by Katie
(Portland (US))
QUESTION:
By Katie, Portland, USA
My former boyfriend has had type 1 diabetes for about 10 years and injects methamphetamine. He often neglects his blood sugar. His behavior has become frightening and bizarre: he goes into the backyard at night pretending to be a squirrel, carries black bags, claims to have killed “evil women,” and has beaten me almost to death. Could methamphetamine combined with uncontrolled diabetes be making him lose touch with reality?
Quick Answer
Methamphetamine can cause paranoia, hallucinations, delusions, severe agitation and violent behavior. Dangerous low or high glucose can also cause confusion or altered behavior, but diabetes does not explain away or excuse repeated violence. Because he has severely assaulted you and is making disturbing claims about killing women, treat this as an immediate safety threat. Stay away from him, do not meet him alone or try to manage his glucose, and call emergency services if he approaches, threatens you or appears violent.
Answer by Dr. Albana Greca, MD, MMedSc
Hello Katie,
I am very sorry you were seriously assaulted. Your priority is staying alive and preventing further contact while trained professionals assess him.
A person who has nearly killed a partner, uses intravenous methamphetamine, appears psychotic and talks about killing women presents a potentially lethal risk. Do not confront him about his drug use, argue with his beliefs, meet him to “calm him down,” or enter a place where he may be present.
The National Domestic Violence Hotline safety-planning service can help survivors in the United States prepare for contact, stalking, threats and emergencies. Use a safe device if you believe he monitors your phone or browsing.
After a serious assault: Obtain medical care even if injuries seem minor. Strangulation, head injury and internal injuries may not be immediately obvious. Tell the clinician exactly what happened and ask that injuries be documented.
Yes. Methamphetamine is a powerful stimulant. Heavy or repeated use can cause extreme sleep loss, agitation, paranoia, hallucinations and fixed false beliefs. Some people become unpredictable, aggressive or violent. Injecting it also increases the risk of overdose, heart problems, stroke and serious infections.
His bizarre actions and claims may reflect stimulant psychosis, another psychiatric disorder, intoxication or withdrawal. The behavior requires emergency psychiatric and medical assessment.
Stopping methamphetamine does not guarantee immediate recovery. Psychosis can continue or recur, requiring addiction and psychiatric treatment. His relatives should contact professionals, not ask you to manage him.
Severe hypoglycemia can cause sweating, shaking, confusion, poor coordination, unusual behavior, combativeness, seizures or unconsciousness. Severe hyperglycemia and diabetic ketoacidosis can cause dehydration, weakness, vomiting, deep breathing and confusion. Our guide to low blood glucose and altered behavior explains why urgent treatment may be needed.
However, a glucose problem cannot be assumed every time someone is aggressive. Repeated assaults, threats and coercive behavior remain abuse regardless of whether drugs or diabetes contribute. A medical explanation does not remove responsibility or make it safe for you to remain nearby.
Learn more about mental changes associated with diabetes emergencies and dangerous blood sugar warning signs.
Do not approach an agitated or violent person to check glucose, give food, inject insulin or search for supplies. Your safety takes priority. Tell emergency dispatchers that he has type 1 diabetes, uses intravenous methamphetamine, may be psychotic and has a history of severe violence. Medical responders can check glucose and ketones while managing the safety risk.
If he is unconscious, having a seizure, breathing abnormally or unable to respond, call emergency services. Do not give food or drink to an unconscious person. If you are not in immediate danger and have been trained to use prescribed glucagon, follow the emergency plan while waiting for professionals—but never remain in an unsafe environment to provide care.
Emergency services should be contacted when he:
Do not personally transport him. Tell dispatchers about weapons, drugs, violent behavior and diabetes so the response can be planned safely.
Methamphetamine use disorder requires professional addiction treatment. Type 1 diabetes requires uninterrupted insulin, glucose monitoring, ketone planning and medical follow-up. Psychiatric symptoms require assessment. None of these responsibilities belongs to a former partner he has assaulted.
You may care about his health and still refuse contact. Law enforcement, a protective order and domestic-violence advocacy are reasonable responses to life-threatening abuse.
This educational response does not replace emergency, domestic-violence, psychiatric, addiction or diabetes care. Severe violence or credible threats require immediate professional intervention.
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