New "drunk tank" opens in Prague

Pavel Bem in the new station for alkoholics, photo: CTK

The Czech media reported on Friday that a heavily drunk man had attacked and injured the crew of an ambulance carrying him to a "drunk tank" in the north of Prague. The incident happened just one day after the newly refurbished facility was officially opened by the Mayor of Prague Pavel Bem.

Pavel Bem in the new station for alkoholics,  photo: CTK
"This is the third station for alcoholics in the city of Prague. The first one was established in 1947 by my teacher, Professor Jaroslav Skala."

Prague's Mayor Pavel Bem is a doctor by profession. He used to specialise in treating drug users and alcoholics. In the past he also worked in the Prague drunk tank, a place for people too drunk to take care of themselves and sober up.

"During my student years I practiced the first anti-alcoholic station. This one is really fantastic, especially because it is a part of the complement of the Bulovka teaching hospital and at the same time offers quite sophisticated services like, for example, the intensive care unit, which definitely is needed, especially during night hours. So I think it's really good that Prague has such a service for those who have troubles with alcohol consumption."

When I visited the facility, it was all shiny and new and quiet. It was hard to imagine what it actually looks like when clients arrive.

"When they bring the person here, we give them a breathalyser test. If they have a sufficient level of alcohol in their system, they stay here with us. Those who are able to undress, take their clothes off themselves. We give them a nightgown and put them to bed. If the person cannot undress, we undress them and give them a warm shower - no cold showers from hose pipes here as the rumour goes! Then we put them to bed."

Tomas Kumsta is a nurse at the newly opened Prague drunk tank. He looks like a no-nonsense person and one who can handle even an aggressive client.

"If the person is aggressive, which often happens with alcohol, we have to use force but the aim is not to beat him up as people often think. We need to pacify him before he hurts us or himself. Then we take him to solitary and tie him to the bed. When his alcohol level drops and he realises where he is, then we release him and take him to a normal bed for the rest of the night. In the morning we give everybody sugary tea because it helps break down the alcohol. The more sweet tea they drink, the better."

The drastic methods nurse Tomas Kumsta spoke about are a thing of the past. The "drunk tank" at the Bulovka teaching hospital looks nothing like a prison. The equipment looks maybe too sophisticated for someone who's too drunk to stand on his feet. The Prague facility is actually among the best-equipped in Europe.

"That's very likely true. I am sure the Prague station is probably one of the most sophisticated and most modern."

Says Mayor Pavel Bem. While a state-of-the-art facility has opened its doors to treat acute cases of alcohol poisoning, the once functioning network of centres for the prevention of alcohol abuse has fallen apart in the Czech Republic. The head of Prague's Addiction Treatment Clinic, doctor Petr Popov told me more.

"In the past there was a network of facilities called "Consulting Offices for Alcoholism and Other Toxic Abuses", there was one in every district. When a person was placed in a drunk tank, he was reported to this office. They could summon him and along with other institutions put pressure on the person to start dealing with the situation. Each time, the pressure would be stronger. Not only was the person made to seek counselling but it could also have implications for their job. This is not possible today, with the collapse of this network there is no chance of getting the information and working with these people further."

A seemingly obvious explanation for the disintegration of the prevention system would be a certain wave of post-communist liberalism that swept the country in the 1990s but doctor Petr Popov says the reasons were more mundane.

"The reason was economic. The doctors in those offices were psychiatrists who beside their normal jobs had to work part time in this office. In the 1990s practically all psychiatrists went private and most of these doctors stopped catering to these clients. Neither health insurance companies, nor the municipalities or the doctors' chamber oblige them to. There are no people, there are no facilities."

Pavel Bem in the new station for alkoholics,  photo: CTK
According to statistics, alcohol consumption is rising in this country, so I wondered how it reflected on the occupancy of the Prague drunk tank.

"The average occupancy is from twelve to fourteen patients per day. The maximum capacity is seventeen. That means for the time being it's enough. If there is any trouble, if the capacity is not enough for Prague, we would probably have to think carefully about what is happening with alcohol consumption in our capital. But currently I'm quite optimistic and I think that seventeen beds is just the perfect number for the needs of our capital."

Although women tend to abuse alcohol less than men, as nurse Tomas Kumsta says, the share of men and women at Prague's drunk tank is about the same.

"We have women here, of course. It's quite common. I would say that these days the proportion of men and women is the same."

Back in the communist days, a night spent in a drunk tank cost the client as much as a bed and breakfast in a five star hotel. Today the gap between the two has widened but still, it's not cheap to spend a night here at Bulovka. After all, such a place is expensive to both build and run. Mayor Pavel Bem.

"The construction costs are estimated at over 23 million Czech crowns and the cost for one night or one day spent at the anti-alcoholic station is from 1,700 crowns to 3,000 crowns based on the services provided. So it's quite a costly service."

A typical drunk can hardly be expected to pay with a gold credit card in the morning so I asked nurse Tomas Kumsta how the money is obtained from the clients who stay overnight.

"We write them a receipt here and then it's up to them how they will pay. But there are official ways of enforcing the payments."

Last week's incident in which a drunk man attacked the crew of an ambulance was a reminder of the fact that alcohol abuse is an issue which this country needs to deal with on a more systematic basis. The head of the Addiction Treatment Clinic Petr Popov says that his colleagues and other experts would welcome the renewal of the once functioning system of preventive care.

"It is necessary to encourage the establishment of such facilities and support their operation. They will not emerge spontaneously. Without help from the state, i.e. the Health Ministry, this network will not function again. There are various contact centres dealing with non-alcohol drugs, they are working very well and it is important that they are helping people. But there aren't any such facilities for people with a drink problem."