Detoxification From Alcohol
Be tender with yourself when you look at this. If you have a problem
with alcohol, you probably have had all sorts of people who have been
far from tender with you. No doubt you have been criticized, shamed,
fought with, talked to, cajoled, bargained with or argued with. In
fact, if someone around you criticizes your drinking, it is one of the
most reliable indicators that you have a problem with alcohol. People
who do not have a problem with alcohol do not evoke pain, frustration
or concern about drinking in the people around them.
Take a quiet look at your alcohol use. You don't have to admit you
have a problem, you don't have to surrender anything. Your own
commitment and experience will guide you in this process. Honesty about
your relationship to alcohol is hard because the very nature of the
disease of alcoholism is denial. Do this review in the privacy of your
own home or office and give yourself absolute discretion over whether
you share your findings with anyone at this time. If privacy supports
your honesty, embrace it. If sharing serves you better, find a trusted
friend to help you ask these questions. The very best alternative is a
friend in recovery.
What is very surprising is that people who do not have a problem
with drinking don't feel bad about it. They don't feel guilty. We talk
a lot about the "denial" of alcoholism. I believe denial is the
response that emerges when the person is made to feel defensive about
their behaviors. When there is no reason to be defensive, people are
remarkably on target about what is going on for them. Take away the
shame or the judgment and you can assess your problems pretty clearly.
"Oh, come on," you say. "Everyone does that!" Everyone doesn't do this.
People who don't have a problem with alcohol are not inclined to
want more when they feel bad. Having a problem with alcohol or
alcoholism is defined as "continued use of alcohol despite adverse
consequences." When a non-problem drinker has an adverse consequence
from drinking, she stops. She will make the connection between feeling
bad and alcohol. A problem drinker doesn't see this connection.
Not making the connection is not about being stubborn or stupid or
even about willful "denial." Not making the connection between drinking
and feeling bad is about chemical changes in the brain that alter the
parts of the brain that form judgment by making a connection between
cause and effect. The parts of the brain that are responsible for
saying, "Hey, this made me feel bad, I don't think I want more," don't
Not making the connection creates a vicious cycle. In the problem
drinker's mind, the alcohol actually makes her feel better, so she
drinks more. Her opinion is confirmed when the alcohol triggers a beta
endorphin release of euphoric feelings. This reaction is why everyone
drinks - the effect is nice. The sugar-sensitive person feels
especially good because alcohol causes a even greater beta endorphin
response in her brain. She feels far better than other people do when
they drink. But the next morning, she is hung over, a feeling that
comes from withdrawal. All the beta endorphin receptors that were
stimulated, or primed, by yesterday's alcohol use are screaming for
That morning-after feeling of wanting to do anything to feel
better is so easily taken care of by having a drink. So she does.
Relief comes. Blessed, sweet relief. And with her "adverse
consequences" switch turned off, the problem drinker's natural response
is to feel that having a quick one is a reasonable and logical way to
take care of bad feelings.
So CAGE stands for:
C - CRITICIZED
A - ANNOYED
G - GUILTY
E - EYE-OPENER
Now, let's go back to each question individually.
Have you ever felt you should cut down on your drinking?
Not a hard one. People usually know the answer to this right away.
Yes or no. No cheating, or fudging. If cutting down is even a passing
thought, answer this one "Yes."
Have people ever annoyed you by criticizing your drinking?
Okay, be honest now. Ever? Think about those times when you have
held your tongue, or wanted to smack someone for making a comment about
your drinking. Think of the fights you have had with your spouse about
it. Answer honestly.
Have you ever felt bad or guilty about your drinking?
This question is pretty straight forward.
Have you ever had a drink first thing in the morning (an "eye-opener")
to steady your nerves or to get rid of a hangover?
A score of ONE is a warning sign.
Remember the meaning of CAGE. Let yourself think about this for a
while. One of two things will happen. You might begin working very hard
to say, "Naw, I don't really feel guilty about my drinking." This is an
example of denial creeping in and wrapping its deadly little body
around your neck. Just pay attention. Consider whether you are getting
farther away from relationship to your body and your own inner wisdom.
