Jul 10 2004
Hospitals are being urged to address the alcohol problems that afflict up to 30 per cent of men and 15 per cent of women who attend as in-patients or in accident and emergency.
Dr Jane Marshall, consultant addiction psychiatrist at the South London and Maudsley NHS Trust, warned that people with alcohol problems had “significantly poorer experience of being treated” than those without a drinking problem. ‘It’s like I am a hologram: they come and stare at me and send medical students to feel my liver. But no-one ever helps me to tackle my problem,’ she quoted one hospital patient as saying.
Yet people with alcohol problems have a higher than average risk of a range of health problems, including neuropsychiatric disorders, accidents, suicide and assaults, as well as cancer and coronary heart disease.
A range of people could be helped by screening tests, which are being used successfully in several hospitals tackling the alcohol issue. Steering groups could be set up to champion alcohol treatments, and dedicated alcohol workers employed. We could also follow the example of the US and Australia in providing ‘drunk tanks’, where people could sober up and then be treated for psychological and physical problems.
As well as a noisy minority who turn up intoxicated at A&E at the weekend, there is a far larger group of ‘hazardous’ drinkers – 25 per cent of men and 10 per cent of women - who may not see themselves as having a drink problem but who will be damaged if their consumption level persists. “By identifying this group through screening, it is possible to provide help at an early stage,” Dr Marshall said.
But doctors find the issues difficult, Dr Andrew Hodgkiss, consultant in liaison psychiatry at St Thomas’s Hospital, warned. One London hospital, St Mary’s Hospital, Paddington, has routinely screened anyone who presents at A&E with head injuries, fits or falls for the last ten years. ‘But it has not been an easy process. It has required cohorts of young doctors to be strongly encouraged to carry out the screening – and has, as a result, been very successful.’