My wife has "severe heart failure" (LVrEF 30-35%) and is alcohol-dependant on 14 units/day. She is also type1 diabetic.
She has decided that she wants to reduce (she isn't ready to say "quit" yet) her alcohol consumption and has decided that she will do "dry January" as a first step. But her GP has advised her that giving up alcohol suddenly could be dangerous for her heart, and that she should reduce her consumption more gradually.
Does anyone have any experience of how quickly alcohol consumption can be safely reduced? Our plan is that she will have 2 units, spread over each day for at least the first two weeks and reduce further if there are no problems. It is a large reduction from her regular 14 units but 2 units is the NHS recommended daily maximum.
If anyone has experience of this I would love to hear from you. It is going to be a tough start to the year but I am hoping that it will be worth it...
EDIT...I have had so many helpful replies, from people with first-hand experience, advising me that a drop from 14 units to 2 units is far too big. We will not be doing this anymore thanks to your advice and will be taking the reduction much more slowly than had been intended. Thanks to all who have contributed...
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Poppeye
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It is very true that been dependant and suddenly stopping can be dangerous for some especially with a heart condition
I think you need a plan and professionals involved in what would be a safe amount to wean of it as that seems like a big drop in units that you are talking about doing
I am pleased you wife is willing to address this issue now and well done to her recognizing she needs to for her health
I will put you a link on if there is anything else on the link that might help you get the support you need to do this safely
I don’t drink so I can’t help, but I want to say well done to you both, you for not giving up on her and for her hoping to make a new start. I hope you both have a prosperous and healthy New Year.
Hello, Poppeye. It is encouraging that your wife wishes to reduce alcohol consumption. Yes, suddenly stopping is known to be dangerous. Medical advice is essential for this. Some reliable advice could be good from charities that support alcoholics. Her dependence on alcohol could also be of the mental sort, so advice and support might be beneficial for that.
I would advise against this course of action. There is a danger of severe fitting. Given that she has pre existing heart problems the outcome could be fatal. If I understand you correctly she plans to reduce her daily consumption by about 86% down from 14 units to 2. There is also a risk of delirium. I really do not think that this is safe. A medical detox might take upto 3 weeks and requires a decreasing titration of chlordiazepoxide.
Thanks...yes, she has seen her doctor who warned about the danger of seizure and advised against cold turkey. I have epilepsy controlled by medication and I know that I never want to have a seizure again...I don't think people know what it can be like or how dangerous it can be. But the question is... what does a gradual reduction look like, how many units at a time?
I suspect that the only people who can answer that question are those with specific training and experience - this is a forum for heart issues, not a forum for specialist in the treatment of alcohol dependency - so we can offer support but not the sort of info and advice you and your wife need
Please keep working on persuading your wife to get professional support with this.
Hi...her heart condition is probably a result of her alcohol dependency which is why I asked the question here. I suspect that quite a number of contributors to this forum have both heart and alcohol dependence issues and some of them have been able to offer some very valuable advice.
I am sorry if you thought I was saying that this group could not help
What I was trying to say is that this is something you need experience support with, it really can be dangerous to attempt the process on your own unless you really know how to manage it and it sounds as though neither of you has the right experience - i truly feel for you both as I have experience of sharing my life with an alcohol dependent partner - I wish you a good outcome
Thanks for clarifying...I guess we already asked her doctor for professional help and her advice was ambiguous...just to cut down gradually. You are right, neither of us has experience and I am seeking advice here. But my wife's doctor has asked her to come in on 3rd January (she knows of the dry January plan) so I guess she will want to see how my wife is getting on just a few days in. I have been allocated control of the vodka bottle and will be decanting a measured daily amount. I have a lot of faith in our GP but, aside from asking her to take into account the fact that her discharge notes following her admittance for heart failure mentioned her alcohol use, I have not discussed the matter with her. We had a talk with the heart-failure nurse about it but my wife felt that I was interfering too far when I brought the issue up. It is a touchy subject and I have to tread very carefully if we are to get a good result. I hope you achieved a good outcome with your partner?
Several members have suggested sources of practical support, I hope you are able to contact at least one useful one soon.
In my experience repeated efforts to cut back were attempted and the process was hard for all involved. I certainly needed support myself. Sadly I can't report success in this case, that's why I hope you will do better.
Please search for local charities specialising in this. They will give free advice on safe reduction - I volunteer at one of these places and they will be able to give advice based on current units. There is also one to one support, group sessions and so much available.
I agree and support contacting a local support group ‘ service for those with alcohol dependency as most note here the proposed reduction may have severe side effects as part of the withdrawal so take professional advice , you can potentially also find the right organisation via your GP
I would say half it first. If she drinks wine, maybe buy some good quality alcohol free wine to mix with her regular drink. Or if she is into vodka or gin stretch it with ginger ale or so. May be easier if she is busy with something at the times she normally drinks. Go for a car ride or go see a movie. Just to get her out of the place she normally associate with drinking. Be realistic though. After all these years it will be a struggle.
