Chronic Substance Abusers

[HERBIE1]

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?

Well Richard, considering the overcrowding of ER's and the issue of proper allocation of resources, the idea of a medically supervised drunk tank might need to be revisited. As any provider who works in a busy urban setting knows, a significant portion of ER beds are filled with folks "sleeping it off", especially on a hot summer night. The thing is, not every one of these people are homeless regulars- many are weekend warriors who were "over served". Maybe spending a night lying in a room full of ripe old homeless guys would be a good object lesson for them. I've always felt that a bed, a banana bag and fluids is far too kind for someone who was dumb enough to drink themselves into oblivion- the "penalty" for their behavior is greatly diminished. Then again, maybe I've been doing this too long...

[fireflymedic]

Can we just have a direct link to rehab centers and drop them off at the door? Sometimes I wonder if that might not be more beneficial than continuing to overburden an already stressed healthcare system.

[HERBIE1]

Can we just have a direct link to rehab centers and drop them off at the door? Sometimes I wonder if that might not be more beneficial than continuing to overburden an already stressed healthcare system.

Careful there. Where will something like that stop? Do we also need to take all pregnant teens to a family planning center? How about taking truants back to school? I guess it depends on your area but there are usually more than enough social service agencies, and most ER's also provide alcoholics and/or drug addicts with referrals upon their discharge.

We also need to distinguish between rehab and detox- not necessarily the same thing. I agree that in most cases, all an alcoholic needs is to sober up and maybe get a meal, not take up space in an EMERGENCY room.

Again- this is a liability issue. No system would want the responsibility for taking an alcoholic to a rehab/detox center if they found out later about an underlying, unaddressed, and serious medical problem that needed treatment.

The drunk tank idea- a medically supervised facility- could work if there was an agreement with the provider. It would certainly take some of the stress off the ER's.

[Richard B the EMT]

Careful there. Where will something like that stop?

Again- this is a liability issue. No system would want the responsibility for taking an alcoholic to a rehab/detox center if they found out later about an underlying, unaddressed, and serious medical problem that needed treatment.

There is also the issue at the rehab centers themselves, something about the person showing up while not under the influence. I believe this is to show the individual wants to be cured.

Edited April 6, 2009 by Richard B the EMT

[fireflymedic]

My comment was directed towards those that call us or others call and say pick them up they are drunk or high (and perfectly aware that is the only problem). We used to frequently get those calls and really it was not much. The cops would just pawn them off on us so they didn't have to take them to jail, or given the choice, they chose us over jail. These are your prime candidates for rehab/detox centers. If there is any question - then they need to go to the hospital for full evaluation OR if there is a question of alcohol intoxication which is also a very real possibility.