HOSPITAL STUDY: METH LEAVES USERS INJURED, BILLS UNPAID

The local cost of methamphetamine abuse has long been evident in
property crime, broken families and the loss of life, but a less
visible toll is the financial strain and additional workload the drug
places on emergency rooms.

"It's the nature of the lifestyle," said. Dr. Mike Sise, trauma
medical director at Scripps Mercy Hospital in San Diego.
"Methamphetamine takes your life away. You lose your job. You lose
your family."

With no job and no insurance, meth users have little hope of paying
for emergency hospital bills.

"It causes a lot of lost revenue," Sise said about the expense at
Scripps Mercy alone. "We calculated the annual uncompensated cost of
care went up to over $1.5 million a year."

Adding injury

Compounding the problem, meth users are likely to hurt themselves
more severely than other patients admitted to trauma centers, he said.

"All sorts of injuries," Sise said about what emergency room doctors
see with patients who use meth. "And they were injured worse."

Meth abusers are more likely to attempt suicide, have a violent
injury, have an altercation with law enforcement and be involved in
domestic violence, he said.

Scripps Mercy is one of two level-one trauma centers in the county.
Besides treating patients, level-one centers teach, conduct research
and publish their findings.

The survey was the only one of its kind conducted at a county
hospital, and the data did not include patients treated at the
emergency room at Scripps Memorial Hospital Encinitas.

Data for the region

Palomar Pomerado Health System does not screen trauma patients for
the presence of drugs so it does not have information about the
injuries sustained to patients on meth or the cost of treating those
injuries, said Andy Hoang, communications manager at the hospital district.

In Riverside County, neither Rancho Springs Medical Center in
Murrieta nor Inland Valley Medical Center in Wildomar, just north of
Temecula, had data about the effects of meth on emergency rooms, said
Teresa Fleege, spokeswoman for the hospital system.

As part of its research, Scripps Mercy analyzed methamphetamine's
effects on the hospital by reviewing 4,932 consecutive trauma
patients who underwent toxicology screening from 2003 to 2005. The
sample represented 76 percent of all trauma patients seen in those three years.

During that time, meth passed marijuana as the most-common illicit
drug used by trauma patients. In 2003, about 10 percent of trauma
patients tested positive for meth. In 2005, the amount had increased
to 15 percent.

A violent world

Patients who were on meth showed a dramatic difference in the
severity and types of injuries they suffered. Those patients were
twice as likely to have a violence-related injury and twice as likely
to have attempted suicide.

Specifically, 47 percent of meth-positive patients had a violent
injury compared with 26 percent of patients who tested negative for the drug.

Meth-positive patients had 33 percent more assaults, 96 percent more
gunshot wounds and 158 percent more stab wounds than patients who
tested negative.

Twice as many suicide attempts and twice as many domestic-violence
victims tested positive for meth than those who tested negative.

About 2 percent of patients had an altercation with a law officer and
tested positive for meth, compared to 0.3 percent who had an
altercation and tested negative.

Watching the scores Injuries also were more severe with patients on
meth. Using a rating called an injury-severity score, trauma doctors
gave patients who tested positive a score of 11.2 compared to 10 for
patients who tested negative.

Patients who tested positive for meth were 62 percent more likely to
receive mechanical ventilation, 53 percent more likely to have
surgery and 113 percent more likely to die from their injuries.
Patients who tested positive for meth also were twice as likely to
leave against medical advice.

"This was something we felt was important to look at because we do
see a fair amount of methamphetamine," Sise said about the research.
"It's a recurrent theme in the injuries we see."

Sise said he was not surprised by the findings. He and other doctors
who compiled the research are publishing their findings in the August
edition of the Journal of Trauma. An abstract with the findings
already has been presented at scientific meetings, and the hospital's
research was published earlier this year in American College of
Emergency Physicians News.

Hospitals report The hospital's findings are similar to other studies
on the drug's effects on emergency rooms.

In 2006, a survey in Midwest states revealed an increase in
meth-related injuries at emergency rooms and additional costs to
treat those injuries.

The National Association of Counties survey found 73 percent of 200
county and regional hospitals had an increase in the number of people
visiting emergency rooms for meth-related problems over five years.

Meth-related incidents accounted for 10 percent of emergency-room
visits in 70 percent of hospitals in the Midwest and 80 percent in
the Upper Midwest, the survey found.

High costs of meth Of all the hospitals in the survey, 56 percent
said their costs have risen because of the drug.

In 2004, the Archives of Surgery, a monthly professional medical
journal, published similar findings about trauma patients at the
Queen's Medical Center in Honolulu.

The smaller study ---- it looked at 212 patients over 12 months ----
also found meth-positive patients had more and greater injuries than
other patients. Of 212 patients in the study, 57 tested positive for
amphetamine or methamphetamine.

Of meth-positive patients, 37 percent had self-inflicted injuries or
intentional assaults, while 22 percent of patients who tested
negative had similar injuries.

That study also found that meth-positive patients had longer hospital
stays and had higher hospital charges.