Hospital Emergency Departments are often at the frontline when it comes to dealing with the harmful effects of alcohol. Although we lack precise details, it is estimated that up to 35% of ED and ambulance costs may be alcohol-related.
Predictably, this is especially acute at night: up to 70% of admissions between midnight and 5am at weekends are estimated to be alcohol-related. The burden placed on staff during these times is enormous, and not helped by the particular difficulties involved in dealing with patients who are drunk.
However, while ED staff are critical in dealing with the accidents and injuries that can occur after drinking, they also play a more complex role in addressing alcohol-related harms.
Two studies published today on our website highlight this in detail.
The third national survey of alcohol identification and intervention in Emergency Departments in England was carried out by researchers at the University of Surrey. The importance of delivering alcohol interventions in Emergency Departments has recently been highlighted by the Royal College of Emergency Medicine. This new study shows that while there remain variations in the form and level of delivery, the picture is promising. Despite the many challenges faced by ED staff, it appears that attention to alcohol and the provision of specialist support is increasing.
The report recommends continued improvement in training, better collaboration with primary care, and improved support for alcohol nurse specialists and ‘alcohol champions’.
Our second report serves as a reminder that many of those who present at ED for alcohol-related reasons are ‘frequent attenders’. These are people, usually drinking at very high levels, who appear at Emergency Departments regularly – sometimes multiple times in a single month. Clearly, this creates challenges for ED staff and resources. It also, however, provides an opportunity to refer individuals to the kind of services that may best help reduce their drinking.
The project team, based at King’s College London, worked closely with ED staff throughout and have produced materials to support their work. Their research increases our knowledge of an overlooked issue, but also provides practical support for staff and those accessing services.
Ideally, we would live in a world where alcohol use puts a far lower burden not only on individuals but also on ED staff than it does at present. Everyone needs to take responsibility for moving towards that goal. These projects show that, with the right training and – crucially – resources, Emergency Departments can do more than pick up the pieces when alcohol causes harm: rather, they can help prevent those harms from occurring through providing screening, advice, referral and support.
To do this effectively, however, requires greater recognition of these opportunities and more investment to develop them.