Pubdate: Mon, 14 Nov 2005
Source: Lexington Herald-Leader (KY)
Copyright: 2005 Lexington Herald-Leader
Contact:  http://www.kentucky.com/mld/heraldleader/
Details: http://www.mapinc.org/media/240
Author: Cassondra Kirby, Herald-leader Staff Writer
Bookmark: http://www.mapinc.org/meth.htm (Methamphetamine)

METH LAB DISASTERS

Kentucky's Only Two Burn Units Are Overburdened by Drug Cooks

His eyebrows and lips already burned away, Ricky Dale Houchens
screamed and thrashed around a tiny trailer in Allen County.

Flames climbed over his face; his skin ran in thick gobs down his
cheeks and over his chin.

Houchens' buddies watched in horror.

The group had been making methamphetamine when the concoction
exploded, engulfing Houchens in a ball of fire. Afraid they would get
in trouble, no one called for help. Instead, someone drove Houchens to
a nearby hospital and left him at the emergency room door.

"My face was smeared all to the side," Houchens said, grimacing at the
memory. "The skin was running down my arms like lard."

Houchens, 28, of Bowling Green, was flown to Vanderbilt Burn Center in
Nashville, where doctors treated him for severe burns on 40 percent of
his body. He was in the hospital for more than two months, racking up
charges of more than $553,000. About $110,000 of that was recovered
from Kentucky Medicaid, he said; the rest will probably go unpaid.

Victims of meth-related mishaps are increasingly overloading burn
units in Kentucky, Tennessee and other states that have seen meth use
explode in recent years.

As patients battle with recovery and disfigurement, hospitals and burn
units say they are in a war of their own: trying to treat meth-related
burn patients who often don't have insurance or money to pay bills
that can reach or exceed $1 million.

"Burn units are a scarce commodity and are becoming more scarce as
time goes on," said John Howser, a spokesman for Vanderbilt Hospital,
where as many as a third of the past year's burn cases have been
meth-related. "If we continue to take on this large burden of care, I
don't know if we will have a burn unit 10 years from now."

Explosive drug problem

Meth, a stimulant that is becoming the drug of choice in some parts of
rural Kentucky, is often concocted in makeshift laboratories in
trailers, apartments and even moving vehicles. Meth "cooks" transform
pseudoephedrine, a key ingredient in many over-the-counter cold
medicines, into the drug. But the process involves several potentially
explosive reactions, mixing chemicals such as brake fluid, lantern
fluid and paint thinner, over heat.

One misstep -- such as fastening a lid too tight during boiling -- can
leave a meth maker on an operating table clinging to life.

For Houchens, the explosion happened before he could
flinch.

Strung out on meth, Houchens and his friends were cooking more of the
drug in November 2004. As the chemicals simmered on a rusty stovetop
in a single-wide trailer in Scottsville, Houchens saw the mixture was
getting too hot.

But when he went to pick the brew up and turn off the burner, the
pitcher's bottom gave away. Before he could react, chemicals splashed
on the burner. Fire engulfed him.

Houchens said he had just snorted a hit of meth, and he felt the
flames climbing a path straight into his head.

His pants burned. When a friend helped him peel what was left of a
T-shirt off his back, lumps of skin came with it.

That was the point at which Houchens recalls first feeling the
pain.

At Vanderbilt Hospital, his stomach was sliced open to relieve
swelling. His intestines were held in place by a tent of plastic
stapled to his midsection.

Meth is "the devil in powder form," said Houchens, who used the drug
for energy and to stay awake for weeks at a time without sleep. He
would spend his nights chasing women, while driving around Bowling
Green with friends.

A year after the explosion, Houchens still can't extend his arms in
front of him or make a firm fist. But, for the first time in his life,
Houchens said, he appreciates the family and friends around him. He
thanks God for saving his life, and says he's working to remain drug-free.

Doctors were able to piece together his face with lab-created skin
that cost about $10,000 per square foot. His neck, face, belly and
arms remain heavily scarred.

But Houchens hasn't paid a penny of the medical costs. He doesn't have
the money or insurance and he still needs six more surgeries.

