Excessive alcohol consumption is frequently linked to street violence and drink-related injuries. Susan Calnan outlines an initiative to counter the trend.
In Cork city, a group of publicans and nightclub owners have taken a proactive approach to binge drinking by taking part in a unique training programme in alcohol and drug awareness, tailored specifically for their staff and management.
Launched a year ago, the pilot programme - known as Club Cork - is the first specific training programme of its kind in Ireland.
It was devised following publication of a report by the Cork Local Drugs Task Force in 2000, which identified the abuse of alcohol among young people as a major issue in all parts of Cork.
The report recommended the setting-up of a pilot project to inform and educate pub and nightclub staff, doormen and managers, as well as off-licence staff, on how to take an active role in dealing with substance abuse on their premises.
Co-ordinated by the Southern Area of the Health Service Executive (HSE), in conjunction with the Garda and the ambulance services in the city, the initiative has already delivered training to staff in more than 38 establishments in Cork, including hotels, pubs and nightclubs.
"The training programme is based on the concept of 'responsible serving' of alcohol and was developed after consulting with local publicans about ways to enable them and their staff to better deal with alcohol and drug misuse," says Sharon McGillacuddy, co-ordinator of the course and health promotion officer with the HSE, Southern Area.
"The majority of publicans wanted to increase their general awareness about alcohol misuse and also their knowledge about other types of drugs that are out there, as well as identifying effective ways to deal with an incident on their premises."
Delivered over two half-days, the nine-hour training programme, which is funded by the Cork Local Drugs Task Force, is designed for all members of staff, including bar workers and door staff, management and proprietors.
The course covers a range of topics, in addition to general alcohol and drug awareness, including conflict resolution, effective communication skills, codes of good practice in relation to alcohol legislation, awareness of the hazards of clubbing and emergency response awareness.
In addition to the nine-hour programme, a follow-up course in cardiopulmonary resuscitation (CPR) is also provided and in recent months more than 50 pub and nightclub staff have been trained in CPR.
"The beauty of this programme is that it creates a partnership between the staff working in these outlets and the emergency services, which in turn gives each partner a greater appreciation of the other person's role," says Kieran Henry, an emergency medical technician (EMT) and station team leader with Cork ambulance service and a lecturer on the course.
"One of the things we do on the course is to outline to participants the structure and role of the ambulance service and to identify the things that staff can do prior to the arrival of the ambulance, in the event of an incident on their premises.
"On any one night, the ambulance service may have to deal with a number of calls, so it's important that information we are given - for example, the nature of the injury and the priority of the call - is accurate and staff are adequately trained to handle a serious incident before the emergency services get to the scene."
Another key objective is to give staff and management a greater awareness of the hazards of drink and drug abuse, which is estimated to cause one in four admissions to accident and emergency departments.
Dr Chris Luke, consultant in emergency medicine at the Mercy Hospital and a lecturer on the Club Cork training programme, has spent the past 23 years working in A&E departments, including a number of years in one of Europe's largest A&E departments in Liverpool.
"Alcohol misuse is still overwhelmingly the problem that lies behind many of the admissions we see every week in our A&E departments," he says.
"Increasingly, however, poly drug misuse is becoming the norm, as more and more young people are now taking a cocktail of drugs - in particular, a combination of alcohol, cannabis and cocaine."
Dr Luke is particularly concerned about the growing use of cocaine in Ireland, which he says can lead to astonishing and terrifying levels of violence, both deliberate and unintended.
After more than 20 years of witnessing, first-hand, the shocking effects of drug and alcohol misuse, Dr Luke says a proactive approach, such as initiatives like Club Cork, is crucial to help combat the substance abuse problem.
"The big question today is how can we reconcile modern hedonism with old-fashioned altruism. My advice is to introduce a commercial solution to the problem - get the publicans and nightclub owners on board and educate them about the hazards of drink and drugs and about the importance of implementing effective health and safety measures. If they still misbehave, even after education and proper training, then penalise them accordingly."
Although it's only one year since the launch of the Club Cork initiative, Dr Luke says the programme is already having an impact and that there has been a slight levelling-off in the number of A&E admissions due to alcohol and drug misuse.
Similarly, gardaí in Cork have indicated there has been a decrease in the number of public order problems in the city.
"On a typical weekend night in Cork city, you can have anything over 16,000 people on the streets after the nightclubs close, so inevitably there's going to be problems," says Sergeant Tony Davis, from the Community Policing Division at Anglesea Garda Station in Cork.
"We've definitely noticed a fall in the number of public order problems in the city, however, in the last two years and we attribute part of this success to the Club Cork initiative."
Publicans and nightclub owners in the city are equally positive. A recent evaluation of the project indicated 95 per cent of participants found the course highly beneficial and said they would recommend the training programme to other staff.
Some members of staff have also expressed interest in receiving more comprehensive training in first aid and plans are already underway to deliver a similar training programme to staff working in off-licences in the city.
"Any pub or nightclub proprietor and their staff will benefit from taking part in a programme like the Club Cork initiative, particularly in terms of becoming more aware of the dangers of substance abuse and how to deal with a potentially volatile situation," says Paul Montgomery, proprietor of Reardons late night bar on Washington Street in Cork.
"It also gives you a greater appreciation and understanding of the work of the emergency services and demonstrates how we can all play our own part in helping to make the streets a safer place.
"As purveyors of alcohol, we do have a certain responsibility to ensure people enter and leave our premises in a reasonable state and that they aren't a danger to themselves or to the general public," he says.