Thanks...you are right, coping strategies are important when the urge to drink becomes a danger. I am trying to set up a network of friends that she can phone if necessary. And also encouraging friend who drink (I don't) not to encourage her...
14 units a day unfortunately means your wife is an alcoholic. I am not been judgemental but my uncle was an alcoholic. Once he stopped drinking and got over the withdrawal he always said he was an alcoholic he just didn't drink . He wouldn't even have sherry trifle as he said his drinking had cost him his marriage and children. And he didn't want it to cost him the rest of the family .
I admire your wife for deciding to stop drinking but you must be a wonderful man who loves her above all else to put up with her drinking . But I know from my uncle how hard it's going to be and she is going to go through some awful withdrawal symptoms and she will become someone you don't know as her body craves the alcohol. It's going to be an awful time for you both but the benefits will mean your wife's health with improve and you will get your old wife back before the drink took her over .
If you do drink would help her if you stopped and don't go anywhere where alcohol is available including family or friends homes where there is alcohol. Until she is sober .
Get in touch with AA and join it they are the experts and members have been through what your wife will . It is a life long commitment and is not going to be easy.
Your wife has made the hardest decision and that's to stop drinking and admit she is an alcoholic. The rest of the journey is going to be hell for a while.
Should say my uncle got his daughter back into his life but his son was 8 years older and could never forgive his dad. And had a friendship with his ex wife. His liver recovered to an extent but died from lung cancer when he was 62.
You are both very brave to face this but your love for eachother will get through the hell to come .
Thanks...we have accepted the fact that she is alcoholic at last. It runs in my wife's family and we have seen it in others, one is sober, two have died. I don't drink myself, having given up 6 years ago when I realised that it was becoming a problem for my wife. I used to drink too much but I am not even tempted any more. I thought that my example of being able to lead a normal, happy social life, would help my wife but it hasn't. AA isn't going to work for my wife but I am hoping that we can use some of their methods.
There may be a local self help group in your area just ordinary people who get together to help eachother and their families. Nothing structured. Your GP may know of a local group . Or an online line forum which may help your wife write down her feelings and get help that way . I know if it wasn't for my HPX Facebook group I wouldn't understand why my body did and does what it does because of them my whole 66 years now makes sense . It's a closed group you have to join and only members can see it . There may be a group like that your wife would be happy with . Just talking to others going through the same thing a place where she can be honest how she feels with nothing but help , support and friendship and no judgement.
How I found my wonderful group was through the rare disease society. Don't know how you would find out but I will look and see if there is a closed Facebook group for your wife.
Hi...and thanks. What is HPX? I searched HPX Facebook and couldn't find anything. There is a stigma in admitting to others that one has an alcohol "problem". This makes it difficult for her to seek help in this way. I have suggested to her that she tells our friends who socialise with an abundance of alcohol, that her doctor has told her that she cannot drink because of her heart condition, thereby avoiding the stigma of admitting her own "lack of self-control" and putting the onus on the doctors advice instead. We have an AA group that meets two doors down from us. In the summer they meet in the garden and we often hear them chatting and laughing loudly. To hear them you would think that they are a group of well-oiled revellers rather than a stone-cold-sober bunch of recovering alcoholics... I think that my wife would enjoy their company if she could bring herself to try it...
HPX is short for hereditary Hyperekplexia. The Facebook group is called The Hyperekplexia Society. It causes a whole host of problems constant pain, falls, we have what is called a startle reflex if we get startled by loud noise ,flashing light or anything unexpected our limbs stiffen and we fall like a log if standing up but we are conscious. If sitting we are frozen . We can choke on our own salvia and foods as our windpipe( can't spell the O word ) can go into spasm . We have what's called a strange walking gait . Think Monty python ministry of silly walks. 🤣. Effects our cognitive function we are clever but have to read things over and over to retain the information. When speaking my words can be jumbled what I think I am saying can be something completely different and don't realise . I can forget what I am saying or repeat myself in a sentence and don't realise I have already said if. Never been able to run,jump ,hit or catch a ball as I fall over. Learning to swim was a nightmare as hard to co ordinate my arms and legs . My hands tremble all the time . Walked with a stick since I was 29. Can't go outside to my bin without or I would fall. Can't get into a car without help but only been last 3 years. Because of no diagnosis denied any disability benefits. Even with my diagnosis of my HPX and heart condition the xxxxxxx PIP gave me zero on everything. But the Brain Charity got me a solicitor pro bono took over a year to get to PIP tribunal and a support worker from the charity went with me . And the tribunal couldn't have been kinder . And awarded enhanced PIP for living and enhanced PIP for mobility indefinitely August 29th 2023 and back dated until 7th March 2022 when I asked for the forms . Plus while waiting to go too tribunal my solicitor told me I was entitled to UC and my caseworker got the health forms for me and I went to a face to face assessment and got it. People at the job centre tried me like a human being not like the people at PIP who are run by robots.
