# Presentation: 524427

## Methamphetamines and Worker Safety May 09, 2006

**Afton Wagner, Programs Field Representative**
**Calvin Kelley, Programs Field Representative **
**OKDHS Children and Family Services Division**
**PO Box 25352 **
**Oklahoma City, OK 73125 **
**(405)  521-2283**

## Worker Safety and Meth 

- When engaging clients involved in the manufacturing of Methamphetamine there are risks CW staff must be must be aware of in order to ensure their own safety as well as the safety of their clients.

**Notes:**
The Key to insuring worker safety when dealing with Meth is to collaborate with Law Enforcement.
	Collaboration is done on the local level with PD and Sheriff’s offices
	MDTs are utilized in the development of these collaborations as there is often criminal prosecution

It is important to complete a historical review of case information to determine if there has been past involvement regarding Meth.  

If there is an indication of the possibility of Meth assistance from Law Enforcement is requested.  

## Risks to CW Staff

- Exposure to Toxic Chemicals
- Toxic fumes
- Risk of fire and explosion
- Weapons
- Behaviors can be unpredictable due to
- Cognitive Impairment
- Psychosis

**Notes:**
Extreme fire potential and explosions
Exposure to hazardous chemicals and fumes
Labs are considered hazardous waste sites and should only be entered by equipped professionals

Parental Factors include: Paranoia, Hallucinations, Decreased social life (isolation), Severe depression, Memory loss, Dramatic mood swings, Acne, sores, Aggressive behavior, Convulsions, Increased heart rate, Violent behavior, panic, Extreme weight loss, Heightened sexual activity, False sense of confidence, Loss of pleasure, Elevated body temperature, Sleep deprivation, Numbness, Impaired speech, Excessive talking, Hyperactive behavior, Poor coping activities, Seizures, Stroke, Death, Tooth loss, Brain damage,

For pregnant women: premature labor, placenta abruption, low birth weight with possible neurological damage
For IV users: AIDS, hepatitis, infections & sores at the injection of the heart lining & valves

## Risk to Children 

- All physical risks previously discussed.
- Parental behavior under the influence:
- poor judgment,
- confusion,
- irritability,
- paranoia,
- violence
- Inadequate supervision
- Inconsistent parenting
- Chaotic home life

## Risk to Children (contd.)

- Second-hand smoke exposure
- Accidental Ingestion of drug or ingredients used to make the drug
- Possibility of abuse
- HIV exposure from needle use by parent
- Chronic Neglect
- Household may lack food, water, utilities
- Children may lack medical care, dental care, immunizations
- Greater risk of sexual abuse if parent has multiple partners

**Notes:**
** Ingestion through Breast Feeding = death

**Elaborate on Neglect & SXAB

## MethamphetamineWhat is it?

- A drug with immense abuse potential
- Commonly known as speed, meth, crank, crystal meth, glass, ice, the poor man’s cocaine
- A CNS stimulant of the amphetamine family
- A powerful upper that produces alertness & elation
- Effects are much longer lasting than cocaine

**Notes:**
Smoked, Ingested, inhaled, or injected
Sold as powder or small chunks resembling rock candy (varies in color)
Can be mixed in water for injection or sprinkled in tobacco or marijuana and smoked
Chunks are smoked in a small pipe

## Meth vs. Cocaine

- Meth is cheaper than cocaine
- The body metabolizes it more slowly making the effects last much longer
- Meth effects can last 10x longer than cocaine
- Meth binges can last up to 7 days while cocaine rarely last more than 72 hours

## Meth Labs 

- Illicit meth on the streets is derived from two sources; clandestine laboratories and imports from super labs
- Clandestine Labs are typically small, utilizing common household appliances, glassware, and chemicals to produce meth.
- Super Labs are found both in the United States and in Mexico.

**Notes:**
Clandestine Meth Labs may be located anywhere: in homes, garages, out buildings, automobiles, hotel/motels rooms 

## Meth Production

- There are many variations in production procedures for meth.
- Each method has its own dangers.  However, all production have in common:
- Many chemicals used are caustic or corrosive, some create noxious & harmful fumes
- Many chemicals found in household items such as lantern fuel, cleaners, acetone, muriatic acid, and diet pills

## How great is the risk?  

***How great is the risk?****** ***

- Oklahoma State Bureau of Narcotics and Dangerous Drugs

**Notes:**
It is important to note that while there has been a dramatic decrease in the occurrences of Meth Labs there has not been a decrease in Meth use.  In fact the use of meth continues to increase. 

An estimate is that 75-85% of all cases involve meth

## Slide 11

- Oklahoma State Bureau of Narcotics and Dangerous Drugs

## OKDHS Response to Methamphetamine Epidemic 

- Developed Policies and Procedures designed to insure staff and client safety.
- Enhanced/expanded training to inform staff of risks involved with the manufacturing of Methamphetamines.
- Enhancement of training to assist staff in understanding the disease process and dynamics.

## Safety Precautions for Cases where Meth Production or use is Suspected 

- Investigations in which there are allegations of Methamphetamine use or production are not initiated without the assistance of Law Enforcement.
- If new allegations of Methamphetamine use or productions are received in an ongoing case the same precautions are taken as in an investigation.

**Notes:**
In each county efforts are made to collaborate with Law Enforcement officials so that there is a joint response to a report of a home in which meth is being produced.  

