My first job in a hospital (I'm an ER nurse ) in 1993 was as an ER tech at Hennepin County Medical Center in Minneapolis.
After welfare checks came out at the beginning of the months, we would have literally dozens of homeless alcoholics lining the hallways of the ER, sometimes stacked in gurneys along the wall, three deep.
The beginning of the month, people would drink hard liquor. Middle of the month, cheap grain alcohol and towards the end of the month, when Walgreens sold 1 liter bottles of Listerine for $2, "List" became the drink of choice.
At the time, it was illegal to be publicly intoxicated in Minneapolis, so the police would pick up the drunks and bring them to the ER for medical clearance, but never take them to jail when they were sober. So, the drunks would marinate all night in the ER until they could blow less than 0.1 on a breathalyser and then they could walk out.
ER overcrowding with drunks became such a huge problem, that the hospital opened up a "drunk tank" or a dedicated hospital unit to let these guys sleep and sober up. It was a 25 bed unit, and you weren't eligible to stay on that unit unless your alcohol level was over 0.3. I routinely saw people at 0.4 and occasionally 0.5. (Legally drunk in California is 0.08 these days.)
On top of that, the ER built a dedicated holding unit for the alcoholics who blew between 0.1 and 0.3 on the breathalyser. It was an 8 room locked holding unit. staffed by 2 nurses, 2 security guards and 2 ER techs. One night, I remember holding over 26 patients in there.
One night, two police officers (understandably) who were quite fed up with the situation brought in 3 patients soaked in urine and feces in to the ER in their patrol car. They could only fit 1 in the back seat of their car, so they brought the other two.... in the trunk of the cop car. Bad plan.
Someone called the press, the cops were suspended. The two alcoholics pressed a lawsuit against the city of Minneapolis, and were awarded $4 Million in damages.
Hennepin County Medical Center, the ER where the alcoholics were brought to knew these two men well. They had had over 200 ER visits and/or hospitalizations in the previous 2 years. So, Hennepin County immediately pursued payment for these two men's ER bills (over $2 Million each), and got a lien on the lawsuit money.
A month after the suit was settled and these men received the payment for the county, and paid off their hospital bill, they started frequenting the ER where I worked yet again--passed out, covered in feces and soaked in urine.
I'm not trying to make judgments. It's a terrible situation all around. Alcoholism is a terrible disease. And, when it's terminal... I think hospice might be the smarter choice.
At least via the hospice model, the alcoholics can die with a few shreds of dignity instead of passing out drunk in a snow bank when it's -20F in the Minnesota winters and having toes and then feet amputated because of frost bite. Also, in the hospice model, the health care system can take care of people who can best use their services.
Good article. It brought back a lot of interesting memories. :)