Howser, the Vanderbilt spokesman, laughs when asked if meth-related
patients like Houchens are typical at the hospital. He said most of
Vanderbilt's patients are from Kentucky and Tennessee, and like
Houchens, the majority can't pay. Kentucky hospitals have seen the
same trend.

In Kentucky, meth lab seizures skyrocketed from 18 in 1998 to 377 last
year, according to the Drug Enforcement Administration. Kentucky's 468
lab busts this year rank it sixth among U.S. states.

"We are looking at being in the hole with these patients," said Portia
Loveless, a University of Kentucky trauma research
coordinator.

Vanderbilt Hospital, a private facility, doesn't get any state money
to make up for uncompensated medical care, Howser said. The hospital
is forced to compensate for the loss in other ways, typically by
raising prices.

Public medical facilities, such as the University of Kentucky hospital
and the University of Louisville hospital, get a lump sum from the
state each year for such losses, but the loss far exceeds that given
amount, doctors at the facilities say. UK and U of L have the only two
burn units in Kentucky.

"But we continue to do what's right and treat these people," Howser
said.

High cost of treatment

As patients go, doctors say, meth users aren't good
ones.

Along with insurance issues, meth burn patients are more likely to
have a longer stay in the hospital than other burn patients and their
hospital costs are significantly higher, according to a University of
Louisville study released this year. The study, which examined 397
adult burn victims at the Louisville hospital, found that meth burn
patients had "higher incidents of inhalation injury and needed more
intense respiratory care and longer ventilator usage" (33 days versus
17 days) because of chemical-related inhalation injuries. They also
typically need more surgical procedures, and their wounds are more
likely to become infected.

Because meth burn patients also go through withdrawal while in the
hospital, they tend to be easily agitated and require more sedation
and restraint than other burn patients, the study said.

In the end, that means higher hospital costs for meth patients, about
$4,000 more per patient than the general burn population. But doctors
say they won't turn away patients, even if they were injured through
illegal means and don't have the money to pay.

"If they come to us with medical problems, we take care of them," said
Dr. Henry Vasconez, director of University of Kentucky Hospital's burn
unit. Vasconez has seen patients as young as 12 burned while making
meth. Although UK has had only about 30 confirmed meth-related
patients since 2001, Vasconez said he suspects that at least 20
percent of his patients each year are burned while making meth.

Most of them offer dubious explanations for their injuries. Even
though doctors strongly suspect the burn was meth-related and they
test positive for the drug, they can't confirm it, he said.

"We could be seeing meth patients every day," said Glen Franklin,
director of the burn unit at University of Louisville Hospital. "We
just can't identify why they have been burned or injured."

Franklin said many patients come in on their own after being burned
and make up the cause of the fire.

Doctors say they are most concerned with the space meth burn victims
are taking up in burn units. UK has only four burn beds and U of L has
five. Sometimes a burn patient who lives near a hospital has to be
transported to a faraway facility because there's no room, doctors
say.

"Burn units are a limited resource in our area," Franklin said. "Meth
patients are eating up that resource by taking up bed space."

Earlier this month, officials said Kentucky has seen a decrease in
meth lab busts since June, when laws went into effect restricting the
sale of over-the-counter cold medicines that contain pseudoephedrine,
meth's key precursor. Officials say the reduction in the number of
people making meth should mean fewer people being burned, but doctors
say that remains to be seen.

Reporting not required

In Kentucky, doctors say they aren't required to tell police about
patients who are burned from suspected meth labs.

Houchens, who appeared in a Newsweek magazine story on meth in August,
said his incident wasn't investigated by police, and doctors didn't
notify authorities when he told them he had been burned while making
meth.

"I guess they figured I suffered enough," he said.

Doctors say they're amazed that some meth burn patients still use and
make the drug even after they are permanently disfigured.

"It's not uncommon to have one person who will be in the burn unit
several times," Howser said. "They don't learn the first time and go
back out and do the same things again."

Houchens said he snorted meth less than two months after leaving the
hospital. A buddy had to hold the straw to his nose.

"I felt like I had let everybody down," said Houchens, adding that he
hasn't used meth since then. "But meth is an evil drug, it's Lucifer
himself. Look at me and see what it has done. After the show's over, I
can't go behind a curtain and take these arms off and put on real,
better ones. This is what's left." 
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