Stopping safely

Why this page exists

Most people who decide to stop drinking simply stop, feel rough for a few days, and are fine. This page is not about them. It is about the smaller group for whom stopping abruptly and alone is genuinely risky — and who are, unfortunately, the people most likely to decide at 2am that tomorrow is the day they quit cold.

We are not doctors and A.A. has no medical position on anything. What follows is the ordinary medical picture, so you can recognise yourself in it and make a call.

Who is most at risk

The risk goes up sharply if any of these are true:

• You have been drinking heavily most days for months or years.
• You get shaky, sweaty, sick or badly anxious within a few hours of your last drink — and a drink settles it.
• You drink in the morning, or during the night, to stop feeling that way.
• You have had a seizure, or hallucinations, while trying to stop before.
• You have been through withdrawal several times. Each episode tends to be worse than the last, which is one of the reasons repeated white-knuckle attempts are not a safe plan.
• You are older, pregnant, or have another serious health condition.

Two or more of those and it is worth a phone call to a doctor before you stop, not after.

What to watch for

Usually within 6 to 24 hours of the last drink: shaking hands, sweating, nausea, headache, a racing or pounding heart, restlessness, bad anxiety, not being able to sleep. Unpleasant, and on its own not usually dangerous — but it is the signal that your body is physically dependent, which is the thing worth telling a doctor about.

Call 911, or get to an emergency room, for any of these:

• A seizure, or anything that looked like one
• Confusion about where you are, what day it is, or who people are
• Seeing, hearing or feeling things that are not there
• A fever, or a heart rate that will not come down
• Severe vomiting, or being unable to keep water down
• Chest pain, or trouble breathing

These can begin a day or two after the last drink — sometimes when someone feels like the worst is behind them. If you are drying out at home and someone is with you, tell them what to watch for.

What a doctor will actually do

Far less drama than people expect. A doctor works out how at-risk you are and, if needed, prescribes medication — usually a benzodiazepine, tapered over several days — that keeps withdrawal from becoming dangerous. Very often this is outpatient: you sleep in your own bed and check in. Sometimes a few days in hospital is safer. Either way it is ordinary, unremarkable medicine.

You will not be lectured. Doctors see this constantly and are far more interested in getting you through it safely than in how you got here.

Who to call

• Your own doctor. The simplest first call, and they already know your history.
• SAMHSA National Helpline — 1-800-662-4357.Free, confidential, 24 hours, English and Spanish. They find treatment near you with or without insurance. Run by the U.S. government; they are not selling anything.
• 988 — Suicide & Crisis Lifeline. If it is darker than drinking, call or text 988. Any hour.
• 911, or your nearest emergency room, for anything on the list above.
• Us — (814) 283-4772.We are not medical, but a member will pick up and talk to you, and plenty of them have been through detox themselves.

About medication, generally

You may meet an A.A. member with strong opinions about prescribed medication. They are speaking for themselves and nobody else. A.A. addresses this directly in its pamphletThe A.A. Member — Medications and Other Drugs, which is clear that no member should play doctor. Do not stop anything a doctor prescribed you because of something said in a meeting.

And when you are through it

Detox handles the physical part, which is measured in days. The rest is what the meetings are for. There is a meeting every day of the week here, and nothing is asked of you when you walk into one. Come when you are ready — including on the way home from the doctor.