Reducing the alcohol burden

According to a new survey, almost half of paramedics in the North East of England have been subjected to alcohol-fuelled physical assaults while on duty (North East Ambulance Service NHS Foundation Trust (NEAS) and Balance, 2015). The survey of more than 350 paramedics details the impact of alcohol misuse on the region’s paramedics, and also revealed more than two in five NEAS paramedics have at some point been sexually assaulted/harassed while on duty. Additionally, nine out of ten paramedics agreed that dealing with alcohol-related callouts places an unnecessary burden on their time and resources; and three in five paramedics believed they shouldn’t have to deal with the consequences of excessive consumption of alcohol. A quarter of paramedics stated that at least 50% of their workload on weekday night times is alcohol related, while two thirds of paramedics stated that alcohol-related incidences account for at least 50% of their workload during weekend shifts.

Unfortunately this survey does not represent an isolated issue affecting a single region in the UK. The burden of alcohol is a global issue, whether that be the 3.3 million deaths every year that are attributable to harmful use of alcohol, or the causal relationship that can be seen between harmful use of alcohol and a range of mental and behavioural disorders, other non-communicable conditions as well as injuries (World Health Organization, 2015). Within the UK, the total annual cost to society of alcohol-related harm is estimated to be £21 billion, with the NHS incurring £3.5 billion a year in costs related to alcohol (Public Health England, 2014). Few other health harms have such high overall costs when the impact on productivity and crime are included, and so it is imperative that more measures are taken to tackle this problem.

As emphasised in the NEAS and Balance report, alcohol should be less affordable, less available and less widely promoted if the overall burden of alcohol on ambulance services is to be reduced. The Government needs to support a range of targeted, evidence-based measures such as a minimum unit price, which has been shown to save lives, reduce hospital admissions and lessen the financial burden alcohol places on frontline services. After all, ambulance staff have a right to work in a safe environment, free from workplace violence.

Currently, the Institute of Alcohol Studies (IAS) is conducting research into the impact alcohol has on emergency services in England (IAS, 2015). The survey has been designed for frontline ambulance staff and developed with the help of the Association of Ambulance Chief Executives. Research into workplace violence against emergency medical services is still in its infancy, so I would encourage all those who have not completed the survey to do so.

References

Institute of Alcohol Studies (2015) Ambulance Survey. http://www.surveymonkey.com/r/?sm=dv%2f2rbLBkjsEC6dqjV3Dv%2bcW6jpu4uNTsg%2fqgjbrjUI%3d (accessed 28 August 2015)

North East Ambulance Service NHS Foundation Trust, Balance (2015) Paying the price: North East Ambulance Service paramedic survey 2015—a summary. http://www.neas.nhs.uk/media/97014/balance_neas_media_report_final_web.pdf (accessed 27 August 2015)

Public Health England (2014) Alcohol treatment in England 2013–14. The Stationery Office, London

World Health Organization (2015) Alcohol Fact Sheet. WHO, Geneva. http://www.who.int/mediacentre/factsheets/fs349/en/ (accessed 28 August 2015)

The importance of being drink aware

While many people will be gearing themselves up for a well-deserved break over the holiday period, countless emergency medical services (EMS) personnel will be preparing themselves for the busiest time of the year. Although there are a number of explanations for the increase in callouts surrounding Christmas, one of the major contributing factors is alcohol consumption.

Injuries relating to alcohol come in a variety of forms and can be roughly categorised as follows: unintentional injuries, such as falls, drownings, cuts and burns; injuries as a result of violence, including intimate partner violence and child maltreatment; and road- traffic injuries. Another notable risk of alcohol consumption is alcohol poisoning, which in the worst cases can lead to death.

Alcohol is the biggest single cause of accidents in the home. Every year in the UK there are around 4 000 fatal domestic accidents, 2.6 million accidents that require treatment in A&E departments and many more accidents not accounted for in the hospital admissions statistics (IAS, 2013b).

In relation to violence, around 35% of victims report that offenders are under the influence of alcohol (Greenfield, 1998). Alcohol use is also associated with two out of three incidents of intimate partner violence (Greenfield, 1998).

The impact of alcohol in your system can have a seriously adverse effect on your ability to drive, due to the range of psycho-motor and cognitive effects that increase accident risk on reaction times, cognitive processing, coordination, vigilance, vision and hearing (IAS, 2013b). According to the Department of Transportation and National Highway Traffic Safety Administration (NHTSA) (2012), almost 30 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver every day. This equates to one death every 48 minutes. However, statistics show that during Christmas and New Year’s, two to three times more people die in alcohol-related crashes than during comparable periods the rest of the year, and 40% of traffic fatalities during these holidays involve a driver who is alcohol- impaired, compared to 28% for the rest of December (NHTSA, 2007). In the UK, despite an overall downward trend in the number of reported drink-drive accidents and casualties since the introduction of the 1988 Road Traffic Act, the proportion of drink-drive road accidents in relation to total road accidents has remained constant over the last decade (14%–18%) (Institute of Alcohol Studies, 2013b).

The fewer ambulances that are called out to treat patients who have over imbibed, the more that can be sent to patients suffering from unpreventable life-threatening emergencies such as cardiac arrests. The importance of the public being drink aware this Christmas can therefore not be overemphasised.

References:

Dept of Transportation, National Highway Traffic Safety Administration (2012) Traffic Safety Facts 2010: Alcohol-Impaired Driving. NHTSA, Washington DC

Greenfield LA (1998) Alcohol and Crime: An Analysis of National Data on the Prevalence of Alcohol Involvement in Crime Report prepared for the Assistant Attorney General’s National Symposium on Alcohol Abuse and Crime. US Department of Justice, Washington DC

Institute of Alcohol Studies (2013a) Alcohol, accidents and injuries. http://tinyurl.com/ njsw5nz (accessed 19 December 2013)

Institute of Alcohol Studies (2013b) Drink-driving factsheet. http://tinyurl.com/oqfqgub (accessed 19 December 2013)

National Highway Traffic Safety Administration (2007) Traffic Safety Facts, December 2007. NHTSA, Washington DC

Taken from International Paramedic Practice, published 20 December 2013.