MAKING CHANGES - Northern NSW Local Health …...2 Making Changes The pros and cons of changing...

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MAKING CHANGES

A SELF HELP GUIDE TO REDUCING OR STOPPING

DRINKING

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Making Changes

The pros and cons of changing which will help you explore the positive and negative aspects of your drinking.

Alcohol dependence and withdrawal to help you determine if you are dependent on alcohol and the experiences of withdrawal you may have when you stop or reduce drinking. It also contains medical advice and strategies to help you through withdrawal.

How to reduce your alcohol use including a calendar to help keep track of your drinking and strategies to help you reduce your drinking.

Getting started which will help to prepare and plan for your journey of change.

Relapse prevention which will help keep you on track and gives strategies for difficult situations.

Relaxation and meditation as well as a link to an internet site for relaxation exercises.

Making Changes is a self-help guide to reducing or stopping drinking. It contains information on:

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Where to from here? Is it time to make a change or keep things the way they are?

Now that you know your drinking risk level the choice is up to you.

Do the following exercises and you’ll be clearer about these issues. Remember, your reasons for wanting to change may not be the opposite of your reasons for wanting to continue using alcohol.

To help motivate you to change your alcohol use, try thinking about the positive and negative things about your drinking.

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What are the positive things about your drinking?

What are the negative things about your drinking?

What are the positive things about changing your drinking?

What are the negative things about changing your drinking?

PROS AND CONS OF CHANGING

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Write down the most important reasons to reduce or stop your drinking.

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3. If I was to do something to change my drinking, what couldI do?

2. How long can I drink alcohol before I start to dodamage?

How do I feel about that?

Some other things you may want to consider at this stage include:

1. What does my family think about my drinking?

How do I feel about that?

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Decision Time

Now it is time to make a decision whether you are going to cut down or stop drinking either for a while, or permanently.

It might be a good idea to discuss your options with someone close to you so they can understand why you are making this change and can support you in setting new goals.

Before you finally set your goal it is important to understand a little about alcohol dependence and withdrawal so you are prepared.

The next section of this self help guide refers to alcohol dependence and withdrawal.

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Alcohol DependencePhysical dependency on alcohol can develop if you drink large amounts regularly (every day or nearly every day) for a period of time (months or years). Your body adapts physically to having alcohol in your system, and if you stop drinking your body has to readjust to having no alcohol in your system. This period of readjustment is called withdrawal.

Alcohol withdrawal symptoms are listed below. If you do not drink every day or nearly every day, then proceed to the next section of the package. If you drink every day or nearly every day, tick the symptoms or signs that you experience:

Anxiety/restlessness Irritability

Tremor Loss of appetite

Difficulties in sleeping Strong urge to drink

Nausea/vomiting Headache/fullness in the head

Sweating Stomach pain/diarrhoea

Fever Perceptual disturbances * *Perceptual disturbances can include problems with hearing, (sounds are ‘harsh’, or hearing things that are not there) problems with vision, (lights seem too bright, or seeing things that are not there) or problems with your skin, (itching, pins and needles, burning, numbness or feeling of insects crawling under your skin).

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WITHDRAWAL Withdrawal usually starts six to 24 hours after stopping (or greatly reducing) drinking and if mild, resolves after two to three days without treatment. Sometimes withdrawal can last for 10 days. Some people can experience severe withdrawal and complications which can be life threatening.

Therefore, before stopping or reducing your drinking, check with your doctor or someone from Drug and Alcohol Services. Seeing a doctor before stopping alcohol may also be beneficial because the doctor can prescribe some medication for the withdrawal symptoms. This is especially important if you have a history of epilepsy or fitting.

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The more you know about what happens during withdrawal and what you can do to help get through withdrawal, the better you will cope with withdrawal.

Arrange to withdraw in a safe environment. Avoid having people around you who are drinking alcohol or using drugs.

Avoid going through withdrawal where there are children. Common symptoms of withdrawal include irritability which may make it difficult to manage children.

Avoid people and places that trigger you to use alcohol.

Eat a healthy diet and drink about two litres of water each day. Avoid large meals – it’s better to have small meals and snacks throughout theday. Avoid fatty foods – its best to eat bread, salads, soups, yoghurt, vegetables and fruit.

