I remember in residency and at some other hospitals where I worked, drunks would be traiged and sent back out to the waiting room, brought in only if there was obvious trauma or they were severely obtunded. Your typical sleeping, stinky drunk waited out in the lobby until it wore off and then he (or she) left in the morning  – usually never coming into the dept for an evaluation.  This was partially because it was really busy and there were sicker people to see, but also partially because, after all, who wants to deal with them?

Great idea on paper – until one of them seizes or suddenly dies because no one realised they also got kicked in the abdomen and had a ruptured spleen. I could see the headlines, “Man dies of massive internal bleeding while slumped over, ignored in the waiting room of the ER”.  After, all this happened in Brooklyn a few years ago when a psych patient in the psych ER waiting room died from a PE and everyone just went about their business, assuming she was either sleeping or acting out.

No, you have to bring them in as much as it sucks.  Once they are in your dept, they are your problem until they are sober.  Maybe a way to solve this is for police depts and family/friends to just keep an eye on them either at home  (or in jail I guess) and let them sleep it off – but Hell, they don’t want the responsibility any more than we do.

Really no solution exists that I can see. Even in ER’s where drunks can be transferred for “detox” at some other facility are really just passing the buck on to someone else.  Sigh.

Third visit for intoxication for a 15 y/o boy. What to do?
We put him in a large 4 person room with two other drunks- but these guys were your typical stinky, toothless, near cirrhotic drunks. (under constant observation by security) As the teenager sobered up, we showed him the other guys, all urine soaked and filthy.
A simple, “straighten out now or end up like them!!” was all it took to scare the crap out of him. He looked horrified.
Hopefully we won’t see him back.

Usually Drunks are unpleasant. Often combative, stinky, and verbally abusive. This is especially true of those who’ve suffered an ass-kicking. Thus, it’s rarely anything put supremely painful for me to deal with drunks who have fractures and or lacerations.
Imagine my pleasure when I had what I found initially to be a supremely angry drunk who was fighting with the security guards. He had multiple deep facial and ear lacerations that needed a lot of work. Amazingly he immediately sat still, stopped fussing, and let me fix them in no time! No Haldol necessary! Afterwards he profusely thanked me and chilled out the rest of the night.
Pure drunkard pleasure!!!
I didn’t give two craps that he was self pay.