'The healthcare system was just trying to deal with me without really dealing with me': exploring individual experiences of methamphetamine-related emergency department visits in Calgary - a qualitative study.

Abstract

Methamphetamine use has risen dramatically in North America, contributing to increased emergency department (ED) visits marked by agitation and complex psychosocial needs. While clinical consequences of methamphetamine use are well-documented, there is a paucity of research capturing the perspectives of people who use methamphetamines (PWUM) when accessing emergency care. This study aimed to explore the lived experiences of PWUM in ED settings to identify service gaps and inform patient-centered care strategies. A qualitative exploratory study was conducted using semi-structured interviews with PWUM who accessed ED services in Calgary, Alberta within the past five years. Participants were recruited through community-based organizations and professional networks. Interviews were audio-recorded, transcribed, and analyzed using Braun and Clarke's six-phase thematic analysis approach. A member-checking session was conducted with individuals with lived/living experience to validate findings. Five interviews were included in the final analysis. Three major themes emerged including: first, experiences of stigma in which participants described feeling judged, dehumanised and often received differential treatment following disclosure of methamphetamine use. This led to avoidance behaviours including leaving against medical advice and withholding substance use histories. Second, many highlighted the need for care beyond acute needs. While acute medical concerns were addressed, participants perceived a lack of attention to underlying psychosocial and addiction-related issues. Opportunities for deeper engagement and referral to supportive services were frequently missed. Lastly, participants provided recommendations for care delivery, namely enhanced integration of acute, mental health and community services; inclusion of peer support workers with lived experience; and creation of alternative care settings tailored to the needs of PWUM. PWUM experience significant stigma and perceive ED care as focused solely on acute stabilisation rather than holistic, person-centred support. Their recommendations call for systemic changes that address both clinical and psychosocial dimensions of care. Integrating peer navigators, expanding service linkages and establishing alternate care environments may improve patient trust, engagement and health outcomes. Future work should incorporate these perspectives to develop more compassionate and effective emergency healthcare responses for PWUM.