Getting Sober From Alcohol: How to Start and What to Expect

Getting sober from alcohol doesn't require a dramatic intervention. Practical options exist that fit into your life.

What You'll Discover:

• What "getting sober" actually means in practice.

• How to assess your current situation honestly.

• Physical considerations before stopping alcohol.

• The range of treatment options available.

• How medication makes getting sober easier.

• What to expect in the first days, weeks, and months.

• How to build support without traditional programs.

According to the National Institute on Alcohol Abuse and Alcoholism, approximately 29 million Americans had alcohol use disorder in 2022, but less than 10% received any treatment. Many people who want to get sober don't take the first step because they think it requires checking into rehab or committing to lifelong meetings.

Getting sober from alcohol can happen in many ways. Understanding your options helps you choose an approach that actually works for your situation.

What Getting Sober Actually Means

The first thing to know is that "getting sober" doesn't have a single definition. For some people, it means complete abstinence from alcohol forever. For others, it means gaining control over drinking and reducing to occasional, moderate use.

Medical professionals now use the term "alcohol use disorder" (AUD) rather than "alcoholism," and they recognize that recovery exists on a spectrum. The goal isn't necessarily lifelong abstinence for everyone. It's developing a healthier relationship with alcohol that doesn't interfere with your life.

This matters because believing you have to commit to never drinking again can be a barrier to getting started. Many people make significant progress by first reducing their drinking before deciding whether full abstinence is right for them.

Something to consider is that your goal may evolve as you go. Someone who starts by cutting back may later decide that complete abstinence is easier to maintain. Someone who initially aims for abstinence may find that they can eventually have an occasional drink without problems.

Assessing Your Situation

Before getting sober from alcohol, understanding where you're starting from helps determine the right approach.

Questions to consider:

• How much do you drink on a typical week?

• How long have you been drinking at this level?

• Have you experienced withdrawal symptoms when you stopped drinking?

• Has drinking caused problems in your relationships, work, health, or finances?

• Have you tried to cut back or quit before?

Your answers help determine whether you need medical supervision during withdrawal, what level of support makes sense, and which treatment options are appropriate.

So, how do you know if your drinking is severe enough to need medical help when stopping? The short answer is that if you drink heavily every day (6 or more drinks) and have done so for months or years, consulting a doctor before stopping is advisable. Withdrawal can be medically serious for heavy, long-term drinkers.

For a structured assessment, see our article on understanding alcohol use disorder.

Physical Considerations: Withdrawal

Alcohol withdrawal happens when your body has adapted to regular drinking and then alcohol is removed. Not everyone experiences significant withdrawal, but it's important to understand.

Who is at higher risk for serious withdrawal:

• Daily heavy drinkers (6+ drinks per day)

• People who have been drinking heavily for months or years

• People who have experienced withdrawal before

• People with certain medical conditions

Timeline of withdrawal symptoms:

• Hours 6 to 12 - Early symptoms begin: anxiety, shakiness, sweating, nausea

• Hours 12 to 24 - Symptoms intensify: increased heart rate, blood pressure elevation

• Hours 24 to 72 - Peak period: symptoms at their worst

• Days 4 to 7 - Most symptoms subside

For most people, withdrawal is uncomfortable but not dangerous. For heavy, long-term drinkers, medical supervision or medication may be needed.

If it seems like withdrawal is a significant hurdle, that's because it can be. But proper support makes it manageable, and the discomfort is temporary.

For detailed information on withdrawal timing, see our article on how long alcohol withdrawal lasts.

Treatment Options

Getting sober from alcohol doesn't have to mean 30-day rehab. Multiple options exist depending on your situation and preferences.

Self-directed with medical support - Working with a doctor or telehealth provider who prescribes medication and monitors your progress. This option allows you to continue working and living your normal life.

Telehealth programs - Complete medical evaluation, medication, and coaching entirely online. Appointments happen via video call at times convenient for you. This option provides professional support with maximum privacy and flexibility.

