Month: November 2021

Everyone’s journey to change their relationship with alcohol is unique. Some people choose to completely abstain from alcohol, while others work to significantly cut back on their consumption through moderation. You don’t have to know your long-term goal in order to get started, and you don’t have to commit to sobriety right away in order to see how drinking less can give you more.

Before we dive into the benefits of cutting back on drinking, let’s define what “moderate alcohol consumption” means. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines it differently for men and women. 

• For men, moderate alcohol consumption is defined as drinking 14 or fewer units of alcohol per week, and no more than 4 per occasion. 
• For women, it’s defined as drinking 7 or fewer units of alcohol per week and no more than 3 per occasion. 

It may take some tapering down and experimentation to discover if moderate alcohol consumption is achievable for you, or if sobriety is a more appropriate goal. Speaking with a therapist specialized in alcohol therapy, reflecting on questions like “can I drink in moderation?”, and practicing mindful drinking are great ways to identify which goals align with your needs and values.  

While traditional recovery programs haven’t always been inclusive of people who want to moderate their drinking, leading medical experts have advocated for the reduction in heavy drinking to be recognized as a meaningful clinical endpoint in the treatment of alcohol use disorder. This is because consuming greater amounts of alcohol can have greater consequences, and reducing the percent of time drinking heavily can have significant health benefits. 

If you decide to embark on a journey of moderate alcohol intake, here are some of the many benefits you can look forward to as you cut back on drinking. 

1. More energy 

Increased energy is one of the great benefits of moderate alcohol consumption after cutting back on heavy drinking. There are many reasons why drinking alcohol can diminish your energy levels. Alcohol depresses your central nervous system, slowing down your brain and bodily functions. 

Over time, unhealthy alcohol habits, including more sporadic binge drinking, can have negative effects on functions such as: 

• Memory
• Cognitive function
• Coordination
• Reaction times

Not to mention, hangover symptoms can result in a substantial lack of energy in the days after drinking.

As you cut back, you’ll notice you have more time in the day and more energy to greet it with. Feeling more refreshed and productive can then lead to countless other professional and personal benefits.  

2. Improved mental health

Alcohol is known to increase anxiety and worsen depression. This is because of the effect it has on the brain’s pleasure center. Initially, alcohol can provide false relief by creating a short-term boost in your “happiness hormones:” dopamine, serotonin, and endorphins. However, in the long term, alcohol ultimately causes an imbalance in these chemicals, which can contribute to an increased risk for depression, ‘hangxiety’, and alcohol dependence. 

Many people also drink more to soothe these intensified negative feelings, creating an unhealthy cycle of using alcohol as a coping mechanism. However, you can break the cycle. 

Not only does moderating your alcohol consumption help reduce anxiety and depression, but it can also lead to other mental health benefits such as:

• Better moods
• Reduced feelings of shame
• Improved self-esteem 

Exploring moderate consumption is a meaningful step towards changing your relationship with alcohol, and you don’t have to do it alone. Online alcohol treatment can help you learn tools for cutting back, while simultaneously addressing co-occurring mental health conditions. 

3. Authentic connections 

Oftentimes, we don’t consider the way alcohol is inhibiting our relationships and social fulfillment. As you start to consume less alcohol at events and spend more time around loved ones while not under the influence, you’ll start to discover your relationships becoming stronger and your memories clearer. Your moderation journey may also reveal important observations, like which relationships aren’t serving you anymore, and which friends and family members make you feel like the best version of yourself.

Navigating moderation and mindful drinking may mean revisiting certain relationships and social plans to prioritize those that honor your goals. Drinking alcohol less allows you to share your authentic self with others and cherish those more meaningful connections. 

4. Weight loss

While everyone experiences the benefits of moving from heavy drinking to alcohol moderation differently, it’s quite common to experience a correlation between drinking less and weight loss. This is because heavy alcohol consumption increases the amount of “empty calories” you consume, slows down your metabolic efficiency, and can contribute to unhealthy eating habits. 

Many people are surprised by how quickly they find themselves experiencing weight loss after quitting alcohol or cutting back, and more importantly, feeling better in their own bodies.   

5. Better sleep 

There’s a strong correlation between alcohol and sleep quality. Because alcohol is a depressant, many people drink at night as a way to calm racing thoughts and induce sleepiness. Alcohol might help you fall asleep faster, but it can negatively affect sleep architecture and lead to sleep interruptions and reduced sleep quality. 

For many, cutting back on alcohol can lead to immediate improvements in sleep quality. Of course, sleep influences all dimensions of our wellness, and improving your sleep quality can have many positive ripple effects in other areas of your life. 

6. Reduced risk of health conditions 

The more you reduce your alcohol intake, the less likely you are to suffer from the many health risks associated with unhealthy alcohol consumption. These health conditions include but are not limited to:

• High blood pressure
• Myocardial infarction
• Liver and cardiovascular disease
• Memory loss
• Cognitive impairment
• Ischemic stroke
• Lung infection
• Night sweats
• Atrial fibrillation 
• Breast cancer and other forms of cancer
• Diabetes

Drinking less alcohol may lead to a lower risk of developing any of these conditions, many of which can have serious consequences. In fact, it’s estimated that 5.6% of cancer cases in the US are associated with alcohol consumption, contributing to the alcohol-related mortality rate.  Drinking less can meaningfully improve health outcomes and quality of life, especially if you suffer from a physical health condition or experience chronic pain. 

It’s possible you have heard that drinking small amounts of alcohol (instead of abstaining) can provide health benefits. For example, some people believe that small amounts of wine can have cardiovascular benefits and help prevent conditions such as heart failure, heart attack, or coronary heart disease. Despite these claims, there isn’t any conclusive research to prove that there are additional health benefits to moderate drinking beyond the benefits of consuming less alcohol. Experts agree that significantly reducing or eliminating alcohol consumption altogether is the best way to improve your overall well-being.

