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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment and referral online, in a confidential video conversation; detox and withdrawal always need supervised in-person care, and withdrawal medicines are never prescribed online.
- What it is: alcohol or drug use that continues despite harm to health, work, relationships or safety; dependence adds tolerance (needing more), withdrawal when stopping, and failed attempts to cut down.
- The dependable signs: they concern the relationship with the substance, not the amount: needing more for the same effect, morning use, failed cutbacks, hiding use, and withdrawal symptoms such as shaking, sweating or anxiety when stopping.
- Stopping suddenly: after heavy daily drinking or regular benzodiazepine use, abrupt stopping can cause seizures and delirium tremens within 6 to 72 hours and can be life-threatening; stopping safely needs medical supervision.
- Outlook: most people who complete treatment reduce or stop their use, and recovery is common; relapse is part of the process for many and is treated, not punished.
- Emergency: if someone may have overdosed, is unrousable, fitting or breathing slowly, call 112 now.
Two things cannot wait for any appointment. If someone may have overdosed, call 112 now. And if you drink heavily every day or take benzodiazepines regularly, do not stop suddenly: withdrawal from alcohol or benzodiazepines can cause seizures and can be life-threatening, and stopping safely needs medical supervision. Booking while still using is not a failure; it is exactly the right order.
When to get in-person care
Call 112 immediately if someone cannot be woken, has slow, irregular or stopped breathing, blue or grey lips, gurgling or snoring sounds, or a seizure: these are overdose signs, and staying with the person saves lives. If an opioid overdose is possible and naloxone is available, use it and still call 112. Call 112 too for chest pain or overheating after stimulant use, and for anyone who develops shaking, confusion, hallucinations or a seizure after stopping or cutting down alcohol or benzodiazepines; untreated alcohol withdrawal can progress to delirium tremens, which is a medical emergency.[2]
If you are having thoughts of harming yourself, call 112 in an emergency. You can also find your national crisis helpline at findahelpline.com. You do not have to wait for an appointment.
Can an online doctor treat substance abuse?
An online doctor can assess substance abuse and get you to the right treatment, and that first step matters more than it sounds. In a confidential video consultation, the doctor maps your use, checks the risks that need urgent attention, and refers you into local addiction services.[1] No detox or withdrawal medication is ever prescribed online, because stopping some substances without supervision can be dangerous.
How an online consultation helps with substance abuse
- A confidential first conversation: Said from your own home, to a doctor bound by medical confidentiality, with no waiting room and nobody to run into. For many people this is the first time the words are said out loud, and that is exactly what the appointment is for.
- An honest safety assessment: Which risks in your situation are urgent, which can be planned around, and, crucially, whether stopping suddenly would be dangerous for you. You leave knowing what must not be done as clearly as what should be.
- A map of the system: Addiction services, supervised detox, substitution programmes and peer support exist in every EU country, but finding the door is hard. The doctor names your local options and writes the referral.
- The rest of you, treated: Anxiety, depression and wrecked sleep usually travel with substance abuse, in both directions. The doctor treats what can safely be treated online and coordinates the rest.
How do I know if my drinking or drug use is a problem?
The dependable signs are about the relationship, not the amount: needing more for the same effect, using earlier in the day or to feel normal, failed attempts to cut down, use continuing despite consequences at work or home, hiding or minimising it, and withdrawal symptoms, shakiness, sweating, anxiety or nausea, when you stop.[3] Two or three of these, present for months, deserve a conversation.
A gentler test also works: if you have ever set yourself rules about your use, weekdays only, never before six, never alone, the rules themselves are information, because people without a problem rarely need legislation. None of this makes you weak or bad. Dependence is a recognised medical condition in which the brain’s reward and stress systems adapt to a substance until stopping feels like an emergency; willpower is involved, but so is neurochemistry, which is why medical treatment and structured support outperform white knuckles.[3][5] Doctors who work in this territory are not waiting to judge you. They are waiting to help, and the earlier the conversation, the more options are still easy.