Outpatient counseling - Meeting with a therapist who specializes in alcohol issues, typically weekly. You learn to identify triggers, develop coping strategies, and address underlying issues.

Intensive outpatient programs (IOP) - Several hours of treatment per week (usually 9 to 12 hours across 3 to 4 days) while living at home. This provides more structure than individual therapy without requiring residential treatment.

Residential treatment - Inpatient rehab with 24-hour care in a structured environment. This is typically reserved for severe AUD, people who need medically supervised detox, or those who haven't succeeded with less intensive options.

Support groups - AA and its 12-step approach, or alternatives like SMART Recovery that use cognitive-behavioral techniques. These can supplement other treatment or serve as the primary support for some people.

For that reason, many people start with less intensive options and adjust if needed. There's no requirement to go to rehab before trying medication or counseling.

How Medication Helps

Medication can significantly improve your chances of successfully getting sober from alcohol. Naltrexone is an FDA-approved option that reduces cravings and the rewarding effects of drinking.

So, how does naltrexone work? The medication blocks opioid receptors in the brain. When these receptors are blocked, drinking doesn't produce the same pleasurable "buzz." Over time, the association between alcohol and reward weakens, and cravings naturally decrease.

Benefits of using naltrexone:

• Reduces the intensity of cravings from day one

• Makes drinking less appealing if you do drink

• Doesn't require complete abstinence to be effective

• Can be taken as a daily 50mg tablet

• Works for both reducing drinking and achieving abstinence

Research shows that people taking naltrexone have significantly fewer heavy drinking days compared to those relying on willpower alone. Many people report that alcohol simply becomes "less interesting" after taking naltrexone consistently.

The medication works best when combined with some form of behavioral support, whether coaching, therapy, or a support group.

Our article on how naltrexone helps you regain control explains the medication in more detail.

Building Support Without Traditional Programs

If traditional 12-step programs don't appeal to you, other options for support exist.

Telehealth coaching - Regular check-ins with a coach who provides accountability and practical guidance. These sessions happen via video call and focus on your specific challenges.

SMART Recovery - A science-based alternative to AA that uses cognitive-behavioral techniques. Meetings are available both in-person and online. There's no requirement to accept powerlessness or believe in a higher power.

Individual therapy - Working one-on-one with a therapist allows you to address personal factors contributing to your drinking. This can happen via telehealth or in person.

Online communities - Forums and groups for people working on their drinking provide peer support and can be accessed anonymously.

Trusted friend or family member - Having someone who knows about your goal and can provide encouragement helps maintain accountability.

All that said, some people do well with AA or traditional programs. The key is finding an approach that fits your values and lifestyle.

What to Expect in Early Sobriety

Having realistic expectations about the process helps you prepare for getting sober from alcohol.

Days 1 to 3 - If you've been drinking heavily, withdrawal symptoms may begin within 6 to 12 hours. These typically peak around 24 to 72 hours. Cravings can be strong during this period.

Week 1 - Physical withdrawal symptoms typically subside by the end of the first week. Sleep may still be disrupted. Energy levels fluctuate.

Weeks 2 to 4 - Sleep improves. Mental clarity increases. Mood becomes more stable. Many people start feeling genuine physical benefits.

Months 2 to 3 - Cravings typically become less frequent and intense. New routines develop. The mental space that alcohol used to occupy becomes available for other things.

Beyond 3 months - The NIAAA considers this early remission. Risk of relapse decreases significantly. Your brain has substantially rewired itself away from the drinking patterns.

If it seems like the first few weeks are the hardest, that's because they typically are. The difficulty is front-loaded, and it gets easier with time.

Taking the First Step

Getting sober from alcohol is a process, not a single moment. The options available today are more accessible and varied than ever, from telehealth programs you can access from home to medications that reduce cravings.

The next step doesn't have to be dramatic. It can be as simple as taking an assessment to understand your situation better.

Take the online Alcohol Use Assessment to learn more about your drinking patterns and see if naltrexone could help you get sober.