# How can we help reduce DUI's ?



## Stopper1 (Dec 3, 2016)

It is so tiring to see repeat offenders of DUI and the damage that is caused to the victims and to the families involved. Why must we see these 'accidents' so often and why is 'alcohol abuse' so poorly treated today? I just watched a TEDx talk on Youtube (from The London Business School) which talks about a relatively new treatment that could get people back in control of their brain and their drinking and just maybe keep them 'smart' enough to not drink and drive. The treatment is called the Sinclair Method. There is a full length documentary on the method as well. 

How often do you see DUI accidents and are you tired of seeing them over and over?  I also watched the documentary "The Business of Recovery" and it seems like the revolving door of rehabs has got to stop - it is time to truly treat alcoholism with 21st century medications.  I would love to know what other new treatments you have seen for AUD. 

All the best,


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## Summit (Dec 3, 2016)

Stopper1 said:


>



I liked her in Babylon 5


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## VentMonkey (Dec 3, 2016)

Where's the scenario???


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## NysEms2117 (Dec 3, 2016)

VentMonkey said:


> Where's the scenario???


Agreed.

However to the OP. I know for a fact this can be solved by Google. Look at "fixing NYS dui's" I know several state approved articles will show up, due to the fact I contributed some of the statistics to them. Dui's are common for parolees to have and there are endless ways to help resolve them .


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## Stopper1 (Dec 3, 2016)

Scenario:   You respond to a DUI situation or to scene where a person is "under the influence" of alcohol to bring them to the hospital for detox/rehab. 
Or you just know someone or have a friend ora  family member that drinks too much, especially if they drive afterwards.
What can you say or do that might help the people involved (the driver, the officers, the victims, the family members).

You can say "I recently watched a TEDx talk of a new method that significantly reduces someone's drinking and their cravings for alcohol. It's called 
*The Sinclair Method*, it's inexpensive, safe and has a 78% success rate vs. < 5% for rehab/AA" - you should *Google it*".  

The documentary 'One Little Pill" gives more in-depth look at this clinically proven method -  and the recent book by Dr. Roy Eskapa provides the details
and 21st-century science behind it. I recommend watching this documentary first - it's a game changer.

"Spreading the word" can help to change the 1939 AA way of thinking - to a 21st century medical-treatment paradigm, like all other diseases.


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## NomadicMedic (Dec 3, 2016)

Why does this smell like spam to me?

I'm all for helping people, but DUIs go with LEO, in custody, unless they're injured, then they come with me to the hospital. Then they're placed in custody. When I'm interacting with a DUI, I'm not going to coach them on how to stop drinking by recommending a Ted talk or a book. 

I applaud your effort, but you're trying to sell to the wrong audience here.


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## VentMonkey (Dec 3, 2016)

DEmedic said:


> Why does this smell like spam to me?
> 
> I'm all for helping people, but DUIs go with LEO, in custody, unless they're injured, then they come with me to the hospital. Then they're placed in custody. When I'm interacting with a DUI, I'm not going to coach them on how to stop drinking by recommending a Ted talk or a book.
> 
> I applaud your effort, but you're trying to sell to the wrong audience here.


I sense the same...


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## Stopper1 (Dec 5, 2016)

OK, you guys got under my skin, calling my post SPAM, but I took some time to calm down - and do I understand your view.  
I also do not approve of anyone selling stuff on this forum. Let me assure you - I am not selling anything and am not affiliated with this method in any way. The big thing to realize is - there is little to no money to be made with TSM. Why?  Because an AUD sufferer can do it themselves at home on $1 / day (for the generic pill - which by the way is over the counter in Spain). TSM is the antithesis of the rehab industry. I also don’t give a damn if the people that put together this TEDx talk, the book or the full documentary even get their money back remind make money (which they so deserve to get back and more – IMO, they should be nominated for an international award in medicine).

