INCREASING CASES OF 'METH MOUTH' BURDEN PRISONS' HEALTH-CARE BUDGETS

Look into the mouth of a longtime meth user, and you'll see one way
the drug marks its users.

You'll see teeth ground to mere nubs, others black with rot, abscessed
gums and other dental nightmares.

That's what Minnesota prison dentist Stephen Boesch sees with
increasing frequency in the mouths of inmates.

With a more than fivefold increase in the number of methamphetamine
offenders behind bars, the drug's effect on teeth is taking its toll
on the state prison budget's bottom line.

"Meth offenders certainly bring added and unusual challenges to the
correctional system.... We are just starting to get our hands around
some of the physiological damage that occurs in some offenders and the
most dramatic of those are the dental problems," said Dennis Benson,
deputy corrections commissioner. "This adds to an already insufficient
health-care budget, which is very difficult for us to manage."

Last year, the state spent$2 million on dental care for inmates out of
a total health-care budget of just less than $30 million. That's up
from about $1.2 million on dental costs the state spent in 2000,
before meth's impact was fully felt in state prisons. The rate of
increase for prisons' dental services cost has far outpaced the
increase in the number of inmates.

Methamphetamine is a highly addictive drug that keeps users buzzing
and wreaks havoc with the mind, the body and the teeth.

Many users stay awake for days, eat nothing or eat junk, drink little,
have dry mouth and grind or clench their teeth constantly. The acid in
meth corrodes tooth enamel, letting decay-causing bacteria seep in.

"All these different factors enter into it, and it is very, very
common for there to be infections and tooth loss," said Deborah
Durkin, environmental scientist at the Minnesota Health Department.

The result is a mouth like that of Jassen Ferris.

"I'm in a lot of pain. If I eat an apple, like, pieces of my teeth
will break off," said Ferris, an inmate in Minnesota's Faribault
prison. He's had five teeth pulled since he was arrested a little more
than a year ago, and he knows more will have to go.

And that's far better dental care than he used to have when he was
smoking meth constantly and living on the streets in St. Paul.

"My early 20s were when I first started getting problems with my
teeth.... If I had a toothache, I'd smoke more and it killed the
pain," said the 31-year-old who first tried meth when he was 15. "When
you are using meth, you use any excuse you can to use some more."

Ferris has access to health care in prison because, like all prison
systems, it is constitutionally required to provide medical care to
inmates.

"It is because of the Eighth Amendment of the U.S. Constitution...
which prohibits cruel and unusual punishment," said Kara Gotsch,
public policy coordinator for the National Prison Project of the
American Civil Liberties Union. "Essentially, inmates are at the mercy
of the correction officials that oversee them because a prisoner
cannot go out and solicit the care on their own."

Ferris' abscessed gums and cracked teeth are typical of dental
problems experienced by the hundreds of former meth users in the
state's prisons. It's what people inside prisons and outside their
walls -- officials and inmates alike -- call by one name: "meth mouth."

"We're seeing it come in groups of mouthfuls of problems," Boesch
said.

In two recent days, Boesch treated Ferris plus:

One man who had been to prison dentists six times. He had abscesses
around all his teeth -- "that's infected tissue and pus," Boesch said
- -- plus four extractions.

Another man with a mouthful of nonrestorable teeth. All of them will
probably have to go.

A third man who had seen prison dentists nine times and had all but
six of his teeth extracted. Those six may not be there long. "I don't
think we are going to be able to save those," Boesch said.

To restore the last six would cost about $5,000 and the inmate will
need dentures at a cost of several thousand dollars. But those are
procedures the inmate would have to seek outside prison walls.

The story is the same in many states facing similar problems with
methamphetamine.

In North Dakota, prison dental costs have risen threefold since 2000,
said Tim Schuetzle, the state's prison division director.

"We do have a real problem with it. Our costs are going up because of
meth," Schuetzle said. The state used to have a contract with a
dentist who would serve the state's two big prisons for about four
days a month. Now that dentist works about eight days a month and the
state is considering hiring a dentist full time.

North Dakota has also adopted inmate co-pays for dental work and begun
recommending fewer dentures for inmates, opting instead for simply
pulling teeth and leaving empty spaces behind.

In Minnesota, it's unlikely any of the meth offenders such as Ferris,
who was sentenced to just less than a year, will get state-sponsored
dentures. In the prison system, dentures are considered part of
routine care and inmates now in Faribault wait 29 years before they
get routine care. The wait may become even longer in the next few years.

"I can see a time in the not to distant future when we will not have
time for routine care at all," Boesch said.