Another Australia Day has come and gone, and I was staggered to hear that around 15% of all people seeking treatment at Emergency Departments (ED’s) that day was for alcohol-related issues. Just think about that statistic for a moment, of all the possible reasons why people would seek help from a hospital’s ED, alcohol related issues account for one in seven people. I don’t know about you, but that is both a staggering and truly frightening statistic.
It got me wondering what the statistics were for a regular day or weekend, and I couldn’t believe what I discovered.
Over a period of one week in December 2014, a study conducted by the Australasian College For Emergency Medicine (ACEM) of eight ED’s across Australia and New Zealand highlighted some fascinating and alarming results:
- At peak times one in eight people arriving at ED’s for treatment were alcohol related
- Across any 24 hour period the rate dropped to 8.3%, or one in 12
- Extrapolating the results out to a 12-month period, it’s estimated half a million people visit ED’s because of completely preventable alcohol related issues
- Alcohol affected patients are more likely to arrive by ambulance and police than any other visitor
How do these statistics impact the health system?
The cost to the Australian taxpayer for alcohol related harm is up to $36 billion per year, depending on where you set the parameters, which is a staggering amount of money to spend on completely preventable injuries and illnesses. Imagine what we could use that money for? Instead it’s spent on health care, law enforcement, decreases in workplace productivity, and pain and suffering caused due to violence, injury, crime and car accidents.
Alcohol is responsible for:
- Over 60 medical conditions including liver and heart damage, and a range of cancers
- A third of all road fatalities
- Annual hospitalisation of 11,000 young people aged 15-24
- 33% of all instances of child abuse
- Death of one young person aged 14-17 per week
- $1.7 billion worth of crime annually
- Abuse of 25% of Australians 14 years-of-age and over
What about the effect on Emergency Department staff?
The problem with excessive alcohol consumption is it doesn’t just effect the person doing the drinking. It also effects anyone who comes into contact with that person, and when they present themselves at ED’s, the staff are often the ones who cop the backlash.
An ACEM survey of over 2000 ED staff in Australia and New Zealand has revealed some quite startling results. When faced with patients who were affected by alcohol:
- 98% had been the recipients of verbal abuse in the previous 12 months
- 92% had been the recipients of physical threats in the previous 12 months
- 88% said their ability to care for other patients had been negatively or very negatively affected
- 87% said they felt unsafe at work in the ED
- 94% said the workload of ED staff had been negatively or very negatively affected
If one in eight people attending ED’s are affected by alcohol during peak times and one in twelve on average, and the chances of being verbal abused or physically threatened is virtually guaranteed, then why the hell would anyone want to do that job?
What’s the likelihood of top quality doctors not wanting to be in that environment, so instead choose to ply their trade in other medical fields? And what about the poor patients who don’t get the medical attention they deserve because of the actions of an alcohol affected patient?
When you think that 500,000 alcohol affected people turn up at ED’s in Australia every year, the conditions ED staff face on a nightly basis is truly mind-boggling.
What would ED staff like done to curb the impact of alcohol in ED’s?
Alcohol policy reform is high on the agenda for the those working in ED’s. The ACEM has called on the government to implement a four point plan to combat the number of alcohol-related injuries or illnesses being presented to ED’s, and reduce the impact on ED staff.
- Introduce compulsory collection of alcohol-related ED presentation data – will provide a clearer picture of the extent of the problem.
- Introduce a preventative health program for emergency departments – screening, brief intervention and referral for treatment program for alcohol-affected patients in ED’s.
- Address alcohol regulation, tax and advertising – establish an independent regulatory board to monitor alcohol promotion, tax according to alcohol level, and reduce the exposure of young people to alcohol advertising.
- Reduce opening hours – evidence from around the world has proven that when closing times of licensed premises and bottle shops are brought forward, and the days they can trade are reduced, consumption and harm decreases.
Given the alarming statistics from the ACEM survey of over 2000 ED staff, and the international evidence that highlights changes that could be made successfully, why is it taking so long for state governments to get on board? There must be a national approach to reducing the impact of excessive drinking, otherwise people are going to continue to be injured at best and die at worst, ED’s are going to be inundated with people with completely preventable issues, and ED staff will continue to be subjected to verbal and physical threats and intimidation.