Methamphetamine-related burns in the cornbelt.

Methamphetamine (MA) is a highly addictive drug that is easily manufactured from everyday household products and chemicals found at local farm stores. The proliferation of small MA labs has led to a dramatic increase in patients sustaining thermal injury while making and/or using MA. We hypothesized that these patients have larger injuries with longer hospital stays, and larger, nonreimbursed hospital bills compared with burn patients not manufacturing or using MA. In a retrospective case-control study, all burn patients >or=16 years of age admitted to our burn center from January 2002 to December 2005 were stratified into two groups based on urine MA status. Of the 660 burn patients >or=16 years of age admitted during this 4 year period, urine drug screens were obtained at admission on 410 patients (62%); 10% of urine drug screens were MA (+). MA (+) patients have larger burns compared with MA (-) patients (9.3 vs 8.6% body surface area burns), have higher rates of inhalation injuries (20.4 vs 9.3%, P = .015), and more nonthermal trauma (13.0 vs 3.1%, P = .001). When compared with MA (-) patients, MA (+) patients require longer hospital stays (median 9.5 vs 7.0 days, P = .036), accrue greater hospital bills per day (dollars 4292 vs dollars 2797, P = .01), and lack medical insurance (66.7 vs 17.7%, P < .0001). The epidemic of MA use and its manufacture mandates that burn centers monitor patients for MA use and develop and institute protocols to ensure proper care of this increasingly costly population.

Pseudoephedrine legislation decreases methamphetamine laboratory-related burns.

Pseudoephedrine (PSE) is one of the main ingredients used to manufacture methamphetamine (MA); approximately 700 to 1000 PSE pills are necessary to "cook" a batch of MA. Steps have been taken to decrease the availability of ingredients needed to concoct MA. On May 21, 2005, the state of Iowa enacted a strict law, making PSE a Schedule V Controlled substance, restricting PSE availability, and sales. Using the same 6-month time frames in 2004 and 2005, we retrospectively compared epidemiological data on burn patients in the year before the new PSE law and again immediately after the law was enacted. Data collected between May 21 to December 31, 2004 and 2005 included sex, age, length of stay, body surface area burn, urine drug toxicity status, insurance status, and cost of hospital stay. Reports on statewide MA laboratory incidents were provided by the Office of Drug Control Policy. In 2004, Iowa ranked second in the nation for MA lab incidents, seizing an average of 120 labs per month. In 2006, Iowa ranked eighth in the nation for MA lab incidents, when only 20 labs per month were seized, an 83% decreased from the previous year. By limiting the availability of PSE, Iowa saw a marked decrease in MA laboratory-related incidents, leading to a drastic decrease in MA related burns statewide.