7. More money

Not only is heavy alcohol consumption damaging to your health, but it can take a significant toll on your financial stability. If you have eight $10 drinks throughout the week and cut back your weekly alcohol consumption to only two on the weekend, you would save over sixty dollars every week. In the long-term, you would be saving $3,120 per year. Another reason unhealthy drinking can deplete savings is because it introduces the risk factor of unforeseen expenses, such as medical bills or pricey cab rides home. You can see how moderation would impact your savings and disposable income by checking out this alcohol spending calculator.

As you navigate what level of moderation works for you, the increase in savings can be a fantastic reward and incentive. Every alcoholic drink you cut back on is that much more money you can put towards other things in your life. Being able to invest this money into a new hobby, retirement fund, investment opportunity, travel experience, or professional endeavor makes cutting back even more worthwhile. 

8. New hobbies

Changing your drinking habits will undoubtedly change your daily routine (for the better!). You’ll likely find you have more free time and mental space to revisit activities that used to bring you joy, and explore new opportunities you’ve been meaning to check out. Better yet, you’ll also have more energy to give to a new endeavor. 

Many people report finding more fulfilling hobbies once they place less focus on drinking, and more focus on their own special interests. You never know what you might discover.

9. Improved sex drive

The relationship between alcohol and sex drive isn’t talked about nearly enough. Unhealthy alcohol use can have several negative impacts on sexual functioning and intimacy. 

These potential side effects include:

• Alcohol-induced erectile dysfunction
• Vaginal dryness
• Difficulty orgasming 
• Nerve damage
• And more 

Reducing your alcohol intake can help restore physical functioning and lead to lower risk of developing these potential side effects. It can also increase self-esteem, strengthen romantic relationships, and lead to an overall improved quality of sex life.

10. Better skin 

Alcohol can have a noticeable impact on how our skin feels and appears due to its dehydrating effects. Unhealthy alcohol consumption can also make us more susceptible to toxins in our environment by lowering our natural defenses. Cutting back on drinking can make your skin appear more hydrated and refreshed. 

11. Recovered gut health

Consuming unhealthy amounts of alcohol can create several different issues in your gut. It can cause unhealthy bacteria to grow while killing off other essential gut bacteria. Alcohol can also cause inflammation and various digestive problems.¹ 

Luckily, the gut is incredibly capable of healing. Decreasing your alcohol intake can allow the bacteria in your gut to regain its natural balance and proper functioning. This will decrease symptoms of nausea, loss of appetite, feelings of weakness, and even psychological stress.

…

If changing your excessive drinking habits feels challenging, you are not alone. Deciding to moderate your alcohol use is a courageous first step, and you don’t need to know exactly how to accomplish it right away. 

Whether you partake in binge drinking or have multiple drinks every night, reducing your consumption to moderate alcohol intake can be a beneficial step towards healthier habits. Expert support can help you develop boundaries and find alternative coping mechanisms.

Monument offers many resources to help you on your journey, such as alcohol therapy, medication to stop drinking, and therapist-moderated alcohol support groups. You deserve to experience the benefits of drinking alcohol in moderation or abstaining completely, and we’re here to help you get there.

Sources:

1. Substance Abuse. “Disturbed sleep and its relationship to alcohol use, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775419/.” Accessed Nov, 25. 2021.
2. Alcohol research: current reviews vol. 38,2 (2017). “Alcohol and Gut-Derived Inflammation, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513683/.” Accessed Nov, 25. 2021.

If you’re using alcohol to cope with social anxiety, you’re not alone. In the absence of a better coping mechanism, many people turn to alcohol to soothe social nerves. Although alcohol can provide temporary relief, it can actually increase anxiety in the long-term. I often speak with my patients about the connection between social anxiety and drinking, and share tools on how to overcome anxiety without drinking alcohol.

Learn more about why alcohol is a commonly used coping mechanism along with tips on how you can stop using alcohol for social anxiety below.

What is social anxiety disorder? 

Many people experience some level of social anxiety from time to time without meeting the clinical criteria for social anxiety disorder (SAD). However, SAD isn’t uncommon; it affects approximately 2-13% of the US population¹. Social anxiety disorder is a mental health condition defined as an excessive fear of social situations. 

For many individuals, social anxiety can prevent them from attending certain events or trying new experiences because of a persistent worry about what could occur. Whether you have social anxiety disorder, or struggle with high social anxiety on occasion, there are resources and support to help you overcome your social fears without leaning on substances. This process often involves taking a closer look at your relationship with alcohol, possibly seeking online alcohol treatment, and finding healthy coping mechanisms.

Why are social anxiety and alcohol use often connected?

Many people struggle with both social anxiety and unhealthy drinking. 20% of patients that suffer from SAD also suffer from alcohol use disorder (AUD) and, inversely, 23% of people with AUD also meet the criteria for SAD.² This correlation is partially due to the common belief that drinking alcohol can help reduce anxiety in social settings. 

You may have heard alcohol referred to as a “social lubricant” or “liquid courage”. Why does alcohol have this calming effect? This phenomenon occurs because alcohol is a depressant, meaning it slows down the central nervous system. This can provide a temporary sense of relaxation. 

Consuming alcohol also causes an immediate release of dopamine, which explains the “euphoric” sensation after having that first drink. The dopamine-driven association between alcohol and pleasure is part of the reason why people develop alcohol cravings. Because of these chemical interactions, drinking may soothe social anxiety at first. However, as I’ll dive into further, alcohol actually causes increased levels of anxiety once the initial effects wear off.

Does alcohol make social anxiety worse?

