New York Times reports on Meth

January 18, 2006

Hospitals Say Meth Cases Are Rising, and Hurt Care

By KATE ZERNIKE
A sharp increase in the number of people arriving in emergency rooms with methamphetamine-related problems is straining local hospital budgets and treatment facilities across the country, particularly in the Midwest, according to two surveys to be released in Washington today.

The studies, conducted late last year by the National Association of Counties, are another indicator of the toll the drug has taken on local communities, particularly in rural areas where social service networks are ill-equipped to deal with the consequences. In July, the association reported that an overwhelming number of sheriffs polled nationwide declared methamphetamine their No. 1 law enforcement problem.

In the most recent survey, conducted late last year, 73 percent of the 200 county and regional hospitals polled said they had seen an increase in the number of people visiting emergency rooms for methamphetamine-related problems over the last five years; 68 percent reported a continued increase in the last three years, and 45 percent in the last year.

The problem was particularly intense in the middle of the country: 70 percent of hospitals in the Midwest and 80 percent in the Upper Midwest said methamphetamine accounted for 10 percent of their patients. Nationwide, 14 percent of the hospitals said such cases made up 20 percent of their emergency room visits.

Methamphetamine users are often unable to hold down jobs because of the highly addictive nature of the drug, meaning they are often uninsured, the hospitals say. Yet many hospitals are required to treat them under state laws.

"These are labor-intensive cases, and the money that's put out is money that the hospitals won't recover," said Jeri Reese, an emergency room nurse manager in Greene County, Iowa, who is scheduled to speak at a news conference explaining the survey results.

Fifty-six percent of hospitals said their costs had risen because of the growing abuse of the drug. In Arkansas, where the problem has increased in severity recently, 78 percent of the hospitals said costs had increased.

Methamphetamine is often made in small home laboratories using toxic household chemicals. Many of the people who arrive at emergency rooms because of methamphetamine have been burned making it or are children who have been exposed to the chemicals.

Users frequently develop rapid heartbeat, increased blood pressure and fevers that can reach 105 degrees. And because the drug's neurological side effects frequently include aggressive behavior and paranoia, the hospitals say they deal with many victims of fights or beatings.

"They're so unpredictable and erratic that when someone comes in, you have to have separate staff just to watch them," Ms. Reese said.

In the second survey, 69 percent of the hospitals reported an increased demand for treatment for methamphetamine abuse, which tends to be long and intensive. And 63 percent of the hospitals said they did not have enough capacity to meet demand.

"It has really rocked us," said Patrick Fleming, director of the Salt Lake County Division of Substance Abuse Services in Utah, who is also scheduled to speak in Washington. "People are staying in treatment slots longer, so I can't spin those beds to someone else. My waiting lists are mounting like crazy."

Though a relatively small number of total emergency room visits are for illicit drugs, the hospitals said methamphetamine was by far the leading drug problem. Forty-seven percent of hospitals, and 57 percent in the Northwest, said methamphetamine caused more emergency room visits than any other drug, while 16 percent cited marijuana, 15 percent cocaine and 1 percent heroin.

The association of counties and many local officials have criticized the Bush administration's antidrug strategy as focusing too much on marijuana. The White House Office of National Drug Control Policy began running television advertisements against methamphetamine last month and has increased some grants for treatment.

Many states have gone further, restricting sales of pseudoephedrine, the crucial ingredient in methamphetamine, and the association said it planned to use the hospital surveys to encourage the federal government to follow suit.

The association also said it wanted more federal money for compensation for hospitals tending to the uninsured, as well as for treatment care, programs to help affected children and continued law enforcement grants for regional drug task forces.