“It is Predictably Unpredictable:” Paramedics Responses to Methamphetamine and Substance Use

It is predictably unpredictable:” Paramedics Responses to Methamphetamine and Substance Use 

Introduction: In Canada, methamphetamine use has increased in recent years, with Manitoba recording a particularly notable rise. As first-line responders, paramedics routinely respond to and interact with individuals dealing with substance use. Understanding these experiences has the potential not only to guide improvements to healthcare delivery, but also to improve paramedic wellbeing. To date, however, only a small number of Canadian-based studies have examined how paramedics experience and navigate responding to substance use in general, and methamphetamine-related calls in particular. 

Objective: To qualitatively examine paramedics’ accounts of how they experience and feel affected when responding to methamphetamine and other substance-related calls. 
Methods: This paper draws upon in-depth, semi-structured interviews with 48 paramedics and 9 fire paramedics in Winnipeg, Manitoba. Study information was provided to potential participants via e-mail and posters. Interested participants were able to contact the research team directly to set up an interview; participation was voluntary and confidential. Participants were asked about occupational stress, job challenges, safety strategies, and conceptions of crisis, among other themes. Interviews were transcribed verbatim and coded, following a semi-grounded approach, using NVIVO qualitative software. 

Results: Participants report that dealing with substance use and meth-related calls in particular, is one of the most (and for many the most) challenging, risky, and emotionally tiring aspect of their work. Findings further demonstrate that paramedics’ experiences vary depending on the substances involved. Participants report that responding to methamphetamine calls (1) increases their (direct and vicarious) experiences of risk and uncertainty; (2) necessitates greater reliance on police and other institutional actors; and (3) generates a greater sense of helplessness and compassion fatigue due to the lack of definitive treatment options. In comparison, participants described a greater sense of (1) safety, (2) feeling of accomplishment, and (3) ability to provide immediate help when responding to opioid-related calls. 

Conclusions: These findings demonstrate that paramedics perceive that responding to methamphetamine-related calls increases their risk and affects their wellbeing on the job. Ongoing research is investigating the policy implications of these findings, and highlights the need for enhanced training on substance use, as well broader treatment and public health responses to substance use.