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Meth lab disasters: Kentucky's only two burn
units are overburdened by drug cooks
Writer: Cassondra Kirby
11/14/2005 Lexington Herald-Leader
His
eyebrows and lips already burned away, Ricky Dale Houchens screamed and thrashed
around a tiny trailer in Allen County.
Flames climbed over his face; his
skin ran in thick gobs down his cheeks and over his chin.
Houchens'
buddies watched in horror.
The group had been making methamphetamine
when the concoction exploded, engulfing Houchens in a ball of fire. Afraid they
would get in trouble, no one called for help. Instead, someone drove Houchens to
a nearby hospital and left him at the emergency room door.
"My face was
smeared all to the side," Houchens said, grimacing at the memory. "The skin was
running down my arms like lard."
Houchens, 28, of Bowling Green, was
flown to Vanderbilt Burn Center in Nashville, where doctors treated him for
severe burns on 40 percent of his body. He was in the hospital for more than two
months, racking up charges of more than $553,000. About $110,000 of that was
recovered from Kentucky Medicaid, he said; the rest will probably go unpaid.
Victims of meth-related mishaps are increasingly overloading burn units
in Kentucky, Tennessee and other states that have seen meth use explode in
recent years.
As patients battle with recovery and disfigurement,
hospitals and burn units say they are in a war of their own: trying to treat
meth-related burn patients who often don't have insurance or money to pay bills
that can reach or exceed $1 million.
"Burn units are a scarce commodity
and are becoming more scarce as time goes on," said John Howser, a spokesman for
Vanderbilt Hospital, where as many as a third of the past year's burn cases have
been meth-related. "If we continue to take on this large burden of care, I don't
know if we will have a burn unit 10 years from now."
Explosive drug
problem
Meth, a stimulant that is becoming the drug of choice in some
parts of rural Kentucky, is often concocted in makeshift laboratories in
trailers, apartments and even moving vehicles. Meth "cooks" transform
pseudoephedrine, a key ingredient in many over-the-counter cold medicines, into
the drug. But the process involves several potentially explosive reactions,
mixing chemicals such as brake fluid, lantern fluid and paint thinner, over
heat.
One misstep -- such as fastening a lid too tight during boiling --
can leave a meth maker on an operating table clinging to life.
For
Houchens, the explosion happened before he could flinch.
Strung out on
meth, Houchens and his friends were cooking more of the drug in November 2004.
As the chemicals simmered on a rusty stovetop in a single-wide trailer in
Scottsville, Houchens saw the mixture was getting too hot.
But when he
went to pick the brew up and turn off the burner, the pitcher's bottom gave
away. Before he could react, chemicals splashed on the burner. Fire engulfed
him.
Houchens said he had just snorted a hit of meth, and he felt the
flames climbing a path straight into his head.
His pants burned. When a
friend helped him peel what was left of a T-shirt off his back, lumps of skin
came with it.
That was the point at which Houchens recalls first feeling
the pain.
At Vanderbilt Hospital, his stomach was sliced open to relieve
swelling. His intestines were held in place by a tent of plastic stapled to his
midsection.
Meth is "the devil in powder form," said Houchens, who used
the drug for energy and to stay awake for weeks at a time without sleep. He
would spend his nights chasing women, while driving around Bowling Green with
friends.
A year after the explosion, Houchens still can't extend his
arms in front of him or make a firm fist. But, for the first time in his life,
Houchens said, he appreciates the family and friends around him. He thanks God
for saving his life, and says he's working to remain drug-free.
Doctors
were able to piece together his face with lab-created skin that cost about
$10,000 per square foot. His neck, face, belly and arms remain heavily scarred.
But Houchens hasn't paid a penny of the medical costs. He doesn't have
the money or insurance and he still needs six more surgeries.
Howser,
the Vanderbilt spokesman, laughs when asked if meth-related patients like
Houchens are typical at the hospital. He said most of Vanderbilt's patients are
from Kentucky and Tennessee, and like Houchens, the majority can't pay. Kentucky
hospitals have seen the same trend.
In Kentucky, meth lab seizures
skyrocketed from 18 in 1998 to 377 last year, according to the Drug Enforcement
Administration. Kentucky's 468 lab busts this year rank it sixth among U.S.
states.
"We are looking at being in the hole with these patients," said
Portia Loveless, a University of Kentucky trauma research coordinator.
Vanderbilt Hospital, a private facility, doesn't get any state money to
make up for uncompensated medical care, Howser said. The hospital is forced to
compensate for the loss in other ways, typically by raising prices.
Public medical facilities, such as the University of Kentucky hospital
and the University of Louisville hospital, get a lump sum from the state each
year for such losses, but the loss far exceeds that given amount, doctors at the
facilities say. UK and U of L have the only two burn units in Kentucky.
"But we continue to do what's right and treat these people," Howser
said.
High cost of treatment
As patients go, doctors say, meth
users aren't good ones.
Along with insurance issues, meth burn patients
are more likely to have a longer stay in the hospital than other burn patients
and their hospital costs are significantly higher, according to a University of
Louisville study released this year. The study, which examined 397 adult burn
victims at the Louisville hospital, found that meth burn patients had "higher
incidents of inhalation injury and needed more intense respiratory care and
longer ventilator usage" (33 days versus 17 days) because of chemical-related
inhalation injuries. They also typically need more surgical procedures, and
their wounds are more likely to become infected.
Because meth burn
patients also go through withdrawal while in the hospital, they tend to be
easily agitated and require more sedation and restraint than other burn
patients, the study said.
In the end, that means higher hospital costs
for meth patients, about $4,000 more per patient than the general burn
population. But doctors say they won't turn away patients, even if they were
injured through illegal means and don't have the money to pay.