Why stopping suddenly can be dangerous
This is the most important section on this page. With alcohol and with benzodiazepines, a body that has adapted to daily use treats sudden absence as an emergency: withdrawal can escalate from shakes and sweats to seizures, and in alcohol withdrawal to delirium tremens, a state of confusion, hallucinations and cardiovascular instability that can be fatal without treatment.[2] That is why heavy daily drinkers and regular benzodiazepine users should never stop abruptly, on their own, because a page like this one, or a worried relative, urged them to. Stopping safely means a medically supervised reduction: for alcohol, a planned detox with monitoring and medication, sometimes at home under a specialist team, sometimes inpatient; for benzodiazepines, a gradual taper designed by a prescriber who can see you regularly.[1] Opioids sit differently: withdrawal is rarely life-threatening in itself, but going it alone carries its own lethal trap, because tolerance falls within days, and a relapse at the old dose is how overdose deaths happen after abstinence.[4] Stimulant withdrawal brings a crash of exhaustion and low mood in which people need support and safety, not solitude. All of this is manageable, and managed every day, by services built for it. The single message to keep: wanting to stop is right; stopping unsupervised, for alcohol and benzodiazepines, is the one shortcut that can kill.
What does harm reduction mean, starting today?
Harm reduction means cutting the risks of use while you decide about treatment, and it starts before your first appointment. It is not permission and it is not surrender; it keeps you alive and well enough to recover.[4]
- Never mix depressants: alcohol, benzodiazepines and opioids multiply each other’s effect on breathing; the combination is behind a large share of overdose deaths.
- Never use alone if you use opioids or unknown substances, and stagger use with the person you are with; someone must be able to call 112.
- Know about naloxone: it temporarily reverses opioid overdose, is carried by many services and pharmacies in EU countries, and using it is always paired with calling 112.
- Respect lost tolerance: after any break, days count, the old dose can be an overdose. This is the most preventable death in the field.
- Assume nothing about street supplies: contents and strength vary batch to batch, and drug-checking services exist in some European cities.
- Do not share equipment, and use local needle and syringe programmes, which are anonymous and free in most EU countries.
- Protect the basics: eat, drink water, sleep somewhere safe, and never drive or work at height while using or withdrawing.
- For drinking: count honestly, slow the pace, alternate with water, keep two or three alcohol-free days if you are not dependent, and if you are dependent, reduce only with medical guidance rather than stopping dead.
Which first step might the doctor recommend?
The first step follows the substance and the safety picture. This is the decision framework the doctors use, aligned with European and UK guidance:[1][2]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Use creeping up, no daily pattern, no withdrawal symptoms | Confidential assessment, honest feedback and a cutting-down plan with review | Usually yes | If cutting down fails or use escalates, structured support is arranged |
| Daily heavy drinking with morning shakes or relief drinking | Referral for medically supervised detox; do not stop suddenly meanwhile | Assessment and referral only | Always: unsupervised alcohol withdrawal can cause seizures and delirium tremens |
| Regular benzodiazepine use, prescribed or not | Referral for a supervised gradual taper with a local prescriber | Assessment and referral only | Always: abrupt benzodiazepine withdrawal can be dangerous, and tapers need in-person oversight |
| Opioid use, dependent or escalating | Referral to specialist substitution treatment; naloxone and overdose planning today | Assessment, signposting and harm reduction | Substitution medicines are initiated and monitored by specialist services in person |
| Overdose signs, withdrawal seizures, confusion or hallucinations | Emergency care now | No | Call 112 immediately; these are medical emergencies |
Not sure which row is you? A doctor can tell you in one consultation.
See available times →What the doctor checks in an online substance abuse consultation
You can say as much or as little as you are ready to, and honesty is met with practicality, not a lecture. The consultation is confidential, like all medical care. The doctor will typically check:
- What, how much, how often: substances, amounts, pattern and route, asked matter-of-factly, because the answers set the safety plan, not a verdict.
- Dependence markers: morning use, relief use, tolerance, failed cutbacks and withdrawal symptoms, which decide whether stopping needs supervision.
- Immediate safety: overdose risk, mixing of depressants, driving, work at height or with machinery, and who is at home, including children who may need things to be safer.
- Physical health: liver symptoms, injuries, infections, sleep and appetite, with local blood tests arranged where they will change decisions.