Alcohol can intensify psychological and physical symptoms of social anxiety disorder within just a few hours after drinking. Once the body starts to process alcohol, symptoms such as irritability, depression, and an increase in anxiety often occur. This is because alcohol disrupts levels of serotonin and other neurotransmitters in the brain, which can worsen anxiety. Anxiety symptoms that occur after drinking can last for several hours or even a full day after drinking. This phenomenon is commonly referred to as hangxiety.  

Many people drink more alcohol to address this increased anxiety, often accompanied by feelings of guilt and shame after the initial effects of drinking wear off. This can create an unhealthy cycle and increase one’s risk of developing alcohol use disorder. The best way to break the cycle is to work towards changing your relationship with alcohol while building more sustainable coping skills for managing social anxiety. The good news is, the journey to overcoming social anxiety and changing your drinking habits can occur simultaneously, and are mutually beneficial. With time and support, you can find coping skills that help you manage social anxiety and reduce the role alcohol plays in your life.  

How to address social anxiety without drinking 

There are both preventative and immediate ways to soothe high social anxiety without alcohol. Developing self-care practices and seeking expert support are some of the best ways to build these skills. 

Meditation, deep breathing, and stress management tools

Identifying ways to lower your baseline anxiety levels can help reduce the psychological and physical symptoms of social anxiety when unfamiliar or uncomfortable situations arise. 

Mindfulness techniques like meditation and controlled breathing can help you slow your heart rate and listen to what your body and mind need. If you find yourself feeling anxious in a social situation, you can excuse yourself for five minutes and do a deep breathing exercise to check in with yourself. Other tools to help calm the nervous system include slowly counting from 1 to 10, observing the environment with all 5 senses, and more.

As you take this moment to ground yourself, you’ll notice that you’re able to return to a calmer state where you’re better able to assess your options. You can ask yourself questions like “what do I need right now?” or “do I need to leave this situation or is it within my tolerance level?” The power of breathwork is that it can allow you to feel safe enough to make a decision that feels right for you.

Journaling for stress management

Journaling is another tool for stress-relief. It’s a great way to notice patterns in your thoughts, behaviors, and feelings that might intensify social anxiety and brainstorm possible solutions. You can try stream of consciousness journaling where you narrate your anxiety in order to examine your discomfort and give it space to be experienced. 

Or, if there’s a person who tends to activate your social anxiety, you could journal in a letter format to see what you would say to them if you had no fear of how they would respond. Whatever style works for you, getting your thoughts out on paper can help you release and reflect. 

Therapy, support groups, and medication

Therapy is one of the most effective treatment options for SAD, and specialized alcohol therapy can address SAD and alcohol use disorder simultaneously. Therapists trained in treating SAD and AUD often use a modality called Cognitive Behavioral Therapy (CBT). CBT can be effective in reducing social anxiety and alcohol consumption over time by improving emotional regulation and assisting in the development of personal coping skills. 

These strategies and tools can decrease both social phobia and the urge to drink. Another helpful resource is to join moderated alcohol support groups, where you can share and get guidance in a safe, anonymous environment. There are groups dedicated to practicing self-compassion or for managing anxiety while changing your relationship with alcohol. 

As you navigate your sobriety or moderation journey, you can connect with a Monument physician, such as myself, to learn more about medication to stop drinking and therapy options available. If deemed appropriate, these medications can help you manage alcohol cravings as you develop healthier habits. There are also medications that are geared to treat social anxiety. Speaking with your primary care provider is the best way to determine if this treatment is right for you. You deserve better tools, and should feel empowered to explore any and all of your options. 

Additional tips for socializing without alcohol:

While reducing your alcohol consumption can ultimately reduce anxiety, it can be challenging to navigate social situations without alcohol in early sobriety. There are several ways to set yourself up for success when socializing without drinking. Some of these suggestions include:

• Keep it small (at first): Practice not drinking in smaller social settings and with people you feel more comfortable with. This gives you an opportunity to practice new tools in a lower-pressure environment.
• De-stress beforehand: Partake in a relaxing activity or play your favorite song to de-stress before an event. Entering an event relaxed gives you the clarity to honor your boundaries. 
• Bring a friend: Invite an accountability buddy to the event to keep you company and remind you of your goals. This can help ease socializing nerves and manage potential triggers if they arise. 
• Practice saying no: At an event, it can be difficult to know how to say no to alcohol or to speak up about your boundaries, especially if you’re already feeling anxious. Preparing what you might say beforehand is a great way to feel more calm and confident in the moment.
• Avoid your phone: While your phone may feel like an easy distraction, it can actually increase social anxiety and potential triggers. Keeping off your phone can help you stay more present both with your goals and the people around you. 
• Remember that you can always leave: Whether your anxiety is heightened or the social situation is too difficult to be in without drinking, it’s always okay to leave whenever you feel ready. Your needs come first.
• And more! (Check out this article for additional tips on socializing while sober)

A small amount of anxiety is normal when encountering a social situation. Accepting this can help reduce anxiety and allow you to set reasonable goals. While drinking may provide initial comfort to natural nerves, it can exacerbate anxiety in the long-term. It can also lead us to say and do things that don’t align with our truest selves. Without alcohol, you’re able to share your most authentic self with others and make genuine connections. What could be a more meaningful way to connect than that?