Avoid alcohol and all drugs, unless prescribed.

Have a supportive person around you to help get through difficult times.

Consider having some drug and alcohol counselling.

Medication can help lower the severity of some of the symptoms. Talk to your doctor about this.

Family and friends should learn about alcohol withdrawal and any medications prescribed, so they can provide support.

Have an emergency plan in place, for instance if you need to see a doctor late at night.

If you have any concerns talk to your doctor or other health care provider.

Getting Through Withdrawal

The following will help you get through withdrawal

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GRADUAL REDUCTION OF ALCOHOL USEMy Drinking Diary

Remember to check with your doctor first, to make sure it is ok for you to reduce without medical supervision.

Get to know your drinking – keep a diary of the total number of drinks you have each day. Remember to look at the “standard drinks” chart before using this diary.

Week 1 My Drinking DiaryKeep a record of your drinking over a four week period

Monday Tuesday Wednesday Thursday Friday Saturday SundayTime of drinking

Number of standard drinks Money spent on alcohol each dayWeight at the end of week

It is recommended that this diary be completed over the next few weeks and each week compare money you spend, your weight and your drinking habits.You may notice that as your drinking reduces, your weight may reduce and

you may have more money to spend on other things.

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http://healthynorthcoast.org.au/wp-content/uploads/2013/08/std-drinks.pdf

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GRADUAL REDUCTION OF ALCOHOL USE: My Drinking Diary

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Think about your drinking and set yourself a goal to drink less. Have something to aim for such as a dose reduction schedule which aims to reduce to zero over one to four weeks.

Try to aim to drink within low-risk limits (no more than two standard drinks per day).

Each day reduce the total number of drinks.

Put off your first drink for a longer time each day.

Instead of having your first drink, do something to keep your mind off that first drink; for example, go for a walk, do some gardening.

Reduce the size of your drink, or dilute it with a non-alcoholic drink or alternate non-alcoholic and alcoholic drinks.

Tips to cut back on drinking alcohol

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Put your glass down between sips

Put routine in your day; for example, get up at the same time each day, have regular exercise and relaxation; no naps during the day and go to bed about the same time each night.

Eat a healthy and regular diet and eat before you start drinking.

Avoid salty foods.

Do not mix alcoholic drinks.

Drink slowly, don’t scull your drinks.

Switch to low alcohol beer and wine.

Avoid rounds or shouts

Don’t allow other people to top up your glass.

Change your routine. Plan other activities at times you normally drink.

Limit the time you spend with heavy drinking friends.

Ask family and friends to support your decision by not encouraging you to drink.

Avoid using alcohol with other drugs; the mix is often unpredictable and dangerous.

Refer to ‘How to avoid relapse’ for more hints on getting off and staying off alcohol.

Tips to avoid drinkingtoo much

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You will need to find out your strengthsand weaknesses. As you discover them, you will be able to develop ways to deal with them.

You will then develop new skills to replace the role you believe alcohol plays in your life.

Think back to the positive things about using alcohol that you listed earlier, as these will need to be addressed in order to make successful changes. For example, if using alcohol helps you to deal with stress, you will need to develop strategies for stress management and relaxation.

http://www.internet-of-the-mind.com/instant-relaxation-exercises.html

GETTING STARTEDAfter looking at some of the issues that are related to your drinking, it would be good to look at some strategies that can help you change successfully.

Changing your drinking habit is difficult. In many ways, change is like a journey:

Like any journey, it requires preparation. The longer you take to prepare, the more likely you are to reach your destination.Be prepared and plan ahead.You may need to develop new strategies as you go along to help you reach your goal.

The next step is to decide what the best strategies for success will be for you. Every journey starts with the first step.


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There are many things that you can do to help you start your journey. Which strategies would you choose?

Before you use alcohol - think about it - practice distraction and delaying

Plan ahead: think about what you can do instead of using alcohol

Remind yourself why you want to change (what are your main reasons for wanting to change?)

Remind yourself of the benefits of not drinking

Ask a friend/relative to help, and tell them about your plans

Avoid difficult situations, and people who drink or use drugs

Spend more time with people who do not drink or use drugs

Keep physically active – being active makes you feel good and improves your well-being

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Write down your own strategies

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MY DIFFICULT SITUATIONS

WHAT I WILL DO ABOUT IT

PLAN FOR ACTION Write down some difficult situations and ways of dealing with them. Some of these may need changing down the track.

