Taking Care of Yourself in the First Weeks of Sobriety

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Early sobriety is a challenging experience.   If we have been using substances regularly and we discontinue our use, our bodies and brains need to adjust to the substances not being in our systems any more.   Early sobriety can go pretty smoothly for some people.  Yet for many people, the first few weeks of sobriety are physically and mentally challenging.   We recommend that people in early sobriety take some basic steps to enhance their physical and mental well-being.

Prioritize nutrition, hydration, sleep, medical care and stress management.  These are the basic building blocks of well-being.    The challenges of recovery will be easier for us to work through, if we address these basic building blocks of well-being first.

CONSULT with a physician before implementing the following suggestions.  Medical conditions may impact what recommendations you should follow.

Basics for Everyone in the First Few Weeks

Withdrawal Can Be Life Threatening – Many people are physically uncomfortable in early sobriety.  However, for some people, withdrawal can be life threatening. Everyone in early sobriety needs to be aware of signs of medical emergencies during withdrawal.   Identify at least one person in your life who can be aware of the signs with you. Have this person stay with you or check in regularly in the first 10 days.  Keep in mind that withdrawal symptoms vary by substance and will depend on our underlying health and physical condition.

  • Alcohol and Benzodiazepines – Alcohol and benzodiazepines have potentially fatal withdrawal syndromes. Always get medical advice before discontinuing use on your own, particularly if you use regularly. Any person who previously experienced seizures or delirium tremens must obtain medical advice before discontinuing use.  Severe untreated withdrawal can result in death.
  • Combined Substances – If you use multiple substances regularly, your withdrawal process may be complicated. Ask for professional guidance right away before you stop using on your own.
  • Emergency Issues – No matter what substance you used CALL 911 immediately if you experience severe vomiting or diarrhea, prolonged tingling or numbness, uncontrollable agitation, severe muscle cramping, stroke symptoms, difficulty breathing, cardiac symptoms, fever, hallucination, seizures, thoughts of suicide, or significant confusion. Remember some withdrawal syndromes can be fatal if untreated.

Medical Advice –Outside of emergencies, understanding our health helps us to make healthy choices in recovery. We may be experiencing health issues that we did not know are a concern.  Or maybe, we are neglecting our health.  Your doctor can help you determine if you are experiencing health issues that relate to your use and that may impact your recovery.

  • Get a Physical – If you have not spoken with a medical doctor about your use, consider scheduling a physical. Share your use history accurately and honestly. If your doctor seems uncomfortable, ask to speak with a doctor who is familiar with substance use disorder or a medical doctor who specializing in substance use disorder.  Talking to your doctor about substances use can be frightening.  However, a medical doctor can make sure that you are in good physical condition or help you to address any health issues that can impact your recovery.
  • Follow Advice – In recovery, you want to position yourself to be as effective as possible. This means that coping with issues as they arise, rather than delaying or ignore them.  Your physical health is very important to sustaining your recovery.   If we are chronically tired, ill or in pain, we will find coping with our thoughts, emotions and experiences more challenging.  In addition, addressing health issues early can prevent complications or more complex health issues that could impact our ability to sustain our recovery.
  • Build Trust – Do you have a good working relationship with your doctor? If you don’t have a doctor, identify one and start to build a relationship.  If you speak with a medical doctor about your use of substances and you feel uncomfortable with that person, explore your thoughts and feelings.  Is your discomfort about disclosing your personal history?  Or, is your discomfort because you are being treated disrespectfully or dismissively?  Talking with anyone about use can be uncomfortable.  A good doctor will listen well to you.  If you explore your thoughts and feelings, you may realize that your discomfort is shame about sharing something deeply personal.  That’s understandable discomfort.  However, if you determine that the doctor is genuinely unhelpful or makes you uncomfortable with being honest, pay attention to those signals.  You can choose a different physician.  You can choose someone who listens to you, is empathetic, and reflects an accurate understanding of your health.

