The recent heartbreaking news regarding a man who suddenly stopped drinking alcohol, leading to severe health issues, confusion, and ultimately death, has shocked us all. I would like to express my deepest condolences to the family of the deceased.

This incident serves as a reminder of the importance of understanding individuals with mental health conditions or fragile psychological states. Caring for patients in this group requires knowledge, understanding, and utmost caution.

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Prolonged alcohol consumption followed by abrupt cessation can lead to a condition known as Delirium Tremens (DTs), or severe alcohol withdrawal symptoms. Patients may experience confusion, delusions, anxiety, or paranoia. Some may also develop physical symptoms like seizures or heart failure, which can be life-threatening if not properly managed.

For those with loved ones who drink regularly, if they wish to stop drinking, it is essential to consult with a doctor beforehand to plan for a safe cessation process. Proper care can significantly reduce the risks associated with withdrawal.

As a psychiatrist, I would like to guide everyone on how to handle patients exhibiting violent behaviors in situations like this to ensure the highest level of safety for both the patient and those around them.

1. Talk with Understanding

When faced with a patient exhibiting aggressive behavior, the first step is not to restrain or use force, but rather to talk. The medical team and staff will attempt to communicate with the patient using a calm tone and friendly demeanor, such as:

• Offering reassurance: "We're here to help you. No one is going to harm you."
• Asking about the cause: "Are you feeling stressed or worried about something right now? We're here to assist."

2. Physical Management
If talking does not reduce the aggressive behavior and the patient is likely to cause harm to themselves or others, physical management measures may need to be employed. The key principle here is to "do only what is necessary and as safely as possible."

• Removing the patient from triggers:
  The patient will be moved to a quiet and safe area, such as a separate room that does not contain any items that could be harmful. Reducing external stimuli, such as loud noises or bright lights, helps the patient calm down.
• Restraint to limit behavior:
  If the patient continues to exhibit aggressive behavior, such as harming themselves or others, restraint may be necessary. This could involve using restraints like cloth straps to limit movement of the arms and legs. However, restraints must only be applied by trained personnel. Training is crucial! The process must be gentle to avoid causing harm to the patient.
  
  

3. Use of Medication When Physical Control Is Insufficient
In some cases, if the patient remains aggressive even after physical management, the medical team may need to administer medication to help alleviate the severe symptoms. Commonly used medications include:

• Anxiolytics: Such as Diazepam to reduce anxiety.
• Antipsychotics: Such as Haloperidol to decrease restlessness and aggression.

• Physical restraint is a last resort: Every step must be carried out with great care and with full respect for the patient's rights.
• Safety comes first: Whether it's the patient, their family, or healthcare personnel, everyone must be in the safest possible environment.
• Continuous assessment: The patient must be monitored every 15–30 minutes for both physical conditions (e.g., posture, urination) and mental status (e.g., stress or anxiety).

4. Post-Incident Review for Improvement
After the incident, both the healthcare team and the patient should engage in a debrief to reflect on what happened:

• Team review: To improve care procedures and coordination.
• Conversation with the patient: To offer support and explain the reasons behind the care provided.

Managing patients with aggressive behavior is not just about ensuring safety — it also reflects respect for human dignity. Healthcare providers must not view patients as problems, but as individuals in distress who need help.

This incident has deeply affected me and many of the professionals who care for these patients. We must re-evaluate how we care for people with psychiatric conditions. These individuals are not threats — they are suffering, and they desperately need our support.