Tapering off Alcohol: What You Need To Know

Safety is the most important part of the recovery journey. If you drink heavily, this includes making sure you have a safe plan for quitting alcohol. Heavy drinkers should never abruptly quit alcohol without medical supervision, as alcohol withdrawal symptoms can be dangerous. Instead, they should begin a supervised alcohol taper. Tapering involves slowly decreasing alcohol use over time, which helps to reduce withdrawal symptoms and improve safety when quitting alcohol.

If you have alcohol withdrawal symptoms when you reduce or stop drinking, or if you have previously quit drinking but relapsed, you are at higher risk of complications. In these cases, you should not try to quit on your own and should talk to your doctor or a professional alcohol rehab facility.

Dangers of Quitting Alcohol Cold Turkey

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 of time, 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.

Alcohol 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 for longer periods. Symptoms include:

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

Delirium tremens is the most serious 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

Tapering off Alcohol

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 give you the ability to self-wean from drinking at home.

What Does It Mean to Taper or Wean off Alcohol?

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.

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 be dangerous in some cases. Tapering alcohol helps to avoid this scenario.

Cons of Tapering off Alcohol

When done under medical supervision, tapering off alcohol has few downsides. However, if you attempt to taper on your own without a doctor’s knowledge, tapering can sometimes be unsafe. 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.

Tapering off Alcohol Safely 

The safest way to taper off alcohol is to do so 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 for you 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 a 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.

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 help assist those who are 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.

Does Tapering off Alcohol Work?

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. 

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 on your own 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 Wean off Alcohol Safely and Effectively

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. 

If you or someone you love is struggling with drinking, The Recovery Village Columbus can help. Contact us today to learn more about alcohol detox and alcohol addiction treatment programs that can work well for your situation.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more