Sources:

1. SW Book. Alcohol Research and Health. “Social Anxiety Disorder and Alcohol Use.” Accessed Nov. 20, 2021.
2. National Library of Medicine. “The Relationship Between Social Anxiety Disorder and Alcohol Use Disorders: A Critical Review, https://pubmed.ncbi.nlm.nih.gov/16042994/” Accessed Nov. 20, 2021.
3. Alcohol Rehab Guide. “Alcohol And Social Anxiety Disorder, https://www.alcoholrehabguide.org/resources/dual-diagnosis/social-anxiety-disorder/.” Accessed Nov. 20, 2021.
4. Drinkaware. “Alcohol and anxiety, https://www.drinkaware.co.uk/facts/health-effects-of-alcohol/mental-health/alcohol-and-anxiety.” Accessed Nov. 20, 2021.
5. GoodRx. “How Are Anxiety Disorders and Alcohol Use Related?, https://www.goodrx.com/conditions/generalized-anxiety-disorder/how-are-anxiety-disorders-and-alcohol-use-related.” Accessed Nov. 20, 2021.
6. Healthline. “Alcohol and Anxiety, https://www.healthline.com/health/alcohol-and-anxiety#living-with-anxiety.” Accessed Nov. 20, 2021.

While it’s widely known that alcohol isn’t healthy, many people are initially unaware of the full extent to which alcohol consumption affects body weight. People often look for explanations for a recent weight change in their diet or eating habits, just to find out the only thing that has really changed is their alcohol consumption. As a physician on the Monument platform, my patients often want to gain a deeper understanding of this connection.

Excessive drinking has consistently been proven to contribute to weight gain.¹ This is often due to changes in calorie intake, metabolism, insulin resistance, and decreased energy related to alcohol consumption. Understanding how these physiological changes work can be an empowering step towards changing your drinking habit and creating a healthier lifestyle. I notice that many of my patients see improved physical fitness within only two to three weeks without alcohol, which can provide extra motivation along the way. 

Keep in mind, however, that your progress is defined by much more than weight loss. Everyone’s body is different, and what’s most important is that you feel comfortable in your own skin and empowered to be your most authentic self. Cutting back on alcohol can make a huge difference. 

Now, let’s get a better understanding of why weight loss after quitting alcohol occurs.

Alcohol use increases caloric intake

Alcoholic drinks typically contain high amounts of what are called “empty calories.” This means the calories in an alcohol beverage have no nutritional value. It can be very easy to lose sight of calories while drinking. However, consuming high amounts of empty calories, like alcohol calories, can have a significant effect on the body.

When caloric intake exceeds the amount of energy burned, weight gain typically occurs. Most importantly, the lack of appropriate nutrition along with increased alcohol consumption can introduce various negative health conditions. This is one of the reasons people feel stronger and more refreshed once they start to cut back on drinking or reach for alcohol alternatives.

Alcohol’s effect on metabolism 

Alcohol is recognized by the body as a carbohydrate due to its significant sugar content. While carbohydrates are a normal food source the body uses for energy, they can become problematic when consumed in excess. The body typically uses insulin, a hormone produced by the pancreas, to help metabolize, breakdown, and store carbohydrates. When alcohol is consumed in unhealthy amounts, the pancreas often becomes overworked and insulin becomes less effective at breaking down carbohydrates. This process is called insulin resistance. 

When carbohydrates aren’t appropriately broken down due to insulin resistance, they eventually become stored as fat. An increase in stored body fat can contribute to weight gain. It can also tax the overall endocrine system, which controls all hormone production. 

A compromised endocrine system can lead to the precursors for diabetes. All of these alcohol consumption-related side effects change the body’s overall ability to metabolize effectively and efficiently, which also decreases its ability to burn fat. You may have heard people describe their metabolism as fast or slow, and alcohol ‘slows’ metabolic efficiency. 

Changes to metabolism affects our eating habits

The body needs calories from multiple food sources in order to remain balanced and healthy. Consuming alcohol in high amounts, and therefore creating an excess of carbohydrates, can cause the body to feel deprived of other food sources. When the body is feeling this way, it tends to signal the brain to crave these food sources more intensely. 

This can lead to making unhealthy food choices and/or overeating. Inversely, the lack of diverse food sources and nutrients can also lead to malnutrition and unhealthy weight loss in some cases of severe alcohol use disorder. Either way, excessive alcohol consumption can lead to unhealthy cycles and eating habits. 

Alcohol causes decreased energy 

After a day or night of excessive alcohol use, many people experience the symptoms of a “hangover”, and may be confronted with “hangxiety.” Because alcohol is a depressant, people experiencing a hangover often find themselves feeling like they have significantly less energy and motivation to do normal daily functions, including the physical activity that would typically help them burn calories. 

The ways in which alcohol affects sleep can exacerbate this lack of energy and activity. The result is fewer calories burned throughout the day and a greater likelihood that those unburned calories will become stored fat, leading to increased weight gain.

Why weight loss is common after quitting alcohol

One of the many benefits of sobriety or significant alcohol moderation is improved physical health. Cutting back on alcohol allows you to decrease your daily calorie intake and regain energy levels. The body also has more efficient metabolism throughout the day, which can lead to weight loss. When people decrease their alcohol consumption, they also often make better food choices, reduce calorie intake, and spread out their meals more evenly throughout the day.

These changes are why many people discover they lose weight within weeks of quitting alcohol. Most importantly, cutting back on alcohol helps people feel good and promotes overall mental and physical wellbeing. As alcohol becomes less important to you, you’re more likely to take time for exercise, explore new activities, and make healthier food choices.  

How sobriety or moderation can improve overall health

Changing your relationship with alcohol can provide countless health benefits. Cutting back on alcohol can decrease your risk of developing various negative health effects such as high blood pressure, raised cholesterol, liver disease (like fatty liver and even liver cirrhosis), heart disease, and other medical conditions. With time away from drinking, the body and mind begin to heal from the impact of alcohol and regain their natural balance. For example, the body starts metabolizing calories and fat as it normally would without the slowed effects of alcohol. 

Learning more about the alcohol recovery timeline can be helpful in understanding what the healing process looks like, and when to expect changes to occur. It’s inspiring to consistently hear from my patients that they feel like they have more energy, increased productivity, can think more clearly, have improved decision-making, and have an overall better health outlook. 

