What if you go to the hospital drunk or high?


By David Joel Miller.

Hospital emergency rooms are filling up with people under the influence.

This is causing a whole lot of problems for hospitals, the emergency room staff and society in general. There is no special reason why someone needs to go to a hospital because they are drunk or high unless they also have a medical or psychiatric emergency.

They end up there because of the other problems drug and alcohol use cause to the person and to society. Often this happens because there is just no other place to send them. Hospitals do not function as an extension to law enforcement and patient privacy is strongly enforced so unless you are in prison when the emergency occurs don’t worry about seeking help because of the legal consequences.

People who are drunk or high are a lot more likely to slip, fall or otherwise injure themselves. The emergency room staff is use to this and unless you broke some major law like hitting someone while driving drunk and you are already in custody, their goal is to get you patched up and out of there.

Some under the influence people really really need to be in the hospital.

If someone has the Delirium Tremens (DT’s), they need to be in the hospital, this is life threatening. But most drunks are just a pain to the workers in the ER. They argue, try to go places and do things that just get in the way.

Heroin and other opiate abusers need an injection to reverse the effects of the overdose, but most enlightened emergency responders carry the injection to do this on the ambulance so that by the time the patient reaches the hospital the emergency is over.

Drunks are most problematic because the alcohol impairs their judgment. They are often suicidal or violent. No not everyone who drinks gets suicidal or violent but many suicidal people abuse substances. A binge drinker is 55 times more likely to attempt suicide than a non-drinker.

Substance abusers make up a significant proportion of admissions to psychiatric facilities. While they are under the influence they are prone to be violent and irresponsible. Some of them are still suicidal or violent after the drugs and alcohol wear off and need further treatment.

Since we don’t know if the current psychiatric problem is only a result of the substance or do they have these issues at other times. Most suicidal, self-harming or violent people who are under the influence end up staying until the drugs and alcohol wear off and they can rationally answer questions about their behavior and intent.

One very effective approach to this over flow of under-the-influence people filling up the hospital ER’s has been the creation of sobering centers.

Situated close to the hospital and under the supervision of medical staff, trained Para-professionals such as substance abuse counselors and mental health professionals can screen patients for medical necessity and supervise detoxification. These systems have worked well. Unfortunately when budgets get tight, detox as well as other services for substances abusers and the mentally ill get cut.

At the time the need is the greatest detox and sobering centers are the most likely to get cut and throw their work back on the already over used ER’s.

Hospitals are also seeing a surge in irrational people as a result of synthetic drug use. (See 7 new drugs parents should be aware of.) Sometimes that psychosis goes away once they detox but other times it seems to be long-term and results in a psychiatric hospital admission.  Professionals are debating whether the new drugs are creating the psychosis or just a stressor that causes the first occurrence of the disorder.

I am convinced that drug use is damaging some brains and creating mental illness which would not have occurred without the drug use. I understand not everyone agrees with this position.

So the conclusion to all this is that if you or someone around you is drunk or high  and there appears to be a medical or psychiatric emergency you should go to the hospital and get checked out and do not worry about the police finding out about this as a result of your visit. If there is no medical or psychiatric problem and no past history of problems most people do not need to go to the hospital. When in doubt call 911, the doctor or hospital first, not your therapist or the social worker.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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