Craig and the mean Methamphetamines

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Craig and the meanMethamphetamines
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Purpose

• About Craig
• Moffat Family Clinic and docs there
• Patient cases
• Community issues evolving around disease and
  addiction
• What to do

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CRAIG AMERICA!!

• Craig, population of 9,500.
• Caucasian 86, Hispanic 11 , Other 3
• Mining, drilling, construction, ranching.
• Pastimes All forms of outdoor recreation.

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Moffat Family Clinic

• 4 MDs, 1 DO, 8 RNs/MAs, 7 support staff.
• Serves surrounding communities.

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Facets of Family Medicine in Craig

• Comprehensive
• Clinic and hospital duties
• Emergency Department
• Ob/Gyn duties
• Surgery C-sections, D Cs, Skin biopsies,
  lesion removal.
• Home Visits

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Facets of the Doctors

• Leadership and Service
• Dr. Caroline Reilly C.O.M.A exec committ., COPIG
  Legislative board.
• Dr. Larry Kipe State Board of Health, President
  of CAFP
• Dr. Andre Huffmire CFAP member, walking stick
  reward

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Most Common Cases

• URIs (Craig Crud), WCEs, Perinatal care,
  Diabetes, Hypertension, Hyperlipidemia, Workmans
  Compensation, Skin lesions, Strains sprains
• SUBSTANCE ABUSE Alcohol, Tobacco,
  Methamphetamines.

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Patient Scenario J.S.

• 36 yo Female prisoner with HTN, anxiety, h/o
  substance abuse.
• Meth addict, in for drug possession.
• CPS took one Meth positive newborn.
• Miscarried in prison.
• Emergency Room eval., performance of DC,
  hospital stay, clinic f/u, prison monitoring.

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Patient Scenario K.L.

• 29 wk pregnant Methamphetamine addict.
• Tested positive when evaluated for preterm labor.
• Multiple docs/clinics visited, diff. cities.
• Drug seeking
• Steamboat E.D. theft pt given option of staying
  overnight or going to jail.

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Methamphetamine Abuse

• High prevalence in Rural America.
• How many Meth addicts did you see?

Admissions per 100,000 people over 12 years
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Cheap and convenient

• 200 can get 100 people high, 4- 34 hours
  each

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WORD!!!

• Smokedgtinjectedgtinhaledgtswallowed.
• REWARD Increases DA release, blocks DA uptake.
• Euphoria, agitation, HTN, Tachycard, delusions,
  weight loss.
• Skin, mouth, brain, heart, lungs BasicallyF.Y.U!

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Fetal effects

• Amphetamines Pregnancy class C
• Methampetamine concoctions vary
• Teratogenic and embryocidal
• Placental abruption, premature delivery,
  withdrawal symptoms
• Enters breast milk

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Before and After
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Before and After
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Before and After
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Societal Controls

• Freedoms
• Laws
• Justice
• 
  Oh my!!!

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Local efforts

• Communities Overcoming Meth Abuse (C.O.M.A)

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(Arranging) ACCESS???

• Medicaid
• Special Connections
• AFS
• Core Services Program For children
• Sliding Scale and Managed Service Organizations
• Audience
• Mean meth, or cruel world?

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Other efforts

• Legislative policy
• Law Enforcement
• Child Protective Services
• Medical Specialists
• Property owners
• Rehab centers

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Other solutions?

• Education, Education, Education.
• Freedom and Laws and Justice?
• What ideas do you have?
• Daunting considering the continuing spread.

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Thats mostly a wrap

• Craig, Moffat, Addiction, basically
• METHAMPHETAMINES
• ARE
• VERY
• BAD

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Walmart done broke ground in Craig

• Please watch your consumerism ladies and
  gentlemen!!!

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THANK YOU CRAIG AMERICA!!

• THANK YOU AUDIENCE!!!!

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References

• Patient J.S.
• The Dasis Report Primary Methamphetamine/Amphetam
  ine Treatment Admissions 1992-2002. Rockville
  MD. September 17, 2004.
• National Institute on Drug Abuse Research Report
  Series Methamphetamine Abuse and Addiction. U.S.
  Department of Health and Human Services NIH.
  Bethesda, MD NIH 2006
• C.O.M.A handouts
• UpToDate. Methamphetamine Drug Information
• Various online sources