The majority of people who enter custody in Moree are on ice, according to Justice Health Clinical Nurse Specialist Kerry Cassells.
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In a statement provided to the Special Commission of Inquiry into the Drug 'Ice', Ms Cassells said in her role as nurse at Moree Police cells, a majority of "patients" disclose ice use.
"I would estimate the majority of patients entering the police cells are experiencing the effects of ice at that time," Ms Cassells said in her statement, which forms part of the evidence for the inquiry's hearing into crystal methamphetamine use in custodial settings, taking place in Sydney this week.
"Some people will have had a hit before the police picked them up and can be aggressive and violent."
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Ms Cassells is the longest serving police cells nurse in NSW, having been employed by Justice Health for 20 years.
When she first started working in the Moree Police cells, she said alcohol and cannabis use was "huge" before oxycodones became the drug of choice for most offenders.
"In the last seven or eight years, it has been predominantly ice," she said.
"The majority of my patients use ice on its own, but some are experimenting with other drugs for specific reasons. For example, some patients use Xanax to keep that euphoric feeling or cannabis to help keep them calm and help their appetite so they will eat.
"They tell me that the first hit is the bee-all and end-all, but they never get it back. So they're using Xanax to make the high stay for as long as possible, but they never get that feeling from the first time back. It's gone. When they use ice and Xanax together, it sends them literally crawling up the walls."
Ms Cassells said when patients, as she calls people in custody, first come into the cells, it's obvious the ones who have been using ice.
"Some patients look like they've been in a concentration camp - they are skeletal and malnourished," she said.
"For example, some patients have gone from 70kg to 45kg because of their ice use."
Over her time working at the Moree Police cells, Ms Cassells has come to know a lot of the patients, and she said the recidivism rate is high, with many people committing petty crimes in order to get into custody to detox so that they can then go to rehab.
"They're committing stupid crimes," she said.
"They'll come here [to the police station] and smash a window or steal a box of food from Woolies because they know when they come here they get good food, they're surrounded by people that care about them and care about their health, safety and security.
"When they come into jail, everything's very structured - they know when they have their showers, when their food's coming, when they can watch TV. It's a very productive place to be when they're withdrawing."
In her experience, Ms Cassells said patients who come to jail and receive treatment, will have improved outcomes in relation to their weight, mental health and overall wellbeing.
"Unfortunately, when patients are released without any support systems in place, they are more likely to fail in their treatment and return to jail," she said.
"I call it the 333-effect - I usually see them again three days, three weeks or three months after they get out."
Ms Cassells said she knows of a number of patients who she's treated in jail that were using ice who have since died by suicide or overdose after returning to the community, where there are too many bad influences.
"When they go back into the community, they feel like it's too hard and they can't do it," she said.
"They're whole life revolves around the drug ... and there's too many people who want to come and bring them down."
In her statement, Ms Cassells said Moree "desperately" needs a detox centre, ideally attached to the rehabilitation unit.
"People need to be detoxed to get into rehab, and both services need experienced people, including psychologists, drug and alcohol and mental health workers," she said.
For years she has also been pushing for the MERIT (Magistrates Early Referral Into Treatment) program to come to Moree, to provide the opportunity for adult defendants with substance abuse problems to work, on a voluntary basis, towards rehabilitation as part of the bail process.
The hearing into the prevalence and impacts of crystal methamphetamine use in custodial settings began on Monday, September 2 and will continue until Thursday, September 5.
