A patient on alcohol withdrawal who reports tactile hallucinations should be responded to by stating which of the following?

• A. You are hallucinating. There are no bugs on your skin.
• B. What you are experiencing must be very frightening, but I do not see any ants.
• C. You feel the ants because of excessive alcohol consumption.
• D. Be still and I'll brush the ants off.

Answer: (B)

During alcohol withdrawal, tactile hallucinations can be extremely distressing, so the best approach is to respond with empathy and validation rather than arguing about what the patient feels. A statement like this acknowledges the fear and the experience, while calmly noting you don’t perceive the same sensation. That combination helps build trust, reduces anxiety, and keeps the focus on the patient’s safety and well-being. It answers the patient’s fear without dismissing their reality, which is crucial when someone is feeling crawly sensations on the skin.

The other responses tend to be dismissive, explain the cause, or physically try to “fix” the hallucination, which can undermine safety and rapport. By validating the emotion and gently separating the perception from the clinician’s own observation, you support the patient and create space for continued assessment and care during withdrawal.