There are a couple of answers--and I'll be brief, I promise.
The Drug Abuse Warning Network in the U.S., whose data you can pull, revealed that six years ago, I think it was, 50% of the American population had experimented with an illicit substance, a psychoactive drug such as cocaine. People over the age of 65 we now routinely screen for street drug use, such as cocaine, because it's common. If you don't ask, you don't know, especially when they're in having a heart attack.
My emergency medicine experience medically is restricted to my residency, which was five years long, and to my clinical practice, and I'm entering my seventh year, so I have 12 years of medicine, but I was also a nurse before, for 15 years. Little did I know, when I moved to sleepy little Victoria, how much methamphetamine I would encounter. I can tell you that in my daily practice in Victoria I encounter over-stimulated, hypertensive, tachycardic, agitated, psychotic individuals probably every other day.
My first day in Victoria, my patient stood up with a stretcher on his back and crashed into the glass door in the trauma room—stood up, with a stretcher on his back, in four-point restraint.
That kind of agitation, most members of the general population have never experienced. People who talk about psychological interactions and therapeutic talk with these people have never seen an agitated psychotic person. Whether they're psychotic because they have organic schizophrenia—which is a terrible, debilitating disease, and you can have psychotic breaks if you're perfectly compliant with your medications.... If you have schizophrenia and you use cocaine, which is startlingly common, then you are even more likely to have a psychotic break.
For these people, delirium is defined by an altered level of consciousness with two things: impaired thinking and impaired input from the senses. These people perceive things differently and they cannot think their way out of it.
If I told you right now that a little unicorn pranced through the middle of this room, you'd all look at me and say, “No, it didn't”, and I would say, “You're right; I'm sorry.” But if you cannot realistically think your way past that and are fighting for your life in your mind.... It's amazing the strength these people exhibit. Anyone who has ever tried to take blood out of a two-year-old knows what I'm talking about: the strength of millions.
But in specific answer to your question, there is no doubt that methamphetamine and cocaine use in this country is on the rise, and it's on a logarithmic rise.
The City of Calgary collected data, I think two years ago, on the incidence of cocaine-related interactions with police, and it was up 300% in one calendar year. In the same calendar year, injuries to police officers were up by 300%. So we are seeing a different person on our streets and in our hospitals and in our psychiatric units than we saw 10 or 15 years ago.
It's not progressing across the country in a very straightforward pattern. It is west to east, and you haven't seen anything yet in Ontario.