Legal Highs, Pissed Pants, and Fist Fights: A Night with Britain's Clubland Paramedics

For many of us, the Christmas period meant doing our best to convert our own blood into alcohol. For others, it was business as usual. Some 900,000 people in the UK worked on Christmas Day; among them were the paramedics and responders who staff the thousands of ambulances throughout the country. For this lot, the holiday season is a time like any other: People still get stabbed, cut their own fingers off by mistake, and suffer colossal heart failures.

In fact, considering our alcohol intake reportedly rises by 40 percent during December—and people traditionally hurt themselves a lot when they're drunk—I figured this time of year must be a particularly busy one for the people tasked with pumping our stomachs and bandaging our open wounds. So, to find out how they cope during a period in which everyone's getting even more fucked up than usual, I went to Birmingham last Saturday—a couple of days after New Year's Eve—to spend the night with the West Midlands Ambulance Service.

Birmingham's drizzly Broad Street was quiet when I arrived at the City Centre Treatment Unit (CCTU), a station—made up of two response cars and an ambulance—that pops up weekly opposite the Walkabout to treat anyone who needs treating.

"We know that on Friday and Saturday nights people are coming here to enjoy themselves," said Mike Duggan, who's been in charge of the CCTU for three of its five years. "Where there are lots of people, and drinking, our call numbers are going to increase, so the CCTU was set up to keep ambulances free for medical assistance. The biggest successes are stopping hospital admissions; we can keep people here who are seriously intoxicated until they get collected, whereas before there wasn't that facility, so they'd be taken to A&E."

In 2015, this center alone treated over 2,500 patients, the majority of whom had been a bit over-eager with the booze. So if you live in Birmingham, regularly find yourself in A&E and have noticed everything moving a bit speedier than it did five years ago, you can thank the team at the CCTU for taking some of the strain off those working at the hospital.

It had just passed 9 PM when Mike started up one of the response cars and hit the switch for the flashing blue lights. "We've had a call for a stabbing in Pigeon Park," he explained. Arriving at the scene, we were greeted by a pair of cops who informed us that it looked like the call was a hoax.

"It came through on a payphone," Mike sighed as we headed back into the car. "To be honest, we don't tend to get calls from phone boxes that turn out to be legit."

This kind of thing is a massive hindrance to the service, as each call has to be treated as if it's real. Just this one dud claim meant two response crews had to get to the location, as well as a doctor being dispatched from outside the center of the city, when they could have all instead been on call to deal with real incidents. In 2015, West Midlands Ambulance Service received at least 455 hoax calls, with 498 in 2014, and over 630 the year before, eating up plenty of time and resources.

As we drove back to the center of Birmingham, Mike and I got chatting about legal highs and the difficulties these substances can cause for paramedics. "They're a real challenge for us," said Mike. "It's not that we've never seen them before, but now they are much more common, sometimes more than your traditional street drugs. People seem to think, because they're legal, they're safe, which is dangerously far from the truth."

When responding to patients who've consumed legal highs, paramedics are often presented with packets bearing names like Black Mamba, Pink Panthers, or Dust Til Dawn. "There's no description on the packets," Mike told me, "just bizarre names and then numbers and chemicals, and we really have no idea what they are."

Watch: 'Spice Boys,' our film about young men in Manchester addicted to the legal synthetic cannabis Spice

Because their contents are impossible to keep track of, with manufacturers routinely changing chemicals to evade new legislation, legal highs present all manner of clinical challenges. Take heroin: although it might be cut with all sorts of nasty shit, paramedics know what they're dealing with.

"Heroin acts as a respiratory depressant, sometimes to the point where you can stop breathing—but we can intervene and recover the patient," Mike explained. "With legal highs, we don't know what they are. If we were to give you something, it might have an adverse effect. Do I give you something that could save your life, but could make you worse?"

A couple of weeks before we met, Mike was called out to a block of flats where a man had smoked Black Mamba, a synthetic cannabis, and subsequently believed he could fly. "When we got there, common sense said to us that he couldn't fly, but he was intent on launching himself off a sixth floor balcony," Mike recalled. "It took me and a small squad of police officers to pin him down and save his life. His chances of survival would have been as good as zero had he made the leap."

Back at the treatment center, it was just past 11 PM and the crowds outside the clubs were getting bigger and rowdier. Leaning against the ambulance was a young guy who, having got a bit too tipsy, had been ditched by his friends. He seemed pleasant—and conveniently his sister's boyfriend had agreed to drive into town to take him off the team's hands—but not everyone who interacts with the CCTU staff is quite so friendly.

"In any environment where you have people drinking or taking drugs, you start with joviality, but as the night goes on, it can often turn to violence and aggression," said senior nurse Les Young, handing me a Haribo from a stash inside the ambulance. "People get into scrapes—domestics, that sort of thing—and often end up getting looked after by us."

