Helping Communities Combat Clandestine Methamphetamine Laboratories Society for Public Health Education 750 First Street, NE, Suite # 910 Washington, DC 20002 Phone: (202) 408-9804 Fax: (202) 408-9815 www.sophe.org © 2007 In conjunction with Agency for Toxic Substances and Disease Registry The American College of Medical Toxicology Table of Contents Part A: An Educational Toolkit for Health Educators Acknowledgments .............................................................................................................1 Introduction ......................................................................................................................3 Primer on Methamphetamine and Clandestine Methamphetamine Laboratories ...........7 Information Sheets ......................................................................................................... 21 Property Owners, Landlords, and Real Estate Agents ......................................................23 Community Leaders ........................................................................................................31 Law Enforcement ............................................................................................................35 First Responders ..............................................................................................................39 Health Care Professional and Child Welfare Officials .....................................................45 School Officials and Parents ............................................................................................49 Retailers and Other Community Members .....................................................................55 Community Action Guide: Mobilizing You Community to Combat the Methamphetamine Problem ........................................................................................... 61 Resource Directory .........................................................................................................87 Part B: A Guideline for Clinicians and Health Care Professionals Responding to Methamphetamine Lab Exposures Acute Methamphetamine Laboratory Exposure: A Guide for Clinicians ..................... 105 Acute Methamphetamine Toxicity: A Guide for Emergency Care Providers ................ 115 Evaluation of Children Exposed to Methamphetamine Manufacture .......................... 121 Environmental Considerations in Cleanup of a Clandestine Methamphetamine Lab ............................................................................ 133 Evaluation Form ........................................................................................................... 145 Helping Communities Combat Clandestine Methamphetamine Laboratories Part A: An Educational Toolkit for Health Educators Society for Public Health Education In conjunction with Agency for Toxic Substances and Disease Registry The American College of Medical Toxicology Helping Communities Combat Clandestine Methamphetamine Laboratories Acknowledgments he Society for Public Health Education (SOPHE) is grateful to the many Tindividuals who provided advice and guidance in the development of “Helping Communities Combat Clandestine Methamphetamine Laboratories.” We would especially like to express our sincere appreciation to the following individuals and organizations for their contributions: Agency for Toxic Substances and Lynn Cook, MHS, CHES, Content Disease Registry (ATSDR) Reviewer, Contractor American College of Medical Paul Froehlich, Content Reviewer, Toxicology (ACMT) Contractor Lisa Lanier, PhD, MPH, Lead Author, Michelle G. Chuk, MPH, National Contractor Association of County and City Health Officials, Content Reviewer Brent Morgan, MD, Associate Professor, Emory University, Atlanta, Nsedu Obot Witherspoon, MPH, GA, ACMT Contributing Author Executive Director, Children’s Environmental Health Network, Michael Beuhler, MD, ACMT Content Reviewer Contributing Author Eleanor Dixon-Terry, MPH, CHES, Michael I. Greenberg, MD, MPH, Assistant Executive Director, SOPHE Professor of Emergency Medicine, Drexel University College of Medicine, Tanya M. Maslak, MPH, Director Philadelphia, PA, ACMT Contributing of Environmental Health Promotion, Author SOPHE Sarah J. Reedy, Resident Physician, Emory University, Atlanta, GA, © 2007 Society for Public Health Education ACMT Contributing Author Part A: An Educational Toolkit for Health Educators Helping Communities Combat Clandestine Methamphetamine Laboratories Part A: An Educational Toolkit for Health Educators Introduction Background The Society for Public Health Education (SOPHE) was founded in 1950 to provide leadership to the profession of health education and to promote the health of all people. SOPHE promotes healthy behaviors, healthy communities, and healthy en- vironments through its membership, its network of local chapters, and its numerous partnerships with other organizations. SOPHE works with its members to stimu- late research on the theory and practice of health education; support high-quality performance standards; advocate for policy changes and legislation that positively affect public health outcomes; and develop and promote standards for the profes- sional preparation of health educators. SOPHE is aware that the illicit production and use of methamphetamine—a highly addictive stimulant—has become a very serious public health problem in the United States. Methamphetamine (meth) is produced in foreign or domestic clandestine super labs, but it is also easily produced in small clandestine laboratories (meth labs), often referred to as mom-and-pop shops, with relatively inexpensive and readily available equipment and ingredients. Methamphetamine abuse and production not only leads to devastating medical, psychological, and social con- sequences for the user, it also leads to enormous and devastating public, environ- mental, and social health issues. The aftermath of methamphetamine abuse and production goes beyond the user to negatively affect all members of a community, including children, law enforcement, property owners, child welfare officials, health care professionals, and retailers. The Health Educator’s Role Health educators promote health and prevent disease, disability, and premature death through theory-based voluntary behavior change activities, programs, cam- © 2007 Society for Public Health Education paigns, and research. Health education is a public health service that is essential Part A: An Educational Toolkit for Health Educators in the performance of the three core functions of public health: assessment, policy development, and quality assurance. By focusing on prevention, health education reduces the financial and human costs that individuals, employers, medical facili- ties, insurance companies, and the nation would spend on health care and medical treatment. Health educators can also play a role in raising awareness and rallying community support in the battle against meth. Health educators may be involved in activities such as the following: • Assessing the extent of a local methamphetamine problem and existing ef- forts to combat the problem • Working collaboratively with community members, leaders, and other professionals to plan, implement, and evaluate activities to either prevent a methamphetamine problem in the community or combat an existing problem • Acting as a resource, advocate, and communicator to enable a community to address methamphetamine abuse and production at the local level “Helping Communities Combat Clandestine Methamphetamine Laboratories” In an effort to address the important public health issue of clandestine metham- phetamine laboratories (“clan meth labs”), SOPHE and the American College of Medical Toxicology (ACMT), with the support of the Agency for Toxic Substances and Disease Registry (ATSDR), joined together to develop this publication to provide health educators and other health care professionals with the information, resources, and guidelines available for addressing clan meth labs at the community level. This toolkit was created to maximize anti-meth efforts by synthesizing the information on meth and meth labs that is available from an overwhelming num- ber of sources and locations and making it available in one comprehensive resource. Although “Part A: An Educational Toolkit for Health Educators” was designed and written with health educators in mind, we feel that it will be useful to a wide variety of professionals and community members working on meth-related issues. In Part A, you will find the following components: • A primer about methamphetamine and clandestine methamphetamine laboratories, which provides basic facts and statistics about what meth is © 2007 Society for Public Health Education and its history, how it is abused, who uses it, its health effects on the user, Helping Communities Combat Clandestine Methamphetamine Laboratories treatment for the user, how and where meth is made, the prevalence of meth labs, control of the problem, and effects on the community. • Information sheets on a variety of community groups that may be af- fected by meth production. The information sheets provide educators with information about how meth and meth labs affect the respective group, what the group should know about meth and meth labs (i.e., key take-home messages), and the role of the group in community anti-meth efforts. The information sheets can be helpful to educators who may be working with or addressing these groups. • A Community action guide that presents