Young drunks swamp emergency departments

Children as young as 10 are turning up at hospitals drunk, part of an alcohol toll that now accounts for 30 per cent of casualties arriving at the nation's emergency rooms.

Accident and emergency staff estimate that 10 to 30 per cent of the injuries they see are alcohol-related.

After big weekend rugby matches or other sports events, more than half the injuries treated are blamed on excessive drinking.

All told, about 7000 to 22,000 alcohol-affected patients a year are treated at each of the country's three busiest emergency units - at Auckland City, Middlemore and Christchurch hospitals - at a heavy cost to the public health service.

"It's very resource-intensive," said Dr Bhavani Peddinti, clinical director of Middlemore's unit.

"It's a significant waste of resources, money that could be spent on treating all the people on the [elective surgery] waiting list."

He and Christchurch counterpart Professor Michael Ardagh agree the problem has worsened since 1999, when Parliament lowered the legal age for buying alcohol from 20 to 18 - a move MPs are reconsidering.

Professor Ardagh said the number of people under the age of 18 coming in with alcohol-related problems had almost doubled since the law change.

Girls and boys as young at 10 were being brought in dangerously drunk. While such cases were rare for that age group, they were "very common" among 14 and 15-year-olds.

And most of them were females, physically less capable of coping with alcohol.

Professor Ardagh said a disturbing feature of the trend was that mid-teens who became dangerously drunk were often deserted by their drinking buddies, even if they had summoned help first.

"More often than not their friends abandon them; that's one of the risks. There's a pretty good chance your friends are going to wander off because you are going to get them into trouble."

Alcohol-related hospital attendances include: Excessive drunkenness - usually teenagers or young adults; illness ranging from mild stomach upsets to liver damage; dependence problems such as convulsions and hallucinations; broken bones and serious injuries from falls; head and other injuries from liquor-fuelled fights; sexual assaults; domestic violence; drug overdoses that began with drunkenness; and suicide attempts.

Auckland City Hospital emergency department's clinical director, Dr Tim Parke, who arrived from Scotland last year, said he was shocked at the amount of drunk-driving in New Zealand, but the country had less alcohol-related violence than Britain.

"The Friday-night syndrome is less of a problem here than where I have come from and there's much fewer stabbings than in Glasgow."

Unconscious or semi-conscious drunks can stay in an emergency department for four to eight hours.

In Christchurch nearly two-thirds are treated in the casualty unit, the rest being admitted for further care elsewhere in the hospital.

The excessively drunk are typically vomiting and are at risk of dying if they inhale their vomit. If conscious, they might be placed on their side and have a device put in their mouth and throat to protect their breathing.

If unconscious, they are connected to an artificial-breathing ventilator. A line is inserted into a vein for saline to dilute the alcohol in their system and help the kidneys to excrete it.

"You need to look after them very carefully when they are that drunk," said Waikato Hospital emergency department clinical director Dr Shameem Safih.

Police might have brought in a drunk and out-of-control patient with a bruise or cut on the head.

"They're swearing and punching. As a doctor it's our duty to find out whether they have been injured in the head because the head injury can cause similar behaviour.

"You end up holding them down, sedate them medically, scan the head to make sure they haven't got a head injury, do blood tests to make sure it's not because of infection ... They do waste quite a lot of resources.

"Mostly they are drunk but occasionally you find a clot in the head because they have been banged by someone."

Middlemore's Dr Peddinti recalls such a case.

A boy was hit with a hammer at a party after drinking a few beers. He was conscious, but was found to have a major head injury and had to be treated at Auckland City Hospital.

Dr Peddinti wants a tougher line on alcohol, including returning the purchase age to 20, although the Medical Association no longer adheres to this position.

"I would like to see restrictions on the sale of alcohol on certain days."

Alcohol workload

Hospital emergency departments estimate 10 to 30 per cent of their work is alcohol-related.

This rises to 30-40 per cent on Friday and Saturday nights and possibly more than 50 per cent after big sporting events.

Auckland City and Christchurch hospitals see around 800 patients a year who have overdosed on alcohol.

Auckland City Hospital's emergency department cost $19 million to run in 2004-05. Alcohol-related costs are not known.