Prevalence of alcohol withdrawal symptoms during the Vrischika month among Ayyappa devotees

Abstract Background Alcohol use disorder (AUD) is a critical and escalating global health issue. Alcohol withdrawal symptoms arise when habitual drinkers abruptly discontinue or reduce alcohol intake. Ayyappa devotees observe a fasting period from November to January, during which they strictly abstain from alcohol and other forms of indulgence. This religious commitment provides a unique opportunity to study alcohol withdrawal in a natural setting. Since symptoms may go unrecognised or underreported, understanding their prevalence can help raise awareness, guide early interventions, and promote health and well-being among devotees. Materials and methods Non-experimental observational study conducted over November to January with convenient sampling. 384 samples with Male Ayyappa devotees aged 18 years and above, Individuals with a history of regular alcohol consumption before Vrischika and Devotees who have abstained from alcohol during the fasting period were included. Alcohol withdrawal symptoms were assessed using the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-AR). Data was analysed using descriptive statistics, including frequency and percentage distribution, to determine the prevalence and severity of symptoms. Result Among 384 samples, the majority of participants experienced no clinically significant withdrawal symptoms during the abstinence period. Only a small proportion of participants reported mild withdrawal symptoms, most notably transient fingertip tremors observed in 0.8% of cases, which were clinically insignificant and did not result in functional impairment or require medical intervention. Other symptoms, such as anxiety and sleep disturbances, were infrequent and self-limiting. Importantly, no cases of moderate or severe alcohol withdrawal were identified. Conclusion These findings indicate that alcohol abstinence during the Vrischika month among Ayyappa devotees is generally well tolerated, with minimal and clinically insignificant withdrawal symptoms.