No two people have the same relationship with alcohol, nor the same relationship with their body. The exact correlation between body weight and drinking is unique to each individual. That said, alcohol has certain effects on the body that can be helpful to understand when looking to change your drinking habit and live a healthier lifestyle. You deserve to feel happy and healthy, and changing your relationship with alcohol can make a huge difference. You also don’t have to do it alone. Online alcohol treatment and a supportive community can help you get there.

Sources

1. National Library of Medicine. “Alcohol Consumption and Obesity: An Update, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338356/.” Accessed on Nov. 20m 2021. 

Making the decision to stop drinking is something to be incredibly proud of. Sobriety can enrich your personal relationships, provide numerous health benefits, and lead to meaningful self-discovery. Like any major transition, quitting alcohol takes time and determination. The first several days without alcohol can coincide with significant changes, which can be overwhelming at first. It’s important to remember that these experiences are part of the recovery process, and are signs that healing and relief are on the horizon. 

Before we dive into the early days of sobriety, let’s discuss how to safely get started on your journey. 

What To Do Before You Stop Drinking 

Prior to beginning your sobriety journey, it’s important to speak with a medical professional to ensure you have a plan to stop drinking safely. While anyone can achieve sobriety, quitting alcohol cold turkey can lead to alcohol withdrawal symptoms that can be dangerous or potentially life-threatening. These symptoms can include:

• Hallucinations
• Seizures
• Psychological symptoms
• Alcohol shakes and tremors
• And more

Your physician can go over your medical history, drinking habits, and risk factors in order to determine if a supervised alcohol detox is right for you, or if it’s safe to immediately proceed with your first week sober. 

If you believe you are experiencing alcohol withdrawal syndrome, please contact your provider immediately and visit https://findtreatment.gov/ to find a location to get supervised alcohol detox near you. If this is a medical emergency, call 911.

Another helpful step to take before you stop drinking is to prepare your environment and support system. Clearing out all alcohol, drinking accessories, and any other potentially triggering items from your space is one of our top tips for early sobriety. Sharing your plan with loved ones, exploring online alcohol treatment, and registering for support groups are also great ways to give your future self as much support as possible. 

How to Start Your First Week Sober

Once you’ve established a safe way to stop drinking with a medical professional and checked in with your support system, you are ready to begin your first week sober. (Or, begin tapering your consumption!) There’s no wrong time to begin your journey. You may decide to start at the beginning of the weekend, so that you have more free time to rest if you experience any initial withdrawal side effects. Alternatively, you may decide to start on Monday so you have a fresh start at the beginning of the week, and a couple days of sobriety under your belt before the additional triggers of the weekend come around. Whenever you decide to start, you should alert your support system and sign up for a few alcohol support groups so you know you’ll have support throughout the week.

Regardless of what your first week looks like, it’s important that you practice self-compassion, and recognize that progress takes time.

What to Expect on Your First Day of Sobriety 

The very first day of a sobriety journey might be full of excitement, nervousness, and many other emotions. Your mind might start racing far out into the future. Remember that all you need to focus on is the day itself. Taking it day-by-day, hour-by-hour, or even minute-by-minute can make you feel more in control. 

It can also be helpful to predict what time of day may be most challenging for you, and come up with a detailed plan for that time. For many people, they’re most likely to experience alcohol cravings in the early evening. To distract yourself from potential cravings you can try an hour or two-long activity such as taking yoga class, attending an alcohol support group, or seeing a movie in theaters. 

Many people also report having trouble sleeping the first night without alcohol (and throughout the first week of sobriety.) If you’re seeking better sleep, it can be helpful to build a calming alcohol-free nighttime routine. We also recommend asking your physician about how to improve your overall sleep hygiene.

The First Week of Sobriety: What to Expect

In the first several days of sobriety, it’s not uncommon to experience varying degrees of acute withdrawal symptoms, alcohol cravings, and heightened anxiety. It’s important to know that you will get through this, and these symptoms are nothing to be ashamed of. They are not permanent. To help you navigate this brief yet challenging stage, let’s discuss why these changes occur and how to safely manage them. 

Withdrawal symptoms 

If you experience acute withdrawal symptoms, it will likely be within the first week of reducing your alcohol consumption. Withdrawal symptoms can occur due to physical alcohol dependence. Alcohol is a depressant, which means it slows down the central nervous system. With repeated heavy drinking, the body and brain get used to the presence of alcohol, and the resulting slow-functioning nervous system. This is a risk factor for acute alcohol withdrawal.

Acute withdrawal symptoms can vary in severity, and regardless of your past drinking habits, it’s safest to connect with a healthcare provider before quitting alcohol cold turkey or significantly cutting back. 

Acute alcohol withdrawal symptoms can include:

• Headaches
• Nausea or vomiting 
• Sweating
• Mental fog
• Mood swings
• Fever or chills

Alcohol Withdrawal Timeline

Many people find it helpful to get a sense of when alcohol withdrawal symptoms might occur in early sobriety. While everyone’s experience is different, common alcohol withdrawal symptoms typically appear at these intervals:

Alcohol cravings

Another common experience in the early days of sobriety is intense alcohol cravings. If you’ve wondered “why do I crave alcohol?,” you’re not alone, and there’s a scientific explanation. 

Drinking alcohol releases dopamine in your brain, otherwise known as the “feel-good hormone.” When you use alcohol to de-stress or reward yourself, your brain makes associations between alcohol intake and relief. With continued alcohol use, even just the thought of having an alcoholic drink can increase dopamine levels and usher in cravings. After an extended period of unhealthy alcohol consumption, the brain doesn’t just associate alcohol with pleasure, but begins to see it as a basic need for survival. This is what is often referred to as alcohol “dependence,” and is why alcohol cravings can feel so intense. When navigating alcohol dependence, intense cravings are signals that the body needs alcohol to retain its state of “normalcy.” 

