If you have an internet outage or DNS problems, the qmail's outbound queue will start to fill up. This is how to force it to process immediately.
/var/qmail/bin.qmail-qstat and/or qmail-qread to see that
there are actually messages in the queue.qmail-tcpokps axl and find the process id (PID) for qmail-sendkill -s ALRM pid