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Tuesday, February 21, 2012

ALCOHOL


Alcohol abuse, its effects on society as well as habitual drinkers, has become a major topic of discussion in the British Society, even as the opinion-makers struggle to find ways to cope with systematic abuse and binge drinking.

TIME FOR A NEW APPROACH TO ALCOHOL
NICK EDWARDS

As an Accident and Emergency doctor, I see at first hand the effects that our booze culture is having on our health. And it scares me: self-induced illness costing the NHS a fortune, putting millions of patient’s health at risk ….. and taking my time away from looking after other patients. Some days I just despair. Last week was one of them.

In the same shift three teenagers were brought in before 9 pm dangerously drunk – the all drank vast quantities of beeer/wine/vodka/odd-coloured – surgery-alcohol-pop, before going out and then collapsed at various places outside the clubs they were on route to.

Ambulances were called and they were brought to my care. One was so drunk we had to suction out the vomit from her mouth to stop her choking to death. Another girl wet herself and then proceeded to vomit on the floor and hurl abuse at the staff. The third was so unconscious we ended up having to take over their breathing and taking them for a CT scan of their head to check that they hadn’t had a head injury. Why on why does this happen so regularly?

Alcohol induced fights
       Later on that evening there had been a punch up outside a night club – alcohol induced. Involved were two patients. Injuries were one facial bone fracture, one neck laceration from biting, two broken hands and a ruptured liver from being kicked in the stomach.
      Between them, the patients had a total of four operations, over 10 days in hospital- four of which were in intensive care and had a total of three A&E doctors, six surgeons, four anesthetists, six intensive care doctors, seventeen nurses, twelve operating department practitioners, three physiotherapists, three pharmacists and an occupational therapist involved in their care. It becomes obvious why alcohol is so expensive for the NHS.ass

     But it is not just your typical binge drinker tha causes problems. Last week a 68 year old retired solicitor came in. His partner had called an ambulance after he fell down the stairs. He had had his usual daily alcohol; four pints of Stella and a couple’ of whisky chasers not to mention a ‘few’ glasses of claret. He fractured his neck and skull and nearly died from internal bleeding. He had to put him to sleep, take him for an emergency scan and then to theatre and then to intensive care. He will survive but it is unlikely he will walk again. His care will be reassuring expensive for the tax payer.

      Chronic alcohol use
Then there are the effects of chronic alcohol use. A 45 year old man came in as he felt so terrible – so terrible that he had n’t been able to drink for two days – a very worrying sign. He had been drinking dialy since he had married. He a drank a bottle of wine with his meal each night and then before bed, a glass or two of whisky. He worked as an office manager, had two children and was very typical friendly next door neighbour.
           But he had given himself alcoholic hepatitis. His liver couldn’t cope any more with this level of alcohol and had gone into “shut-down”. Unless he stops drinking it won’t be long before this is a permanent state, liver cirrhosis develops and then he could become another sad statistic.
           Sometimes at work, you just despair and wonder why it is happening. Of all the drugs there are alcohol is the most dangerous – in the short term and long term. It is also the drug which cuases the most problems and costs the most for the NHS.
            Drinking glamourised
But all that has happened in the last few years is binge drinking has been glamourised and alcohol has been become easier to get and cheaper.
            So, what can society do? We need to de-glambourise alcohol – celebrities have a role to play as we know the influence they have. But we all need to be more responsible : teaching our children sensible limits and drinking responsibility ourselves. How many people reading think it is ok to drink a bottle of wine at night?  As my patient showed it is dangerous and you need to cut-down. Learn how much is safe to drink and stick to it otherwise you could end up in a similar state.

But the government needs to act. Self regulation of the alcohol industry has failed. We need a coordinate approach, which doesn’t damage the pub trade or affect the millions of people who sensibly enjoy a few pints a week.
            
             The health of our populations is more important than the share prices of a few drinks companies and supermarket.

            Here is my manifesto:

             We need a minimum alcohol price; supermarkets should be banned from selling crazily cheap alcohol. Not only would it cut alcohol consumption, but would help pubs as people will be less inclined to drink at home.

            Change Culture

We should encourage European style café culture and not a let’s get as drunk as possible as quickly as possible. Pubs should be forced to have adequate seats and tables and not be “vertical drinking” establishment. Redesigning of pubs has been shown to cut down massively on excess drinking. 24-hour drinking has not really increased alcohol drinking in A&E, it has spread it out throughout the night. I would be happy for 24 hour drinking to continue if real changes were made to drinking culture.
           
            Curb Promotions

Promotions which encourage excess drinking should be banned – drink as much as you can for a tenner, buy one get one free shots etc.

We should have a tax which is reflective on how strong the alcohol is and how likely it is to be drunk by underage teenagers. Overall tax should be increased on alcohol as this has shown an overall decrease in demand. It may not be popular but a few extra pence a week for the majority of sensible drinkers would save thousand of precious lives a year.
Clubs and pubs should be fined much more if they sell under age people and drunken people. The extra taxes should be hypothecated and not enter into general taxation pot. They should pay for alcohol withdrawal programmes and extra A&E staff for evenings when the consequence of alcohol hit us.

Don’t glamourise drinking

Finally, adverts glamourising alcohol should be banned and there should be explicit labels how much alcohol there is in drinks shown on the front of drinks.
            If any from drink industry does not believe me, then please join me on Saturday night in A & E. You will go home in despair, as I do most  nights and you will be persuaded that something needs to be done.

                               The write is a doctor who wrote the book “ In stitches, the highs and lows of life as an A & E doctor.” --- The Independent.

Source: The Tribune, February 18, 2012.


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