Fortunately, our brains are neuroplastic, which means they have an incredible capacity to heal and change. With time and support, the brain can reset to its natural dopamine balance and start to crave alcohol less and less. 

How to manage cravings

In the meantime, cravings can cause significant discomfort and challenges throughout the alcohol recovery timeline. Wondering how to manage alcohol cravings? While there’s no one-size-fits-all solution for cravings, medication and therapy are clinically-proven to be effective tools to help manage them. 

Medication to stop drinking:

Naltrexone is an FDA-approved medication that works to block the release of dopamine when consuming alcohol. As you continue taking it, the associations between alcohol and pleasure weaken in the brain. Because of this, naltrexone is proven to reduce the risk of returning to any drinking as well as return to heavy drinking.1If you’re interested in a medication assisted treatment program, you can speak to a physician via Monument to learn about what options best suit your needs and goals.

Alcohol therapy:

Behavioral changes can also play a significant role in reducing cravings. In alcohol therapy, a therapist specialized in treating substance use disorders can help you identify potential triggers, manage alcohol cravings, and establish healthier coping mechanisms. You can work with your therapist to create a plan for if and when cravings arise, and learn how to recommit to your goals if a setback occurs. 

It may feel uncomfortable at first to ask for help and explore additional resources. Seeking support is a sign of strength and courage. This truth can become even more clear once you begin treatment and can take you far in making progress towards your goals.

Heightened Anxiety 

There’s a physiological explanation as to why anxiety is so common in the first week of sobriety. You can read this article for a deeper understanding of why you feel anxious when you stop drinking. There are two primary reasons. The first one involves how alcohol acts as a sedative, and what happens when you remove that sedative. 

The other potential reason is that you may have been using alcohol as a coping mechanism for pre-existing anxiety. Co-occuring alcohol use disorder and anxiety is incredibly common. Once you stop drinking, you may be confronted with underlying anxiety without the false relief of alcohol. Whether you feel anxious from quitting or have an anxiety disorder (or a combination of both), finding stress-relieving activities and resources can help manage anxiety. 

These can include:

• Exploring mindfulness and meditation
• Practicing yoga
• Joining a support group
• Doing physical exercise
• Journaling about stressors
• Calling a loved one
• Engaging in alcohol therapy

With time, your brain will restore its natural moderation system and you will learn healthier coping mechanisms to help manage anxiety. 

Other physiological changes

While everyone’s journey is unique, it’s also common to experience changes in digestion, emotions, and more. 

Change in appetite and dehydration 

It’s perfectly normal to experience changes in appetite in the first week of sobriety. Your body is likely feeling deprived of a substance it has grown to expect, and your appetite may fluctuate as your body and brain recover from past alcohol use. While this may be unsettling, it’s important to remember that it’s temporary. To feel better more quickly, it’s crucial to stay hydrated and eat nutritiously during the first several days of sobriety. Drinking lots of water and eating whole grains, fruits, vegetables, and proteins low in fat can help you feel more energetic and full. Ultimately, sobriety contributes to improved digestion, hydration, and physical fitness. It’s just around the corner.  

Overwhelming emotions 

Alcohol has a numbing quality that can subdue emotions in the short term, while ultimately intensifying them over time. If you’ve been consistently drinking, once you remove alcohol from your system, it’s possible you will feel a rush of the emotions you’ve been suppressing. While this can be really challenging at first, learning to process and manage emotions without alcohol is what will ultimately facilitate healing and growth.

The fear of failure and judgment can also be especially intense in early sobriety. A helpful way to process emotions is to share them with others who are navigating similar challenges. You can share in Monument’s 24/7 anonymous forum or one of our 60+ moderated alcohol support groups each week. You are not alone. 

Sober for One Week: How Does it Feel?

Towards the end of one week sober from alcohol, it’s likely that you will see improvements to your sleep cycle, energy levels, mental clarity, anxiety levels, and overall well-being. You will also discover that without drinking, you have more time and money. You might return to old hobbies or discover new ones, and enjoy a boost in savings. Everybody’s journey is different, and if you don’t feel as many benefits after seven days, it doesn’t mean they aren’t going to develop. Everyone’s alcohol recovery timeline is different. 

Many Monument members have shared that the first week of sobriety was one of the most difficult hurdles in their journey because of all the changes. They also describe it as the most hopeful. After one week without alcohol, you’ve proven to yourself that you can do hard things. You’ve discovered that incorporating self-care into your routine is obtainable, and given your body the time to start to regain its natural balance. One week sober is something to be incredibly proud of.

Psychological Adjustments and Support Systems

Understanding the Psychological Shift: Individuals often experience a significant psychological shift during the first week of sobriety. As the body detoxifies, the mind also begins to process emotions and thoughts without the filter of alcohol. This period can bring clarity but also heightened emotions, including anxiety and mood swings. Recognizing and accepting these feelings as part of the recovery journey is crucial.

The Role of a Support System: Establishing a strong support system is essential during this early stage. Whether it’s friends, family, or a dedicated sobriety group, having people to share experiences can provide comfort and reduce isolation. Online forums and sobriety apps can also offer 24/7 support and resources, helping to maintain focus on sobriety goals.

Engaging in Mindfulness Practices: Incorporating mindfulness and relaxation techniques can significantly aid in managing stress and emotional volatility. Practices such as meditation, deep-breathing exercises, and gentle physical activities like yoga can enhance mental clarity and emotional stability, supporting the sobriety journey.

Educational Resources: Leveraging educational materials about addiction and recovery can empower individuals with knowledge, helping them to understand their experiences and develop coping strategies.