I have had alcohol in my family for 15 years now. It crept into our happy family silently and disguised as it does in most families today until it finally became so bad and dangerous for us and for the general public, I had to do something. I spent the last 5 years researching this damned disease and hoping to find the very best medical treatment – which I did last year - the Sinclair Method from Finland. It is by far the best (really the only) scientifically based medical treatment for alcoholism in the world, IMO. AUD is largely DNA based. The only treatment better would be DNA editing - which I am sure will come one day. TSM has been around for many years - in the US it is available but virtually unheard of by 99% of our doctors (not taught, not a money maker). But what I also found out was appalling and I could spend hours telling you but I won’t. The documentary does that pretty well. IMO it is spot on in every way. In the US, and in the world, 12 steps has become the basis for all treatment. I do not begrudge AA. It has saved many (albeit a tiny percentage of the people suffering in the world). Until very recently no other treatment was available so AA flourished. Two guys, without any credentials or science, came up with AA 75 years ago. Now we have a clinically-proven scientific method. TSM is no magic pill – it requires effort and commitment. But it can change well many lives for the better (78% success rate). It has given my loved one a new beginning and total control once again (with no cravings) and I have witnessed its successes so many other times.

My loved one was brought to a hospital maybe 10 times by caring EMT’s.  I know you guys can’t help them on the spot - in their condition. So I just ask you to open your minds, watch the 15min TEDx talk and learn about TSM. Watch the documentary and tell others. EMTs need this knowledge. I won’t rest until every cop, EMT and doctor in the US knows about TSM.  They could have saved my family years of suffering. We don’t send diabetics who crash their car to jail or to life-long meetings to talk about how they can’t handle sugar - we give them 21st century medical treatment. AUD patients deserve the same respect.


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## NysEms2117 (Dec 5, 2016)

@Stopper1 I'm not going to "offend you" anymore. But I firmly suggest your find some new research. I also suggest you look and see the 1 TRUE STEP in fighting addiction of some kind. I also encourage you to look at ways we do this with no medicine. 
*this is spoken from experience and somebody that deals with folks that have been caught and served over. 1 year in state prison for DUI's*


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## Stopper1 (Dec 5, 2016)

I spent 5 years researching the subject - never saw anything about 1 True Step. I just now spent 15 minutes and cannot even find a reference to 1 one True Step. Please provide a link with the scientific clinical evidence that it works better than 78% of the time. I would be happy to look into it. I hope you will spend 15 minutes and watch the TEDx talk on the Sinclair method. The clinical evidence for TSM can be found at Cthreefoundation.org and in the book by Dr. Eskapa. They will enhance research as well. 
I am always amazed that people think that a AUD sufferers must not use  a simple safe medication - must do it all by themselves. What BS ! Maybe we should eliminate all medications and let people fix themselves for all diseases. Alcohol is the number one over-used drug in the world. It can disease your brain, your liver and your kidneys. Replacing a fifth of alcohol with one little pill seems like such a small thing to me especially when you regain your life in the process.

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## NysEms2117 (Dec 5, 2016)

Stopper1 said:


> I spent 5 years researching the subject - never saw anything about 1 True Step. I just now spent 15 minutes and cannot even find a reference to 1 one True Step. Please provide a link with the scientific clinical evidence that it works better than 78% of the time. I would be happy to look into it. I hope you will spend 15 minutes and watch the TEDx talk on the Sinclair method. The clinical evidence for TSM can be found at Cthreefoundation.org and in the book by Dr. Eskapa. They will enhance research as well.
> I am always amazed that people think that a AUD sufferers must not use  a simple safe medication - must do it all by themselves. What BS ! Maybe we should eliminate all medications and let people fix themselves for all diseases. Alcohol is the number one over-used drug in the world. It can disease your brain, your liver and your kidneys. Replacing a fifth of alcohol with one little pill seems like such a small thing to me especially when you regain your life in the process.
> 
> Sent from my Moto G (4) using Tapatalk


The first true step into rehab is wanting to do it/be there. You can medicate the crap out of somebody, the second they leave(the rehab or treatment center) they simply won't take the medicine. None of your(proposed) methods and medicines will be able to solve anything if the person does not want to rehab/better themselves. Surely in 5 years of research you have heard this. In my measly 2 years of being a parole officer I learned that in about 2 months. If somebody WANTS to do something they can, i'm pretty sure you'd be able to find a few million search results saying something along the lines of "the mind can be more powerful then drugs". I've had dozens of parolees on parole for DUI's, that did not even need me(their parole officer) because they WANTED to change, and changed by themselves, some first time offenders, some long history offenders. Now there have been others that simply didn't want to change(guess what... they re-offended and went straight back). Theres a very distinct pattern..


