Health officials scramble to confront meth 'epidemic' in emergency rooms

A meteoric rise of methamphetamine use in Alberta is forcing health officials to explore new options to handle patients who are high on the drug — with sometimes violent and abusive behaviour — when they end up in emergency rooms.

Dr. Eddy Lang, head of emergency medicine in Calgary, said these patients are "often very physically agitated, they're flailing their arms, they're unable to settle."

Emergency room staff sometimes have to bring in security officers.

"Because they're often feeling that they are being chased or pursued or persecuted — that's part of the psychotic complications of methamphetamine use — they can be verbally abusive as well," Lang said.

The top ER doctor said health officials across the province are exploring new approaches.

They're reviewing different medications to sedate patients high on meth, Lang said. They're considering the idea of having paramedics transport patients with milder symptoms to a home or a shelter where they can safely detox, instead of an ER.

They're also encouraging staff who feel stressed after a difficult confrontation with a patient to seek counselling, "so they can talk through what they are going through and hopefully get some guidance and support to feel safe and comfortable to go back to work," Lang said.

Meth, which is highly addictive, relatively cheap and widely available, has skyrocketed in Calgary's illicit drug trade. Lang said the "epidemic" is putting a different strain on the health system as many patients struggling with opioid addiction turn to meth as a drug of choice.

"We've had to deal with (agitated or violent patients on drugs) for decades, but now, rather than it being a sporadic event, it's a more regular occurrence because of the amount of meth that's in use in the city," he said.

The Calgary Police Service underlined the extent of the problem Wednesday when releasing the latest results of its "Daylight Initiative," a co-ordinated response to the exponential growth of meth in Calgary.

In the first two months of the year, police laid nearly 250 charges against 43 people for their alleged roles in drug trafficking. Officers seized a combined 240 grams of meth, cocaine, crack and heroin, among other substances.

Lang estimated every Calgary emergency room sees a couple of patients high on meth a week, which he said is compounded by other pressures, including a "rising burden" of frail and elderly patients, along with people facing other addictions and mental health challenges.

When asked about the meth problem, Alberta Health Services said in a statement thousands of its front-line staff are already trained to help prevent or de-escalate a crisis situation safely. It said all Calgary hospitals have security officers on site, in case they're needed.

According to Lang, not all patients with symptoms from meth use should end up in emergency rooms. Someone high on meth who is behaving unusually in a public place, such as a coffee shop, may prompt a 911 call. But Lang said it may be more appropriate for that person to detox in a shelter that can offer counselling services, rather than a hospital.

"Those agitated symptoms don't always occur, and when they do occur, they just wear off on their own," he said.