I recently completed nursing training. I was surprised how many alcoholic people were on general medical wards for complications of drinking. Yet nobody seemed interested in getting them into treatment. They were discharged after a couple days. I saw some more than once in a three month rotation!”
Wish I could say I was surprised. But even now, this is more the rule than the exception. An epidemiologist once told me that she had only to pull up hospital records for patients admitted multiple times in a two year period for a few different diagnoses to get a reasonably accurate count of the number of alcoholic patients. They ‘keep coming back’, you see.
The medical professions have been dealing with alcoholism and alcoholic patients for thousands of years, and this experience has led to some pretty hard and fast views on the subject. Medical training focused naturally on serious medical consequences such as liver disease and gastrointestinal illness. Delirium tremens and withdrawal seizures caused no end of problems on hospital wards, so most improvements were in respect to management of detox.
This emphasis on acute care helped foster the revolving door we know so well. The patient’s immediate problems would be addressed, followed by discharge, followed by a return to drinking, followed by a reappearance of acute distress, followed by readmission to the hospital, followed by… and so forth.
Alcoholism was seen as self-induced. Nobody much bothered to explain why alcoholic patients were doing this to themselves. It was assumed to be the result of some personality defect, or circumstances, or perhaps referred over to the psychoanalysts in another wing.
Change began in the 1960’s following introduction of a more formal disease concept. Not well received at first; if you stood up at a medical convention and stated that alcoholism was itself a disease, you’d get laughed at or booed, or just ignored.
Nowadays you encounter medical professionals with very different views. Still, I’d guess that every hospital in America has its share of alcoholic patients occupying medical beds, where they receive short-term treatment for acute problems.
Repeatedly. So in that sense, little has changed.
More progressive (or better funded) institutions sometimes have consultation procedures where an addictions professional is called in to interview and perhaps refer an alcoholic patient to treatment prior to discharge from the hospital. Some patients object to this, of course, preferring to repeat the cycle. Still, the hospital administration should be commended for making the effort.
— July 4, 2014 @ 
