How to get help
DIY detox

It's possible to change problematic patterns of alcohol use without outside help. Even in the case of severe dependence, some people find their own way to a sober life. Unfortunately it's not possible to predict who is likely to succeed in giving up or cutting down. And there's certainly no single method that's been proved to work. But there are a few important common guidelines:

• Be clear about your goal
• Spend time in planning and preparation
• Don't give up at the first hurdle or lapse
• Know when and how to ask for help.

Define your goal
Make a list of the reasons why you want to change and the reasons why you don't. Trawl widely through your thoughts and experiences and don't censor anything. If you've been completely honest and the reasons for change don't outweigh the reasons not to, you may find it difficult to succeed. Keep a diary over a week, charting where you drink, when, with whom and the cost and the consequences. It can reveal problem areas and the possibilities of change.

Give it up – or cut down?
The goal of moderation is where a lot of people choose to start. Research shows that you can avoid more severe alcohol problems if you take steps early enough. If you opt for this, work out what moderation would mean in practice and what level of use would free you of your problems. Consult close friends, partners or members of your family too. Then set clear limits, per session, per day or per week as appropriate.

If you've tried to cut down several times and failed, you've had physical or mental-health problems to do with your alcohol use, or a doctor has advised you to stop, it may be best to give up altogether. It may also be time to consider asking for help.

Plan for success

• Think about who is likely to be supportive, and who you might have to avoid or be more assertive with. Is there someone who could act as a mentor?
• Think about alternative pleasures and activities that can help replace the drink.
• Think about the best time to stop or begin cutting down.
• Think about the best environment for giving up or cutting down. It should be safe. Some people find it helpful to take time out and be quiet; others want the stimulation and distraction of activities.

Weather the pain
If you're giving up completely, find out what withdrawal is likely to involve, physically and psychologically. The symptoms of withdrawal from severe dependence on alcohol are potentially disturbing and even life-threatening, such as having fits. If you don't want to consult your own GP, you could contact a local drugs agency. Remember though, withdrawal is a distinct phase that has an end.

Craving a drink is a normal part of giving up and there are 'tricks' for dealing with this. Techniques include a conscious decision to delay your response – 'I want a drink, but I'm not going to have one now' – or taking your mind off it by talking to a friend.

Lapse and relapse
The job isn't done once you've stopped – it's where the real action starts. Everyone knows the joke about the smoker who says giving up is easy: 'I've done it a hundred times!' Get to know your high-risk situations – the 'triggers' that make you likely to use again.

A moment of weakness is not necessarily a disaster. There's a subtle but important difference between a lapse and a full relapse. You can pull back from a lapse. But sometimes people use a lapse as an excuse for complete relapse: 'I've had one sip; I may as well drink the whole bottle.'

Ask for help
If you're interested in more self-help materials, the organisations listed here should be able to provide them. You can ask for them anonymously. There are also some very useful websites, including step-by-step programmes for moderating your use or stopping completely.