Alcohol: help with drinking less, or stopping

Get help straight away

Call 911 or go to Emergency. Don't wait for an appointment.

• A seizure after cutting down or stopping
• Confusion, or seeing or hearing things that aren't there, in the days after stopping
• Vomiting blood, or black, tarry stools
• Hit your head in a fall and now drowsy, confused or vomiting
• Thoughts of ending your lifeYou can also call or text 9-8-8, any time.

Please don’t stop suddenly on your own if…

Alcohol is one of the few drugs where stopping all at once can be dangerous. That doesn't mean you can't change. It means the safest way is with medical help — often at home, with a plan. Call us first: 905-683-0690.

• You drink every day, or nearly every day, and have for weeks or longer
• You get shaky, sweaty, sick or anxious in the morning or when you go without — and a drink settles it
• You've had a seizure, severe confusion or hallucinations when stopping before
• You've needed hospital or medical help to stop before
• You also take medicine for sleep or anxietySome of these make withdrawal more dangerous.

Contact us today if

Not an emergency, but worth being seen the same day.

• Your skin or eyes look yellow
• Your belly or legs are newly swollen
• You've been falling

What helps

Changing how you drink is common, and it's treatable. Most people get help from their family doctor, close to home.

There's more than one goal. Some people want to stop. Some want to drink less, or have fewer heavy days. Both are real goals. Cutting down counts — it means less harm to your liver, heart, sleep and mood.

There are medicines that ease cravings, or take the pull out of drinking. They're safe for most people, and not enough people are offered them.

Talking helps too — counselling, peer support, a group. You can have both medicine and talking.

Drinking and how you feel often go together

A lot of people drink more when they're low, anxious, stressed, or not sleeping — and drinking tends to pull those the wrong way, especially sleep and mood. That isn't a character flaw, and it isn't a separate problem you have to fix first. There's help for it, the same as for drinking, and often the two get better together — so it's worth telling us about both.

• If low mood or anxiety is part of it →
• If sleep is the hard part →

A different way to use naltrexone

Naltrexone is one of the medicines Canadian guidelines recommend first for alcohol. Usually it's taken every day, often with the aim of not drinking.

There's another way, called the Sinclair Method (or “targeted” naltrexone). You take it before you drink, on the days you drink. It doesn't stop you drinking that day. It makes drinking less rewarding. The aim is that over weeks and months, the pull gets weaker.

It only works if you take it the way it's meant to be taken — before drinking, every time. That is not what a standard pharmacy label says. Ask your doctor to write down exactly when to take it.

Why haven’t I heard of it? It asks you to keep drinking while it works. That sits uncomfortably with the idea that the only answer is to stop. That's not a reason to rule it out. It's a reason to talk it through.

Naltrexone isn’t safe for everyone — tell us if:

• You take any opioid pain medicine — codeine, Tylenol 3, oxycodone, hydromorphoneNaltrexone blocks it and can bring on sudden withdrawal.
• You take methadone or SuboxoneNaltrexone can bring on sudden withdrawal.
• You use street opioidsNaltrexone can bring on sudden withdrawal.
• You have hepatitis or serious liver disease right now
• You're pregnant, or trying to get pregnant
• You're breastfeeding
• You have surgery coming upOpioid pain medicine won't work normally — tell every doctor, dentist and hospital you're on naltrexone.

At your appointment

We'll ask how much you drink and how often. No judging. We can work out together what counts as a drink.

We'll check whether cutting down or stopping could cause withdrawal, and plan how to do it safely.

Blood tests before starting a medicine, and along the way, check your liver and general health.

You choose the goal. Then we go through the options together — medicine, counselling, the group.

Worth asking

• —Is it safe for me to cut down or stop on my own, or do I need help with withdrawal?
• —Which medicines could help me, and will my drug plan cover them?If you have Ontario Drug Benefit coverage, naltrexone is covered. Other drug plans vary — ask.
• —If I try the Sinclair way, exactly when do I take it, and what do I tell the pharmacist?
• —What should my blood tests show, and when do we repeat them?You can look up any blood test you've been sent for at labs.ajaxharwoodclinic.com.
• —What do I do if I have a bad week?

If you’re here for someone else

You're welcome at the group too. Call us for advice on how to raise it with them. The safety lists above matter for them as well — especially the one about not stopping suddenly.