Tuesday 20 December 2011

The Cost of Alcohol

"41 year old female, abdo pain, vomiting, alcoholic"

We've all had a drink. We've all got drunk. We've all had weekends where we have drunk to excess, but short of a rotten hangover, that's where it ends. Unfortunately, the culture we live in has drinking woven into the fabric of society and because alcohol is such a common, popular element in many activities, it can be hard to see when drinking has crossed the line from moderate or social use to problem drinking. When drinking to excess becomes the norm and alcohol is used to make you feel better or avoid feeling bad, that's when the reality of alcoholism becomes apparent. Alcohol contributes to 35% of all A & E admissions and that rises to 70% at weekends. Obviously, ambulance staff the world over grumble and sometimes make light of 'scooping up drunks' out of the gutter on a friday night but the problem runs much deeper than a weekend binge.

Alcoholism and alcohol abuse are related to many factors which are more often than not interconnected. These include genetics, upbringing, social environment, and your emotional wellbeing. People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems and as eluded to in my last blog (Mental Health), those who suffer from a mental health problems such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol is sadly used to self-medicate. It is these patients that we see all day every day, and the cost to maintain their continuing need for medical treatment is what is a putting the health service under a pressure it simply can't cope with. Add to that the cost of the anti-social behaviour and crime that results from alcohol and the cost not only to the NHS but the country as a whole is enormous.

Negating the £3 billion yearly cost of alcohol on the NHS and putting to one side the 33,000 alcohol related deaths in the UK alone last year, the cost to personal health and family life can be catastrophic. Liver cirrhosis, kidney transplants, pancreatitis and cancer, to name but a few are just some of the debilitating illness's that alcoholics suffer with. This particular patient had chronic pancreatitis, which is an inflammation of the pancreas. It causes severe abdominal pain that lasts for days on end. The damage is irreversible. Years of alcohol abuse has caused her body to start shutting down. We arrived at the block of flats and made our way up the outer concrete staircase. When we arrived at the walkway, an elderly lady, head in hands, stood outside the flat. She didn't need to say anything, her look said it all. She was tired, she was hurt and was full of despair. There is only so much a parent can do for their daughter. We made our way up to the room where Sarah lay on the bed wretching and crying in pain. A brief look around the room showed all the tell tell signs of alcohol abuse. Tins, spirits, dirty clothes, no pride in her appearance, a musky haze around the room and the smell was enough to paint a picture. Every minute she would let out a gut-curdling squeel as she vomited the smallest amount of bile into a bucket. She had been doing this every minute for the past 8 hours. She had been in constant pain for 2 days, been to hospital twice, had had 4 ambulances and 1 doctor out to see her. She was red faced, pouring with sweat and covered in vomit and looked exhausted. That was her life. That was her choice. That was alcohol. 

We took her to the ambulance, the retching continuing all the way, the squeals of pain reverberating off the concrete jungle. Wearing a stained white t-shirt, dressing gown and socks she was a sorry figure walking through puddles to the ambulance. A resignation that this was what she could expect from what is likely to be a rather short life. Her mum followed behind, not a word spoken, just a look of solemn exasperation. We did all the necessary checks and left to go to hospital. In between the retching and screaming I tried to talk to her. She had been an alcoholic for 10 years. She wanted to die. She had lost her husband, her kids, her house and her job to alcohol. Her mum had taken her back in to look after her. I genuinely believe she was at rock bottom. We arrived at hospital, and as we lowered the bed on the tail lift I helped her mum down the steps. Our eyes met and a tear trickled down her cheek. In that single moment, the true cost of alcohol became discernibly apparent.


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