Environment and Support

Patients attempting alcohol withdrawal should be in an environment that is quiet, non-stimulating, and non-threatening, and where alcohol and other drugs are not readily available. Hospital admission is indicated for delirium or where withdrawal cannot be managed safely otherwise. A range of strategies should be used to reduce anxiety, and these are particularly important for those experiencing withdrawal delirium or hallucinations. Such strategies should include: 

• • • employing a slow, steady, non-threatening approach 

    • explaining all interventions clearly 

    • speaking slowly and distinctly in a friendly manner 

    • maintaining eye contact when speaking 

    • avoiding confrontation and arguments 

    • testing the patient’s reality-base and orientation repeatedly and, if necessary, re-acquainting the patient with their environment 

    • explaining to the patient that the unreal nature of illusions and hallucinations may cause anxiety and are likely to be part of the alcohol withdrawal syndrome 

    • recommending a night light to reduce the likelihood of perceptual errors and exacerbation of anxiety and psychotic phenomena during the night.