But this isn't doom and gloom. When the limb jerks started in 1988 my husband just said we alter our way of life to suit you and be a normal family. Our children never missed out on anything I was a hands on mom only thing I couldn't do was go out by myself. So we could go out I went in a wheelchair. Nick my husband had wheelchair rage anyone cut in front of us he hit them. The wheelchair was specially made as I was 19+ st in those days.
But I adapted and do things my way . Still cook from scratch,bake ,make chutney,jam and marmalade. Went on holiday this year twice by myself my first holiday since 2005. Booked in October to go too Llandudno in May . Go to sit fit class every week and exercise at home daily . Go to the Brain for a craft group. Going to my first classical concert in February.
I live my life to the full. I never knew I was disabled until I went to high school and bullied everyday for 5 years. My large extended family never treated me as different nor the friends I grew up with and we went to the infant and junior school on the private housing estate I grew up on.
Not brought up with money but rich in love and attention.
Just looked there are 2 groups on Facebook closed groups so only members can see what you write one is called Soberful
other one
How I Quit Drinking Alcohol.
Only few thousand members so small group as they are spread over the country. Read their mission statement . They may be a fit for your wife . And they are the experts as they have gone through and going through what your wife has to face . Nothing like real life experience and they will help .
That was why Amy Winehouse died because she stopped so suddenly,also as on so many units she should concentrate on cutting daily amount first doing it slowly
I didn't know that...and I adore Amy Winehouse's music...I had "Back to black" on at full volume whilst preparing the Christmas dinner! I will tell my wife this fact...thanks
Detox takes 4 to 5 days. Usually it’s done using a drug like Librium to ward off seizures. All recovered/recovering alcoholics will tell you that “reducing” doesn’t work. People who only want to reduce their consumption never gain control. They always go back to where they were at the beginning. If you want to stop by reducing go by two units per day over a week. Your wife will still have some symptoms of detox and physical craving but not enough to be dangerous. You will need help from people who have been there and got the T shirt. Alcoholics Anonymous and Al Anon, ignore the God bit if you want. So called health professionals who haven’t been addicts themselves are a waste of time. I’ve been there myself, 23 years sober and have seen dozens of my contemporaries fail. They’re all dead. We alcoholics cannot just have one drink. Nowadays I neither need nor want to drink alcohol.
Thanks...yours is the reply that I was looking for. Her GP said that she should reduce gradually but not by how much and over what period of time. I suggested that her GP should increase her antidepressant dose which she agreed to. I wonder if that would help in the same way as the Librium. Her GP didn't suggest any other drug to help. I have epilepsy which is controlled by medication...I could spare a couple of those pills (Levetiracetam) without doing myself any harm. I agree, it takes an alcoholic to know how to help an alcoholic...I used to be a drinker myself (now sober 6 years) and I recognise the convoluted mind-games that go into continuing the habit. I will not have a single drink, but I don't think I was ever a true alcoholic. I know that "reducing" doesn't work...but even getting to the point of wanting to "reduce" has been a struggle. One step at a time, it is just too big a leap to commit to quitting just yet. I thought that heart failure would have been the wake-up call to quit but it hasn't...it is amazing how strong the addiction is. It needs to be seen to be believed, people think that it is just a failure of self control and will-power, they haven't been there.
It’s pretty clear that your wife needs medically supervised detox and rehab. You’ll never do it at home. Your only hope is a detox and rehab unit. They do exist. I was fortunate enough to be able to get into one and I am one of the few, about 5%, alcoholics who survived.
Agree with Mentdent. If I look back at my experience, reduction doesn’t work for a hardened alcoholic. I myself ended up in hospital with alcoholic hepatitis. It was then when I had reached rock bottom that I eventually saw what I really was. I was bright orange with a distended stomach. I watched the lady in the next bed die while I was in hospital for several weeks. I couldn’t face food and had to have the indignity of having a tube put down my nose so I could be fed in order to recover. There is a serious chance this could happen to your wife. Medical intervention is really needed I think before it’s too late. I have regained my life and my family, but a year after been sober I had a heart attack, this year I found out I also have an ascending aortic aneurysm. Last year I had kidney cancer. Not sure I will live a long life because of the dreadful way alcohol took hold of me. But I am trying my best. I truly despise alcohol and neither myself or my husband have touched it for nearly four years. The awful truth is alcohol will kill her if she doesn’t stop. And believe me it’s a terrible death. The lady next to me was delirious shouting out etc. She was in her early thirties. I wish you all the luck in the world x
I'm a recovering Alcoholic. I'm nearly 11 years Sober now. I was drinking over a litre of Vodka a day. That's 40 units daily.Reducing for me wasn't an option as my Liver had just about failed. I was hospitalised, medicated up to the eye balls to prevent seizure and monitored constantly. I was in for a month.