Enrolling in Therapy: For those who find the emotional and psychological challenges overwhelming, seeking support from mental health professionals can be beneficial. Counseling and therapy sessions can provide personalized strategies to navigate the complexities of early sobriety, addressing any underlying mental health conditions that alcohol use may have masked.

A look at the journey ahead

Recovery is a marathon, not a sprint. No victory is too small to celebrate, and no setback can erase your progress. In the coming weeks of sobriety, you’ll likely feel a mix of challenges and relief. You may experience Post-Acute Alcohol Withdrawal Symptoms (PAWS), which is characterized by symptoms such as mood swings and anxiety. You will also discover additional benefits of sobriety, such as increased energy, mental clarity, and weight loss. There might even be a period of great elation and euphoria, which is often described as “the honeymoon phase.” Learning more about three weeks sober and beyond can you a better idea of what to expect. And if thinking ahead is overwhelming, we get that! You don’t need to know where you’ll end up to make incredible strides.

Sources:

1. JAMA Network. “Pharmacotherapy for Adults With Alcohol Use Disorders in Outpatient Settings, https://jamanetwork.com/journals/jama/fullarticle/1869208.” Accessed Nov. 19, 2021.

Important safety information:

Naltrexone has the capacity to cause hepatocellular injury (liver injury) when given in excessive doses. Naltrexone is contraindicated in acute hepatitis or liver failure, and its use for a patient with active liver disease must be carefully considered in light of its hepatotoxic effects. 

In the treatment of alcohol dependence, adverse reactions include difficulty sleeping, anxiety, nervousness, abdominal pain/cramps, nausea and/or vomiting, low energy, joint and muscle pain, headache, dizziness, and somnolence. This is not a complete list of potential adverse events associated with naltrexone hydrochloride. Please see Full Prescribing Information for a complete list.

More people than ever are recognizing the negative effects of drinking alcohol and re-evaluating how it shows up in their life. As a physician on the Monument platform, I speak with patients every day who are looking to change their drinking habits in order to improve their health and happiness. Once they’ve decided they want to make a change, a question many people find themselves asking is whether sobriety or moderation is a better option for them. 

To evaluate this question, it’s important to recognize that alcohol use disorder (AUD) is diagnosed on a spectrum, and can be addressed in different ways depending on the individual. While working with a clinician is the best way to determine what goals and treatment approach is appropriate for you and your medical history, here are some useful pointers to consider when reflecting on the question of abstinence vs. drinking in moderation. 

First, let’s dive into the difference between abstinence (AKA sobriety) and moderation. 

Looking for the guidance of an expert clinician? Join Monument to explore your options. 

What is sobriety?

Sobriety is more clearly defined than moderation. When a person chooses to be abstinent, it means that they refrain from all alcohol consumption for a duration of time. However, when someone starts on a journey of sobriety, it doesn’t necessarily mean they are committing to a lifetime of abstinence. They may have adopted a sobriety challenge, such as Sober September or Dry January in order to gain the space to re-evaluate their relationship with alcohol. They might practice sobriety regularly with interspersed episodes of moderation. Or, they may have decided on sobriety as a permanent change in their lifestyle.   

From a health perspective, complete abstinence is recommended for certain populations. This includes those managing liver disease, bipolar disorder, abnormal heart rhythms, or chronic pain. It’s also recommended for people who are pregnant or trying to become pregnant, people younger than 21 years of age, individuals who take medications that interact with alcohol, and those who find they cannot maintain moderate drinking over time.¹ Alcohol also increases the risks of other health conditions, including cancer. While sobriety can be achieved by anyone, it’s important to check in with your healthcare provider before making significant changes to your drinking patterns. For individuals with severe alcohol use disorder and possible physical alcohol dependence, quitting cold turkey can cause withdrawal symptoms that may be dangerous or even life-threatening. It’s vital to discuss your goals with a physician to determine how to stop drinking alcohol safely. Treatment professionals can advise if supervised detox is required, and provide next steps tailored to your needs. 

Though sobriety has a clear definition, you may still be asking yourself, what is sobriety, and what will it mean to me? How do I create an abstinent lifestyle? Oftentimes it can mean learning how to manage cravings, engaging in alcohol treatment, finding community, and introducing alcohol alternatives into your daily life. A sober lifestyle is something to be proud of, and the team at Monument is here to provide answers and encouragement throughout your journey.

What is moderation?

Total abstinence is not the only option when changing your relationship with alcohol. For some people, drinking in moderation can be a viable pathway to a healthier life. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the definition of moderate alcohol use differs for men and women. 

• Moderate alcohol use for men is defined as drinking 14 or fewer units of alcohol per week, and no more than 4 per occasion. 
• For women, it’s defined as drinking 7 or fewer units of alcohol per week and no more than 3 per occasion. 

A standard alcoholic beverage (or ‘unit of alcohol’) is defined as 12 ounces of 5% beer, 5 ounces of 12% wine, or 1.5 ounces of 80 proof liquor.² While no amount of alcohol consumption is considered healthy, reducing alcohol intake in line with these amounts can reveal the benefits of moderate alcohol consumption (instead of heavy drinking).

The moderation approach to alcohol treatment is also referred to as the harm reduction model. As defined by the National Harm Reduction Coalition, harm reduction is “a set of practical strategies and ideas aimed at reducing negative consequences associated with drug or alcohol use.” Alcohol recovery is not an all-or-nothing process. Moderate alcohol consumption can be lifelong, or may serve as a “step-down” approach to quitting alcohol either temporarily or permanently. Either way, exploring moderation and aiming for more controlled drinking can be a hugely meaningful step. Working with a physician and therapist in an online alcohol treatment program can help you set moderation goals, make progress towards them, and evaluate what’s working for you over time.

A moderation approach may be recommended for those who prefer a gradual approach to progress. Here are additional reflection questions from a therapist to help you understand your own relationship with alcohol, and if moderation meets your needs and preferences.

