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Tapering Off Alcohol: Does It Work? Is it Safe?

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Gary Bowers

Article Updated: 09/25/2020

Number of References: 6 Sources

Tapering off alcohol was long ago considered the primary approach for alcoholism treatment. While it is possible to manage alcohol detoxification without medical supervision, it is extremely dangerous and can be fatal. Along with increased direct risks to one's health, tapering also results in a much higher relapse rate. Here we will examine the unique risks and methods that people have used to taper off alcohol.

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What is Tapering?

Tapering is the practice of reducing the consumption of alcohol over a period of time until the amount of alcohol in the system has dropped to zero. The goal of an alcohol taper is to minimize the withdrawal symptoms while still undergoing detox. In essence, tapering is a detoxification process that is not being administered or observed by a doctor or medical staff. It is commonly a self managed detox method which is usually less successful than a program at an alcohol detox center.

Alcohol self-detoxification is possible through the practice of tapering, and before the advent of certain medications and treatment programs, tapering was the most commonly applied approach to treating alcohol withdrawal. There may be situations in which tapering off alcohol at home is the right decision, whether it’s due to a lack of health care, the belief that the alcohol use isn’t severe enough to warrant admission into a professional detoxification center, or a desire to minimize the symptoms of alcohol withdrawal.

Let’s consider some of the pros and cons of tapering off alcohol in a self-care setting:

The Pros and Cons of Tapering Off Alcohol

Pros:

Cost Effective (depending on insurance plans, etc.)
Can be done from the comfort of one’s own home.
Less dangerous than going “cold turkey”.
Good for someone who is less likely to suffer serious withdrawal symptoms (mild to moderate alcohol use).

Cons:

Alcohol is still a toxic and addictive substance, even in small doses.
Can be dangerous if serious symptoms arise.
Can be difficult to remain focused, chances of returning to previous drinking habits are high.
Some symptoms/complications may go unrecognized/untreated without medical observation.
Medications needed to assist with withdrawal symptoms may be unavailable or difficult to acquire.
Without careful planning and observation, it’s possible to rush the tapering process, or taper too slowly which can lead to return to previous drinking habits.
Dangerous for someone who is more likely to suffer serious withdrawal symptoms.
Not ideal for people with pre-existing health conditions (high blood pressure, diabetes, epilepsy).

Seek Advice Before Making a Decision About Alcohol Reduction Strategies

The pros and cons outlined in this article will give some indications about the general concept of tapering off alcohol, but there are many personal factors that should be considered before someone chooses to go this route. These are general guidelines, and different people will experience different alcohol withdrawal timelines depending on their drinking habits. It is highly recommended to speak with a doctor, therapist, or some form of medical professional before beginning.

Conduct research on different approaches. Gain the perspective of those who have attempted tapering off alcohol. Seek the counsel of family and close friends. The more information gained and the more emotional support provided can make a big difference. Personal health, both physical and mental, as well as someone’s current drinking habits should also be taken into account before deciding on anything.

Medications Used in Tapering Off Alcohol

There are medications that help with the overall experience of tapering off alcohol, most of which are safe when used as directed or prescribed. Someone will need to talk to their doctor about their plans to taper off alcohol use, and under their care, they may prescribe different medications to assist with a tapered detox. Here is a quick glance at some of the most commonly prescribed alcohol withdrawal medications that are well-recognized in the medical field for being effective adjunct treatments for tapering. These medications will minimize withdrawal symptoms and stabilize the body and brain during alcohol tapering:

  • Benzodiazepines (BZDs): BZDs have been FDA-approved to treat alcohol withdrawal symptoms for many years. These sedative-hypnotic medications have many properties that make them ideal for addressing the symptoms of alcohol withdrawal including their anti-anxiety and anticonvulsant properties. There are many different medications that fall under the BZD classification, each may carry a unique set of benefits such as faster/shorter-acting, or slower/longer acting. BZDs include diazepam, chlordiazepoxide, lorazepam, oxazepam.
  • Anticonvulsants: There are a number of medications that fall under this category, and after BZDs, these are among the more commonly prescribed medications to treat alcohol withdrawal syndrome (AWS). Among the more commonly prescribed are carbamazepine and gabapentin. Anticonvulsants will have milder sedative qualities but are effective in treating some, but not all, symptoms of AWS. Additionally, some anticonvulsants may carry a greater risk of side effects or other medication interactions.
  • Barbiturates: BZDs surpassed barbiturates as the standard of care for AWS many years ago, owing to their similar-to-superior functions and fewer side effects. However, there are situations in which barbiturates may be substituted for BZDs, specifically phenobarbital, which has a strong record of treating delirium tremens (DTs), a serious and potentially fatal side effect of AWS.
Benzodiazepines For Alcohol Withdrawal

Things to Consider When Planning to Taper Off Alcohol

Before someone attempts to taper off alcohol in a self-care setting, there are many factors to consider. Not everyone will have the same reaction to alcohol detox by tapering, so careful thought and planning is needed to make sure someone goes into the experience well-informed and prepared. This will not only help with regards to safety, but will dramatically improve the chances of successfully achieving the alcohol intake goals that were set beforehand. So what things should someone put into their alcohol tapering toolkit? Here are some ideas:

  • Motivations: Why is someone considering this? What negative aspects has alcohol use played in their decisions? Understanding someone’s intentions and motivations at a root level will help them understand if tapering alcohol use in a home setting is right for them.
  • Planning Ahead: If someone decides to adjust their alcohol intake suddenly – especially if they have developed a level of dependency – they may easily run into unwanted or unexpected physical and mental symptoms. A complete tapering detox plan could take anywhere between 3-14 days based on someone’s current alcohol intake. Also, selecting dates in their calendar will allow them to focus on this, and this alone will be crucial. Planning to taper alcohol use during a major life event, like a wedding or a child birth, can add unnecessary complexity to this situation.
  • Tapering Schedule: To calculate a tapering schedule, first someone will need to be very honest about the amount of alcohol of any kind that they consume (on average) on a daily basis. From there, someone can create a safe plan for tapering that will be less likely to cause serious complications.
  • Medical Precautions: Pre-existing health conditions can make detox by taper a dangerous prospect. A history of high blood pressure, diabetes, or epilepsy (to name a few) can create a complicated web of side effects and symptoms once the regular amount of alcohol is reduced.
  • Hydrate: Stay hydrated with water or sports drinks such as Gatorade. Gatorade will offer electrolytes and hydration, but most varieties also have a very high sugar content, which can cause more harm. Avoid coffee, caffeinated drinks, and overly sugary drinks. The caffeine and sugar are both stimulants, and their presence can upset the body’s balance even further.
  • Diet and Supplements: Eating healthy, whole foods with high nutritional content can absolutely improve the quality of the tapering experience. Alcohol use can rob the body of necessary vitamins and minerals. Vitamin B1 and magnesium are typically very deficient in chronic alcohol users. Consider a balanced supplement in addition to healthy choices. Avoid processed sugar, junk food, and excessively fatty or greasy foods.
  • Exercise: Moderate exercise is always good. Exercise can stabilize blood glucose levels, improve cardiovascular health, and works incredibly well at improving mood and outlook.
  • Support Network: Make sure that there are people around that can offer support, encouragement, guidance.
  • Contingency Plans: If health issues arise, or if symptoms intensify out of control, it could be a sign that medical observation is necessary to complete alcohol detox.
  • Aftercare: Removing alcohol is really the first step in a lifelong process of recovery and well-being. Incorporating talk therapy or support groups can help make lasting changes in someone’s relationship with alcohol.

Alcohol Taper: What Amounts To Use

First, someone needs to assess their average alcohol intake on a daily basis. This will form their baseline, the starting point from which the taper will begin. In the United States, one “drink” or “serving” of alcohol is measured as:

  • 12 ounces of beer (5% ABV or similar)
  • 8-9 ounces of malt liquor or stronger beer (8% ABV or similar)
  • 5 ounces of wine (12% ABV or similar)
    —One standard bottle of wine (750ml) is about 5 servings of alcohol
  • 1.5 ounces of liquor (gin, vodka, whisky, rum) (40% ABV or similar)
    —One standard bottle of liquor (750ml or a “fifth”) is about 17 servings of alcohol

Many treatment professionals recommend using standard beer (about 5% ABV) for use when tapering off alcohol. While the choice of drink is up to the individual, beer is considered the safer option, and no measuring is needed – one standard can or bottle of beer is the correct amount to use.

Alcohol Taper Sample Schedules

The schedules provided here are illustrative only, as someone’s individual needs may require deviation or alteration to this schedule. Each schedule assumes 8 hours of sleep per day; 16 hours awake.

For those who drink 20 or more “servings” of alcohol a day:

  • Day 1 – drink one beer every hour, starting upon waking until bed (16 beers)
  • Day 2 – drink one beer every 1.5 hours, starting upon waking until bed (10 beers)
  • Day 3 – drink one beer every 2 hours (8 beers)
  • Day 4 and onward – Reduce amount of beers by 2 (two) each day until zero

For those who drink less than 20 “servings” of alcohol a day, it is recommended to reduce their daily number of drinks by 2 (two) each day until zero. So if their average number of drinks is 16 per day, their schedule would look like this:

  • Day 1 – 14 beers
  • Day 2 – 12 beers
  • Day 3 – 10 beers

These schedules should provide a starting point to consider. Of course someone can take a more aggressive approach, but remember that severe symptoms can be triggered if the reductions are too drastic. Be cautious, but be assertive; it is possible to safely taper off of alcohol use!

Self-Care Alternative - Medically Monitored Detox

There is no single route to recovery, but recovery is possible, and it all starts with an honest appraisal of one’s drinking habits. For those who find that reduction of their alcohol by tapering in a self-care setting isn’t safe medically, doesn’t provide the right support, or simply isn’t effective there are a number of alternatives that are overseen by licensed professionals. These will offer medical assistance, access to therapy, support services and more, providing a well-rounded and holistic approach to recovery. Examples of professionally supported detox include:

Medically Monitored Detox: With 24/7 medical support and access to therapies, professional detox centers are typically the first option in professional detox support. The length of stay in a professional detox center would be around 5-7 days depending on the severity of the situation; their primary purpose is to oversee the detox. That said, with access to and partnerships with a network of inpatient and outpatient treatment facilities, detox facilities can help chart a path towards recovery

Inpatient (Residential) Treatment: These facilities are live-in facilities that provide a sober environment that will offer complete care. Inpatient treatment programs can last from 30 days to 1 year depending on the facility, depending on the extent of the addiction and a variety of other factors. Isolation from outside influences and intensive therapy are essential elements of inpatient treatment.

Outpatient Treatment: Outpatient treatment will offer the intensive therapy and effective treatment one would expect from inpatient treatment, but with the freedom and flexibility of the outpatient setting. These programs will allow someone to come to a facility for day programs and return to their own home each night.

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