THE FALLOUT: 'I FELT MY FACE JUST MELTING'

Wired on methamphetamine and craving more, Ricky Dale Houchens set out one night last November to cook a fresh batch of the drug. He met some buddies in rural Scottsville, Ky., at a trailer that doubled as a crude lab. As the concoction simmered, Houchens, 27, noticed it was getting too hot. When he picked up the pitcher, the bottom gave way and the combustible mixture splashed onto a burner. The resulting blast engulfed Houchens in a ball of fire. "I felt my face just melting," he recalls. "The skin was running down my arm... like lard." Eventually, he was transported to Vanderbilt University Burn Center in Nashville, where specialists treated him for severe burns on 40 percent of his body.

Burn victims like Houchens are increasingly popping up in hospitals across the country. In Tennessee, meth-lab seizures have skyrocketed, from 226 in 2000 to 942 in 2004, according to the Drug Enforcement Administration. When labs explode, they not only kill and maim the cooks; they wreak financial havoc on the facilities that treat them, since the vast majority of meth victims lack health insurance. In Houchens's case, his hospital charges totaled more than $553,000, only $110,000 of which was recovered from Kentucky Medicaid. As many as a third of Vanderbilt's burn cases at a given time in the past year have been meth-related. "If we continue to take on this large burden" of $5 million to $10 million per year in uncompensated care, says Dr. Jeffrey Guy, Vanderbilt's burn director, "I don't know if we will have a burn unit five or 10 years from now." Across the state line, the Mississippi Firefighters Memorial Burn Center suspended new admissions in May and may need to shut down permanently. Part of the reason: the financial strain from treating meth-lab burn patients.

Since many meth ingredients are flammable, one false move by a cook can yield disaster. When Selena Humphrey, 19, used to make the drug with her friends, "we were always on pins and needles," she says, as they would accidentally spill chemicals or start small fires. Eventually, an explosion sent her to Vanderbilt, where doctors had to chisel melted plastic--which had lined the walls of the lab--off her face.

The toxic substances make patients like Humphrey tougher to treat. A recently published study by the University of Louisville's burn center laid out the typical traits of meth-lab victims: deeper chemical injuries, greater resuscitation requirements, longer periods on a ventilator. Even worse, most of them offer dubious explanations for their injuries, says Dr. Michael Smock of St. John's Mercy Medical Center in St. Louis. That dishonesty complicates diagnosis and slows the response to things like eye injuries, which can cause severe damage if not treated quickly.

Meth patients' treatment is expensive--$10,000 per day on average at Vanderbilt. But the hospital can at best recover about 30 percent of that from the state Medicaid program, which is already overextended. "This is just another set of pressures that we don't need," says Will Pinkston, who coordinated Tennessee Gov. Phil Bredesen's meth task force.

Few meth-lab burn victims ever face arrest. Authorities are reluctant to enter hospitals because of the potential chilling effect on doctors and nurses who have a professional responsibility to treat all patients. Though a Tennessee anti-meth law enacted in March contains a provision requiring health professionals to report meth-lab burns and injuries to law enforcement, Vanderbilt's Guy hadn't been informed of it until asked about it by NEWSWEEK.

If jail can't set lab-accident victims straight, you'd think at least the agony of burn recovery would. But few seem to learn their lesson. Guy recalls one meth patient who was snatched from near death and was about to be discharged when he made a final request: some pseudoephedrine for supposed sinus problems. As for Houchens, the Kentucky burn patient, it took less than a month after his discharge for him to snort a line of meth again. "I felt bad, like I let everybody down," he says. But meth is "Lucifer himself." The burn specialists who tend to the drug's human detritus would surely agree.