For instance in Oklahoma County, when CPS receives a referral alleging Methamphetamine use or manufacturing.   

## Collaboration  

- CW staff maintain regular contact with law enforcement to stay informed about the most current indicators of Methamphetamine production.  The Oklahoma Bureau of Narcotics and Dangerous Drugs Control information flyers are kept in supply in each county office.

## Indicators of Meth Production

- Some of the indicators of Meth use and production identified by the Oklahoma Bureau of Narcotics and Dangerous Drugs Control are:
- Strong odors re: unusual chemicals such as ether, ammonia, or acetone
- Little or no traffic around the home during the day, but significant activity during very late hours
- Extra efforts made to cover windows or to reinforce doors;
- Trash not put out for collection;

**Notes:**
NOTE: OKDHS policy includes descriptions of some of the indicators of Meth use and/or production.  This is an effort to insure that all staff have access to needed information.  

Significant accumulation of items such as cooking dishes, coffee filters, or bottles that do not appear to be for regular household use

Outbuildings, hotel & motel rooms, apartments, storage sheds, garages, and vacant buildings are all common places where meth is produced
Vehicles loaded with with laboratory materials or chemicals
Thefts of anhydrous ammonia fertilizer

## Indicators of Meth Production (contd.) 

- Significant accumulation of items such as cooking dishes, coffee filters, or bottles that do not appear to be for regular household use;
- Presence of unusual quantities of chemicals;
- Outbuildings, hotel and motel rooms, apartments, storage sheds, garages, and vacant buildings are all common places where methamphetamine is produced; and
- Vehicles loaded with laboratory materials or chemicals.

## Initiation of Investigation 

- The CW worker, in initiating an investigation alleging use or production of Methamphetamine:
- Requests law enforcement to accompany him or her;
- Remains in the car until law enforcement has determined that the residence is safe to enter; and
- Does not enter circumstances when there is evidence of a Methamphetamine the residence under any laboratory.

**Notes:**
NOTE: Policy should provide staff with instructions that guide their practice so that they have clear steps to follow.  Ambiguity leaves staff to interpret what the expectations are and therefore leaves them in the position of responsibility in decision making in situations that are unfamiliar and unsafe.  	

## Presence of Meth Lab

- When evidence of a Methamphetamine laboratory either outside or inside the residence is encountered, the CW worker:
- Does not enter any residence where there is any evidence of Methamphetamine laboratory materials or chemicals on the property;
- Discreetly but immediately leaves the residence if he or she unknowingly enters a home in which there is evidence of a Methamphetamine laboratory, and drives to a safe location to contact law enforcement; and
- Follows decontamination procedures as discussed in next section

## Decontamination

- If there is any exposure to a Meth lab decontamination procedures are followed.
- Cover car seats and floorboards with plastic covering and wash hands with soap and water before touching the steering wheel;
- Go to a safe location to change clothes and place the dirty clothes in a plastic trash sack.  All exposed skin surfaces should be washed with soap and water.  Wash any items carried into the home with soap and water; and
- Make every effort not to touch any surface until the skin has been wiped with disinfectant wipes or items washed with soap and water.

**Notes:**
We have learned not to use wipes-because it gets it into the skin.  
Use running water and soap.
Tide for clothing.
Rinse off shoes with soap and water before into own residence.

## Basic Safety Equipment Items 

- a cellular phone, whenever possible;
- one change of clothing;
- clean towels
- surgical gloves for handling children that may be injured or exposed to Meth
- disinfectant hand wipes;
- plastic trash bags for covering car seats and floorboards, and for carrying clothes that may need decontamination; and
- dust masks to limit breathing of chemical or other fumes.

## Safety Precautions for Children who most likely been exposed

- Prearrange an agreement with law enforcement to handle decontamination for children
- Law enforcement will transport children
- Whenever possible, children are taken immediately for medical exams.  If not the same day, then arrangements will be made as soon as possible

## CW Worker Education in Safety Protocol 

- 	CW staff are trained in Safety Protocol by OKDHS programs staff and Law Enforcement Personnel in safety procedures
- Basic Worker Safety in CORE
- Substance Abuse Level I
- Substance Abuse Level II
- Substance Abuse Level III

## CW Staff Training 

- Training materials should provide staff the opportunity to;
- Develop skills in recognizing the signs and stages of drug use on a continuum
- Understand of the dynamics of substance abusing families
- Signs, stages and levels of abuse; pharmacological effects
- Short and long term effects of substance abuse

## CW Staff Training (contd.)

- Understand how assessment tools aid in formulating an effective treatment plan (SASSI)
- Improve their communication skills and utilization of assessment tools
- Dual diagnosis of abusers,
- Assess whether or not there is a concern of use
- If Meth use has been an issue what are the client’s needs for intervention
- What are the risks of relapse

**Notes:**
Parents are not amenable to treatment

## CW Staff Training (contd.)

- What are the available intervention resources and how does  the client access
- What are the ongoing community supports and how does the client access
- Treatment modalities,
- Appropriate goal setting and
- How to avoid burnout when dealing with abusers
- Staff should be given instruction regarding communication with service providers

## Implications for Practice 

- Prepare staff for working with clients engaged in the use and/or manufacturing of Methamphetamine through;
- Development of standardized protocol
- Training
- Collaboration with community partners and Law Enforcement