METH BURN CASES FORCE HOSPITALS TO ADAPT

Evasive Patients Hinder Own Care

LITTLE ROCK, Ark. -- They often arrive anonymously, dumped in the
hospital's emergency room bay with burns over their bodies.

Some become blind because they won't tell a doctor how they were burned,
afraid that mentioning any of the chemicals used to make methamphetamine
will get them prosecuted.

As the number of burn victims from these meth lab explosions and fires
rise, doctors at burn units say they've had to take a more aggressive
approach to treating patients.

Common injuries include chemical burns and scalds to the skin. Other
chemicals can blind victims by seeping into their eyes and melting their
corneas. Those burns take days to set in.

Pam Holt worked as a nurse at St. John's Hospital in Springfield, Mo.,
where some of these meth burn patients refused to admit to her how they got
hurt, even though she could often tell the cause.

"I would say to them, 'If you were making meth and you got this in your
eyes you could go blind, so you have to come clean with me,' " Holt said.
"If they tell us and they're honest with us, then we can help them, but in
two days the damage is irreversible."

Once, a teenage boy came in with burns about his face. He had been making
meth in his parents' basement when chemicals leaked.

"He denied it was a meth lab; said it was a carburetor," Holt said. "He got
this chemical in his eyes and is blind to this day."

Jimmy Parks, a nurse in the burn unit at Arkansas Children's Hospital, said
sometimes the truth will come out, but only after much prodding and coaxing.

"They hardly ever say, 'I was working on my meth lab,' " Parks said.
"Usually [they claim] the water heater blew up.

"And then it kind of comes along when we finally work it out."

The patients drain already financially strapped burn units.

The federal Drug Enforcement Agency said Missouri had 2,207 methamphetamine
lab seizures in 2001, up from 863 in 2000. In Arkansas, one of the Southern
states with soaring numbers, 366 seizures were reported in 2001, up from
235 the year before. In Oklahoma, seizures jumped from 383 in 2000 to 580 a
year later.

In New York, however, only eight seizures were recorded in 2001.

"You can pretty much guess that people who are running meth labs out of
their back room are not insured," Parks said. "Percentage-wise they tax
more than the average patients."

That's not the only problem patients injured in meth lab accidents bring to
burn units.

"There's always a danger to the paramedics," said Dr. Ken Larson, who heads
the burn unit at St. John's Hospital. "They [the burn victim] can still
have chemicals on them, so they can get my personnel contaminated."

Burn units have changed the way they treat patients because of the delayed
reactions to the chemicals.

Larson is writing a paper he plans to distribute to hospitals that
regularly deal with injuries from meth lab explosions. He said emergency
workers on the front lines need to know what to look for when they first
treat the patients, and that workers can expect the patients to lie.

"Now anytime anyone has any burns around the eye -- it may have nothing to
do with meth -- we treat all of them as if they have . . . exposure to
those chemicals. It's extra effort on our staff but it could save vision,"
Larson said.

At Hillcrest Hospital in Tulsa, Okla., nurses immediately do a drug test if
they suspect methamphetamine may be involved in a burn. "We do a drug
screen so we know what we're dealing with," said Lisa Delozier, nurse
manager at the hospital's burn unit.

Sometimes the police must intervene.

"These guys come in and we have the police sitting with them sometimes,"
Parks said. "Sometimes they leave against medical advice. They're afraid
they're going to get in trouble with the law."

Larson said it is his job to treat the patient; it's up to the police to
put the manufacturers out of business. Doctor-patient confidentiality is
always part of the equation.

"That's a fine line," Larson said. "It's not something where I'm willing to
call the police department, where I say, 'Joe over here, he's been making
meth and you need to check out his house.' "

Police say they speak with prosecutors before questioning any medical workers.

"We wouldn't do anything to jeopardize the doctor-patient relationship,"
said Captain Mike Davidson, of the Arkansas State Police. "But some doctors
might be willing to openly discuss what would have been said."

Hospitals have trouble pinning down numbers to prove just how much
methamphetamine burdens burn units. St. John's points to between eight and
10 cases out of 250 burns in a year, but patients being evasive skew the data.

"The problem with reporting is that you have to base your data on what the
patient tells you," Holt said.

With firmer numbers, hospitals could seek additional funding to ease the
strain on their budgets.

"As a state, the taxpayers are having to fund that payment for these fires
that are related to illicit drug production," Larson said.