Tipplers in city feeling the pinch

After lockdown, psychiatrists see more persons with withdrawal symptoms

08/04/2020, SERENA JOSEPHINE M.,CHENNAI

Difficult times: The sudden closure of TASMAC outlets has prompted the District Mental Health Programme to issue guidelines for doctors to treat addicts. B. Jothi Ramalingam

Five days after Tamil Nadu declared a lockdown on March 24, psychiatrists started to see persons walking into hospitals and de-addiction centres, with alcohol withdrawal symptoms.

The sudden closure of TASMAC outlets across the State prompted the District Mental Health Programme to issue guidelines for doctors to assess and treat persons who are addicted to alcohol and who seek help for withdrawal symptoms. Now, there is a steady flow of persons with withdrawal symptoms.

At the Institute of Mental Health (IMH), the outpatient department has been seeing a minimum of three new patients with withdrawal symptoms every day.

“We usually get patients with withdrawal symptoms. Now, the number of patients is more despite lack of public transportation. They come in with complaints of tremors, headaches, restlessness, nausea and vomiting. Many of them have moderate and severe withdrawal symptoms,” a doctor said.

Lakshmi Vijayakumar, a psychiatrist who has been managing the de-addiction centre at Voluntary Health Services, said, “We are seeing quite a number of people with withdrawal issues. There are persons who have experienced seizures and psychological symptoms such as visual and auditory hallucinations. There are persons with underlying psychological disorders with alcohol use disorder (AUD). Co-morbidity is common in AUD. Some have mood disorders. We are seeing a high number of such patients too.” In addition, they were receiving cases of domestic violence associated with withdrawal symptoms, she said.

Most of the patients, she said, are from the low and lower-middle sections of the society.

“Initially, those with withdrawal symptoms require medical treatment. Some will experience tremors, difficulty in eating that could last for four to five days. They will also experience an inability to sleep and will feel the need to seek medical help. We need to provide hydration. They will need IV fluids and sedatives. Those absolutely addicted to alcohol — AUD — require detoxification for the first three to four days, which can be followed by counselling,” she said.

R. Thara, vice-chairman of Schizophrenia Research Foundation, said they have had family members of persons experiencing withdrawal symptoms approaching them with queries. “There are persons with symptoms ranging from mild to severe. In fact, there is an economic dimension too, as they are trying to buy alcohol sold at exorbitant prices in the black market. This has led to an economic drain in the families. In future, these aspects should be taken into account and closure should be in a staggered manner,” she said.

IMH doctors said many persons were unaware that treatment was available for withdrawal symptoms. “We are also informing their family members that care should be taken to ensure there is no alcohol relapse after the lockdown is lifted,” a doctor said.