A MAN under the influence of ice slashed his neck with a meat cleaver when emergency services arrived at his home, a special commission of inquiry heard in Maitland on Tuesday.
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Dr Nick Ryan, director of Tamworth hospital emergency department, recounted the incident as the inquiry heard from front-line health and emergency service workers about the burden the drug was placing on already stretched services.
Dr Sujatha Venkatesh, the clinical director of Mater Mental Health's Psychiatry Emergency Service, said 15 to 20 per cent of patients appearing at the service were affected by amphetamine-type substances (ATS), a number which she said had increased over the past two years.
She told the commission the service was responding to eight to 10 patients per week who were displaying "acute behavioural disturbances" caused by such substances, including psychosis and violence, which she said was "a huge strain" on her staff, partly because services that could be provided for intoxicated patients in mental health units were "limited".
"Staff are trying to look after these patients ... But in turn, the staff get assaulted," she said.
"But because these patients get better ... and if they don't have any underlying mental illness, we don't have the facilities to keep them any longer under the mental health act. So we need to let them go.
"They go back and use again and they come back. The staff get burnt out in this process.
"We are seeing a lot of staff moving out of intensive-care units," she said.
Senior staff specialist of addiction medicine at Calvary Mater Hospital Dr Craig Sadler said that while there was a "large group" of methamphetamine users who don't experience the acute symptoms of the drug, it was a group that mainstream services "don't see a lot of".
Dr Nick Ryan, director of the Emergency Department at Tamworth hospital, said that was certainly the case at his hospital. He shared a recent experience of staff and emergency workers in Tamworth in order to describe the amount of resources needed to respond to people experiencing acute symptoms of ATS intoxication.
He said ambulances were called to respond to a man who had reportedly been using ice.
"When they got there the patient actually had a meat cleaver and when he saw the ambulance and police arrive he started to slash his neck ... and got four or five deep gashes in his neck."
He said that by the time the patient got to his emergency ward sedation was wearing off and he was again becoming "uncontrollable".
"He had to be given a general anaesthetic and be intubated to control the situation to keep him safe and us safe and so we could attend the wounds on his neck. He then spent several days in the intensive care unit after going to an operating theatre."
While Dr Ryan said such incidents only occur a few times a year, patients needing to be physically and chemically restrained to ensure their own and staff's safety presented a "couple of times a week", with a significant number of cases related to ATS use. He said eight staff were needed to perform that procedure.
The hearings on Wednesday, which featured testimony from six health professionals from the Hunter New England region, discussed ways to intervene in cycles of drug use while patients were present in emergency wards. Multiple witnesses mentioned the difficulties posed by waiting lists when patients expressed a desire to detoxify or access rehabilitation services.
Dr Ventakesh suggested the creation of a third space in ED where emergency physicians and mental health staff could work together to monitor the physical and mental health aspects of patients who were intoxicated and coming down from drugs, and provide them with access to drug and alcohol workers.
Earlier in the day, the commander of the Port Stephens Hunter police district, Superintendent Craig Jackson, said that policing resources were also being stretched in the region by increasing callouts to people suffering psychotic episodes and other mental effects of the drug.
He said that in worst-case scenarios police officers were responding to ice-affected people, transporting them to emergency wards and then staying with them for up to "seven hours" to ensure they did not endanger others in hospital. He said this was largely due to a lack of ambulances.
"They're not under arrest, it's a health issue," he said. "It comes down to resourcing."
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