The region's frontline emergency and health workers have told the NSW Government's Ice Inquiry they often have to resort to sedation and restraint to treat patients affected by the drug.
On the first of two days of hearings at Nowra local court on Thursday, Commissioner Dan Howard heard from health and hospital workers, police and paramedics, and drug and alcohol service providers from across the Illawarra Shoalhaven Local Health District (ISLHD).
In order to protect the patient, the paramedics and others, restraints are applied as these limit the opportunity a patient has to be aggressive.Paramedic Matt Sterling
Illawarra paramedic Matt Sterling told the inquiry that in situations where patients had used ice and were hostile or aggressive, it was "more common than not" that he would sedate or restrain them.
"I have observed that these patients are aggressive and reluctant to attend hospital but in my opinion they are unsafe not to transport," he stated.
"The risk of the patient to themselves or to other people is high and they do not have the required capacity or competency to refuse transport."
Mr Sterling said padded restraints often needed to be combined with chemical sedation, as it was not always known if the sedation would work - or for how long.
"In order to protect the patient, the paramedics and others, restraints are applied as these limit the opportunity a patient has to be aggressive," he said.
Mr Sterling, an operational paramedic and supervisor, said in other regions he'd worked drug users tended to be from a lower socio-economic group, were older (40 to 45 years) and ice was not their first drug of addiction.
In the Illawarra Shoalhaven, ice users came from all walks of life though tended to be younger (mid-20s to 30s) and not using other drugs.
He said he'd seen how ice had impacted families, especially where ageing parents were trying to seek help for an adult child who used, as well as parents of minor children who were addicted.
He called for additional training for paramedics, and community education - particularly for school children - about the impact of ice.
"Coinciding with an increase in (ice) use, has been more reports of paramedic assaults," he said.
"We need targeted training .. to reduce these incidents."
Dr Simon Tucker, interim clinical director of Shoalhaven Hospital's Department of Medicine, said hospital workers were also subjected to assault by ice-affected patients.
We shouldn't be judging people making choices we don't agree with ... it's our responsibility to look after them.Dr Simon Tucker, Shoalhaven Hospital
Protocols were in place to identify patients who could become aggressive, or lash out, to protect staff and the patients themselves.
"We shouldn't be judging people making choices we don't agree with ... it's our responsibility to look after them," he said.
Involuntary sedation or restraint was used on a patient about once a fortnight: "It's an appropriate option but a last resort option".