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The isolation room in the Echuca hospital emergency department is battered and bruised.

It has patches of different coloured paint and plaster and a large black piece of wood over its most recent wound.

It is no stranger to violence from aggressive drug or alcohol-affected patients.

But it appears that such instances—which see staff abused, police called and the need for extra security staff at peak times—are on the rise.

ED unit manager Craig Frew said the past 18 months had seen a rise in the number of people presenting who were either affected by drugs such as crystal methamphetamine (ice) or alcohol.

One case this month saw a man spend 12 hours in emergency, who had to be given sedatives and put in the isolation room where he vented his frustration on the walls.

Cases like this were ‘‘challenging’’ for staff, Mr Frew said.

Though not all were as extreme as that recent case, staff were often in the front-line when it came to dealing with affected people.

Not knowing what would come through the door was part of the job, but Mr Frew said it was still distressing for staff, volunteers and other patients.

‘‘Staff are prepared for that to a certain extent,’’ he said.

‘‘(But) staff aren’t here to be abused.’’

Mr Frew said a hospital volunteer who was rostered on the evening in question said the experience was an eye-opener.

‘‘She’d never seen anything like it,’’ he said.

‘‘It’s (also) quite distressing for other patients and their families.’’

He said treating a patient such as the one who was using ice last week used a lot of resources, including hospital staff, security staff, police and mental health staff.

ED director Bob Allan said alcohol and ice caused some people to react badly and sometimes aggressively to t