Reducing in your wife's case is the sensible way to go. Stopping immediately carries inherent risk of seizure.
Reducing needs to be carefully managed and controlled.
Alcoholics are devious, believe me, and will find a way to try and beat any reduction plan.
Make sure you are in charge of how much and when you allow the drink.
It will not be easy, neither for your wife nor for yourself. Be prepared for tantrums and screaming.
Sorry to paint this picture, but whilst this will be the hardest thing she ever does, in time it will be the most rewarding.
Strongly advice any Alcohol support groups in your area.
Many thanks. Yes, we are prepared for a tricky time ahead. I am hoping it will be worth it though. I know what you mean about the deviousness, having found various bottles stashed away behind cleaning products under the kitchen sink for instance. I have to be very careful not to be too controlling though...it is easy for my wife to interpret my attempts to support her as "controlling behaviour" or coercion...I am trying to recruit friends to do some of that work for me. Thanks for your reply, it is good to hear from people who have struggled and succeeded. I stopped drinking 6 years ago and I have just as good a social life as I did when I was drinking, better in fact, but you don't realise that you don't need alcohol until you have stopped drinking it.
If you have received medical advice that a sudden decrease in alcohol consumption is at best inadvisable I would follow that advice and jointly aim to slowly reduce consumption. If I understand your intentions correctly cutting down from 14 units a day to 2 units is a sudden decrease and is therefore inadvisable. So I suggest you forget the tag 'dry January' and agree a modest reduction with her starting 1 Jan, say one glass of wine or equivalent reduction every three or four days, and take it from there, with the aim of cutting down progressively over a two month period, perhaps by setting a target of being alcohol free by 1 March. You could also incentivise her efforts by putting aside the money you have jointly saved so that she can buy something she would not have otherwise had, which is what I did when I stopped smoking many years ago. You will certainly need to monitor her progress without it becoming burdensome and also be somewhat sympathetic to her needs since you are up against a dependancy, and you do not want that to create unnecessary barriers to her progress. I hope things go well for you both.
Thank you. I am glad that I asked the question here as the consensus is that cutting down to 2 units is far too quick. I had to quit oral steroids last year and there is a strict protocol on how to do it...I am guessing that alcohol reduction is a similar issue. Incentives are a good plan. I am hoping that she can enjoy some social occasions without alcohol. I think that the association between enjoying an occasion and drinking alcohol needs to be challenged. If she can enjoy an occasion without drinking then she will be likely to want to repeat the experience. I need friends on board to help with this plan. Wine isn't the issue, it is vodka, the alcoholics' classic go-to. It can be hidden in innocent looking soft drinks, takes up little space when hidden beneath the kitchen sink etc etc...
Good Morning Firstly I want to reassure you, your wife has Moderate heart failure. I had severe Heart Failure at 20%function but 3 months on medication I moved from severe to moderate 32% function.
Secondly I personally don't drink but have had close family members that were dependent on Alcohol. And your doctor is correct. Even without the heart issues you can't go cold turkey.
My suggestion would be to slowly reduce the intake. So for example days 1 reduce from 14 units to 13 units.
Then day 5 to reduce 13 to 12units. Then day 10 12 to 11.
Giving her body time to adjust and recover. Dependency is an horrible illness. And the body will fight the withdrawal.
But talking from Heart Failure perspective. I know when travelling 100 miles north and back on the same day I need a couple of days to recover. And the withdrawal will be exactly the same affect.
sounds like a good planning with your wife really wanting to remove alcohol…but thought lies in her other ailments not mentioned by others…her type 1 diabetes. I presume she is insulin dependent and has a Freestyle Libre or similar continuous blood glucose monitor …remember that as alcohol is removed something food/ drink often replaces it ‘as something to do’, so carb intake and timings likely to get very different. Perhaps worth asking your diabetic specialist team …I don’t drink very much so have no idea how alcohol or withdrawal effects BG, when peaks/ troughs likely to happen, though currently adjusting insulin dosing by 40% with new drug making a very unpredictable diabetic challenge!
Hi...yes, insulin dependent with a Freestyle Libre. But she is a very well-controlled diabetic with over 40 years experience. I am also very experienced in picking up the signs so I think we are fairly safe on that front. I am expecting there to be some challenges to the blood-sugar but it is probably nothing that we haven't dealt with before. She doesn't really use food as a "comforter".
Yes just common sense maybe dropping by 2 units per week with trial and error she has too be willing to do it, maybe if dine very gradually would not be such a withdrawal shock
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Worried and awaiting diagnosis
Medication and nausea 
Cold hands and feet
Dry January
