IT'S 2.30am and the emergency department at Leeds General Infirmary is packed.
In a stark reminder of the consequences of a Saturday night's drinking, nearly every seat in the waiting area for the minor injuries unit is taken.
On several of the tables are stacks of cardboard sick bowls. Nobody has had to use one – yet.
It's clear that several have been drinking heavily. They sway, shout, swear and make little sense, except to their equally-intoxicated friends.
As these patients have the least serious ailments, they are likely to be waiting several hours for treatment.
But that's something many find hard to understand.
Judgment skewed by alcohol, the friend of one patient – who has banged his face – marches up to the room where the charge nurse is attempting to triage other patients to prioritise them in order of need.
He starts haranguing the medical staff about why his friend is likely to wait the full four hours which hospitals are obliged to treat or admit the virtually all patients in.
The nurse tries to explain there are others in greater need, but with little effect.
"If I stab him in the body, will he be seen sooner?" comes the retort.
Meanwhile gangs of girls stalk the corridors, holding up their friends and telling them "come on babe, it's not good enough, is it?".
A girl, who is staggering around apparently paralytically drunk, is brought in by two police officers.
They try to seat her in the waiting area but she won't stay there and they have to spend several minutes in the corridor calming her down.
Staff have to issue teacher-like frequent reminders that this is a hospital so shouting and swearing won't be tolerated.
Danielle Johnson is waiting quietly for her turn but she's a little unclear about how she came to have a bump on the head.
The 20-year-old was out in Headingley with a group of friends when she was injured.
How much had she been drinking? "A lot," she says. "Vodka, beer and lager."
This was a quiet night for the staff of the LGI emergency department.
Charge nurse Richard Rees-Jones said their busiest times were when the pubs and clubs shut – after 11pm, 2am and 4am. Up to 30 per cent of patients will be there because of alcohol.
"If they haven't had a minor injury from standing on glass, it will be alcohol-related fights or assaults," he said.
"Or they will pass out completely and will be vomiting."
The effects can also be much worse.
"I've seen a few who have consumed a vast amount of alcohol quickly and ended up in intensive care. Some will end up with long-term brain damage," he said.
But the humiliation of the consequences of excess drinking can be extreme too.
"We don't have clean clothes for them, so people will have to walk home covered in vomit, or faeces if they have become incontinent," Mr Rees-Jones added.
Over his 15 years in the field, he is clear that things have got worse and victims of the drink-to-get-hammered culture aren't restricted to weekend evenings.
Most patients in for alcohol-related reasons are aged between 17 and their early 30s – but teenagers as young as 13 have been brought in after binge drinking.
For medical staff, treating a drunk patient can be made much harder because of their attitude.
"Staff do have to put up with a lots of abuse, though we don't
just put up with it – we will remove them," the nurse said.
"Most of us have a low threshold because we won't put up with it."
A world where no-one drank to excess is hard to imagine, but Mr Rees-Jones says it would make the lives of the emergency department's team "massively simpler".
"We could give the care that's needed to the people who are not affected by alcohol," he said.
Though all patients are looked after as best as resources allow, treating those there because of booze inevitably means things are more stretched.
Which means those in the minor injuries unit waiting room with bumps to the head after falling while drunk are going to wait longer.
However sometimes those bumps can be much more serious. Earlier a man was brought in after tumbling to the ground and doctors decided he needed a CT scan to ensure he didn't have a potentially life-threatening brain injury.
Thankfully he hasn't and just needs to sleep off the booze.
"That's the kind of problem that we deal with – people who are so drunk they fall over, bang their head and we have to make sure it's nothing serious," said Dr Alison Sykes, accident and emergency consultant.
"Because they are drunk they don't put their hands out to stop themselves. Then we have to do a brain scan and that costs a lot of money."
In this case the patient wasn't badly injured but Dr Sykes said that other incidents linked to alcohol – such as a pedestrian hit by a drunk driver – can be fatal.
Those with chronic alcohol problems are frequent patients too, though she warned that the hospital was not the place to go for those who know they have a problem and want to detox.
The reasons people drink heavily can be complex and Dr Sykes said it's difficult to guess what people are facing which may lead them to overindulge.
But whatever the ailment or injury, or reason behind it, a constant stream of people come to the emergency department because of booze.
"We see someone every hour," she said.
"You can have some nights where all you see are people who are drunk. It's a huge problem.
"Ultimately it uses resources that we cannot direct elsewhere. It impacts on other people."
SAFE DRINKING GUIDELINES
Safe limits for alcohol, as recommended by the Department of Health, are not more than three to four units per day for men and two to three per day for women.
A unit of alcohol is equal to a pub measure of spirits.
A pint of ordinary strength lager, ordinary bitter, or normal-strength cider contains two units.
A 175ml glass of red or white wine contains 2.3 units.
A pint of strong lager or cider, or best bitter, contains three units.
Alcoholics Anonymous holds meetings every day in Leeds. Call 0845 769 7555 or visit www.alcoholics-anonymous.org.uk.
If you are concerned about your own or someone else's drinking, call Drinkline on 0800 917 8282 or visit www.al-anonuk.org.uk.