Manitoba

Man in meth psychosis sits in ER for 24 hours, given bus token to leave

Friends of a meth addict said they received mixed messages from medical staff at Winnipeg's Health Sciences Centre as the patient experienced verbal outbursts and hallucinations.

No place to take Winnipeg's meth addicts when they're hallucinating, advocates say

Jeremy and Teresa Zehr say they're concerned that meth addicts do not have a clear spot to go when undergoing meth psychosis, meaning they could put themselves or others at risk. (Jeff Stapleton/CBC)

Friends of a meth addict in psychosis said they spent 24 hours in a hospital ER waiting room, with no clear options of where he could go — other than onto a city bus.

Jeremy and Teresa Zehr said they received mixed messages from medical staff at Winnipeg's Health Sciences Centre as their 19-year-old friend experienced verbal outbursts and hallucinations.

"We got the sense that they were trying to move him out, whether that's to a homeless shelter, or at one point they offered a bus token," Jeremy said.

"To a kid who's in psychosis and is confused, that's not going to help anybody."

Meth psychosis is caused by use of methamphetamine over a long period of time.

Symptoms include hallucinations, delusions and paranoid, bizarre or violent behaviour, according to the Centre for Addiction and Mental Health.

"He's confused, he's scared and he's angry … so it is quite a volatile space for him, but also for staff, and we understand that," Jeremy said.

"At one point he told the doctor he was going to punch him out. Another time he started yelling and saying, 'You should know what's wrong with me.' Even though at that point [the doctor] really didn't."

5 doctors, 5 different answers

The family friend was seen by five doctors over 24 hours, all of whom gave the patient different answers, the Zehrs said.

He was brought in to the ER by police over the Easter weekend. He claimed he had been beaten up.

"They had picked him up from a drug house.… We just saw him sitting in a corner [of the ER] by himself, just looking very desolate," Teresa said.

The young man said someone had held a gun to his head and kicked him in the ribs. He also complained he was having trouble breathing.

'Not really much we can do'

The Zehrs said they waited 10 hours before their friend was seen by a doctor.

"[The doctor] just tried to say, 'Well this is just how it is. There's not really much we can do. He's going to just have to sleep it off, and kind of get on his way,'" Teresa said.

"We really had to push them to see what else there was available for him."

The family says they spent 24 hours at the HSC emergency department. After seeing five doctors, the patient was eventually referred to a bed at Main Street Project. (Jeff Stapleton/CBC)

The doctor gave them information about treatment. The family said that wasn't helpful.

"We understand the treatment options, but he needed support in his psychosis. And that was the thing that they weren't able to do. So then they sent him back to the general ER," he said.

"A doctor came back later, woke him up, told him he can't sleep there anymore. We said, 'There's nowhere for him to go.' So they kind of left us. We had two more doctors come in the next 12 hours checking in with us," Jeremy said.

After spending 24 hours in the ER, a different doctor referred the man to the Main Street Project, where a handful of beds are reserved by the hospital for meth patients.

Hospital responds

The Health Sciences Centre said most people recover from meth-related psychosis within 12 to 24 hours, although it can last longer.

A hospital spokesperson said meth withdrawal does not always require medical treatment.

"Generally speaking, a patient presenting to an emergency department with crystal meth psychosis is assessed by an emergency doctor. If the patient has a prolonged episode of psychosis, the ER physician may consult psychiatry," spokesperson Katherine Fox said in a statement.

She said the hospital's 11-bed addiction unit offers short stays for people going through withdrawal.

However, most of those beds are used by people going through alcohol withdrawal, which requires medical treatment, the hospital said.

In 2018, the hospital added six additional beds for complex mental health issues, including people with psychosis.

"Once patients are stabilized, they are transferred to other units or discharged into the community," a spokesperson wrote.

'People in psychosis are ending up in back lanes'

People who work with drug users say they're not surprised to hear what happened to the 19-year-old.

There's no real plan for dealing with meth psychosis, according to Marion Willis, the founder and executive director of St. Boniface Street Links.

"Police will pick them up, take them to hospital, oftentimes an ER doctor will see the person, determine they're not a danger, and let them go. There have been some disastrous consequences of that."

"People in psychosis are ending up in back lanes, and on streets, and on buses, in places where they use more. The citizens of this city and in this province pay the price for that.

"Imagine putting somebody who's in drug psychosis, who's hallucinating and delusional and thinks that people are after him, giving them a bus token and thinking he can ride a bus full of people?"

Marion Willis is the founder of St. Boniface Street Links and its executive director. She says there is nowhere for people to go when they're in meth psychosis, meaning they often end up in the community as a risk to themselves or others. (Tyson Koschik/CBC)

There's been no real investment made to provide more services, she said.

She said there is no legislation that allows police to hold someone who is addicted to drugs, unlike someone who is drunk.

"The city needs to have a drug stabilization unit just for meth users or drug psychosis, but we don't have that," she said. 

Falling through the cracks

Rick Lees, executive director of Main Street Project, said many drug addicts don't get the help they need, especially if they don't have an advocate. 

"There's lots of folks that are out on the street now that have psychosis, who have no way of finding their way into the system, and we're not even counting those people because we have no way to count them," he said.

"Acute care isn't designed for the longer term management of things like this. What we need is far more money invested in mental health and addiction."

The Zehrs said they feel the hospital staff did the best they could, but want to see a safe spot for people to come out of psychosis outside of the ER.

"Just where people are able to be supervised, so that they are safe and those around them are safe. I think there needs to be something so that it's not an expectation on the medical system," Teresa said.

The couple, who both live and work in the city's North End, said they're used to seeing Winnipeg's meth crisis.

"Now we've experienced it on a personal level with somebody we love."

Friends of a meth addict in psychosis said they spent 24 hours in a hospital ER waiting room, with no clear options of where he could go — other than onto a city bus. 2:43

About the Author

Marina von Stackelberg is a CBC journalist based in Winnipeg. She previously worked for CBC in Halifax and Sudbury. Connect with her @CBCMarina or marina.von.stackelberg@cbc.ca