Just finished my shift and it was heavy compared to the other days. As the title already mentions, here's what it looks like at the emergency room or the wards when alcoholics get too much fun in this festive season.
- They come in via ambulance with a history of drunk driving and involved in an accident.
- Got too intoxicated with alcohol now their folks can't wake them up.
- Got too drunk for their own good so they overestimate their capabilities and fall head first.
- Binged drinking for a couple of days due to a series of office parties for the holidays or family reunions, and when they stopped, they started feeling the effects of lacking alcohol in their system.
Without going in depth of the details:
TL:DR
Alcohol withdrawal syndrome can lead to a life threatening emergency and it happens when people who are used to abusing alcohol don't get their regular alcohol intake and they experience withdrawal symptoms.
Alcoholics use have a poor insight and judgment when it comes to their drinking habits and it's not only them that suffers but their loved ones whom they may abuse at some point.
Not all alcoholics became alcoholics out of their rational will so it's dangerous to generalize people getting the consequences of their lifestyle choices. In psychiatry, it's relatively rare to have a single diagnosis for a mental condition as some comorbidities occur than can overlap the presentation.
For instance, a Schizophrenic patient who isn't a known case yet will initially present as having troubles with sleep so they self medicate with alcohol or smoke a lot to lower their dopamine levels in the brain which cause their symptoms. So when they first interact with the health care system, they can present as alcohol induced psychotic disorder and once detoxified but still with persistent psychosis, that's the time we entertain another underlying disorder unmasked.
There's also the standard alcoholics trying to deal with their underlying depression, so once they get detoxified, we move on to exploring and treat the possible underlying depression that triggered the habit in the first place.
Or maybe, these are just ordinary people that picked up a bad habit influenced by peers that caused them to be alcoholics.
A lot of the health care team would usually prefer not to deal with the tantrums, the episodes of delirium in the ward because there's this stigma about alcoholics just getting the consequences of their actions, I get this part that's not exactly the right mindset when trying to be compassionate about your care.
It's been a staple guideline that we should be treating people without being hindered by our own prejudices. Sometimes all you need to do is detoxify them, treat the underlying problem like psychosis, depression or mood disorder, and then their lifestyle significantly improves for the better but this is a long term process and it takes a lot of effort since most people have trouble getting rid of bad habits. I'm not a saint, I do get annoyed when there's a lot of them because each withdrawal case can present differently and this is oversimplifying the experience.
We don't know what leads people to start and perpetuate bad habits. While it's easy to dismiss the consequences of their actions includes them suffering for it, we don't usually know the reasons that led them to lead that lifestyle. Being an alcoholic is a consequence of some other triggering cause that remains to be explored, at least, that's the lesson I learned from treating these patients during their episodes of withdrawal.
We do what we can anyway since that's part of the job. At some point, you just get used to seeing the same names or faces in the ward. You discharge them well, hearing promises of staying away from the vices and then they come back a few weeks or months later. At least you tried~
What made me think about this routine more is how prevalent these cases happen a lot during the holidays because parties and reunions happen often.
Thanks for your time.