Missed opportunities? Management of patients with alcohol problems in a surgical ward.

Patients with alcohol problems necessitate treatment with counselling, and hospital admission for alcohol related complaints presents an ideal opportunity for this. This paper aims to examine the management of patients with alcohol related complaints on a surgical ward. Patients were interviewed to analyse the extent of their alcohol problem and counselling received, and doctors completed a questionnaire about counselling they offered. Forty seven out of 435 patients (10.8%) had alcohol related complaints; 28 of these 47 were alcohol dependent; 22 out of 28 alcohol dependent patients were not spoken to about their alcohol consumption on this admission. Thirteen doctors responsible for hospital admissions completed the questionnaire: although an alcohol history was almost always taken, counselling was rarely offered. In conclusion, the management of patients with alcohol problems in the emergency admission was sub-optimal. The treatment most needed was counselling, and this ideal opportunity for intervention was almost always missed.