Nutrition – We recommend eating regularly.   Many people, whether they use substances or not, do not eat on a routine schedule in regular amounts.   We suggest that in early sobriety you eat something every four to six hours.  Keep in mind that your body and brain need nutrition throughout your waking hours to fuel your healing process.  Being well-fed can also help you manage cravings.  Sometimes when we experience a craving to use, we may be misreading signals that are actually telling us that we are tired, hungry or thirsty.   The goal is eat something, even a piece of fruit, on a regular basis.

  • Make it easy – If you’re ambitious and want to cook, that’s wonderful, enjoy the experience! If you aren’t feeling motivated to eat, think about options like smoothies and instant breakfast drinks.   Keep it simple and easy.
  • Be Prepared – Have options ready-to-eat. Good options can be small bags of fruits or vegetables or breakfast bars.  You can grab these options right out of the fridge or off the counter.  If you are out and about, have a couple of ready-to-eat options with you.
  • Prioritize It – If you tend to forget to eat, try setting an alarm.  We often have a lot on our minds in early sobriety. Prioritize eating before resolving conflicts or tackling major projects.  Generally, when we’re well fed, we’ll be better able to take care of the other issues that come up.
  • Be Aware of Triggers – Cooking, certain foods, events with food, and having meals out are often associated with our patterns of substance use. If this is true for you, think about changing things up.   Cook with people who care about you and can help you through urges.   Consider holding off on meals out, until you plan out how to address your cravings.  Think about avoiding places or events that are associated with your use.  Try different foods or eating in those settings that provide you with a feeling of confidence about your ability to cope and stay sober.
  • Vitamins and Minerals – Consider taking a basic multi-vitamin tablet every day. Your body may need to replace some nutrients.  Always follow packaging instructions. Do not take extra multi-vitamins to “catch up.” For some people, a bottle of vitamin water a day is a more pleasant option and can help them stay hydrated.
  • Eat Mindfully – When you eat, pay attention to the experience. What does the food look like, taste like and smell like?  Think about all the actions and motions of eating from picking up the food to swallowing the food.  Allowing yourself this focus is good practice for observing physical information from your body.  Mindful eating may help you slow down and appreciate your food more.  Observing your physical experiences can be very helpful for learning to notice and address urges and cravings to use.

Hydration – During early sobriety, stay hydrated.   For many of us, hydration was not a priority when we were using.  Hydration is very important to keep the body functioning well.  Water helps our body transport nutrients within our systems.  Water is also critical for our system to process wastes and toxins.  Water keeps your body and brain lubricated and functioning. These tips can help.

  • Pay Attention to Caffeine– Be aware of your intake of caffeinated beverages. If you are noticing that you need caffeine throughout the day, it may be a sign that sleep maintenance would be a good focus for you.  Caffeine is also dehydrating and can increase your physical sense of stress and anxiety.
  • Notice Sugar Cravings and Intake – Sugar cravings are a common experience in early recovery. Consider options that have healthier sugars and provide some additional nutrition, like fresh fruits.   Some sugar intake is normal.  However, maybe you notice that you are consuming a lot of sugary foods or drinks all day.  Rather than automatically reaching for soda or candy, have healthful options for hydration and food handy, try those options first.  You may notice that after some water and piece of fruit, the craving for sugar passes or is at a manageable level.
  • Carry a Water Bottle – Keep a water bottle with you at all times, refill it throughout the day. When you experience a craving try drinking a glass of water and then re-gauging the craving level.  Your craving level is likely to go down and feel more manageable.
  • Get an Adequate Amount – Men should drink around 13 cups of water (or non-alcoholic beverages) a day. Women should drink around 9 cups of water (or non-alcoholic beverages) a day.   Remember caffeine dehydrates, so you may need to drink some extra water if you use caffeine throughout the day.   Keep in mind that if you are vomiting or have bowel issues, you might need more fluids to replace what your body is losing.   Basically, you should not feel thirsty regularly. If your urine is a dark or odd color or you feel thirsty a lot, consult a doctor.  Anyone with kidney conditions should obtain and follow medical advice about hydration.

