The Chronic Public Inebriate

thegreypilgrim

thegreypilgrim

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The Clark County EMS agency in Nevada has instituted an interesting and progressive policy regarding the chronic ETOH-abuser. You can read it here.

Under this policy, Clark County paramedics can transport a chronic public inebriate to a sobriety center rather than to the MAR's ED. There are some fairly specific provisions which must be fulfilled in order to "clear" a person to be taken to a drug/alcohol abuse facility which I think are appropriate.

What do you guys think about this? Good idea? Can of worms waiting to be opened?
 
thegreypilgrim said:
What do you guys think about this? Good idea? Can of worms waiting to be opened?
Click to expand...

I think it's a great idea.

We often transport people to the ER, just so they can be transferred to a psychiatric or substance-abuse facility a few hours later after "medical clearance". If protocol allowed us to similiarly clear patients who have no other medical complaints, we'd save everyone a lot of time and effort. We'd also help patients who are frustated with the system, and just want to get the speciality help they need.

The one problem I anticipate is that the substance abuse facilities will get fed up with the inebriated patients who just want a turkey sandwich and a nap and then leave the program. The ED filtered out those patients before in that they wouldn't accept transfer to a rehab program, and they just got to sit in the ED until they were sober enough to be safe.
 
Interesting...so they can either sleep it off in the ER or sleep it off in a drug abuse facility?
 
I think it is a good idea. Perhaps there they will be able to get the counseling they need to recover.

My biological father (sperm dopnor) was a chronic alcoholic, and so was I for a while in my life. It is a shame to see patients get transported to an ED and simply get released. Hopefully here they can get teh help they need to understadn tehre are other means of dealing with issues, and there are other ways of getting satisfaction out of life.
 
I'm glad you were able to kick the habit Jeffrey, it must have taken a lot of discipline on your part. I'm considering the "drunks" I have dealt with in EMS. These aren't the people that are successful in rehab.

There's a reason that rehab/detox/AA programs have ridiculously high rates of relapse and dropout. Rehab in the US is a joke, people do it for the wrong reasons. The majority of individuals are either "forced" into it (legally), or have to do it for other reasons (to keep their job/position or for family).

If they are running detox clinics that are staffed just to allow drunks to sleep it off so the ER doesn't have to waste time with them, fine. But to think these programs have the ability to fix the chronic alcoholics that we generally pick up on the streets is a bit naive.
 
Perhaps I am naive and overly opimistic; this I cannot despute. I have always tried to maintain a positive view of humanity, even though I have not always been as successful as I had hoped.

The reason I overcame it is becasue I fell deeply in love with a women, and she gave me a choice. I decided I loved here more the alcohol and I realized I felt better without the booze, and life became a whole lot ccheaper...lol.

I was unaware of the statistics you mentioned becasue I never went to a program. The thgouht of losing her in my life was sobering enough. I do agree however that forcing someone to take AA classes is a waste of time. My grandfather always used to ell me "You can lead a horse to water but you cannot make him drink". Someone has to want the help before they can accept it.

I suppose I was more fortuante then most.
 
Patients who come to the ED with problems related to alcoholism, or if this is determined to be part of their history, are always offered assistance (in my area at least). Many of them won't accept it and are discharged once sober.

I'm assuming that most patients who are transported to the ED sober up and leave, refusing to take the assistance and enroll in a program. Some obviously do get help.

Maybe transporting these people to a program will make it easier for them to accept assistance. However, I think that many will abuse the rehab places and just walk out once they have had a good meal, a nice rest, and some time in a comfortable environment.
 
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