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Longer term goals

Write down some personal goals for the next few months:

By the end of next year I want to be:

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Some other things to think about now could be:

1. What benefits have I noticed from drinking less?

How do I feel about this?

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2. How has my life changed since I stopped drinking?


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3. If I started drinking again, what would happen at home?


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Now it’s time to think about your reasons for wanting to change again. Write down the most important reasons to change your alcohol use.

Are my reasons for wanting to change different from before?

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HOW TO AVOID RELAPSE Becoming free of alcohol will be a big reward in itself but for many that is just the beginning. The opportunities that freedom from alcohol brings may include the reward of the lifestyle that you have dreamed about and certainly owe yourself.

Many people find the temptation to drink may pop up now and then – sometimes months or even years after quitting. This is often a fleeting feeling and is usually easy to deal with. Having such a feeling does not mean that you have failed – it may be a natural response to certain strong triggers.

It is quite common for people to make mistakes when they are trying to learn a new skill. It is important to know that this does not mean failure, but is a temporary setback. Don’t give up. Many people who are ultimately successful find that they have a slip along the way.

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Learn to “urge surf”. A craving to drink builds up and then breaks away like a wave in the surf. Learn to ride that wave/urge until it breaks away

Avoid alcohol/drug-using friends. Prepare yourself beforehand for these situations, e.g. “I can’t come to Harry’s because I have something else on”. Also avoid places where alcohol will be used

Start regular stress management techniques and develop new interests, such as a sport or hobby; practice deep slow breathing; have regular exercise and relaxation periods; seek out supportive friends; join a self help group (NA/AA); have some counselling; think positive and believe you can do it

Meet new people and develop healthy friendships

Think your problems through, don’t just react

The following are some handy hints for avoiding relapse – which ones will you use?

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Talk to a person you trust about how you feel

Focus on your achievement so far (e.g. 10 days sober)

Remind yourself of your alcohol related problems

Look at problems/difficult situations as something you can learn from

Plan your day/week (you might even want to write it down, in a journal or worksheet)

Reward yourself for doing well; for example, after managing a difficult situation or period of time, do something nice for yourself as a reward (except alcohol or drugs)

Remember if you have a slip, get straight back on track – don’t let it turn into a binge. Learn from the slip so that it doesn’t continue to happen and don’t give yourself too hard a time

Some more handy hints for avoiding relapse – which ones will you use?

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Here is a list of common triggers/high risk situations. Which ones might apply to you?

Having a great time with others who are drinking

Missing the feeling of being intoxicated

Having withdrawal symptoms (physical pain from not using alcohol)

Walking past a hotel

Stressful situations

Feeling like I can have just one drink

Experiencing a strong craving to drink

A specific time of the day that you used to drink

Being around family members who drink

Feeling great and wanting to get intoxicated to feel even better

Hanging out with friends I use to have a session with

Weekends

Being bored or having nothing to do

Feeling stressed out

Someone offering you a drink and having trouble saying no

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Where

When

Doing what

Feeling what

Thinking what

To identify your high risk situations and triggers, ask yourself about the following situations where you feel most tempted to drink alcohol:

*Make sure you think of all of the above when doing your action plan.

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Relaxation exercises


Relaxation And Meditation

Learning to relax when you want to is like learning any other skill, like driving a car or playing golf. Once learned, the skill of relaxation enables you to develop the ability to switch your levels of concentration on and off when required.

By controlling your concentration you can reduce your reactions to everyday stressors and develop a deep and complete relaxation response.

Through practice, this relaxation response can be called up regularly and the harmful effects of stress can be minimised.

Relaxation hintsPractice for a minimum of 10 minutes daily.

Relax in a quietroom and arrange itso that there will be no interruptions.

Not immediately after a meal - wait for an hour or two.


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Alcohol and Drug Information Service (ADIS) free call 1800 422 599

For confidential advice and/or referral to your nearest Drug and Alcohol

Service

Drinkcheck and Making Changes were developed by Northern NSW and Mid North Coast Local Health Districts Drug and

Alcohol and Health Promotion Services. Produced in partnership with North Coast NSW Medicare Local.

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