1 Ask the question
EM staff should routinely enquire and record alcohol intake during the medical and nursing assessments.
2 Assess further
EM staff should decide whether the patient has hazardous drinking, alcohol abuse or alcohol dependency. Look for co-morbid problems: alcohol is a risk factor for a variety of medical problems as well as depression and self-harm.
3 Give feedback and information
About treatment services to hazardous drinkers/alcohol abuse.
Hazardous drinkers or those with alcohol abuse but not alcohol dependency should be given feedback about alcohol-related harm and offered their preferred follow-up agency from the menu of options on the alcohol service patient information leaflet (available in the ED interview room and on the ED Intranet). If there are additional mental health concerns, refer to Psychiatry at CUH.
4 Detoxify and prevent complications of withdrawal in alcohol dependent patients
Alcohol dependent patients should have a full physical assessment, including assessment of severity of alcohol withdrawal, orientation, seizure risk. Detoxification should involve the use of reducing doses of benzodiazepines (to ease withdrawal and to prevent seizures and delirium) and adjunctive parenteral vitamins (to prevent Wernicke-Korsakoff Syndrome).
5 Decide who to admit and where
Some patients may require medical admission (i.e. those with co-morbid medical illness, delirium tremens,, malnutrition, seizure history, absence of social supports). Others may require psychiatric admission (i.e. those with where there is a comorbid acute mental disorder with associated acute risks). Most will be suitable for symptom-triggered detoxification in CDU (see CDU symptom-triggered detox guideline) or discharge home.
6 Give information / refer to aftercare / alcohol treatment services
In addition to detoxification and feedback about alcohol-related harm, all alcohol dependent patients should be offered their preferred follow-up agency from the menu of options on the alcohol service patient information leaflet (available in the ED/CDU and on the ED Intranet). If there are additional mental health concerns, refer to Psychiatry at CUH.
7 Referral to CUH Social Work
- All patients under 18 who present to the ED with a drug/alcohol problem
- All cases of adult presentation with drug/alcohol problem where Child Protection/Welfare concerns are identified
- All cases of adult presentation with drug/alcohol problem where Domestic Abuse/Elder Abuse is identified
- Arbour House, Addiction Treatment Centre, Douglas Road, Cork (South Lee Catchment area) 021 496833
- Community Counselling and Advisory Service, 10 Church Street, Cork (North Cork Catchment area) 021 4212382
- Community Counselling and Advisory Service, Skibbereen (West Cork Catchment area) 028 23456
Residential alcohol treatment centres
- Tabor Lodge, Ballindeasig, Belgooly, Co Cork, 021 4887110
- Matt Talbot Adolescent Services, Trabeg Lawn, South Douglas Road, Cork, 021 4896400
- Alcohol Treatment Centre: St. Helen's Convent, Missionary Charities, Blarney, Co. Cork, 021 4381687
- St John of God Hospital, Stillorgan, Co Dublin, 01-2881781. Private hospital. You will need a doctor referral
- St Patrick's Hospital, James Street, Dublin 8, 01 2493 200. Private hospital. You will need a doctor referral
Alcohol treatment services
- Alcoholics Anonymous PO Box 137, Eglinton Street, Cork. 021 4500481
- AlAnon/Alteen (Support Group for relatives of drinkers), Family Groups Ltd, PO Box 55, Eglinton St, Cork. 021 4311899
- "Together Razem" is a Social Integration Centre for Polish living in Cork they provide many services one of them Addiction Counselling