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## Summit (Dec 5, 2016)

Not knowing that much about TSM or naltrexone in the setting of AUD, I hopped over to Pub Med... and.... holy crap is it hard to find non-paywalled articles even using my institutional access. Here are good articles I found and I cannot read ANY of them.

Opiod Antagonists in Alcohol Abuse
http://www.cochrane.org/CD001867/ADDICTN_naltrexone-and-nalmefene-for-alcohol-dependent-patients
LARGE meta review, found these moderately effective and recommends them basically because AUD is so prone to relapse.

Safety and Tolerability of Pharmacological Treatment of Alcohol Dependence: Comprehensive Review of Evidence
http://link.springer.com/article/10.1007/s40264-016-0416-y
2016 drug safety no full text

Acamprosate vs Naltrexone - Cochrane small metareview
http://www.cochrane.org/CD004332/ADDICTN_acamprosate-for-alcohol-dependent-patients
Equally effective

Reductions in Alcohol Craving Following Naltrexone Treatment for Heavy Drinking.
https://www.ncbi.nlm.nih.gov/pubmed/27402770
n=200 28 day study inpatient rehab wish I could read full text

Most docs are using meds for treatment, but have their dobuts
https://www.ncbi.nlm.nih.gov/pubmed/27895598

Naltrexone reduced efficacy in certain subpopulations due to genetics.
https://www.ncbi.nlm.nih.gov/pubmed/27510425

Naltrexone ineffective in alcoholics during Monetary Incentive Delay
https://www.ncbi.nlm.nih.gov/pubmed/27600363

Psychomotivation underlying AUD may influence which pharmacological intervention is more effective
https://www.ncbi.nlm.nih.gov/pubmed/27480445

Saw some animal data that Varenicline may be synergistic with Naltrexone

Looked at Cthreefoundation.org and found ZERO links for clinical evidence.


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## Stopper1 (Dec 5, 2016)

NysEms2117 said:


> The first true step into rehab is wanting to do it/be there.


I fully agree with you on this one. All AUD treatments including the Sinclair Method only work for people that are ready to get their drinking under control, but I believe a large percentage of the alcohol abusers of today want just that. They are hiding their addiction at home because they see no way out. They are afraid to even mention it their doctor - because they will be 'labeled' alcoholic in a database, told to detox (expensive), , told to spend 30 days away from work and spend in an expensive rehab, told to fully abstain from alcohol (total abstinence) for the rest of their lives and they really should attend AA meetings on a weekly basis - maybe for the rest of there lives. Wow!  Can you imagine telling that to a college kid - or even to an adult whose drinking is out of control. Not even another beer! for life! The number of functional alcoholics that never go to a doctor is staggering, because that is all that's dished out for 'treatment' today - which really is no medical treatment at all. 

One little pill (50mg of naltrexone) is not medicating the crap out of someone. Getting black out drunk once a week is. 
You only take it on days you drink, which after 3-6 months, for many is seldom - for many others it's never again - with all cravings extinguished.
Did you watch the TEDx talk?

No treatment works for everyone. TSM doesn't work for 22% of those that try it. They may not be ready I guess or the medication may not work for them.
With all due respect to your experience, we will have to respectfully disagree on what works best for AUD treatment. 
I will stick to supporting a proven method with an 78% success rate.


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## Stopper1 (Dec 5, 2016)

Summit said:


> is it hard to find non-paywalled articles even using my institutional access.


You may want to use your home computer. The Sinclair Method is all over the www.
Google, Youtube,  TEDx, Wikipedia.  I'd recommend Googling it from home.  Your firewall must be blocking info.

www.cthreefoundation.org is a non-profit that has the best information.

