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Methamphetamine: A Looming Concern for the ED

Emergency Management Alert, November 9, 2005

Emergency responders and managers are well aware of the looming dangers posed by methamphetamine and of Congress's recent attempts to control the problem. As indicated in the just-released Environment of Care: A Compliance Guide to the JCAHO's Management Plans (HC Pro, Inc.), hospitals have had to contend with many problems relating to methamphetamine, or "meth." According to the book's author, Thomas Huser, MS, CHSP, meth usage is one of the fastest-growing drug problems in the country, is creating real problems for medical staff, and is redefining the environment of care. Violent or potentially violent, often unmanageable, and unpredictable, meth users possess special medical conditions that may have direct and indirect effects on the safety, security, and efficiency of a medical department.

As reported Nov. 5 in the Omaha-World Herald, "a 2003 study of drug use found that 12.3 million Americans had tried meth at least once, and admissions to emergency rooms have risen substantially with cases of meth abuse." Although a problem nationwide, methamphetamine manufacture is a particular concern in the Midwest, where meth is often manufactured with materials used in agriculture (e.g., anhydrous ammonia, used in agricultural fertilizer). It's not unusual to find "cookers," or meth labs, in such places as an abandoned farm house, a trailer, or the back of a rented truck. The ingredients' flammability, combined with the structure of makeshift labs (which have, at best, improper ventilation) sets up prime conditions for explosion during cooking. Thus, emergency department (ED) doctors are seeing a vast increase in the number of patients arriving in the ED with severe chemical burns. Be assured that patients burned while making meth will not bring a chemical data sheets with them to the ED. Is your facility prepared to treat, transport, or manage such victims?

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