By Courtenay Holscher
Friday night in the ER at Denver Health: intoxicated 34-year-old male with a bloody nose from a fight; intoxicated 51-year-old male who fell down in a parking lot; intoxicated 23-year-old female whose friends called 911 after she passed out at home. Every room but one has somebody who’s had too much to drink.
These people are not sick in the traditional sense of the word. They don’t have a chronic disease or major trauma. What they do have is a problem that we all should recognize as a disease: binge drinking.
The National Institute of Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that results in a blood alcohol concentration (BAC) of 0.08% or more. This usually takes four or more drinks over two hours for women or five or more drinks over two hours for men. Most people have impaired reasoning and depth perception at this BAC, and many have slowed reaction time and slurred speech as well. The euphoria and talkativeness of lower BACs are often gone by this point. This isn’t drinking for “social lubrication” anymore.
Binge drinking is responsible for more than half of all alcohol-related deaths in the United States.
What we do in the ER for these folks is pretty much the same as what you do at home: give them water and electrolytes (at home you do this with Gatorade, in the ER we do this with an IV) and watch them. Make sure they don’t have other injuries that the alcohol has numbed them from noticing. It’s a very expensive and inefficient use of resources to sober up at the hospital. The other injuries, the cuts and bumps that require stitches and neck braces, wouldn’t have happened had the person not been so intoxicated. After they’ve sobered up, we ask them to get help for their alcohol abuse.
What’s tricky about binge drinking is that it could happen to any of us. It isn’t always alcoholism or addiction, but it is always alcohol abuse. Whether you’ve simply lost track of how many drinks you had or you were drinking to get drunk, it’s a problem. But, it’s a problem that we can handle.
For most of us, we just need to slow down and have a glass of water here and there. Make sure not to drink on an empty stomach. If binge drinking becomes a pattern, there are 12-step programs, support groups and online communities that can help. The first step in all of these is to recognize that binge drinking is a problem and something we can tackle.
Back in the ER around 7 a.m., our patients start sobering up. They tend to be embarrassed, cranky, and tired. Sometimes they apologize for their behavior when they were first brought in. A friend comes to pick them up, and we don’t hear from them again. I always wonder what they think of their night in the ER and if they learn anything from the experience. I wonder when or if they will be back after another binge.
Courtenay Holscher is a second year medical student involved in the LEADS track at the University of Colorado. She grew up in Cincinnati, Ohio, and attended the University of Michigan where she studied biomedical engineering.