At 12.45am on a Tuesday morning the drunk in bed eight wakes up and he's not happy.
"I don't need to do what you say and I really don't give a f..k what you want," he tells the two security guards trying to get him back into bed in Calvary Hospital's emergency department.
He doesn't know where his clothes are, has no idea how he got to hospital (his friends called an ambulance after he passed out drinking), and he is refusing to co-operate.
Soon, two doctors, the wardsman and several nurses have joined the security staff around the man, trying to calm himand get him back into bed so they can check him for injuries.
By 1.15am after prowling the corridors of the ward and the carpark outside he's demanding to go home and trying to pull the cannula out of his arm.
Three beds away, the girl who had been drinking all night and spat in the face of the ambulance officer trying to treat her on the way to hospital has passed out again and is snoring loudly.
So far, it's been a pretty quiet night. The previous Saturday the department had dealt with a near comatose man who had drunk himself unconscious at a Civic pub and didn't know what was in the pill he had taken (he thinks it might have been ketamine); a girl who had dislocated her ankle riding her bike home drunk; and a highly aggressive woman who subjected ambulance and police officers to a 25-minute verbal tirade after they found her in the crumpled wreckage of her Mercedes that she had apparently driven into a parked car at high speed in Braddon.
These incidents are just the tip of the iceberg says the Australian College for Emergency Medicine, which has warned that hospitals across the country are becoming battlegrounds as drunk, aggressive patients flood through their doors.
While the scourge of ice and other amphetamines has grabbed much of the media's attention, a recent national survey of 2000 emergency department staff has revealed alcohol as a vastly greater problem: 92 per cent had been physically threatened by drunk patients, 98 per cent had been verbally abused and 88 per cent said the care of other patients had been negatively affected by drunks in the department.
The survey, conducted in December, found one in eight patients nationally had ended up in hospital as a result of harmful alcohol abuse and the college says nearly half of all Australians reported drinking at levels that put them at risk of injury.
In Canberra on the night the survey was taken, 20 per cent of admissions involved alcohol but registrar Clare Foss says that figure is conservative - the following evening four of every five patients coming in the door had alcohol-related injuries or were massively intoxicated.
"I've been punched, I got hit in the head with a mobile phone while I was heavily pregnant, then there are people getting needle sticks and getting splashed (when drunk patients rip their drip out) … you get pretty good at ducking and weaving."
Dr Foss said she had noticed an increase in drunk 12-14-year-old children presenting at Calvary over the last decade and dealing with aggressive drunks was particularly difficult, because doctors had a duty of care and many patients did not realise they had other injuries until they sobered up.
"We CT scan every drunk with a head injury because, unlike a pub where you can just bounce the aggressive ones, here you've got to ask, 'are they trying to kill us because they have a head full of blood, are they (hypoglycemic) or just angry?'"
Director of Emergency Medicine at Calvary Stuart Stapleton says due its proximity to Civic, Calvary gets most of the drunks causing problems in Civic. While violent drunks pose a serious risk to staff, other patients are also suffering.
"The biggest concern with these patients is if they do require all those additional resources then you're taking resources away from other patients, putting those patients at risk because you may have to shuffle things around and might not be able to watch them as closely as you'd like to."
Victorian-based lead researcher on the alcohol study Dr Diana Egerton-Warburton said the situation was getting out of control, and required governments around the country to implement stricter harm-reduction measures, like limiting pub opening hours as has been trialled in parts of Sydney.
"Frankly, at times it's more like working in a nightclub. We had a drunk man knock a doctor unconscious because he wanted a sandwich," Dr Egerton-Warburton said.
The college is calling on governments to introduce 3am as the latest time for serving alcohol in pubs and clubs, a freeze for new late night licences and 10pm as the latest time for packaged liquor sales.
In 2010 the ACT Government made a number of changes to the Liquor Act in response to community concerns about anti-social behaviour and violence stemming from alcohol abuse. The Government recently concluded a review of those changes and a spokesman said the government was still considering its response.
