Series: 7 Of 10

COUNTY HEALTH CARE WORKERS SEE INCREASE IN METH USAGE

The Growing Use Of Methamphetamine Is Stretching Douglas County Health Care
Providers' Resources.

Charlie Ross, an emergency room doctor at Mercy Medical Center in Roseburg
for the past six years, said methamphetamine abusers appear in the hospital
with increasing frequency after snorting meth, taking it orally or
intravenously shooting it into their bloodstreams.

By the time an addict reaches the ER, it's usually because of an overdose
or psychiatric problem. Patients on meth exhibit a "fight or flight"
reflex, Ross said. They come into the hospital sweaty, their hearts racing
and paranoid. Some experience seizures.

"They frequently are picking at themselves," Ross said. "They say, 'Don't
you see these bugs? They're crawling all over me.' There's no discussing it
with them. They truly believe it's real."

Ross said people who use methamphetamine can damage their hearts,
experience high blood pressure and injure their internal organs. In the
long term, Ross said they can expect permanent changes in their mental status.

He said about five years ago, Oregon doctors were advised by state health
officials to check lead levels in patients who were admitted to the
hospital after taking methamphetamine. Because of the dangerous "cooking"
process involved in making the drug, lead residue from implements made its
way into some batches. Lead is highly toxic, and prolonged exposure to the
metal can cause damage to organs and the brain.

"You could become a Mad Hatter, like in 'Alice in Wonderland,'" Ross said.

Kathleen Nickel, director of communications at Mercy, said the financial
impacts to the hospital caused by methamphetamine use are substantial. Most
drug abusers who come to the ER are uninsured, but the hospital must treat
them anyway.

Although uninsured methamphetamine users account for only a fraction of the
$15 million Mercy has provided in charitable care in 2003, it still adds up
to "a lot of money," Nickel said.

Barbara Murry, who is the director of employer services and outreach for
the ADAPT drug treatment program, said there is a connection between
methamphetamine abuse and lack of health coverage.

Murry said ADAPT's River's Edge program for insured outpatients had only
one client who used methamphetamine, and he dropped out.

"We don't see nearly as much methamphetamine use in our insured clients,"
she said. "I think, in large part, it may have to do with employment. It's
very difficult to go to work when you're using meth."

Murry said in a recent conversation with area employers, she learned that
an increasing number of job applicants are testing positive for marijuana
and meth before they even get the job.

"It's a powerful drug. People who use it can't even resist it long enough
to get a job," she said.

Most of ADAPT's services, therefore, are primarily paid for by the state,
through the Oregon Health Plan.

Methamphetamine use rarely results in fatal overdose, but over time can
contribute to organ failure that results in death.

Ric Bennewate, Douglas County Sheriff's deputy and former medical examiner,
said "I can remember only two cases in the last couple of years where the
death was directly related to methamphetamine, whether because of an
overdose or arrhythmia. Particularly people who inject the drug have a
sudden increase in blood pressure and heart rhythm. They go into arrhythmia
and die. More often though, you have people who've been killed after using."

Bennewate, who resigned from the head medical examiner position earlier
this year, continues to offer his services to the office part time.

Most meth users who come to the ER end up in the hospital's Behavioral
Health Unit instead of the morgue.

Dr. Scott Mendelson, a psychiatrist in Mercy's Behavioral Health Unit who
has a background in brain research, has worked in Roseburg for three years.
In that time he has seen up to six patients a week suffering side effects
of methamphetamine use.

The drug gives users a strange clarity, Mendelson said. It stimulates the
release of norepinephrine, which makes users alert, and dopamine, which
brings pleasure. It is not uncommon for meth users to be awake for 48 to 72
hours. The drug also increases sex drive and reduces inhibitions.

"What's so addictive is that the feeling is so intense," he said. "When
methamphetamine abuse is combined with alcohol, or other drugs, it makes
people careless and reckless. We see fairly chronic users. It's
unfortunate. They can be depressed because their thoughts are disorganized
and they have permanent cognitive brain damage. In the acute phase, they
can be psychotic."

Mendelson said many of the patients he sees are burned out on the drug, but
don't know how to stop.

"They are very depressed and think that life just isn't worthwhile
anymore," he said. "They figure they're better off dead, and think that
nothing will be as good as the first methamphetamine high."