Problem is, people are often still raging from their confrontations while Les and the team are trying to treat them. The paramedics have a duty of care over patients, so they'll keep on treating them wherever possible, but, said Les, "Getting attacked? It's becoming a sad reality of the job."

Outside, a group of wasted lads staggered over, asking the crew if they would check the "government computer thing" for a date of birth, because one of them had forgotten to bring out his ID. Unsurprisingly—partly because the "government computer thing" is not a thing—they were told there was no chance.

"We had a large fight outside Walkabout a while back," said Les as the guys wandered off. "I'd say ten blokes having a punch up, and plenty of police were deployed."

The girlfriend of one of the guys was shouting at the police. "I identified myself as an ambulance man and said I was concerned for her welfare, so suggested she come and stand by the ambulance with others not involved," continued Les. Instead, the woman told him to fuck off and swung her red stiletto straight at his face. "I managed to avoid it [hitting my face], but it hit me in the chest, which was really quite painful," said Les. "It was a fairly minor injury, but it scared me. I could have lost an eye, and this wasn't in a confrontational environment."

I'd always seen paramedics on nights out as the good guys. They train for years to treat the sick and wounded, then end up looking after you when you're throwing up all over yourself, which I think you'll agree is a very nice thing to do.

However, all that hard work and altruism doesn't necessarily come to mind when you've had eight pints and a bag of Dust Til Dawn. Between April and September of 2015, the number of physical assaults on West Midlands Ambulance staff rose by almost 30 percent, to 139 incidents, and those are just the ones that got reported.

As we were about to grab a cup of tea, the rear doors of the ambulance we were sitting in swung open and a young women dived in, howling. At first I thought we had a major incident, but it turned out someone had just accidentally stepped on her big toe, smashing the nail and giving her a scare.

"Have you got a wipe?" her friend asked anxiously.

"If this blood stains my desert boots…" he muttered, wiping away at his shoes.

As Les got on with treating the woman's injury, the blood and the shrieking getting a bit too much for me, I went for a chat with veteran paramedic Tony White, who was in his car, hiding out from the rain.

"This isn't everyone's cup of tea, doing the treatment center. People just think of drugs, drunks, and fighting, and think, Nope, it's not for me. It's fair enough, really," he laughed.

In October of last year, a survey found that 53 percent of police time is spent dealing with alcohol-related crime, with the majority of police and ambulance staff blaming 24-hour licensing for the increase of booze-related incidents. As little as ten years ago, when bars closed at 2 AM, emergency services could plan, overlap shifts, and, because they knew when they'd be getting an influx of calls, increase the amount of staff accordingly.

"We just can't plan any more," said Richard Smith, who's been on the job for 14 years. "Even the bars don't know when they'll close. If you'll keep drinking, they'll keep serving."

Back in Richard's clubbing days—which he assured me were long-finished—you'd go to the pub until 10 PM, before charging into town to find a nightclub, which would close less than four hours later.

"Now people can just party until they drop. There's no time limit," said Richard. "When people had that structure, I think the clubs, emergency services, and the people themselves managed it better."

It all felt a bit "back in my day," but I knew Richard had a point.

"It's just not fair," he continued, "the way that things have changed. While we're tied up doing this, we're not doing what we're trained to do. I didn't study to pick up people who can't control their own greed; when you've shat yourself, urinated on yourself, and rolled around in your own vomit."

Mel Perrins only started working as a paramedic three months ago, but she's already dealt with her fair share of messy patients. "I was on a job in Oxford and we got called to a female on a Sunday afternoon, about 6 PM," she told me. "She was laying in a taxi, rank, and had pissed and shat herself. She must have been in her twenties, having been out drinking with her dad."

While the clubbers outside began to stumble home, Mel reflected on what she's made of the job so far.

"This year I've worked Christmas Day, Boxing Day, New Year's Day. I've worked all of it, and the frustrating thing is I joined this job to really try to help people, you know. Make a change."

The Broad Street CCTU—and other schemes like it throughout the UK—do a good job of looking after people on nights out. People who probably wouldn't need looking after were it not for the huge quantities of alcohol they'd drunk.

For most paramedics, I can't imagine it's why they got into the job. As Tony pointed out, many find that literally any other type of work beats dealing with bleeding, shitfaced clubbers—but they continue to do it nonetheless, in the face of government cuts and, subsequently, a larger workload. None of the Birmingham crew I spoke to, for instance, had been given a pay-rise in the past five years, despite their responsibilities increasing.

Nobody wants to prevent Britain's weekend warriors from enjoying themselves. But if there's one thing I picked up from my evening in Birmingham, the least we could do—I'd imagine—is not drink to the point that we shit ourselves. Or, at the very least, when someone comes to help us out, not chuck our shoes at their face.

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