Dr. Doug Melzer usually works nights in the emergency room at Providence St. Patrick Hospital in Missoula. He spends most of his time dealing with the typical emergency room fare: heart attacks, pneumonia, broken hips.
But about once a week he treats patients coming into the emergency room because they’re psychotic from taking too much methamphetamine.
These patients are terrified. Their hearts are beating fast. Usually they’re hallucinating.
When they come into the ER, security guards meet them at the door. Six or seven people strap them to a hospital bed and a doctor injects them with a tranquilizer.
At St. Pat’s most of the rooms are filled with medical equipment: monitors on the walls, gauze on the shelves and needles to start an IV. But they have one room set aside for these patients. The walls are bare. There’s a hospital bed in the center of the room.
“A lot times we’ll even take the bed out of there and just leave the mattress on the floor,” Melzer said. “They can literally pick up these 100-pound beds and throw them against the wall.”
Normally a security camera monitors the patient from above, but someone recently ripped it out of the ceiling. There’s a discolored patch of drywall showing where a patient had punched through the wall. Scratch marks covered the room’s Plexiglas window.
As Melzer was explaining how he handles these kinds of cases, another doctor knocked on the door and said a psychotic patient had just come into the ER because of meth.
Typically, meth is considered a long-term problem that requires months or even years of treatment. But according to data from the national Substance Abuse and Mental Health Services Administration, 93 percent of Montanans with substance abuse disorders don’t get treatment.
When these people are in crisis and need help, a lot of times they end up in the ER.