I’m working lately in a little corner of what I call Emergistan, where drug abuse is extremely common.  And since I work in the emergency room, I see things right from the street. Patients either come in themselves, or come after an encounter with EMS or police.  Their presentations are raw, unfiltered, undiluted.

I am no academic, as I have said on many occasions. But I am a ‘medical scout.’ I see things as the emerge and evolve and often before much research has been done.

Many of the patients I see who are agitated or psychotic are very difficult to control.  I won’t bore the reader with drugs and doses, but I give them a lot of meds to try and calm them down and make it possible for us to evaluate them in a manner that is safe for patients and staff.

And it is taking so much more sedation than ever before to simply make them go to sleep for a little while.  Invariably as soon as the sedation wears off they’re up, confused, restless, pulling off monitors, pulling out IVs, wandering in the hallway, into other patient rooms, falling down and trying to escape into the wild.

My theory as Dr. Scout?  Marijuana of increasing potency, mixed with methamphetamine (made with who knows what and in stunning quantities across the border and in the US) are, synergistically, producing a state of agitation and delirium that is new, dangerous and terrifying to behold. And resistant to our normal means of controlling patients.

Watch the coming months and years.  These people are dangers to themselves, to those around them and to responders and health-care workers.

Of course we’ll keep treating them!  But we need to think about how to manage them.

Thanks to changes in their drugs of choice, it’s just getting harder all the time.

And I don’t want to hear a word about the wonders of weed. Doubtless most people can use it without a hitch.  But if we continue to ignore its clear, remarkable dangers, then we’re setting the stage for disaster.




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