As to the links you sent. They are not The Sinclair Method.
Keep in mind the current medical guidance on Naltrexone is wrong - to take it every day which is very ineffective. 
TSM - you only take it on days you drink, which after 3-6 months, for many is seldom - for many others it's never again - with all cravings extinguished.
The documentary One Little Pill explains the Pavlovian science and the well understood concept of pharmacological extinction. 

Another great PBS Nova special called "Memory Hackers" describes how simple one-time medications can be used today to change long held fears.
Amazing info - the entire episode is on Youtube.


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## Stopper1 (Dec 5, 2016)

PEER-REVIEWED RESEARCH AND WRITINGS BY J. DAVID SINCLAIR, PHD
PEER-REVIEWED STUDIES

http://www.cthreefoundation.org/explore-the-science-of-tsm.html#.WEXAWuYrLyQ


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## NysEms2117 (Dec 5, 2016)

I can settle on agree to disagree. However I have a few points to think about. 1. Think about somebody that never takes medication. 100% healthy. 1 pill to them will be a lot. Especially every single day. Also the people I deal with, I am that person that says you cannot drink, hell I even tell those parolees they can't even have alcohol in their residence, as well as alcohol paraphernalia(beer cans, shot glasses, anything of that sorts). Which seems to work well. The concept of rehabbing is to get people to the point where they don't need anything "special" in this case medicine to get through the day. Some states call my job a "rehabilitation specialist".  I haven't read up on the medication but how can you predict when your going to drink? I'd also have to disagree on the Doctor bit but that's another story for another day. 


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## Summit (Dec 5, 2016)

Stopper1 said:


> You may want to use your home computer. The Sinclair Method is all over the www.
> Google, Youtube,  TEDx, Wikipedia.  I'd recommend Googling it from home.  Your firewall must be blocking info.


Institutional access means I get into medical journals that are paywalled, not that there is a firewall.

By the way, google, youtube, tedsx, and wikipiedia are not academic sources. 

Neither is a website run by the method's creator with a few articles that are mostly 10-30 years old and links to his patent.


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## Stopper1 (Dec 5, 2016)

Oh my bad. I can't argue with you. You have access that I don't. Do you have access to research in Finland? That is where Dr. David Sinclair scientific journals would be in their entirety. Lay people like myself don't have that kind of access. I really don't want to get into a drawn out discussion over what's on the www  but it does provide insight into the latest brain research and it is daily finding new medical ways to treat all diseases including AUD. Most of us rely on the web to find good alternatives to 1939 pseudoscience. You can't discredit the entire web just because it isn't behind some paywall institutional access. You seem to have the medical background. Are the C3 links pointing to bogus science in your opinion? C3 is not run by Sinclair. He died after giving away all his research results. Believe me C3 is not a money-making proposition. Just people trying to help people. It's that simple. Let's not over complicate this. People want a real scientific trial-based treatment other than 12 step. Got any better ideas?

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## Summit (Dec 5, 2016)

I'm not opposed to the TSM. I don't know enough about it. I'd like to know more.

While nobody in my life is subject to the ills of AUD, I take care of people who are in the ICU on a regular basis. I hate seeing it (and they are usually frustrating patients). Heck, it was shocking seeing the actress in your OP talking about it on TedX (since I had a crush on her 20 years ago... OMG am I that old?)

I'm well aware how bad most methods are. Of course NYS's point that no method works without a desire to quit.

I'll try to peruse the papers on C3 when I have some time. Sometimes I think I'd like to be a PMHNP... be a bit different from ICU/EMS...


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## Stopper1 (Dec 5, 2016)

Sounds good. If you have Amazon Prime you can watch the full documentary 'One Little Pill' for free. Again the info & the method are free and there is no money to be made. It may also be free from your library via Hoopla digital.  You will be amazed ... you might be more motivated to slog through scientific papers after.
The Cure by Dr. Eskapa is much easier to read for people like me. I have a technical/science background and every bell went off when I read it, but then again I have seen family up close while suffering with and feeling helpless with AUD.  Alcohol makes them behave just like lab rats (to put it bluntly).


