THE additional strain placed on the health service by festive revellers on 'Black Friday' can be revealed, with hundreds of extra calls to the ambulance service and as many as one-in-three attendances at A&E drink-related.

The last Friday before Christmas has become the busiest night for partygoers over the festive season, as office parties and revellers fill up pubs and clubs.

Figures obtained by the Sunday Herald show on last year's Black Friday, the Scottish Ambulance Service attended around 20% more incidents than a normal Friday. However calls surged by as much as 50% around peak times such as midnight.

Statistics provided by one health board also show around one in three attendances at a hospital A&E on last year’s Black Friday was related to alcohol.

The new figures come in the wake of renewed concerns over Scotland’s relationship with alcohol, following a shocking report which revealed alcohol is a factor in more than half of ambulance call-outs at the weekend.

Campaigners and doctors’ leaders have renewed calls for measures to tackle the issue, such as introducing minimum pricing of alcohol.

The figures from the Scottish Ambulance Service show over the 24 hours from midday on Friday 19th December last year, it attended 1700 emergency incidents. That compares with an average of around 1,435 over ‘normal’ weekends throughout the year – up by 18.4%. Within that timeframe, the increase was as high as 50% at certain times, such as midnight.

A spokesman for the ambulance service said: “Alcohol has a significant impact on ambulance operations across Scotland, particularly at this time of year.

“Our ambulance cover is increased to respond to the rises in demand, which can surge by 20% at peak periods over Christmas and New Year and is mostly alcohol-related.”

Last week a survey of frontline ambulance staff and 999 call handlers revealed alcohol is a factor in more than half of ambulance call-outs at the weekend,

But the service warned alcohol-related problems are no longer a “weekend phenomenon”, with nearly half of all calls during weekday evenings also related to drink.

Two-thirds of staff in the survey said they had been physically assaulted by members of the public who had too much to drink.

Mel McDevitt, a Glasgow-based paramedic said alcohol had a “massive impact” on her everyday job, ranging from dealing with teenagers who have drunk too much and passed out to drunk drivers causing car crashes, and chronic alcoholics.

She said: “It also impacts my job in that I am less available to do things that you would think of – if your granny has a heart attack, chances are there are probably another three ambulances somewhere out dealing with something to do with alcohol and might not necessarily be available for things you would classify as actual emergencies.”

She added: “When I joined the ambulance service I don’t think I realised just how much abuse paramedics and ambulance staff take, particularly from alcohol-related issues.

"I get sworn at and shouted at on a frequent basis every day. I have been spat full in the face, I have had knives pulled out on me on more than one occasion, had people trying to punch me. It is relentless.”

Other figures show that 13 out of 40 A&E attendances at Raigmore Hospital in Inverness on the night of‘Black Friday’ in 2014 were alcohol related – around one third of all cases. That compares to 20% for the previous Friday.

There was a similar pattern the previous year, with 16 out of 41 admissions – 39% - related to alcohol on the Friday before Christmas in 2013.

NHS Highland said it generally expected to see up to 10 additional emergency cases on the Friday night closest to Christmas, and a doubling in the number of casualties where alcohol has been mentioned a factor.

Andrew Rowlands, consultant in emergency medicine at NHS Highland, said: “No matter how much one drinks alcohol always increases the risk of errors of judgement and of accidents.

“The consequences can be significant and even lifelong and may extend well beyond the direct effects on the individual drinker.

“Certainly increased drinking over the festive period puts significant additional pressure on the health care system – especially the emergency services.”

Shobhan Thakore, a consultant in emergency medicine with NHS Tayside, said the most common alcohol-related issues were falls causing injuries to the head or a limb, people being intoxicated with concerns about drowsiness and self-harm while under the influence of drink.

He added: “Carrying out clinical assessments on patients who are intoxicated can be difficult and, in some cases, their behaviour can also be very challenging and distract staff from other patients who are in need of our care.”

Martin McKechnie, vice president for Scotland of the Royal College of Emergency Medicine (RCEM) said it was estimated around one in every five attendances at A&E throughout the year was directly related to alcohol consumption - either directly by the casualty, or being injured due to someone else's drinking.

He said there was likely to be a rise in the proportion of alcohol-related incidents over the festive period, but cautioned against the idea of A&E departments becoming “warzones” as a result.

He said: “If you look at the actual figures, the busiest months of the year are May and June for alcohol-related attendance because people go to the park on the nice summer evenings.

“For the two weeks over the festive period, it is busy and there is an increased proportion of alcohol-related injury.

“But it is May and June which is the busiest time for alcohol-related injury.”

McKechnie said the ideas which have been floated to address the issue - such as charging drunk patients for their treatment or sending them to “drunk tanks” instead of hospital - were “easy to say” – but pointed out patients had to be seen and treated.

He said the RCEM supported measures such as minimum pricing of alcohol and a crackdown on advertising as way to try and tackle the wider problem.

“There is no doubt we have an unhealthy relationship with alcohol in Scotland and there is evidence from various countries around the world that minimum pricing does have an effect on certain groups,” he said.

“It is the ones that probably have the most harmful relationship with alcohol in terms of trauma and violence and injury that would be most affected by a rise in price.”

Norman Provan, associate director of the Royal College of Nursing Scotland, said dealing with the adverse effects of alcohol placed additional pressure on a system “already bursting at the seams” for most of the year.

But he added: “While alcohol is a factor in many people attending A&E, it does not mean that people who are drunk or who have alcohol problems should be treated any differently to anyone else. Nurses are very passionate about being non-judgemental in the care they provide.

“Scotland – as we are all aware – has a difficult relationship with alcohol and we need to tackle some of the root causes resulting in so many people attending A&E because of it.

“We also need enough staff working in A&E sufficiently trained and skilled in dealing with people affected by alcohol so that they don’t have any impact on the care provided to anyone else attending A&E at the same time.”

Alison Douglas, chief executive of charity Alcohol Focus Scotland, said paramedics, nurses, doctors and the police were spending too much time and resources “mopping up the mess caused by excessive drinking”.

She added: “They are particularly busy during the festive season as people tend to overdo it and need medical treatment for passing out, falling over or being assaulted.

“Encouraging individuals to drink less is difficult when we are surrounded by cheap alcohol that is constantly promoted as an everyday product.

“Addressing the affordability of alcohol through minimum unit pricing is an effective way to protect vulnerable citizens, create safer communities and support front line services.”

A spokeswoman for the Scottish Government said it was committed to tackling alcohol-related harm and urged revellers to drink responsibly.

She added: “There are measures in place at a local level to deal with those who are drunk and incapable, including Safe Zone Buses. This local service aims to help relieve pressure on our emergency services by ensuring vulnerable people are kept safe, and offers guidance on how to drink more responsibly to help people cut down on their drinking.

“There is no single best practice model for services of drunk and incapable people.

“Services should be developed directly in response to local needs and remain flexible when needs change.”