- Mental health: depression, anxiety and any thoughts of self-harm, asked plainly, because substance abuse and mood illness feed each other and both deserve treatment.
- Your goal, on your terms: stopping, cutting down, or just understanding the situation are all legitimate starting points, and the plan is built to yours, not to an ideal patient’s.
You leave with an honest risk picture, a named local pathway with the referral made, harm-reduction steps for the meantime, and a doctor who expects to see you again rather than a leaflet and good luck.
Treatment options for substance abuse
What you can do yourself, safely
Start with the harm-reduction list above; it is the self-help that keeps people alive. Add three quiet moves. Track your real use for two weeks without editing, because the honest number is the foundation every plan is built on. Tell one person you trust; secrecy is the condition’s best friend, and one ally halves its power. And look up your national helpline at findahelpline.com, which lists substance-use as well as crisis lines, so support exists at 3 a.m. and not only at appointment times. If you are not dependent, structured cutting down, counted drinks, alcohol-free days, money moved visibly to something you want more, genuinely works, and a booked review adds the accountability that private resolutions lack. What you must not do alone has been said, and is worth repeating once: if your body has adapted to daily alcohol or benzodiazepines, reduction is a medical procedure, not a willpower project. Do it with supervision.
Treatment through specialist services
Real treatment exists in every EU country, and it works better than most people fear. Supervised detox manages alcohol withdrawal safely with monitoring and short-term medication, inpatient where risk is higher.[2] Opioid substitution treatment with methadone or buprenorphine, initiated and monitored by specialist services in person, cuts overdose deaths and steadies life around treatment.[4] Relapse-prevention medicines for alcohol dependence, such as acamprosate or naltrexone, have decent evidence and are usually started within specialist or supervised care.[1] Around the medicines sit the things that carry recovery: structured psychological therapies, community addiction teams, peer groups from twelve-step to SMART Recovery, and support for families in their own right.[5] To be unmissable about the online part: benzodiazepines, opioids and other controlled medicines are never prescribed online, and neither is detox or withdrawal medication. The doctors assess, refer into these services, treat the anxiety, depression and sleep problems that can safely be managed remotely, and stay alongside you between specialist appointments. A prescription is never issued without a consultation, and in this field, the honest prescription is very often a referral.
When substance abuse is assessed online, and when you need in-person care
Assessed online: the confidential first conversation, whenever you are ready for it; honest assessment of your use and its risks; harm-reduction planning you can start today; referral into local addiction services with the paperwork done; treatment of anxiety, low mood and sleep problems alongside, where that is safe; support while you wait for specialist appointments; and conversations with worried partners and family members about how to help without fuelling the fire.
In-person care: all detox and withdrawal management goes to supervised local care, alcohol and benzodiazepine withdrawal because it can be dangerous, opioid substitution because it is rightly a specialist, in-person treatment; overdose signs, withdrawal seizures, confusion or hallucinations go to 112 now; medical complications such as jaundice, vomiting blood, injuries or infections go to in-person assessment promptly; and thoughts of harming yourself go to crisis support today via 112 or findahelpline.com. If low mood or anxiety is the engine underneath the use, the depression and anxiety pages cover that treatment, and it can start at the same consultation.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about substance abuse: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with an honest risk picture, a named local pathway and a booked review: anything prescribed follows the consultation, and never for detox online. If your doctor decides you need to be seen in person, you get a full refund.
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Frequently asked questions about substance abuse
What is substance abuse?
Substance abuse is a pattern of using alcohol or drugs that continues despite the harm it causes: to health, work, relationships, money or safety. It sits on a spectrum from risky use to dependence, where the body adapts so that more is needed for the same effect and stopping brings withdrawal. It is a treatable medical condition, not a moral failing.
How do I know if my drinking or drug use is a problem?
The dependable signs of substance abuse concern the relationship with the substance rather than the amount: needing more for the same effect, using in the morning or to get through the day, failed attempts to cut down, hiding or minimising use, giving up things you valued, and shaking, sweating or anxiety when you stop. If the people around you have noticed, that counts too.
What causes substance abuse and addiction?
