“There is little doubt that the ban on alcohol has brought with it a number of benefits to our society including a reduction in violence and trauma as a result of accidents caused by intoxication,” says Dr Duncan Laurenson, a general medical practitioner and substance use disorder specialist, who manages the detoxification programme at Akeso Stepping Stones and Kenilworth in Cape Town. 

The ban on alcohol sales could potentially have a darker side, however, in that sudden alcohol withdrawal in a heavily addicted person may cause a range of symptoms that can vary from being physically and psychologically uncomfortable to life-threatening. Mild symptoms include mood swings, irritability, anxiety, fatigue, and insomnia, which in some individuals may last for weeks and even months. 

“Of even greater concern is that severe withdrawal in some at-risk people with a history of continuous heavy drinking, particularly the elderly, can result in high fevers, confusion [delirium], hallucinations, tremors and coma (delirium tremens), as well as seizures, heart attack or stroke if they are compelled to suddenly stop consuming alcohol,” adds Dr Laurenson.

Dr Laurenson says that statistics published by the World Health Organization last year show that South Africans are some of the heaviest drinkers in the world. 

“It may surprise many people to learn that in the high-risk individual, alcohol withdrawal is more dangerous than any other type of drug withdrawal,” says Dr Laurenson.

“So, while the ban on the sale of alcohol brings with it many benefits for society, we should also be mindful of, and closely monitor, those who have a history of heavy drinking and who may no longer have access to alcohol. This is particularly important if the individual has had a long history of heavy drinking, is over the age of 50, and has also had a previous history of seizures, heart attack or stroke, as they are at particularly high risk of suffering serious, and even potentially fatal, withdrawal symptoms.”

He explains that persons who regularly use alcohol can become physically and mentally dependent on them to the extent that when they are no longer able to have them, they experience a surge of adrenaline and cravings. This, in turn, creates a distressing series of withdrawal symptoms known as “withdrawal syndrome”. The severity of the withdrawal can range from mild and uncomfortable to chronic and life-threatening, depending on the person’s age, physical and psychological characteristics, duration of use and the type of drug.

“Delirium tremens symptoms, also known as the DTs, are a potentially dangerous expression of alcohol withdrawal symptoms. The DTs describe a state of confusion that produces hallucinations and delusions, which generally occur within 24 – 72 hours after stopping alcohol consumption, but they can appear more than a week after the last drink. It should be noted that the mortality rate among those with DTs is in the region of 5-10% if not treated.”

So what should you watch out for and what can you do if you have a family member or loved one who is going into alcohol withdrawal at this time? Dr Laurenson says that if you witness a person who has a history of heavy drinking start to shudder and shake, become delirious and/or suffer a seizure, they may have a serious alcohol withdrawal problem that requires urgent treatment at a hospital or mental health facility.

“If you have concerns about a loved one who is suffering alcohol or drug withdrawal, you can call a rehabilitation facility, or an addiction unit such as we have here at Akeso Stepping Stones and at other Akeso mental health facilities, for advice on how to handle the situation. 

“If the individual concerned is suffering from delirium or has a seizure, however, you should call an emergency medical services provider so that they can receive medical treatment urgently. However, anyone who is concerned that they may have an alcohol addiction problem should consider treatment, as alcohol use can have serious long-term physical and mental health implications,” concludes Dr Laurenson.

Dr Duncan Laurenson, a medical practitioner and substance use disorder specialist, who manages the detoxification programme at Akeso Stepping Stones in Cape Town, says that symptoms may include the following:

Akeso is a group of private in-patient mental health facilities, and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and addictive conditions. Please visit www.akeso.co.za or email info@akeso.co.za for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.