It took 15 people to restrain one violent man who was highly intoxicated on ice in a hospital last Thursday, senior nurse Christopher Waters said in Dubbo on Tuesday.
Seven police and eight hospital staff were required at Dubbo Base Hospital to control the man.
"It looked like everyone from Dubbo was there from the police force," Mr Waters said. "It was such a racket. We called the police to ask them to come in and save the day."
Mr Waters, the senior emergency room nurse at the Dubbo hospital, said he had been assaulted "many times", including being king hit by patients who had taken ice (crystal methamphetamine) or a mix of other amphetamines.
Some of the seven police who helped restrain the man last week were also injured. "It is an amazing drug and it brings this incredible strength, and people ended up getting hurt."
The drug's use in Dubbo and in the far west of NSW was an "epidemic", the Special Commission of Inquiry into the Drug Ice heard on the first of two days of hearings.
Mr Waters said 25 people he met two years ago were now dead from the drug. This included two who died within a fortnight in late May; one who died from pancreatitis had been "on a bender for two weeks" while the other had fatal heart-related complications.
He cited the case of a woman who presented with psychosis, typical of the drug, who believed she had insects crawling under her skin.
After moving to Dubbo two years ago, Mr Waters said he noticed a 50 per cent increase within six months, which has since remained steady.
Dr Ian Spencer, a GP who has worked at Wellington Hospital for 35 years, said ice was a very violent and dangerous drug. "That is part of the drug," he said.
"It is highly dangerous, highly addictive, it is a disease."
Dr Spencer said the erratic and aggressive behaviour was caused by the drug not the patient.
In his opening address, Nicholas Kelly, counsel assisting the commission, said the evidence was clear.
"This region is in crisis right now. It is a crisis that spans country, generations and services and the people it affects are desperate for help," he said.
Very often those in urgent need of treatment had to wait months and travel long distances, with Indigenous people having to travel more than 100km.
Ice patients waiting four days in ER for referrals
In emergency, severely affected patients could wait 100 hours or more before a mental health or drug or alcohol-related bed could be found in the region.
A Dubbo Base Hospital, Mr Waters said they had experienced delays of four days, waiting for a referral to Bourke or Brewarrina in the past months. NSW Health's goal was to see and discharge patients in four hours.
The number of people arrested in the Dubbo local government area on possession of amphetamines (including ice) was double the state average with 197 arrests per 100,000 people.
Other data from the Bureau of Crime Statistics and Research (BOCSAR) shows arrests for possession and use have increased 66 per cent over the last two years, and 21 per cent over the five years to 2018.
The rate of methamphetamine-related hospitalisations in the Western NSW Local Health District was 40 times greater than the average in NSW, with 83.6 per 100,000 people compared to 2 per 100,000 people in 2009-10, NSW Health data found.
Dr Spencer said many patients come from impoverished families, and he was alarmed by the number of young people who were using it with long-standing unemployment a factor.
The commission heard many people using ice injected, ingested or smoked it.
But it was the intravenous use that caused complications relating in death. "Once they convert to intravenous use, the ballgame changes," Dr Spencer said. Most were using many drugs, and patients were dying because they are mixing it with fentanyl.
Dr Spencer said the reason why it was such a bad epidemic was that it was readily available.
"Children feel as if they are strong enough to be able to handle the effects of the drug without becoming addicted, but the addictive power of amphetamines is similar to cocaine, and they very quickly become addicted," he said.