The dukes of deception who run the National Association of Counties are insulting your intelligence once again with a half-cocked "survey" about the methamphetamine menace.
Now, before I commence, let me assert that I know all about the dangers—and the pleasures, such as they are—of methamphetamine. While correspondence from readers detailing their personal meth sufferings or those of a family member will cause my Gmail inbox to swell, not even the most horrific testimonial will persuade me to recant what I'm about to write.
The survey in question, titled "The Effect of Meth Abuse on Hospital Emergency Rooms" (PDF), prompted respectful headlines from newspapers this week when assignment desks everywhere should have round-filed it:"Hospitals Say Meth Cases Are Rising, and Hurt Care" (New York Times);"Meth cases put strain on ERs" (USA Today); "Meth causes more hospital visits than any other drug"(Salt Lake Tribune); and "Meth strains hospitals in Indiana: Emergency rooms across Midwest, nation report rising caseload"(Indianapolis Star). The NBC Evening Newsgave it the up-close and personal treatment of "Brian Williams: Plastic Honky Zombie or Midwestern Meth Head?" Just kidding. The headline listed on Nexis for the story is "Meth addicts drain on emergency rooms."
The headlines give no sense of the NACo survey's narrowness. You've got to read into the second or third paragraph of each story—or deeper—to learn that NACo surveyed only county public hospitals or regional hospital emergency rooms, and that the survey firm they hired questioned only 200 institutions. Upon these data the survey establishes the finding—if you want to call it that—of a 73 percent increase in meth-related visits over the last five years.
How representative of the nation's emergency departments is the survey sample? The American Hospital Association counted 4,079 emergency departments in its last census, meaning the NACo survey reached less than 5 percent. How representative are the surveyed establishments of the nation's EDs? Not representative at all. According to the Centers for Disease Control, 58 percent of all emergency departments are in metropolitan areas and account for 82 percent of all annual use. Of the 200 departments surveyed for NACo, 161 serve rural populations of less than 50,000. (The survey didn't collect results from 11 states.) The survey can't possibly give us a good idea how well the nation's EDs are handling meth-related incidents.
The survey's allegiance to, um, scientific rigor continues in its six-part questionnaire. The questions include, "In your opinion, what's the top illicit drug seen in presentations at your hospital's emergency room?" and, "In your best estimate, what percentage of total presentations in your hospital's emergency room in the last two years is methamphetamine related"? In other words, go ahead and take a guess—we'll report it, but we won't require you to send supporting data.
This isn't the first time NACo has bamboozled the press with a bogus methamphetamine survey. Reason magazine's Nick Gillespie (a friend) hammered NACo for its equally flimsy survey of law-enforcement agencies dated July 5, 2005. Its leading questionnaire begins, "As you may know, methamphetamine use has risen dramatically in counties across the nation." Every bit as anecdotal as the emergency department meth survey, the law-enforcement survey reached 500 county law-enforcement agencies in 45 states. (The association states that there are 3,066 counties or county equivalents.)
Why does NACo conduct and distribute these sham surveys? Because when reporters write stories based on them, it helps NACo shake the federal dollar tree for its 2,000-plus member counties, which is one of its main missions. Confirmation of that hypothesis can be found in the last paragraph of the New York Times article, which reads:
The association also said it wanted more federal money for compensation for hospitals tending to the uninsured, as well as for treatment care, programs to help affected children and continued law enforcement grants for regional drug task forces.
The Meth-Mouth Chronicles: While we're on the subject, let's see how accurately the press is defining "meth mouth." As I reported last summer, no evidence suggests that methamphetamine or its precursor compounds erode, corrode, or otherwise burn teeth. Even so, the press continues to report that urban myth as truth. (See the first cited item for my thesis.)
Here's a current selection of meth-mouth misinformation:
For those who smoke meth, the chemicals eat away at teeth.— Casper Star Tribune (Wyoming), Jan. 5, 2006
One of the major indicators of meth use, officials say, is a condition that has become known as "meth mouth." [Meth educator Bob] Nickisch, said this condition is one which can be easily recognized by dentists and health care professionals, as the harsh chemicals used in meth work to eat away the enamel of the teeth causing a rapid onset of tooth decay that is abnormal.— Black Hills Pioneer(South Dakota), Jan. 16, 2005
The use of meth can cause not only mental health problems such as depression or psychosis, but also long-term physical problems such as "meth mouth," a condition in which the teeth are burned away due to prolonged meth use.— Vue Weekly (Edmonton, Alberta, Canada), Jan. 5, 2006
Signs of methamphetamine use are prevalent in a user's mouth. The toxic chemicals used to make the drug irritate and burn the skin inside the mouth, creating sores that lead to infection.— Craig Daily Press (Colorado), Dec. 7, 2005
"Meth mouth" is the appearance of dark spots on the teeth and decay in the roots. The symptom is caused by acid in meth.— Eyewitness News 5 (St. Paul, Minn.), Nov. 17, 2005
I started out on Burgundy but soon hit the harder stuff. Send your meth fables to firstname.lastname@example.org. (E-mail may be quoted by name unless the writer stipulates otherwise.)
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