just has to quit drinking entirely.
And if that’s the case, below are actions you need to take to help you get away from your drinking habit.
First and foremost…
I’m going to say something that will probably be a turn off to a lot of people. That is, find a Twelve-Step group close to you and start attending immediately. Often this will be
Alcoholics Anonymous, but there are other kinds of groups as well.
For many years I accepted all the arguments against it – not anonymous; don’t have the time with work and the kids; don't believe in God so the higher power thing is bogus; I’m not that bad; it’s just for old white guys.
But I can’t do that anymore. And I do mean can't. There are just too many studies that show you’re going to do a lot better if you get connected with AA than if you don’t.
I know adding one more thing to an already busy day or week is a problem for a lot of people. Working full time, trying to take care of family obligations, things can be really tough.
However, there is such a thing as meeting on line. It might not have quite the personal touch that being in person gives you, but it can still be quite helpful. And you're likely to do better with it than without it.
Being connected with others who share your need to stop drinking can give you support when things are at their worst.
There are probably people out there who do it on their own. They do stop drinking without any intervention from anything or anybody else. I have to say I’ve never met one. But I’m told they do exist.
However, many, and maybe most, can’t or don’t. And AA has a better track record for helping people to stop drinking than any other program or organization.
We in the medical profession like to think we have the most to offer people with drinking problems. But the data out there says it isn’t so.
AA has us all beat.
Stop drinking! Steps to take
1. Start attending twelve step meetings. There are a million different types of twelve steps meetings.
And as I said above, we know that people who go to such meetings to get help to overcome whatever their addiction is, in this case alcohol, do better if they attend than those who don’t.
There's no magic in going to 12-step meetings. The idea is that when you participate in 12 step meetings, you're spending time with people who either aren’t ,or are trying not to, drink and who may have some suggestions on how to get over the rough parts.
At the very least, you know you're not the only one fighting this battle.
2. Remind yourself every day that you cannot have ANY alcohol, not just cut down, at least for today.
I think about everybody’s heard of "taking one day at a time."
What this means is promise yourself that you won't drink TODAY. It can get overwhelming to try to look down the road for years and say you'll never drink again as long as you live. So promise yourself you won't drink TODAY. And then stick by your promise.
Tomorrow you'll pledge to not drink TODAY.
3. No alcohol in the house
If you live with someone who drinks, ask them to drink elsewhere and keep it out of the house, or consider moving out temporarily (or permanently) with someone who doesn’t drink.
Clean out all the places you used to hide bottles of alcohol. You know where they are.
Get rid of EVERYTHING. Don’t kid yourself that you “forgot” a bottle somewhere. Neither you nor anybody else will believe that.
4. Find someone who’s willing to give you support to stop drinking
Most of us don’t want to lose at what we’re trying to do. But we REALLY hate to let
somebody else see us fail, so this serves two purposes.
a. We know someone else is watching.
b. We have someone to turn to for moral support if (when) things get tough.
Arrange a daily call with that someone
Be honest with them about how much you’re drinking or thinking about drinking.
Discuss things you can do instead of drinking when you get strong urges for alcohol. And you will...get urges, that is.
5. Make a detailed plan of activities you can do with your time.
You probably spent a lot of time drinking. And you might have been doing a lot of things at
the same time. Chances are good, though, that you didn’t do them very well. Plus, you may not remember doing them at all if you were drinking enough.
The idea here is to know what you’re going to do instead of drinking. This way, you won’t suddenly find time on your hands and not know what to do with it that doesn’t include alcohol.
6. Possibly helpful but not absolutely essential for everyone trying to quit: find a health care professional who works with people who have addiction problems and discuss the following:
a. Will you need help with withdrawal?
You absolutely should NOT try to stop drinking by yourself if you have ever had real alcohol withdrawal.
I don't mean just feeling shaky or queasy in the morning.
I mean real alcohol withdrawal, delirium tremens (DTs). This means hearing and seeing things, your blood pressure and heart rate shooting up, maybe even having seizures.
If you have ever add REAL alcohol withdrawal or some other medical conditions that could complicate withdrawal, you should find a medical professional to work with you to stop drinking.
A health care professional might be able to make the withdrawal process a little easier for you as well as monitor your heart rate, blood pressure and other physical issues to be sure you are withdrawing safely.
b. Would medication to help with alcohol craving and common problems be a good idea for you?
I offer EVERYONE with a drinking problem, whether they’re trying to stop or not, medication to help decrease alcohol craving. They won't make you quit or make you sick if you drink on top of them. But they may help decrease your appetite for alcohol.
Two medications are approved for this:
1. Naltrexone orally or as a long lasting shot, vivitrol. This actually blocks opioids too, so
if you're on a pain killer like vicodin or oxycodone, you can't take this medication.
2. Acamprosate (campral) taken orally
Lots of times I offer people BOTH medications. Nothing works for everybody and this increases the chances that I’ll find the right thing for you. And in the early days, anything that might help a little can really mean a lot.
c. Something for sleep
1. Maybe an herbal tea or herbal sleep assistant
2. I do not recommend either prescription over the counter sleep medications during
this time. Natural is best. If you just have to have something, though, ask your provider
to prescribe a non-standard (non- addictive) something to help.
7. STOP DRINKING
a. Let your support system know today is the day
b. Work with your health care person if you and they think you’re going to need help to
stop. This may be the time to arrange for in patient detox if you aren’t safe to try it
alone.
Dealing with craving and relapse.
Just not taking a drink can be hard. But often times people aren't expecting to feel like they do after they stop. And they're not prepared for the craving, the dreams, the things (cues) that increase the chances that they'll start drinking again.
But I've talked enough for today. Next post I'll talk about what happens AFTER you no longer drink.
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