Crystal Clear

Photograph courtesy of the drug enforcement agency

The putrid smell of her own flesh burning was not enough to make Jade Wilhite seek medical attention. She was following the methamphetamine user code: do not get caught.

The day she tilted her head back to administer what she thought was a soothing liquid for her tired, irritated eyes, was the day her loyalty to that unwritten oath would be tested.

Unknown to the now 26-year-old mother of two, the bottle marked Visine contained muriatic acid – a key ingredient used to manufacture the highly addictive stimulant also known as meth, crank, speed or crystal.

“I will never forget the smell,” Wilhite says shaking her head rapidly as if to shake the memory from her brain. “My eye was burning, you could smell it. I could have lost my eye … and still I couldn’t bring myself to seek medical help.

“I was afraid to admit it. I was afraid to let anyone know. I didn’t want to have to go in (to hospital/doctor’s office) and tell anybody that I had grabbed meth ingredients and put them into my eye.

“My friend, who was in the house with me, grabbed me and held my head over the kitchen sink and sprayed cold water into my eye for at least an hour.

“The smell … oh my, the smell,” she said shaking her head in disgust.

Hours after her eye was flushed with water, a friend of a friend brought over a bottle of medicated drops in hopes of quieting the symptoms, a difficult task to administer to an eye that was swollen shut and oozing puss.
Although she is able to see out of the affected eye, she has never had it checked and frequently deals with irritation and cloudiness.

The eye drops mishap wasn’t enough to make Wilhite quit. Instead she continued to chase the rush she felt from the first time she snorted the drug.

“It (using meth) scared me to death at first, but then it quickly became a way of life.”

Wilhite was 14 when she first snorted the drug, but eventually began shooting it up.

Everyone’s Problem
She is one of the 1.4 million users impacted by the meth epidemic plaguing the country. According to the Tennessee Department of Health, 90 out of 100 people will become addicted to meth by smoking or injecting it just two times.

The Vanderbilt University School of Nursing plays a key role in organizing a series of  health care-oriented workshops on meth in eight different communities across the state.


How Meth Impacts Brain Chemistry
Methamphetamine (Meth) is a neurotoxin that primarily effects dopamine pathways in the brain. Read more »

Meth might look like raw sugar, but there is nothing sweet about the addiction caused by the drug that can be taken orally, snorted, smoked, inhaled or injected. Once ingested, it takes only 15 minutes to get into the system and  increase heart rate, blood pressure, body temperature, breathing rate and alertness. After 24 hours, 57 percent of the drug is still in the system. According to literature provided in the workshop, it can take about a year for the brain to return to normal.

One of the most alarming trends investigators are seeing: meth use and manufacturing are starting at a younger age.

“We run the risk of losing an entire generation to the addiction of drugs, if we haven’t already,” said Tommy Farmer, assistant special agent in charge of the Tennessee Bureau of Investigation and state director of the Tennessee Methamphetamine and Pharmaceutical Task Force.

“There is a national epidemic of drugs and addiction,” Farmer said. “And Tennessee has ranked in the top 3 in the number of meth lab seizures in the United States for the past five years. With an increase in use comes a rise in health-related illnesses.

“Health care workers need to be educated about the risks, what to look for and how to deal with these patients, as well as know how to protect themselves,” cautioned Farmer.

Hepatitis, cholera, AIDS, herpes and TB are among the diseases most commonly associated with meth users. A growing number of health concerns include cardiac issues, seizures, pulmonary and respiratory disorders, strokes, liver and kidney failure, skin and dental problems, paranoia and death.

“Health care Response to Meth Labs” was a daylong educational workshop in Columbia, Tenn., funded by the Tennessee Department of Health Hospital Preparedness Program, the Tennessee Hospital Association and organized by the National Center for Emergency Preparedness (NCEP) at Vanderbilt University housed in the Vanderbilt School of Nursing.

“Practitioners have wanted guidance and direction,” said Stephen Guillot, director of the NCEP at Vanderbilt. “Hospitals and first responders have been looking for procedures and protocols to follow when working with meth users, turned patients.

“We wanted to offer pertinent information about preventive and protective actions that our health care workers can take while performing their duties and responsibilities,” said Guillot. “The response to the seminars was overwhelming.”

The workshop attracted hospital administrators and managers, physicians, nurses and nurse practitioners as well as hospital safety and environmental managers, public health officials, law enforcement, fire officials and emergency medical services personnel.

Protecting Health Care Workers
One participant was Chris Brown, EMT-PCC, with Vanderbilt University Medical Center’s Adult Emergency Department.

Despite having 20 years of experience in emergency medical services, Brown is learning the best practices for treating and responding to meth users. But he also has an eye on how to protect his staff and others who interact with these patients.

As an EMT, Chris Brown knows the do’s and don’ts of dealing with crystal meth users. Photo by Daniel Dubois.

Brown described a regular scenario for emergency room health care providers – law enforcement will routinely bring in people who have been arrested in a meth lab bust to receive medical clearance. In addition to providing patients with necessary medical care, health care teams must also consider the possibility of contamination. In most situations, the simple act of removing a person’s clothing, typically a task performed by first responders or police officers on the scene, will eliminate about 90 percent of the contamination threat.  If needed, patients will also be showered at medical facilities to ensure that all contaminants are washed off. Vanderbilt’s Emergency Department is equipped with a decontamination room.

