Alcohol Screening

[Ronald Gross]

I don't think anyone is going to argue with you on anything but the
presumptuous part.  True, the information we gather is important as it
will assist us in managing a patient and help clarify the reason(s)
behind altered states of consciousness.  True, too, that we are not
enforcers, and that the results of drug and alcohol screening/testing
must remain a part of the medical record and not the purview of the law
UNTIL subpoenaed.  And true again that the primary diagnosis might just
be EtOH intoxication, with MCC or MVC as the second in the list, for
without the EtOH it could be argued that the crash just might have never
occurred to begin with!  

However, the longer we say that we cannot successfully intervene or
have any effect on the lives of "those already befallen", the longer
those lives will remain wasted, and the longer we will allow those
wasted lives to waste and destroy the lives of the innocent people who
happen to be in the wrong place at the wrong time - right in the path of
the befallen bent on continuing his/her wasted ways 'cause no one gave a
damn enough to make the effort to redirect!  And lastly, true yet again
that success here will require "significant social resources" that we,
as clinicians are obliged to find and engage.

OK, I will put away my soap box and go back to work.  Heavy
sigh.......

Ron

>>> <bensonblues at comcast.net> 8/17/2006 10:06 AM >>>
I feel that screening trauma victims for alcohol and drugs of abuse is
medically necessary to give the provider information necessary for
optimum care. Drugs and alcohol can complicate diagnosis and management.
However, it is rather presumptuous to believe that the emergency/trauma
team can 'intervene' with any real degree of success. Although sentinel
events in the life of addicts/alcoholics are opportunities for
intervention, success in this area usually requires significant social
resources that are lacking in the lives of many people (family support,
etc). Further, physicians must avoid becoming involved in the role of
enforcement, lest we loose the trust of our patients. Patient
information about drug/alcohol use acquired by physicians to assist in
providing medical care should remain part of the medical record, and
should not be available to insurance companies and law enforcement to
further destroy the lives of those already befallen. State laws which
provide for the a
 cquisi
tion of evidence when officials are investigating a crime have been in
place for years, and have been successful. DB
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