Chronic Substance Abusers

[chicagoambo]

same crap different cities

[Phoenix_Pixie697]

In Flint we very rarely just transport chronic druggies just to transport them, but frequent flyers that are "out of control" or Overdosed all go to the same place, and they're pretty efficient in dealing .

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[DirtJerZ]

personally i like to beat the crap out of them since i have to go to the hospital anyway! jk obviously.

[BronxMedic]

It's a huge problem where I work. I have two frequent fliers in particular who waste our time on a regular basis, meaning at least 3 or 4 times a week. Both of them always come over as ALS calls. One guy claims chest pain from the pay phone in front of the liquor store whenever he runs out of booze and money. The other guy lays down to sleep where ever he happens to be. Instead of calling it in as a drunk, well meaning bystanders inevitably call it in as an "unconscious", making it ALS. I've listened as arrests in my area are assigned to a unit with a 15 minute ETA while I waste my time dealing with these assholes.

We really should be allowed to refuse transport to these malingerers, but with parasite lawyers just dying to sue, I've resigned myself to this unpleasant part of the job.

[crotchitymedic1986]

We had two patients like you have, that called multiple times per day/week. Our Director went to their homes and just told them that from that day forward, we would only transport once per 24 hour period, and that we would only transport them to the closest facility (they had started going further and further out, after they wore their welcome out at the local facilities).

You may also be able to convince the ER Doc to check with the patient's pharmacy to get a list of how many prescriptions and what prescriptions they are on (not a HIPPAA violation, as it is related to their care). With that print out, he will have enough to mandate a rehab admission at your local psych facility.

[CBEMT]

In our metro area, they used to be arrested for public intox, or given a ride home if they weren't belligerant.

Then one day the po-po dropped one guy off at his house that they'd had a hundred times before, except this time he was hypoglycemic and died on his porch.

So now they they all go to the ER, many every day, and some more than once a day.

[primemedic01]

There's an article in JEMS this month that DC has begun a program that involves a non medical transport van that will come and transport frequent flyers after being triaged. I don't remember the specifics, but you can check it out. Any DC providers that can attest to this?

[HERBIE1]

The old days of drunk tanks worked out just fine- until an occasional one died from complications due to a secondary medical problem and people became upset. Now nobody wants that liability. Maybe there needs to be some type of medically supervised drunk tank so they can sleep it off without tying up an ER bed. As for shelters, most around here refuse to admit someone who is intoxicated. They simply don't want the hassle. The police here used to take drunks in transport wagons, as well as folks who had minor problems- to the ER. Again- liability(and the fear of infectious diseases)- has them now call EMS for anyone with a boo-boo.

[Richard B the EMT]

Continuing along on Herbie1's response, NYC outlawed "Drunk Tanks" around 1975 or so, due to numerous diabetics suffering the effects of their illness, which we know can mimic intoxication, who died in the tanks, which, incidentally, were IN the ER/EDs.

Are there still jurisdictions that still use them?

[CBEMT]

Our ED had a drunk/drug/psych tank (Ok, fine, "Clinical Decision Unit") with CNAs and RNS 24/7, and MDs that float in and out, but they've all been breathalyzed and BGL'd before going there. Anybody who's critically intoxicated goes to a critical care/trauma room, anybody who isn't critical but needs more than casual monitoring goes to an Urgent bed. Once they're sober, out the door till the next time.

It smells like a cross between sweaty gym socks and a bus station bathroom. Basically it's a homeless shelter by another name.

Edited March 17, 2009 by CBEMT