Sleep – Substance use can have significant impacts on our sleep cycle and sleep experience.   When we use substances, sometimes we do not sleep for long periods.  Or maybe, rather than sleeping, we are passing out.  Passing out and sleeping are not the same experience.    Some substances change the order, timing and length of our progression through sleep cycle.

In addition to the direct effect of the substances, we are often under a great deal of stress when we are using and in early recovery.  Stress impacts sleep quality.   Sleep is critical for our brain and body to function effectively.    Substance use and stress are very draining for our systems.  We need adequate rest to offset those impacts and sleep is critical for adequate rest.

  • Remember You Are Not Alone – Be aware that sleep is one of the most commonly impacted areas for people in early sobriety. Sometimes our sleep is impacted for months after we discontinue use.  Your body and brain are resetting and healing.  That can take time and the sleep disruption passes for most people.  If you still are not sleeping well after two months sober or you are sleeping too poorly to function well, consult a doctor.
  • Be Cautious With Sleep Aids – Many prescription sleep aids are habit forming. If you take prescription sleep medication, make sure your doctor is informed about your substance use history.   Over-the-counter medications and supplements can be helpful for some people.  Consider consulting with a doctor or counselor before using these aids to sleep.  Never use medication intended for a purpose in addition to sleep, just to sleep.  For example, “nighttime” cold medications can have habit-forming ingredients.  With any prescription, supplement or over-the counter medication, follow all instructions.  Don’t take more than recommended.   Don’t take these medications and supplements for longer than recommended.  Generally, these aids are not intended for use every night or for use regularly longer than two weeks.  If you still can’t sleep, it may be an indication of an issue that requires medical advice.
  • Dreams and Nightmares – Again, you are not alone if you notice more dreaming or experience nightmares. Many people experience more active dreaming in early recovery.  Using dreams are also common.  For most people, dreams get less intrusive with longer sobriety.   Some suggestions for addressing these dreams are:
    • If the dreams do not pass after a couple of months or are significantly impacting your ability to function, consider speaking with a medical professional like a medical doctor, a psychiatrist or a psychologist. Vivid scary dreams and nightmares can be associated with medical conditions like sleep apnea, adverse reactions to medications, or post-traumatic stress disorder, anxiety disorders and depressive disorders.
  • Sleep Hygiene – Most people can improve the quality of their sleep by creating a sleep hygiene routine. Here are some tips:
    • Establish a sleep schedule – Go to bed and get up at consistent times
    • Allow Adequate Time – Create and preserve a nine-hour block for sleep. Some people need a little more and some people need a little more. Protect this time from distractions and other priorities.
    • Reduce or manage caffeine Intake – Don’t use caffeine for 6 hours prior to sleep. Allow caffeine to process out of your system prior to your bedtime.
    • Eat Less Right Before Sleep – Some food in your system may help you sleep. If you eat a lot of food or certain types of food in the hours before you sleep, you may notice your sleep is affected.  Some people will notice dreams get more vivid.  Other people might notice that falling asleep or staying asleep is harder. Consider smaller portions with good nutritional value if you need to eat before you sleep.
    • Get comfortable – Get your bed and bedroom as comfortable and comforting as possible. Pay attention to noise and light.  Think about earplugs or soothing noise, if sound keeps you up.  Wear a sleep mask or put up light blocking shades, if light bothers you. Pick colors and fabrics that are comforting.  Replace your bed if you need to and can afford to address it.  Remember you spend a lot of your life sleeping, so investing in comfort is important.
    • Don’t Toss and Turn – If you’re not falling asleep within a half an hour, get up and do something simple and relaxing. When you feel drowsy, return to your bed.
    • Avoid screens – Screens emit light that can interfere with sleep. Also, we are often stimulated by what we are doing with screens.  Turn them off the hour before your scheduled sleep time.
    • Follow a routine – Develop a routine for the hour before your scheduled sleep time. The routine should move you towards sleep and be low impact.  Follow the same habit for undressing, pajamas, skin and dental care, etc.  This can start a habit for your brain and body to prepare for sleep.

