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Just another boozy night (Herald Sun, opinion)
30 June 2008
Sunday. 1.00am. A twenty-something year-old man stumbles into the emergency department, blood dripping from a gash above his right eye, his two mates attempting prop up his 100kg frame.
Sunday. 1.00am. A twenty-something year-old man stumbles into the emergency department, blood dripping from a gash above his right eye, his two mates attempting prop up his 100kg frame.
The triage nurse doesn’t need to ask if he’s been drinking; she is five metres away but can smell the alcohol on his breath and seeping out of his pores.
By the time I examine the young man thirty minutes later, he and his two friends have made sexual advances on the triage nurse, vomited on the waiting room floor and made numerous demands for morphine and pseudoephedrine.
His knuckles are scratched and bleeding and the gash above his eye is deep. It’s difficult to tell whether the man is suffering from concussion or whether he’s just feeling the effects of the alcohol.
To be sure I order some tests and the consultation takes twice as long and uses double the resources as it should.
I recommend an overnight stay for observation but, thinking he knows better, and wanting to return to the local nightclub to “get” the guy who punched him, the young man discharges himself.
As the clock strikes midnight on Friday, Saturday and Sunday, emergency departments around the country begin flooding with men and women who have been injured or harmed as a result of – directly or indirectly – excessive drinking.
Night after night doctors and nurses treat teenagers with alcohol poisoning, recipients of brutal beatings and stabbings, and worst of all, victims of road trauma accidents caused by drunk drivers.
We have all seen the photos of drunken violence on our streets in the front pages of our newspapers. But the violence doesn’t stop in the ambulance or on the way to the hospital.
Doctors and nurses in our emergency departments clean up the mess, cop the abuse from drunk patients and are tasked with breaking bad news to families caught up in the mess.
We push other patients needing treatment further and further down the emergency triage queue to treat injuries which could have been prevented. Extra pressure is put on already stretched beds and resources.
Of course binge drinking in not just an issue among teenagers and nightclub revellers.
I regularly see older patients with destroyed livers, stomach ulcerations and limited brain function resulting from prolonged alcohol abuse. Excessive drinking can lead to diabetes, overweight and liver damage.
In Australia, alcohol is estimated to contribute 5.3 per cent of the burden of disease for men – who are more likely to drink to risky levels – and 2.2 per cent for women.
The health costs are enormous to individuals, and also to the community. The last available figures are now ten years old, when the tangible social costs of alcohol consumption in Australia were estimated to be $5.5 billion in 1998-99. I’m sure it’s a lot more now.
The massive growth in emergency department presentations, the lack of beds in public hospitals, and the lack of capacity in the system have all been well documented.
Working in emergency departments today is a lot harder than a few years ago. In my emergency department, alcohol-affected patients take up a significant amount of time and resources. The stress and the unpleasant task of dealing with drunk patients is another pressure we just don’t need.
There is a place for alcohol in our community. It can help us unwind, it goes well with food, and it is served at the places we go for entertainment. But excessive alcohol consumption is major health problem.
The debates around the Federal Government’s alcopop tax and the State Government’s 2am lock-out trial have been useful in highlighting the some of these problems, but it will take more than a single measure to change binge drinking culture.
Emergency Departments are at the pointy end of the harm caused by alcohol. We are there to help, regardless of the state of the patient. We do not judge the individual, but I am concerned at a society where so many people are caused such harm through alcohol abuse.
Dr Stephen Parnis is an emergency physician and vice president of the Australian Medical Association Victoria.
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