"If they
come to us with medical problems, we take care of them," said Dr. Henry
Vasconez, director of University of Kentucky Hospital's burn unit. Vasconez has
seen patients as young as 12 burned while making meth. Although UK has had only
about 30 confirmed meth-related patients since 2001, Vasconez said he suspects
that at least 20 percent of his patients each year are burned while making meth.
Most of them offer dubious explanations for their injuries. Even though
doctors strongly suspect the burn was meth-related and they test positive for
the drug, they can't confirm it, he said.
"We could be seeing meth
patients every day," said Glen Franklin, director of the burn unit at University
of Louisville Hospital. "We just can't identify why they have been burned or
injured."
Franklin said many patients come in on their own after being
burned and make up the cause of the fire.
Doctors say they are most
concerned with the space meth burn victims are taking up in burn units. UK has
only four burn beds and U of L has five. Sometimes a burn patient who lives near
a hospital has to be transported to a faraway facility because there's no room,
doctors say.
"Burn units are a limited resource in our area," Franklin
said. "Meth patients are eating up that resource by taking up bed space."
Earlier this month, officials said Kentucky has seen a decrease in meth
lab busts since June, when laws went into effect restricting the sale of
over-the-counter cold medicines that contain pseudoephedrine, meth's key
precursor. Officials say the reduction in the number of people making meth
should mean fewer people being burned, but doctors say that remains to be seen.
Reporting not required
In Kentucky, doctors say they aren't
required to tell police about patients who are burned from suspected meth labs.
Houchens, who appeared in a Newsweek magazine story on meth in August,
said his incident wasn't investigated by police, and doctors didn't notify
authorities when he told them he had been burned while making meth.
"I
guess they figured I suffered enough," he said.
Doctors say they're
amazed that some meth burn patients still use and make the drug even after they
are permanently disfigured.
"It's not uncommon to have one person who
will be in the burn unit several times," Howser said. "They don't learn the
first time and go back out and do the same things again."
Houchens said
he snorted meth less than two months after leaving the hospital. A buddy had to
hold the straw to his nose.
"I felt like I had let everybody down," said
Houchens, adding that he hasn't used meth since then. "But meth is an evil drug,
it's Lucifer himself. Look at me and see what it has done. After the show's
over, I can't go behind a curtain and take these arms off and put on real,
better ones. This is what's left."
The facts about meth
What is
methamphetamine?
Methamphetamine is an addictive stimulant that floods
the brain with dopamine, a pleasure-related chemical, and strongly activates
certain areas in the brain. Small doses can raise alertness and block hunger.
Commonly known as: meth, speed, crank, ice, chicken feed and chalk.
Forms of meth: powder, pill, capsule and solid forms. It can be taken by
snorting, smoking, ingesting and injecting.
Why users use: a single dose
of meth lasts 6 to 8 hours; a single dose of cocaine lasts 8 to 20 minutes.
Average price per gram of meth in Kentucky: $150
Risks and side
effects: anxiety, emotional swings, paranoia, violent behavior, fever and
convulsions. Meth also causes increased blood pressure, which may cause death
from burst blood vessels in the brain or heart failure.
Spotting a user:
Frequent meth users typically are:
* Gaunt, and lose extreme amounts of
weight.
* Paranoid, easily agitated and able to go without sleep for
days or even weeks
* Not hygienic, with rotten teeth and possibly skin
sores from digging at imaginary bugs under their skin. Dangers of meth making:
Meth manufacturing releases harmful toxic chemicals into the air, and toxic
byproducts can poison streams and kill vegetation and livestock. For every pound
of meth produced, there are five to seven pounds of hazardous waste.
Signs of a meth lab: Strong and unusual odors of glue, cat urine,
ammonia or other chemicals, as well as finding lithium batteries that have been
torn apart or a cooler or thermos that smells like ammonia. Other signs include
excessive trash and empty jugs of muriatic acid, brake fluid, drain cleaner and
lantern fuel.
Cost of cleanup: The average direct cost to clean up a lab
several years ago was about $17,000, but because of improved technology, it is
now about $2,000 to $3,000 per lab in Kentucky.
Trafficking and
seizures: Much of the meth in Kentucky is created in mom-and-pop labs in houses,
apartments, sheds and even vehicles. When the drug is smuggled into the state,
it is transported primarily to Louisville, Lexington and Covington. State police
say an increasing number of mobile meth labs are being transported in vans,
trailers and sport-utility vehicles, helping cooks avoid detection.
Meth-related burns in Kentucky
* The average age of a
meth-related burn victim in Kentucky is 35. Ninety percent of patients are white
males and don't have insurance.
* There are two burn units in Kentucky,
at the University of Kentucky Hospital and University of Louisville Hospital.
Vanderbilt Hospital in Tennessee also regularly treats Kentucky patients.
UK has four burn beds. The facility treats meth-related burn patients
mainly from Central and Eastern Kentucky, but the hospital has also treated
meth-related patients from Tennessee, West Virginia, Indiana and Ohio. From 2001
to 2004, the hospital has treated 30 confirmed meth-related patients.
U
of L has five burn beds. The facility treats meth-related burn patients mainly
from Kentucky, but it also serves Indiana and Tennessee. From 2001 to 2004, the
hospital has treated 15 confirmed meth-related burns.
Vanderbilt has 20
burn beds. The facility treats mostly patients from Tennessee and Kentucky, but
it also serves Northern Alabama and Mississippi. Information was not available
on how many confirmed meth-related patients Vanderbilt has seen in the last
three years, but hospital officials say rarely a day passes when they don't
treat burns or inhalation injuries from making meth.
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