METH POSES THREAT TO HOSPITALS

Health Workers Urged To Protect Themselves Against Toxic Fumes

NASHVILLE - The Hippocratic Oath tells doctors: First, do no harm.

But when dealing with methamphetamine users it must be amended to read:
First, protect yourself.

Dr. Barry S. Wagner, director of medical recruiting at Emergency Coverage
Corp. in Knoxville and a member of the Cumberland Medical Center in
Crossville, said health care professionals have been sickened by the stench
of a drug user's clothes and chemicals found in bodily fluids.

"We don't have all the answers because all the answers don't exist," he
said Tuesday during a panel discussion at the three-day Methamphetamine
Response Conference. "If you treat this as a typical diagnostic problem,
you're going to come out on the short end of the stick."

Typically, emergency room personnel are taught the ABCs of treatment:
Airway, breathing, circulation. But when dealing with a meth user, "D" for
decontamination must come first.

Wagner recommended that emergency staff immediately undress a meth user,
then bag and burn the clothes at a secure site.

Meth is similar in its chemical makeup to dopamine, the naturally occurring
"feel good drug" in the brain. Users describe methamphetamine's effect as a
"total body orgasm."

But meth also disrupts serotonin in the brain, creating hallucinations.
Many users imagine bugs are crawling under their skin. This leads many to
scratch their limbs until they bleed, increasing the risk of infection.

Others often report seeing "tree people" and go for days without food or sleep.

He said methamphetamine users can be homicidal during the upswing of the
drug's effect, and suicidal on the downslope.

"The tendency for violent behavior among meth users is 100 times greater
than with angel dust," Wagner said. "Emergency room staff has had knives
thrown at them and meth users have battled big, strong police officers.
Remember, if you go down, there will be no one to treat the patient."

"Officers respond to all types of calls but for situations involving
methamphetamine, an officer would notify someone with metro narcotics
because they have special training dealing with meth labs and users," said
Lt. J.D. Hale of the Jackson Police Department. Metro narcotics officers
are equipped with chemical suits and equipment to protect themselves from
the dangers of dealing with meth.

Emergency room staff should wear a small respirator when treating meth
users, Wagner said. The long-term effect of secondary exposure to meth
fumes isn't known - and the effectiveness of small respirators in
combatting the danger is unclear.

"But it can't hurt," Wagner said.

A full haz-mat suit would protect workers, but the cost is too high.

The illegal drug is also highly flammable, and the chemicals on the clothes
of people admitted to emergency rooms can ignite.

"What do we have a lot of in emergency rooms?" Wagner said. "Oxygen. There
have been cases of explosions."

Methamphetamine is often called the "poor man's cocaine."

Cocaine and meth each cost about $100 a gram. The difference is that
methamphetamine can be manufactured in a makeshift lab with household items
such as pills containing ephedrine or pseudoephedrine, rubbing alcohol,
drain cleaner, salt and matches.

The drug's effect can last for hours, and many users try to extend the high
for days.

Drug users face increased risk of heart attack, stroke and pulmonary disease.

Wagner said a cocaine user can live for 20 years, but the life expectancy
for a methamphetamine user is five to seven years. Users who share
hypodermic needles to inject the drug also face an increased risk of AIDS.

Wagner said there is no easy cure for the drug, which is about 95 percent
addictive, and no proven long-term therapy.

"If the person isn't willing to commit to a year of treatment, he will
relapse," Wagner said. "The cost of treatment at the top centers where
movie stars and rock stars go is $1,000 a day. Who can afford that?"