Statistics published by the World Health Organisation last year show that South Africans are some of the heaviest drinkers in the world…

With alcohol sales having been banned since the beginning of the lockdown many are running low on stocks, or have completely run out. For alcoholics, this may be a life-threatening situation.

Under Level 3, alcohol sales will be allowed again, but those who are battling addiction, may already be dealing with the serious physical and psychological consequences of alcoholism.

“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.

Range of symptoms of alcohol withdrawal

“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.

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“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.

South Africans are ‘heavy drinkers’

Dr Laurenson says that statistics published by the World Health Organisation 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.

“We should 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.”

Physical and mental dependence

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.”

How do you know when a person is suffering from alcohol withdrawal symptoms?

Dr Laurenson says that symptoms may include the following:

  • Anxiety
  • Fatigue
  • Insomnia
  • Irritability and mood swings
  • Delirium (confusion)
  • Seizures
  • Clammy skin
  • Dilated pupils
  • Tremor (shakes)
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