Physical Activity – A little bit of physical activity can have a big impact.  Think about setting a basic goal around physical activity.  Aim to set some time aside to be active and to start getting your heart rate up for 15 minutes at a time.  You can start slowly and gently.  For example, your goal might be to walk briskly for 15 minutes one day in a week.  Physical activity can aid in sleep and help your body to process stress hormones.   Taking a walk can be a good way to address cravings, too.

Stress Management – Your body will be under physical stress in early sobriety.   Your body and brain are healing and adjusting to not having the substance present in your system.   In addition, many of us are experiencing significant stress with relationships, work life or legal issues.  Here are some tips:

  • Body Awareness – What does “stress” feel like in your body? Many of us will notice muscle tension, changes in breathing or increased heart rate.  When you notice your physical feeling of stress, use the feeling as a signal to engage in stress coping before your experience transitions to an urge to use.
  • Breathe! – When we are stressed, our breathing changes. We may not breathe deeply or we may feel like our body is taking over.   Deep breathing engages the relaxation response in your nervous system to address the stress.  Take some measured breaths in and out, start with a comfortable count of two when you inhale and then when you exhale.  You can increase that count as you get used to this type of breathing.  Try and engage your diaphragm, too.  Breathing from your diaphragm is less work for your body.  A simple way to engage your diaphragm is to breathe through your nose, rather than your mouth.  Another option is to lie on your back with your knees bent, use a pillow under your knees.  You will naturally breathe from your diaphragm.  With this breath work, we want balanced and controlled breathing.  We’re getting stress reduction benefits from both our inhalation and our exhalation of breath.
  • Identification, Prioritization and Boundaries – What people, places, things and experiences create stress for you? Identify your stressors first. Then, decide what needs to be addressed immediately.  Allow yourself to place boundaries between your well-being and stress triggers that do not require your attention right now.    Allow yourself to identify stressors that can be focused on later and those stressors that do not actually require you to intervene.   If someone in your life is pushing a boundary, consider explaining your limits and why the boundary is important.  Remember you can allow yourself to just say “no.”
  • Identify and Utilize Support – Early sobriety can feel isolating. We experience physical and emotional stress when we think we do not belong, that we are alone, that we are not understood or that we are disconnected.   The good news is that many opportunities for support are available.  Identify people in your life you can speak with openly and honestly.  Identify and enroll in professional services like counseling, treatment and therapy.  Identify and attend community events that do not involve alcohol, like religious services or a non-using book club.   Consider sober support groups.  Many free sober programs, in a variety of formats, are available.  You have choices available to obtain support.  Some sober support resources are:
    • Secular Organizations for Sobriety – Secular (non-religious) sober support groups
      • http://www.sossobriety.org/
    • Women for Sobriety – Sober support groups and online message board focused on emotional and spiritual growth for women in substance use recovery
      • http://www.womenforsobriety.org/beta2/
    • SMART Recovery – Self-empowerment focused substance use recovery groups, face-to-face and online meetings.
      • http://www.smartrecovery.org/
    • Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) – 12-Step Recovery support groups for people in substance use recovery, face-to-face and online meetings.
    • Recovery Coaching through Minnesota Recovery Connection – Free, individual recovery coaching with trained volunteers
    • Minnesota Recovery Connection’s Support Group List – A variety of support groups lists for many focuses including people in recovery, support for people with mental health diagnoses and for families of people in recovery.
      • http://www.minnesotarecovery.org/resources/Support_Groups.html

Disclaimer: All content on this website is for informational purposes only. It does not substitute for clinical treatment or advice. If you, a friend, or a family member is struggling with mental health and/or addiction issues please call our main office at 952-926-2526. For emergencies, go to your nearest emergency room and/or dial 911.