Bid to rid A&Es of drink scourge

DOCTORS have been given guidelines to help rid hospital wards and A&E departments of patients with alcohol problems.

The guidelines have been drawn up by Dr John Sheehan, consultant psychiatrist at the Mater Misericordiae Hospital in Dublin, who found that up to 40% of in-patients meet diagnostic criteria for alcohol misuse and dependency.

Almost one in four attending A&E are there either directly or indirectly as a result of alcohol.

Dr Sheehan has called for in-house alcohol counsellors to be installed in every hospital in the country and said unless alcohol abuse detection rates improve, such patients would continue to clog up the health service.

"At the moment, the detection [of a drink problem] rate is very low less than one in five.

For example, if a person comes in smelling of a drink and with a broken leg, the leg is looked at, but not the condition that might have contributed to the break," he said.

"We introduced an alcohol counsellor to the Mater to encourage the patient to talk about his use of alcohol. It led to a 300% increase in the numbers availing of existing alcohol services in-patient services, counselling and information leaflets.

It also lessened the chances of a return trip to hospital for those who spoke about their misuse of alcohol."

Dr Sheehan's study was confined to the Mater, but he said the findings are typical of what is happening in hospitals around the country.

It recognised the crucial position the attending doctor was in to intervene and produced a set of guidelines aimed at improving detection rates.

He said he would like to see alcohol counsellors in all general and teaching hospitals so those identified as having a drink problem could be offered immediate treatment.

Alcohol counsellors are currently based in the community. To place them in-house, Dr Sheehan said, would help cut back on current massive losses to the economy as a result of healthcare costs, absenteeism and disability costs.

It would also provide a safer environment for staff to work in.

"On Tuesday night this week, the gardaí had to be called after a drunk guy picked up a fridge and threw it at staff in the Mater.

Patients who come into A&E drunk are often aggressive and violent, not just towards staff, but other patients," Dr Sheehan said.

Health Minister Micheál Martin said the guidelines were timely.

"In 2001, Ireland ranked second after Luxembourg for alcohol consumption. We all know the adverse effects. They extend beyond the physical health issues to mental, social, emotional and financial," Mr Martin said.

Dr Sheehan said most of the increase in consumption is down to wine and spirits.

His guidelines will advise doctors on the questions to ask if they suspect a patient has a drink problem, the type of blood tests used to confirm alcohol damage, pharmacological approaches to reducing alcohol cravings and referral to an alcohol counsellor.