But the question still lingers about the contamination hazards to those who work with meth users. Despite varying thoughts – it has not been determined to what degree, if any – that a person’s health is endangered by the mere proximity to or actual contact with a meth patient.

What is known is that direct exposure and inhalation of the toxic and flammable chemicals, fumes and vapors from meth production have serious and often deadly outcomes.

According to Brown, it’s not always about the physical exposure the drug imposes. The emotional impact is also a hazard.

“It makes me sad to know that the overwhelming addiction to the drug puts rational judgment and common sense right out of the picture,” he said.

“The struggle for me is trying to make sense of it.  You do your job to the best of your abilities without bias or prejudice. It’s later when they have left your care that you have difficulty justifying giving all you’ve got for the person who not only disregards their own existence but everyone around them.”

For the past seven years Brown has worked on the front lines as a critical care paramedic, which allows him to float between the trauma bay and triage areas. He also plays a role in emergency preparedness and decontamination operations.

Warning Signs
“Meth patients can be pretty belligerent. They are truly in an altered state,” said Brown. “We have to approach them with extreme caution because there is such a high level of paranoia.”

With some ease, Brown readily identifies the recognizable signs of a meth user: the distinct chemical odor that exudes from their skin and often pollutes their clothing, tooth erosion/decay, highly irritated/itchy skin; questionable burns and stories that don’t match injury patterns.

Other indicators that typically raise red flags that meth could be involved include: respiratory issues, tooth aches/ abscess, insomnia, body aches and erratic behavior, twitching or repetitive behavior.

“Meth really degrades a person’s overall appearance,” said Brown. “The erosion that meth causes is so disheartening – the emaciated look, the sunken eyes, the track marks all over them.

“If the signs and symptoms point to some kind of drug use then we have to start asking the right questions and putting things together.”

Investigating the reasons for an emergency room visit by a potential meth user requires great finesse because of the potential for violence, he added.

“In an emergency room, you don’t really know what you are getting. Meth patients fall into the same category. As health care workers, we need to have more situational awareness around people and about those we are helping.”

As a former user, Wilhite can attest to the need for utilizing caution.  She recalled periods of agitation, aggression and short temperament. It was a far cry from her life before meth.

Her Journey
Wilhite describes an idyllic childhood in Baxter, Tenn. Her mom stayed home with her three daughters, and at one time, her father was the mayor of her hometown. There has never been smoking or alcohol use in the home.

Wilhite was involved in softball and basketball through middle school. When she became a football cheerleader, she was introduced to drugs and began sneaking out to meet friends to get high.

The frequent escapes turned into days and weeks. Eventually, she didn’t return home.

“Once I started using, everyone around me was a user because I pushed away everyone else,” Wilhite said. “I bounced around quite a bit – staying with whoever had the dope.

“My days were spent thinking about meth, using meth. I never knew what was going to happen. All I could focus on was what I was going to do next to get that high; what I was going to steal or who I was going to rob to get money to get the dope… I was lost in how I was going to get it and how I was going to do it.

“It controlled me completely. I totally lost sight of the morals I was taught growing up.”

Twice when she was pregnant, Wilhite voluntarily stopped using meth. Even then, she never told her health care providers about her addiction.

Her boys, ages 6 and 8, live with her parents.

Jade Wilhite is committed to recovery and rebuilding her life. Photo by Daniel Dubois.

“I stopped using the day before I went to the doctor,” she said. “And I didn’t pick it back up after I walked out of there. It was one thing to damage my own life, but it’s another to endanger the life of a baby I was carrying.”
Fraught with insatiable desire to use, Wilhite resisted.

“There were times I was miserable sitting around watching everyone do it. I wanted it so bad, but I didn’t.

“I am a good person,” she said clutching her chest. “It is hard to tell myself that these days, because of the way I acted for so long and not being able to quit … After I had my first son, I was determined. That was it. This baby was going to fix me.”

But the temptation was too strong. She began leaving her then 6-month-old son with her parents for days, weeks and months at a time to get high with other meth users. She returned nearly two years later. Her longest period of sobriety was the first two years of her youngest son’s life.

The Right Path
Today she is enrolled in a drug rehab program called DC4 – a Davidson County Drug Court Residential Program. Serving 29 counties throughout Tennessee, the long-term residential drug and alcohol treatment program is voluntary.

The typical length of treatment is between 18 to 24 months. Residents are provided with an intensive outpatient program, individual and group counseling, 12-step program groups, relapse prevention, psychiatric evaluations, dual diagnosis treatment, vocational training, job readiness, GED/Basic Education Training and Life Skills training.

Wilhite joined the program in May in exchange for a six-year jail sentence.

Well aware of the difficult road to recovery, she finds strength in knowing she is on the right path. She is looking toward her future. After graduating from the program she hopes to pursue a career in drug and alcohol counseling.

“Going through addiction and getting a little piece of recovery, I just want to give back,” she said. “There are endless possibilities for me. I know it is doable. I have heard from so many graduates whose lives have changed and they have gone places they would have never imagined.”

As a panelist on the Health Care Response to Meth Labs Workshops, Wilhite hopes sharing her story will have an impact. She said she is sickened by photos of her 100-pound body from her days of using.

“I know that if someone had really told me, if I had heard from a former meth user about what it really does, I know I wouldn’t have tried it.

“Going into schools and educating kids and being honest – that’s really the only way to stop it. We have to stop it,” she said.

– Jessica Pasley