Crystal Meth

On a more serious note about crystal meth, there was an article in Sunday's paper about the epidemic this has become in this country. Middle Tennessee has the unfortunate distinction of being the largest meth producing state in the south east.

The costs to society are enormous. Below is a snip from another article in the same paper focusing on the toll that Vanderbilt University Medical Center's Burn Center (the largest in the south) takes as a result of treating victims of meth lab explosions:

Meth injuries are not unique at Vanderbilt's Regional Burn Center. A week ago, seven of the critical-care unit's 20 beds were filled by patients whose injuries were meth-related, either from making the homemade drug or from hurting themselves while under the influence of the highly addictive substance, according to Guy.

This patient is unique, however. He's a two-timer.

A few months before his latest injury, the man spent weeks recuperating in another hospital's burn unit after a meth lab flared up.

''This time he comes to us for a few months,'' said Guy, referring to Vanderbilt's Regional Burn Center, one of the largest burn injury units in the South.

Total estimated bill from both conflagrations: near $1 million. At Vanderbilt, the bill is already approaching a quarter of a million and is rising at the rate of $10,000 a day.

How much will Vanderbilt be paid for the critical care?

''Zero,'' Guy said, matter-of-factly.

''What drunk drivers are to emergency rooms, methamphetamine is to a burn center. This is uncompensated health care. Vanderbilt is private. We don't receive state funds for this type of care.''

Meth, a stimulant that has become the drug of choice in many parts of rural Tennessee, is typically concocted in homemade laboratories. The object is to transform pseudoephedrine, a key ingredient in many over-the-counter cold remedies, into methamphetamine.

To do so requires several potentially volatile reactions produced when various chemicals, including brake fluid, lye and lantern fuel, are combined over heat.

One misstep can bring a meth maker to Guy's operating room.

And, as patients go, meth users aren't good patients.

The influx of meth patients at Vanderbilt's burn unit has risen so dramatically that Guy fears the care will harm his unit's mission. The man on the operating table is a good example. He had to be brought to Vanderbilt on a medical plane at a cost of thousands just for transportation.

''I've got a clinical mission to care for thermally injured patients within 200,000 square miles,'' Guy said. ''That includes those in meth labs. Vanderbilt is always going to do the right thing. The question is, how long can we continue to provide that kind of service?''

Unfortunately, burns are a ''disease of the economically challenged,'' he said.

Generally, 35% of all burn cases seen by the Vanderbilt hospital are not covered by insurance.

''When we look at meth patients, in excess of 90% of them have no insurance. Who pays for that? Society does,'' Guy said.

According to The Journal of the American Medical Association, trauma patients who are meth users are more likely to have longer stays in the hospital and the bill they run up is likely to be significantly higher.

In the JAMA study, which examined 212 minimally injured trauma patients, the authors concluded meth patients require ''an increased use of hospital resources, measured by length of stays and charges.''

The average length of stay for meth patients compared to the general population increased from 1.7 days to 2.7 days. Hospital charges for the meth patients were $4,000 higher than the general population.

For burn patients in particular, the rule of thumb is they stay in the burn unit one day for every percentage of their body affected by third-degree burns. If a patient's injuries cover 60% of his body, a stay of 60 days is expected.

''We see only the worst cases,'' Guy said.

At the recent annual methamphethamine conference in Nashville, Guy told accounts of some of the worst, including a man burned so badly in a meth-related explosion that his stomach had to be opened due to swelling. His intestines were held in place by a tent of plastic stapled to his midsection.

On a screen behind him flashed a photo of that man in the burn unit.

''This is what happens when you mess with meth, when meth messes with you,'' said Guy, as audience members flinched.

''This is what every person who cooks meth ought to have to see.''

Dan Ramage, a licensed clinical social worker who works in the burn unit, said patients injured in meth lab accidents don't cease to be a burden once they are discharged. In fact, often the opposite is true because of underlying substance abuse problems, marital discord and financial worries the person had before the injury.

''This is a much larger problem for the community. Dr. Guy may save the person's life and I might provide some counseling services while they are in the hospital, but when they leave they face the same problems they used to have. Now, some of them also have terrible disfigurement to adjust to,'' Ramage said.

