Hospitals feel strain of drunks who fight

EMERGENCY departments in Queensland public hospitals are being strained by hundreds of thousands of drunken and violent patients.
Almost one person a minute is thought to be attending the state’s emergency departments for alcohol-related reasons, but experts fear that could be a conservative estimate. Australasian College for Emergency Medicine chairman David Rosengren said studies showed alcohol was a factor in 25-30 per cent of presentations at emergency departments.
The latest figures produced by Queensland Health showed that 373,000 people presented at its emergency departments in three months.
“Alcohol is such an insidious undercurrent in a lot of other presentations,” Dr Rosengren said. “It can be one of three things – the cause of that presentation, someone intoxicated or on the receiving end of intoxication. The vast majority of what we see in an emergency departments from the violence of alcohol is people who have been in fights punched up.”
Dr Rosengren said the true extent of the problem was unknown because alcohol was not recorded in emergency data. “It’s a very big issue, but we can’t actually record that because there’s no system in place,” he said. So any figure that we’re going to see is going to be a gross underestimate of the actual true incidents of alcohol-related problems. All we can do is correlate from other data sets that exist but we work on specific studies that are published, which indicate 25-30 per cent of all ED presentations have alcohol as a factor in some manner – either the primary or secondary cause.”
Dr Rosengren, a staff specialist at Royal Brisbane Hospital, said Friday and Saturday nights were the busiest times for the hospital. “A hospital such as Royal Brisbane, which is close to the nightclub spots in the Fortitude Valley, just fills up,” he said.
Since October last year, RBH, Gold Coast and Cairns hospitals have been part of a Queensland Health trial targeting people presenting for alcohol and drug problems. Addiction Psychiatry director Mark Daglish said it saw up to 480 people a month and 80 per cent of those cases were because of alcohol.
“We know we’re missing a significant proportion because there are those ones who come in, particularly on a Friday and Saturday night, who have been discharged,” he said. “We reckon it’s usually about a third of all inpatients usually have drug and alcohol problems – so it’s big numbers. The common ones we see in the morning are losers of fights.”
Dr Daglish said three-quarters of people presenting in emergency for alcohol or drugs were males and almost all were under 45. “If you’re talking about alcohol and violence, you’re generally talking about men unless they’re taking it out on women,” he said.
“Alcohol and testosterone is a dangerous mix – it really is. On the Gold Coast, they’re seeing a younger population than we’re seeing, which would be in keeping with their demographic on the Gold Coast.”
Dr Daglish said people needed to be made more aware of the acute impacts of binge drinking, and recommended rolling the intervention program across all Queensland hospitals. “The impetus for the service came from this realisation that a lot of the problems from alcohol and drugs come from the early users who are often not yet dependent or not yet in treatment but are still causing themselves and other people a lot of damage,” he said.
“A lot of them were young and not in treatment, but one place they did go was the emergency department, usually on a Friday and Saturday night, usually intoxicated at the time, and there’s a fair few frequent attendees. If you intervene in their drug and alcohol use early, you can shorten the duration of their admission, which means they’re spending less time in the hospital and they’re in treatment towards their substance abuse as well as the trauma.
“Once they’re dependent, you need a lot more.”
Source 21st July 2009

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