Police have seized 585 kilograms of ICE in a Sydney drug bust. Most people probably hear the news and not give it much thought once the news reader moves onto the next story. But the reality is, even if you are not touched directly by drug abuse on a daily basis, it will have a huge impact on the whole of our community, socially and financially. Ultimately this drug would have been destined for distribution to the rest of Australia and I for one think it should have a big impact on the number of aggressive and psychotic patients that present to our Emergency Department for the next few months, hopefully longer.
ICE is the purest form of crystal meth. It is extremely addictive. And it is one of the causes of the presentation of aggressive patients to our Emergency Department. Patients who have ingested ICE are usually sleep deprived, some not having slept for days. They are out of control, paranoid, hallucinating, itching or picking at their skin, aggressive, malnourished, have high blood pressure, an increased heart rate, dizziness, headache, possibly fever from infection due to non-sterile injecting habits and may have also injured themselves as a result of aggression or the inability to make reasonable decisions for themselves.
Patients with these symptoms are usually brought into the department by the police. Often against their will, but in this condition we have a duty of care to reasonably detain them for their own safety and for the safety of others in the community. As you can imagine this creates a highly volatile situation. However it is a very common presentation in our department and we have very good and well rehearsed strategies, policies and procedures in place to ensure the smooth running of these situations. We have excellent resources which range from the police, our security staff, registered nurses, mental health nurses and experienced senior doctors. We also have a designated place for this type of patient to go to initially. Consideration is given to the presenting patient’s safety, the safety of other patients in the department and the safety of all staff involved in the situation.
If the patient is unable to be verbally de-escalated or refuses oral medication as part of this strategy then the medical management of this situation is a chemical sedation process (medication) either intravenously or intramuscularly, to relieve the patient from some of the symptoms and to create a safe environment for all others. We can then proceed to treat the physical condition of the patient. The patient will at this time be asleep.
The patient then spends many, many hours in the Emergency Department and when all the medical issues are resolved and the patient is awake and alert and not requiring admission for a medical reason they then receive a mental health assessment. ICE use affects a persons mental health by causing psychosis, which involves delusions, hallucinations and distorted perceptions of reality. Which if prolonged can lead to a diagnosis of schizophrenia. ICE use worsens existing mental health problems and affects the users ability to work and maintain an adequate financial situation. It affects relationships and families and can lead to homelessness in a downward spiralling cycle of circumstances.
So you can see why it is such a great thing that 585 kilograms of ICE has been prevented from reaching the streets and will never make it into the hands of the sons, daughters, mothers and fathers of our society. Beside the four hundred million dollar street value cost attributed to this seizure it will save our communities hundreds of thousands of dollars in costs related to law enforcement, ambulance services, medical care, mental health program’s, family breakdown, crime’s committed to pay for the habit and probably a lot of other things that I cannot even begin to imagine.
This is not meant to be a definitive treatment plan or a tool for educational purposes.
The majority of people don’t need to deal with this type of thing on a daily basis at work and probably don’t realise the impact of this on the individuals who do. Do you have an example of an experience with someone on Ice or another drug? I would love to hear about it.
Stay safe, be happy,