An unconscious man was hauled into the hospital nearly dead this past winter.
He had fallen on the ground and landed on the ice.
He was there long enough for his body heat to melt the ice, so he was laying in a puddle when he was found and taken to The Memorial Hospital's emergency room.
He'd passed out from a methamphetamine overdose, according to the doctor's diagnosis.
He survived, but if he had been found more than a half-hour later, the young man probably would have died, Dr. Allan Reishus said.
While methamphetamine cases have tied up the courts and filled up the Moffat County Jail in recent months, TMH also has felt the impact of the addictive stimulant's increased presence in Craig.
"We've definitely been increasing in our visits with severe overdoses," said Reishus, a member of the emergency room staff.
Over the past six to 12 months, Reishus estimated several patients suffering from methamphetamine overdoses have been brought into the emergency room each month.
As in many of the methamphetamine overdoses treated by the staff at TMH, the hypothermic young man didn't come in voluntarily.
Most of the patients have been brought in by the police or an ambulance crew, because someone dialed 911 after the individual overdosed, Reishus said.
The police are required to bring all drug suspects to the hospital to receive a medical clearance before taking them to jail, said Craig Police Chief Walt Vanatta.
It's usually easy to identify a patient who has overdosed on meth, Reishus said.
"The patients are paranoid, wild-eyed, out of control, and making no sense. The challenge is to protect the patient from injuring themselves," Reishus said.
At times, it has taken six hospital staff members and police officers to restrain one meth patient, Reishus said. The patients take up staff time and pose a danger to them at the same time.
"They become incredibly strong. They bite, kick, and spit and have no respect for anyone," Reishus said.
But while going to such trouble for these patients, there isn't much doctors can do to help them. Symptoms of a methamphetamine overdose include accelerated heart rate, high blood pressure and hypothermia, an ailment where a patient's body temperature climbs so high they could die. Other times, overdose patients suffer severe seizures. Reishus recalled one incident where a young man who had overdosed endured grand mal seizures for more than one hour in the emergency room.
Medications are available to alleviate these symptoms, but there is no antidote for a meth overdose, Reishus said.
"The treatment is basically observation," he said. "Usually in a few hours the person is exhausted and falls asleep."
"Our core purpose is to restore and preserve the health of the community and to that extent any kind of substance abuse detracts from improvements," said Randy Phelps, TMH administrator.
People brought in for meth overdoses often have no have health insurance, so the cost of treating them is passed on to the taxpayers.
In 2003, the hospital charged $10,367 for methamphetamine treatment.
"All but $450 of that was uncompensated, so we underwrote it," Phelps said.
Reishus said he thinks meth users who experienced mild overdoses seldom report to the hospital. Other times, users who suffered an injury while high go to the hospital, but only after they have come down from their high.
That makes it a challenge for the hospital to identify many meth users. Injuries suffered from meth use could range from automotive accidents to falls and fights, Reishus said.
Doctors and nurses at the hospital aren't in the practice of interrogating patients about how they got their injuries, but they often realize they aren't getting honest explanations, Reishus said.
"There is a whole system in place to recognize alcohol use, but when it comes to drugs that isn't the case," said Beka Warren, patient care planner at TMH.
Because meth is illegal, patients are less likely to admit using it, Warren said. The acute paranoia brought on by excessive meth use usually keeps addicts away from the hospital whenever they're involved in an accident or overdose on the drug.
But confidentiality laws prohibit hospital staff from informing law enforcement officials of a patient's involvement with illegal drugs, Warren said. The law only requires hospital staff to report a patient who has an injury that appears to be related to the commission of a crime, such as burglary or assault.
When a patient does come in, it is Warren's job as patient care planner to ask the patient if he or she would like help recovering from addiction. After determining what type of treatment the patient needs, Warren refers them to an inpatient treatment facility, a psychological program, or a support group such as Narcotics Anonymous.
Craig's nearest inpatient meth treatment facility is Colorado West Recovery Services in Grand Junction. It has the ability to treat 30 patients at a time, said Barbara Kinkelaar, division director at Colorado West. On average, about 12 patients are in treatment, and one or two of them are from Moffat or Rio Blanco counties, Kinkelaar estimated.
She said most of Colorado West's Craig patients are referred there by Craig Mental Health. When they are first brought in, patients are usually placed in detox. It takes two to three days for a user to get clearheaded, although some patients suffering psychosis have spent as long as a week in detox.
"There's a lot of ambivalence at that point. They've been brought by their family or the police," Kinkelaar said.
Unlike alcohol or heroin detox, which can potentially kill a patient, meth detox doesn't pose a fatal danger. However, the physical harm caused by prolonged meth produces a wide range of maladies which treatment staff watch for while a patient detoxifies.
Patients are placed in dormitory-style housing for monitoring. There are no medications to treat meth withdrawal, although the staff will administer over-the-counter drugs for headaches or nausea, Kinkelaar said.
After the detox phase, patients enter a 21-day recovery program, where they participate in individual and group therapy, as well as nutrition and physical and mental health classes.
But three weeks is a short time to recover from what could have been years of substance abuse, Kinkelaar said. Most patients are encouraged to move to Colorado West's halfway house for the three months following the treatment. At night, they participate in therapy sessions at the halfway house, while by day they go to work in Grand Junction.
After their three-month time in the halfway house has ended, patients are referred back to Craig Mental Health. Some stay in Grand Junction and continue working at the jobs they had while in treatment. Others return to a support network of friends and family in Craig, while still others leave the area to escape the lifestyle that led them to their problems in the first place, Kinkelaar said.
Rob Gebhart can be reached at 824-7031 or firstname.lastname@example.org