Giving alcohol to an alcoholic?

wannabeHFD

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I'm doing paramedic clinicals and We had a call for an alcoholic who's family wanted him to get rehab. He tried to quit, went through bad withdrawal, but drank a half bottle of tequila today. He wanted another shot before he'd agree to go, and the paramedic I was with let him. This struck me as an odd move, but he explained that one wouldn't matter and would avoid him getting violent over our refusal.

What are your thoughts on their decision?
 

Handsome Robb

Youngin'
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I'd prefer they didn't but if that's what it takes to keep him from freaking out and coming voluntarily fine.
 

chaz90

Community Leader
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Did it work? The guy was already intoxicated after half a bottle of tequila (probably baseline for him). I'd do the exact same thing if that's what it took before he'd come along.
 

Arovetli

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Alcohol can be "prescribed" in the hospital in certain circumstances for alcoholics to stave off withdrawals, though the quantity is closely monitored.

So it is not unheard of. In the situation you describe, I wouldn't necessarily encourage or discourage it, I would focus on getting the patient safely and effortlessly to the hospital.

One shot certainly isn't worth picking a fight over.
 

DesertMedic66

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If that one shot is the deciding factor to get the patient to come to the hospital calmly then yes.

20:21 patient placed on O2. 20:22 patient given 1 shot of tequila PO with positive results :rofl:
 

Ecgg

Forum Lieutenant
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Absolutely, why instigate a fight? If you get called to a scene by "concerned citizens" for undomiciled who is protecting that bottle in a paper bag with his dear life are you going to try to wrestle it away as well?
 

Milla3P

Forum Lieutenant
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Let him have his "last" shot or fight him all the way to the detox?!

David Crosby once agreed to detox as long as he could freebase cocaine on the private jet all the way to rehab.*

Risk V Benefit. What's that shot going to do that hasn't already been done already.

*Disclaimer: if you're thinking about letting your pt smoke cocaine in your truck, call your supervisor.

**Double Disclaimer: if you don't know who David Crosby is, what do you know?
 

Bieber

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If he was mentally competent, what right does EMS have to tell someone what they can or cannot due prior to entering the ambulance?
 

VFlutter

Flight Nurse
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Go for it. One more shot won't change anything and if it makes him cooperate then great.

In the hospital we will sometimes provide alchohol in tapering doses to facilitate a smoother withdrawal but that is rare. He will get a few banana bags, some benzos, and rest.

Without proper medical care during rehab programs most will relapse. Delerium Tremens is horrible to go through, especially not medicated.
 

medicsb

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Also, in my experience, though alcoholic drinks can be prescribed, CIWA protocol (Clinical Institute Withdrawal Assessment) or some other benzo regimen is usually used for withdrawal.
 

Remi

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If he was mentally competent, what right does EMS have to tell someone what they can or cannot due prior to entering the ambulance?
This.
 

Trashtruck

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I think he did the right thing. The ultimate goal is to get the guy to go to the hospital, which he probably won't do until he's sufficiently :censored::censored::censored::censored:ed up. Finish the bottle if you want, bring it along with you. Whatever it takes.

Rehab centers who pick up pt's at airports or from their homes to transport to the rehab center will allow them to drink or cop drugs lest the pt jump out and run away in search of said drink or drug.
 

Arovetli

Forum Captain
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If he was mentally competent, what right does EMS have to tell someone what they can or cannot due prior to entering the ambulance?
There is a good bit a paternalism inherent to healthcare, but as is pointed out, though you may know what is best for the patient, they can still generally do whatever they want to do.

Too many folks be tellin' folks how to be.
 

wannabeHFD

Forum Lieutenant
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If he was mentally competent, what right does EMS have to tell someone what they can or cannot due prior to entering the ambulance?
The pt had a history of seizures and it was clear he wasn't exactly "mentally competent" his sister warned he might be combative when We arrived. The family didn't object either, and his mom is the one that poured it for him. He could barely stand and hardly knew what was even going on. He asked who We were at least three times like We just got there. He never gave us any problems, but he kept thinking We were cops.

The only thing was that on the way to the hospital, he would look off into nowhere doing like a screaming moan over and over while reaching out for something. I think he was trying to explain what was going on but his mind couldn't manage to verbally communicate it. The only thing We got was that he was really wanting a cigarette
 

wannabeHFD

Forum Lieutenant
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DT seizures? Give daddy his medicine before he rides.
Oh he wasn't going through withdrawal when We were there. He already downed over a half of a bottle of tequila before We got there. He has been trying to quit previously but I suspect it wasn't going so well
 
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