The other thing that might happen is you may be jostled into
realizing that you do have a problem with alcohol. If you decide that
you would like to stop drinking, there are a number of factors to take
into consideration before you do. First, you will need to estimate how
severe a withdrawal you will have based on the frequency and volume of
your drinking. You will need to honestly and accurately figure out how
much alcohol you consume in a week. You can do this by recording your
alcohol consumption right in your food journal. Do this for a week and
then take an honest look at the frequency and amount of your drinking.
Calculate the number of drinks you have in a day or a week. A drink is
4 oz. of wine, one beer or 1 oz. of hard liquor. So if you have three 6
oz. glasses of wine (18 oz.), this would be the equivalent of 4.5
After you know where you now stand, you can start to plan your
detox process. Just as in your detox from sugars, you will want to
determine your style for making change. You can either taper down and
then stop or you can stop all at once. Most people find it much easier
to go for sobriety all at once. You don't have to be making decisions
about how much, when, where, with whom all of the time. You can focus
on one decision only - the decision not to drink.
It will be important for you to have some sort of support as you
make the change. Do not stop drinking without telling anyone what you
are doing. Work with us on the recovery list. And find someone locally
who has been through alcohol detox. Talk to that person. Alcoholics
Anonymous (AA) can be a wonderful support because everyone in AA has
been through this process. The only requirement for going to AA is a
desire to stop drinking. You don't have to be an alcoholic. You don't
have to sign up, you don't have to agree with the program, you don't
have to do it any particular way. You don't even have to talk in the
meeting. You can sit quietly in the back and slip out quickly any time
AA can give you a lifeline to others who know about recovery. They
can provide you with a road map and concrete suggestions about how to
handle what you are feeling. If you go to a meeting and don't like it,
don't assume that you won't like a different meeting. Some meetings are
boring, some are abusive and most are profoundly supportive and
If you are not comfortable in meetings, find at least one person
to support you in your alcohol detox. Do not expect your spouse or
partner, your daughter or your son to be your primary support. They are
too closely involved. Find at least one person who has been there. Talk
about what you are doing. Tell your story. Get books about recovery. Go
to a treatment professional.
If you plan to stop drinking all at once, you must have medical
supervision for your detox if any of the following are true for you:
1. If you have a history of blood pressure that is higher than 140/90.
2. If you have used more than a six pack of beer daily, more than
six 4 oz. glasses of wine or more than eight ounces (half a pint) of
liquor per day for over a year.
3. If you have had prior withdrawal symptoms, such as depression or
4. If you have ever had seizures for any reason, and in particular if
you have had alcohol DT's.
5. If you are using any other (either illegal or prescription)
drugs in combination with the alcohol. This particularly includes
benzodiazipines such as Valium, Librium or Xanex.
Withdrawal from significant or long standing alcohol use can be a
serious process. Keep yourself safe as you make this change. You are
taking a very important and brave step. Withdrawal symptoms can include
depression, insomnia, sweating, tremulousness, agitation, irritability,
and brain "fog." In fact, go to the sidebar which lists the withdrawal
symptoms for nicotine. You may experience may of these same things
since alcohol and nicotine do share some neurochemical pathways.
Withdrawal usually starts 4-6 hours after the time you usually
have your alcohol. If you drink every day at 6:00 PM, you will begin to
experience discomfort that evening. If you have been a heavy drinker,
your doctor may prescribe short term medication which will minimize the
possibility of having seizures during detox.
Making the food changes in preparation for going off of alcohol
will greatly enhance the likelihood that you can achieve and maintain
long term sobriety.
When you actually start your detox, increase your vitamins and
increase your fruit intake the first week you stop drinking. If you
feel edgy during the day, have an additional 1/2 teaspoon of the
B-complex liquid. (Don't have it in the evening, though, it will keep
you up.) We encourage our clients to have 2-3 bananas a day for that
first week. You can add one to your power shake and then use them as a
snack later in the day. Make sure you have a baked potato before you go
to bed. It will help your serotonin function and will support the
normalization of your sleep patterns.
The clients in my clinic cannot believe what a difference it makes
to have done the food plan first. They have fewer withdrawal symptoms,
very little craving and feel better than they have in years. This food
plan can support the power of your commitment.
Kathleen DesMaisons, Ph.D., Addictive Nutrition