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## akflightmedic (Dec 5, 2016)

I am scared if we cure all the alcoholics and drug abusers then there would be no EMTs/Paramedics left....I mean how else would we get through our shifts without those helpers?


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## NysEms2117 (Dec 5, 2016)

akflightmedic said:


> I am scared if we cure all the alcoholics and drug abusers then there would be no EMTs/Paramedics left....I mean how else would we get through our shifts without those helpers?


I may be out a job too  lol.


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## Stopper1 (Dec 7, 2016)

I know I'm extremely sensitive about this subject because of how it's affected our family. Please tell me you guys are kidding. Your profession is to help people and and I know that's why you got into this. There will always be plenty of people to help.

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## Summit (Dec 7, 2016)

Your sarcasm meter is broken


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## NysEms2117 (Dec 7, 2016)

Not speaking for Ak because that ain't cool. I was joking. I think you should see a broader scope, I made it clear that I was kidding. Life tip: Ease up a bit, you'll drive yourself crazy otherwise


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## Stopper1 (Dec 7, 2016)

Ok I'll chill

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## gotbeerz001 (Dec 8, 2016)

Being so emotionally invested into something is a double edged sword; while that passion may give you additional drive, sometimes it can blind you in other areas that are relevant but do not fit with your individual experience. 

If you are serious about informing people and effecting change, maybe find a group that has an established reputation and work towards formalizing some pub ed materials. You could join/form a non-profit which has a solid online/social media presence as well as booths etc at events. 

Going off about a single method on a random internet forum and having such a contentious approach to the audience you say you are trying to influence is sure to get you nowhere fast. 


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## Stopper1 (Dec 9, 2016)

I don't wish to argue, but your post seemed a little contentious as well - maybe you didn't mean it that way. You may not have a friend or relative dying by alcohol, I don't know. I will admit to being emotionally invested. You might be as well if a loved one of yours had come close to death from alcohol.

As to finding another group, I still think EMTs that deal with alcohol deaths (especially the innocent families) on a daily basis, is a group that should at least know of a new treatment. I'll admit I came on a bit strong - sorry - but the science and the evidence is staggering to me. I was really just asking EMTS to watch one 15 min talk and then think about it for the people they know who are suffering.

This isn't just some random new 'single' method to just try and see how it might help. It's ground breaking. I would compare it finding insulin for diabetics, so to not talk about it is a crime.   Again, I am sorry for seeming contentious - didn't mean to be.


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## NomadicMedic (Dec 9, 2016)

Why are you not getting this?

EMS doesn't (and IMHO shouldn't) offer counseling services to alcoholics. It's not our mandate. 

 We customarily see patients for a short period of time, primarily dealing with acute instances of injury or illness. And frankly, were undertrained to perform most of those tasks. 

You'd be better off posting your crusade on a social work or public health/nursing forum. 

Good luck with your mission, but in continuing to push this on an EMS forum, you're trying to cram a square peg into a round hole.


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## gotbeerz001 (Dec 9, 2016)

Stopper1 said:


> I don't wish to argue, but your post seemed a little contentious as well - maybe you didn't mean it that way. You may not have a friend or relative dying by alcohol, I don't know. I will admit to being emotionally invested. You might be as well if a loved one of yours had come close to death from alcohol.
> 
> As to finding another group, I still think EMTs that deal with alcohol deaths (especially the innocent families) on a daily basis, is a group that should at least know of a new treatment. I'll admit I came on a bit strong - sorry - but the science and the evidence is staggering to me. I was really just asking EMTS to watch one 15 min talk and then think about it for the people they know who are suffering.
> 
> This isn't just some random new 'single' method to just try and see how it might help. It's ground breaking. I would compare it finding insulin for diabetics, so to not talk about it is a crime.   Again, I am sorry for seeming contentious - didn't mean to be.



I felt as though I was (maybe) being direct but trying to offer you a more appropriate avenue. 