''It's a terrible situation, especially when you consider that most meth patients are from rural America. These are good ol' boys who have become addicted to this stuff and it's absolutely destroyed their lives, and in rural areas there are even fewer mental health and other services than you would find in a metropolitan area.''

Later this year, the burn unit is expanding to new quarters on the Vanderbilt campus. Nine beds will be added.

Guy said he has no hope that the excess beds will remain empty for long. Many of them will be filled by patients with burns caused by the production of meth, he speculated as he stapled skin grafts to the man in his operating room.

''I wish I could say he would be the last,'' Guy said, ''but he won't.''

By the numbers


The typical cost of care per day for a person in the burn unit at Vanderbilt University Medical Center.


The percentage of meth labs that Tennessee accounts for in the Southeastern United States.


The number

of meth lab discoveries in Tennessee in 2004.


The number of high-frequency percussive ventilators in use at Vanderbilt's burn unit. The ventilators breathe up to 500 times a minute for burn patients, which promotes healing and keeps the lungs clear.


The going price per square foot of lab-created ''skin'' used in skin grafts.


The average number of critical burn patients treated each year at Vanderbilt.


  • 5 Comments sorted by Votes Date Added
  • In the Pacific Northwest, we've been dealing with the meth crisis for several years now - it's only just beginning to become widespread in your area of the country.

    Hold onto your hat, TN. This is a good-news bad-news situation.

    The good news is that as they become more proficient, the number of exploding meth labs decreases. Practice makes perfect.

    The bad news is everything else. Here's what we have in Oregon, and what you are probably starting to experience in Tennessee:

    INCREASE: Home invasion robberies, often with injuries. Meth addicts looking for anything and everything they can sell and they don't care if the owners are home. In some cases, they have been shot by the owners.

    INCREASE: Stranger-to-stranger strongarm or armed robberies.

    DRAMATIC INCREASE: Identity theft. Most Oregonians do not use their mailboxes anymore for outgoing mail. Me, I sit on pins and needles if my credit card statement or bank statement is late. Daily monitoring of bank accounts is not uncommon.

    INCREASE: Homelessness and increasingly aggressive panhandling in the downtown area.

    POLICE TACTICS: In Portland, there is a detachment of police officers dedicated to addressing meth crimes and labs and nothing else. They take no other calls, they aren't accountable to anyone for any other police work except concentrating on busting meth labs and addicts. Usually, on a good day, they'll make a significant number of arrests only to have the addicts/cooks back on the street within a few hours.

    There may be some good news on the horizon, though. Several months ago, we copied a law passed in Kansas (I think) which requires that all pseudoephedrine-containing medications must be sold behind the counter in the pharmacy or grocery store. In order to purchase it, the individual must produce some form of ID. Since the law went into effect, we have seen a 20% drop in the number of meth lab busts.

    Good luck, TN. The fun is just beginning.

  • What is it about TN? Didn't you guys just have a sheriff arrested for 'cooking' meth? Also, that area has been the center of abuse of oxycontin for some time. You have nothing better to do?

    Good luck. This seems to be a scourge of especially rural areas where the meth labs can get away from detection. That is until they blow up.
  • Whatever happened to stills and good ole corn mash moonshine? I guess those days are long done. Wow...I had no idea that Crystal Meth labs were so common. As far as I know around here we only find one or two every few months...maybe they hide it better here.
  • We have had meth labs in Kansas for several years. We have passed laws to keep the ingredients like sudafed off of the shelves. It has helped. I live in a small community and meth is one of our biggest problems. Meth also effects the small children living in the homes. Children have trouble in school etc. We keep closing down the labs but they just pop up somewhere else. Meth user also have problems with their teeth.
  • Meth is becoming a big problem in Georgia also. The State legislature just passed a law to keep cold medicine off the shelf. If the Gov signs it the bill, in order to buy a package of Sudafed, etc. would require the purchaser to sign for the purchase with ID.

    Question! In the example TN HR used, why was the burn victim running a second meth lab a few months after being burned in his first meth lab? Shouldn't he have been in jail after the first incident?
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