Substance abuse develops from a mix of genes (addiction runs in families), early or heavy exposure, stress, trauma, untreated depression, anxiety or ADHD, chronic pain, and an environment where use is normal or easy. The substance then changes the brain's reward and stress systems so that use becomes compulsive, which is why willpower alone so often fails and treatment works.
Why is stopping suddenly dangerous?
Stopping alcohol or benzodiazepines suddenly after heavy daily use can cause seizures and, with alcohol, delirium tremens, a confused, agitated state with a racing heart and hallucinations that can be fatal. Withdrawal starts within hours and peaks over one to three days. Substance abuse involving opioids brings miserable but rarely dangerous withdrawal, and relapse after a break carries a high overdose risk. All of these need medical supervision.
How do I stop drinking safely?
If you drink heavily every day, or get shaky, sweaty or anxious when you stop, do not stop suddenly: sudden withdrawal can cause seizures and delirium tremens. Keep drinking at your usual level, book a substance abuse assessment, and let the doctor arrange a supervised detox, in a clinic or through a specialist community team. Booking while still drinking is the right order, not a failure.
Can an online doctor prescribe detox or withdrawal medication?
No, never: withdrawal from alcohol and benzodiazepines can be dangerous and needs supervised care, opioid substitution treatment is initiated by specialist services in person, and controlled medicines are never prescribed through online consultations. Any online service offering home detox medication for substance abuse should be avoided.
How is substance abuse treated?
Substance abuse is treated in steps: an honest assessment, a safe plan for stopping or cutting down (supervised detox where withdrawal could be dangerous), talking therapies such as CBT and motivational work, medicines that reduce craving or relapse for alcohol and opioids started by specialist services, treatment of the depression or anxiety underneath, and ongoing support through community teams or peer groups. The online doctor assesses, refers and follows up.
How long does withdrawal last, and what does recovery look like?
Alcohol withdrawal peaks within one to three days and settles within a week, though sleep and anxiety can take weeks; opioid withdrawal peaks around days two to three and eases over a week. Recovery from substance abuse is measured in months: cravings fade over the first weeks, mood and sleep repair over months, and most people who complete treatment reduce or stop their use. Relapse is common and is treated as part of the process.
Is a substance abuse consultation confidential?
Yes, a substance abuse consultation is confidential. It is a medical consultation, covered by medical confidentiality and GDPR-aligned data handling, held by video from wherever you choose. Nothing is shared with your employer or family. Like any doctor, the doctor must act only where someone is at serious and immediate risk, and would discuss that with you first wherever possible.
Do I have to be an addict for this appointment to be for me?
No, and you never have to use that word. Worried about the direction of travel, failed cutbacks, a pattern your partner has noticed: all of it is enough reason to talk about substance abuse. Earlier conversations mean easier options, and plenty of people come simply to find out whether their use is a problem.
What can I do myself while waiting for specialist care?
While specialist care for substance abuse is arranged: never stop alcohol or benzodiazepines abruptly after heavy use; never use alone, and never mix alcohol with opioids or sedatives; keep naloxone nearby if opioids are involved; eat and drink regularly; tell one person; and keep the follow-up appointment with the doctor, who watches your safety and mood while the referral progresses.
Where do I find addiction services in my country?
Every European country runs addiction services, from community teams to supervised detox and substitution programmes, but the doors have different names in different places. The doctor identifies your local pathway for substance abuse during the consultation and makes the referral. For out-of-hours support, national helplines are listed at findahelpline.com.
Can you help me with someone else's drinking or drug use?
Yes: partners and family members book consultations about someone else's substance abuse in their own right: to understand what is and is not dangerous, to learn what helps rather than enables, to plan a realistic conversation, and to look after their own sleep and mood, which the situation erodes.
- Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (CG115), NICE, National Institute for Health and Care Excellence, 2011.
- Alcohol-use disorders: diagnosis and management of physical complications (CG100), NICE, National Institute for Health and Care Excellence, 2010 (updated 2017).
- Alcohol: fact sheet, WHO, World Health Organization, 2024.
- Opioid overdose: fact sheet, WHO, World Health Organization, 2023.
- Drug misuse in over 16s: psychosocial interventions (CG51), NICE, National Institute for Health and Care Excellence, 2007.
- Alcohol-use disorder, NHS, National Health Service (UK), accessed October 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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