Many meth patients come into the hospital because of a physical ailment. “They present with chest pain, palpitations, and/or shortness of breath, although these conditions clear up pretty quickly,” says Dr. Garner.
Tip-offs that the problem might be drug related include poor hygiene, disheveled appearance, and edgy, antsy behavior. Additionally, says Dr. Rawson, “Weight loss, skin sores and scabs, dental disorders, nervous behavior, and paranoid ideation are blue-ribbon signs of meth use. In places where users inject meth, look for needle marks. In regions where users smoke meth, pulmonary disease and coughing are common.”
In the patients Dr. Garner sees, meth’s lasting effects affect their physical health less than their mental health and quality of life. “Meth deteriorates them to the point that they can’t work, and they detach themselves from family, friends, and society as a whole,” he explains. “They require a lot of deep-seated [psychiatric] therapy to deal with multiple issues.”
While most of the meth users Dr. Garner sees are poorly educated and come from the working class, meth is increasingly popular among college students and professionals. In fact, he says, “I know of several doctors for whom meth was the drug of choice.” It is important for hospitalists to remember that addiction knows no socioeconomic boundaries. Many clinicians view meth addicts in an unsympathetic light and as people who have caused their own problems. This is a barrier that needs to be overcome, stresses Dr. Garner.