Johnson had suffered severe burns on his arms, hands, face and left calf. Eighty percent of his lungs were damaged from inhaling chemical fumes. He had no eyelashes, no eyebrows and no vision in his left eye. Doctors had replaced the irreparably damaged tissue on his hands and forearms with skin grafts from his thighs.

Still, he was able to walk out of the hospital after twenty days. By April he regained his vision and almost full mobility in his hands. His arms, though, remain the color of cherry Kool-Aid, as though he fell asleep on the beach for days and woke up with the worst sunburn imaginable.

"It's a constant burn," he says of his limbs, which he must keep covered with elbow-length white fabric gloves for 22 hours each day in order to compress the skin grafts and keep them healing properly.

Dr. Michael Smock, head of the burn unit at St. John's Mercy Medical Center, says about 25 percent of his patients are injured in meth mishaps.
Dr. Michael Smock, head of the burn unit at St. John's Mercy Medical Center, says about 25 percent of his patients are injured in meth mishaps.
Firefighters battle a house fire started by a meth lab explosion.
courtesy of Franklin County
Firefighters battle a house fire started by a meth lab explosion.

The other lingering damage was done to his bank account. The bill for Johnson's time in the burn unit totaled more than $67,000. The two-and-a-half-hour ambulance ride to St. John's cost an additional $2,000. He left the hospital uninsured, unemployed and, given his condition, unlikely to find a job in the near future.

According to doctors at burn units across the Midwest, patients like Johnson have become an alarmingly familiar sight in their wards.

"We're seeing, now, maybe 25 to 30 percent of our patients or higher have meth-related burns," says Dr. Michael Smock, director of the St. John's burn unit. The facility typically treats about 220 patients each year from a region that encompasses parts of eastern Missouri, southern Illinois and northern Arkansas.

"We had an impression that it seemed to go down, maybe in the 10 percent range, for a couple of years," Smock says. "But in the last six months to a year, it's picking up again."

Law-enforcement officials say measures to restrict pseudoephedrine purchases briefly curtailed the number of mom-and-pop meth labs and the violent explosions that inevitably accompany them. But in the wake of the new laws, a highly combustible method known as "shake and bake" has emerged as the technique of choice for small-time cooks. It's portable, and easy to conceal, making it possible to whip up a batch of meth while en route from one pharmacy to another. (To read more about the two main methods for making methamphetamine from pseudoephedrine, click here.)

"It's a lot more volatile of a process than the other methods they were using," says Kevin Glaser, coordinator of the Southeast Missouri Drug Task Force. "Before, we never had the labs exploding — I mean, they would occasionally, but with this new method we've seen and recorded what I'd regard as a significant increase in lab explosions."

The region's burn units are struggling to cope with the corresponding influx of patients. Each one racks up approximately $6,000 in treatment per day; stays of up to six months are common. Doctors say unpaid bills, coupled with the labor-intensive care needed to nurse meth-burn victims back to health, are sapping their resources.

"There's not a good workers'-comp plan with drug manufacturing," quips Dr. Jeffrey Guy, director of the Vanderbilt Regional Burn Center in Nashville. "They're never insured. The costs of their treatment just get passed on to society. People who live in affluent areas, when these people blow themselves up they tend to say, 'Oh well, it's one less drug addict.' That couldn't be further from the truth."

According to the American Burn Association, a coalition of more than 3,500 doctors, nurses, hospitals and firemen that promotes burn-related research, treatment, rehabilitation and prevention, the number of burn-care facilities nationwide declined from 132 to 125 over the past five years, in large part owing to the costs of treating uninsured patients.

In the case of meth-burn victims, the situation is compounded by limited social and economic resources and the severity of the injuries.

"Because these people have less money, they end up staying in acute-care facilities longer," explains Dr. David Greenhalgh, chief of burns at the University of California, Davis Medical Center. "They don't have funding to get nursing help or go to a rehabilitation center or get in-home care."

Two studies published by the burn unit at the University of Iowa in 2008 found that meth makers typically "have larger injuries with longer hospital stays and larger, non-reimbursed hospital bills" than others with similar injuries. The university also found that meth burns accounted for at least 10 percent of its own patient population.

"We have a certain amount of healthcare resources to use in the state," says Barbara Latenser, one of the burn surgeons who co-authored the papers. "As a taxpayer I don't want to be using that resource for somebody who blew their ass up cooking meth."

Smock worries about a disaster scenario in which many people are critically burned at a time when his ward is filled with recovering meth addicts.

"As a nation we're really walking a pretty fine line with our burn-care resources," Smock says. "Each burn unit has perhaps five to twenty beds as a common number. Most are running at 70 or 80 percent capacity on any given day. There's not a lot of space to put hundreds of burn patients in this country."

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