Emergency departments and alcohol: the perpetual hangover.

Abstract

Alcohol is deeply woven into the social fabric of Australia and New Zealand. It is a symbol of celebration, a palatable pleasure, embedded within our sense of identity and, for some, it is a refuge from adversity. With excess, a pervasive toxicity manifests. This is evidenced by alcohol's contribution to major causes of death, especially among teens, and contributing to twice as many deaths as seen from road accidents.[1, 2] Such attribution is not isolated to Australasia, with alcohol-related harm ranking as the third leading cause of disability in high-income countries.[3] To emergency service providers, the consequences are evident, and has provided motivation to assist governments to legislate change.[4-6] The collateral damage from such harm has also been well documented, affecting not only the patient and their families, but also the emergency workers who are often in the direct line of fire.[6] Given the wide ranging impact of alcohol-related harm, it is essential that the drive to change is not reliant on select individuals, economists or politicians, but comes from the entire emergency community, and society at large. Despite highlighting violence as a significant hazard for ED staff nearly two decades ago, there has been little progress in reducing its incidence. This is a multifactorial issue that needs greater attention. Strategies such as tailored department design, communication techniques, increasing security presence or issuing fines for behaviour partially address staff safety and violence in the ED, but do not address the significant contribution of alcohol.[45, 46] It is the imperative of emergency clinicians to champion a new, more responsible era in alcohol culture.