As @DEmedic alluded to, when we see these people, they usually are not in a state where they can hear anything in regards to the consequences of their life choices... Hell, if we're lucky, we may get them to accurately tell us what they've been doing the past 4-8 hours. Our role is to pick up the pieces and to deliver them to a facility in (hopefully) a slightly more improved state than we found them. The facility will render care until they are out of their acute event and then maybe/hopefully there is somebody who can show them a better way... But that somebody isn't us. 
By the time they get out, we are onto our next shift and have likely seen 6-8 more patients who are suffering from an acute event that is maybe NOT a direct result of their conscious poor choices over the past 24 hours. 
Frankly, getting emotionally invested in our patients does not lend well to a long career in this field. In fact, we often got into this field because the single-dose approach fits best with our personalities; if we wanted long invested relationships with our patients, we would become PAs or MDs... Those professions certainly pay more. That said, I want to see all my patients improve but realize that I have very little control over that simply due to the fact that our encounters are so short. Every now and again I will have a patient that strikes a chord and I will go out on a limb to have a mini "come to Jesus" talk with but these cases are few/far between and I usually have no way to get any feedback as to whether what I said made a difference; so I say my peace and move on. 

I also wish you the best in your endeavor, but I believe you have a misunderstanding about what our job actually is.  


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## gotbeerz001 (Dec 9, 2016)

Last thing I have to offer: 
If you want to integrate EMS into the education effort, be part of a legitimate organization and create a simple postcard which has all the necessary info to help the alcoholic navigate to a specific website. 
Once that is done, talk to each provider agency and find out if they would support handing them out. 
If they agree, the EMS crew would have the option to leave the info sheet with the pt belongings so that they have it when they sober up. 

That is about all I would be willing to do if my agency said this is a thing they are supporting. 

This will require significant work on your part and you will likely meet with significant resistance due to possible legal implications because every decision made in EMS has to pass the "will I be sued for this" test. 

Maybe @akflightmedic has more info from an owner's perspective


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## Carlos Danger (Dec 12, 2016)

I'm not sure that reducing DUI's is necessarily the same thing as treating chronic alcoholism. It seems to me that a large percentage of DUI's are among folks who party too hard and don't have the best judgement, but aren't necessarily chronic alcoholics. That said, it seems logical of course that anything that has a significant impact on the overall problem of alcoholism would likely have a significant impact on DUI-related morbidity and mortality.

I never heard of using naltrexone to treat alcoholism before I read this thread. It certainly sounds interesting. Not being able to access any of the current literature on the topic though, I have to believe that if it were really an efficacious and feasible treatment, it's use would be much more common.

As others have said, as paramedics we aren't really in a position to advocate effectively for this type of treatment.


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## akflightmedic (Dec 16, 2016)

At this time, I simply would be hands off. This is not what EMS is set up to do at this time...even being an advocate of this product or any therapy/treatment..whatever. I do not like the phrase "that's not my job" however there are times where it truly applies and in my opinion at this time...it is not the smart thing to even think about taking on. EMS is NOT the right audience or movement for any of this.

So much more to expand on but most of it has been already covered by other posters. In short...no.


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## ExpatMedic0 (Dec 16, 2016)

You know what I am going to do next time I get a DUI patient? Treat the patient like any other patient for any acute injuries or medical illness and transport if needed. In my report, I am going to write a non-bias patient care report that only has to do with the patient's injury and illness findings or maybe a SOAP chart.  I am not going to touch any legal issues or assumptions, and I am certainly not going to give drug and alcohol counseling to someone in a pending criminal case, because I am not licensed to do that. There is an entire healthcare system; we are merely the first 15 minutes of what could be hours, weeks, months, or even years of patient care for one incident. There are the specialist, drug and alcohol counselors, ect, etc. If you want to make an impact in prevention of alcohol-related injuries or even DUI specifically, then get a master of public health degree and work on an evidence-based public health campaign. If it's successful, publish it in a peer-reviewed journal and have it replicated with the same successful results multiple times.


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