Connect with a Care Team at Monument 

How do you decide between sobriety or moderation?

Remember that goals are flexible

First, know that your decision isn’t carved in stone. There is no “one size fits all” approach to changing your relationship with alcohol, and all pathways are unique. One person may start out with a moderation goal and later decide that a sober lifestyle more closely supports their aspirations and wellness. Another individual may pursue sobriety and later decide that they want to try to drink in moderation once they’ve clarified their boundaries. 

Regardless of your path, working with a physician and therapist can provide answers, reassurance, and guidance throughout the process. You also don’t need to have a clear understanding of your goal to start making progress. 

Reflect on the alcohol use disorder criteria

Research indicates that while the likelihood of avoiding heavy alcohol consumption is highest in abstinence-focused individuals, those with moderation objectives were also able to reduce their alcohol use. An individual’s ability to avoid excessive drinking is also influenced by other factors such as past alcohol consumption, as reflected by an alcohol use disorder diagnosis. Alcohol use disorder (AUD) is diagnosed based on 11 criteria. Depending on the number of criteria met, an individual will be diagnosed with mild, moderate, or severe AUD.

Individuals with severe AUD often find that in the long term, sobriety is the most achievable goal for them. Keeping alcohol in your life in a healthy way can be really challenging, especially for people who have exhibited more severe drinking habits and patterns. 

While moderation may be more achievable for those with a mild or moderate diagnosis than those with severe alcohol use disorder, it’s also a great starting point for those exploring making a change. With the support of an expert Care Team, many people begin their journey by gradually reducing their weekly alcohol consumption.

The idea of moderation and mindful drinking is also a great way for people who are asking themselves “should I stop drinking?” to start reflecting on their relationship with alcohol. Proactively cutting back on drinking can start to illuminate how drinking less can give you more, and create the mental clarity to identify your goals and values. There are no requirements for changing your relationship with alcohol and seeking treatment. 

Examine external factors

While your relationship with alcohol is entirely personal, reflecting on outside influences can be helpful when considering the relative benefits of sobriety or moderation. These influences may include family dynamics, workplace culture, friendships, strained relationships, and lifestyle elements. 

Understanding how external factors will support or impede your success can help you determine if moderation is something that feels achievable within your current lifestyle and circumstances, or if sobriety is a more realistic goal. It’s also important to know that you can change certain circumstances, and therapy can aid in helping you set boundaries that empower your progress.

Spend time self-reflecting 

The choice between harm reduction vs. abstinence is most often made by an individual after careful reflection and introspection. This can include thinking about your common patterns and learning styles. Are you someone who likes to ease into things, or do you prefer an all-or-nothing approach to change? If you lean towards gradualism, moderation may be a more comfortable place to start.

Consider how alcohol is currently showing up for you. Is it a main character in your day, or more of an afterthought? If alcohol is playing a central role in your life, you might find more success exploring sobriety. A key component of goal setting is also identifying what feels achievable.  Ask yourself questions like, can I drink moderation? Am I able to stop after a few drinks? Is a balanced relationship with alcohol an option for me? You know yourself and your drinking habits better than anyone, and putting thought into the decision can reveal powerful insights. It’s also important to remember that it’s not a permanent line between “moderate drinkers” and “abstainers.” You can always reevaluate your relationship with alcohol and revisit your goals. 

Consider the health benefits

The benefits of sobriety or moderate consumption over heavy drinking are another factor in the decision-making process. Cutting back or quitting alcohol use can help prevent many health risks associated with unhealthy drinking habits. These health risks include but are not limited to:

• High blood pressure
• Alcohol poisoning
• Diabetes
• Cardiovascular disease
• Ischemic stroke
• Hippocampal atrophy
• Cognitive decline
• Cognitive impairment
• Liver disease
• Cancer 

These health risks can be severe, and some even contribute to alcohol-related mortality rates. On the other hand, upon cutting back on drinking, many heavy drinkers experience improvements in sleep, cognitive function, weight loss, productivity, interpersonal relationships, energy, and overall mental health. Your specific health goals, health risks, and medical history may play a role in your choice to either moderate or abstain from alcohol. This is especially true if you suffer from specific health conditions or are cutting back to avoid increased risk of specific health consequences. 

No matter which path you choose, you deserve resources and support. At Monument, you can meet with a physician, such as myself, to discuss if medication to stop drinking is appropriate for you. There’s also specialized alcohol therapy where you receive a personalized treatment plan catered to you and your goals. Lastly, you can join moderated alcohol support groups to get encouragement and gain accountability in a non-judgmental and secure forum.

The journey to changing your relationship with alcohol is about progress, not perfection. Whether you’re working towards sobriety or moderate alcohol intake, the most important thing is to keep going. Every day presents a new opportunity to define your goals and make progress towards them. Learning more about your options and the health benefits of cutting back is already a meaningful step.

Sources:

1. American Psychological Association. “One Year on: Unhealthy weight gains, increased drinking reported by Americans coping with pandemic stress, https://www.apa.org/news/press/releases/2021/03/one-year-pandemic-stress.” Accessed Nov, 18. 2021. 
2. NIAAA. “Recovery From Alcohol Use Disorder: A virtual roundtable discussion of a new NIAAA Research Definition.” Accessed Nov, 18. 2021.
3. NIAAA. “Drinking Levels Defined, https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking.” Accessed Nov, 18. 2021.
4. Library of Medicine. “Drinking Risk Level Reductions Associated With Improvement in Physical Health and Quality of Life Among Individuals With Alcohol Use Disorder, https://pubmed.ncbi.nlm.nih.gov/30395350/#:~:text=Conclusions%3A%20One%2D%20and%20two%2D,person%20%22feels%20and%20functions%22%20following.” Accessed Nov, 18. 2021.