Methamphetamine accounts for more emergency-room visits than any other drug, a survey by the National Association of Counties finds.

The survey of 200 hospitals run or financed by counties in 39 states and Washington, D.C., shows that 47 percent said methamphetamine is the top illicit drug involved in emergency-room visits. Sixteen percent said marijuana, and 15 percent said cocaine.

"This is a national problem," association spokesman Tom Goodman said. "The costs of methamphetamine are placing a great strain on county governments."

Hawai'i was not included in the study, which was released on Tuesday, but Jill Miyamura, vice president of Hawaii Health Information Corp., said data collected and analyzed by HHIC from July 2004 to June 2005 indicates 36 percent of all drug-related visits to emergency rooms in the state are because of amphetamine abuse/dependence.

Miyamura said emergency-room amphetamine visits have increased from 2000 to 2004, and about 2 percent of all emergency-room visits are because of illicit drug use.

The data gathered by the Hawai'i agency also show an increase in the charges for these visits, some $11.8 million in 2000 compared with $29.7 million in 2004, she said, adding that in 2004, the public was responsible for paying 73 percent of those charges, some of which may not have actually been paid to the hospital.

"Our tax dollars are paying for those problems," she said.

Of the hospitals surveyed nationally, 73 percent said emergency-room cases involving meth have increased over the past five years, and 56 percent said hospital costs have risen because of the treatment of meth patients.

Locally, Kaiser Permanente's Dr. John Murray said yesterday the national findings sound about right. The numbers might even be higher because crystal methamphetamine contributes to other serious condition seen in emergency rooms such as heart attacks and strokes, he said.

"I would agree with their overall finding that it's a significant contributor to medical illness and emergency-department visits," Murray said. "I also agree with the fact that (crystal methamphetamine) emergency-room cases have increased."

Dr. Craig Thomas, an emergency physician at Castle Medical Center, said the numbers may be skewed because not every patient who comes to the emergency room is tested for drugs. He also doubted the merit of the survey without numbers to back it.

"I don't think anybody has the numbers to the precision of 47 percent," Thomas said.

Methamphetamine is a highly addictive stimulant that can be injected, snorted, smoked or swallowed. The drug can be manufactured in home labs using cold pills and other easily purchased ingredients.

Nearly 12 million people in the United States have used meth at least once, according to responses to the 2004 National Survey on Drug Use and Health conducted by the U.S. Department of Health and Human Services. About 1.4 million used meth within the previous year.

A separate survey by the counties' association of 200 state and county treatment program directors in 35 states and the District of Columbia found that 69 percent reported an increased number of people seeking treatment for meth abuse.

On the Mainland, the problem appears to be particularly acute in the Midwest, where meth's path of destruction in rural communities is well documented. In Nebraska, for example, nearly every hospital surveyed said up to 10 percent of emergency-room cases involved meth.

Bill Hansell, president of the National Association of Counties and a county commissioner in Umatilla County, Ore., says meth abuse can damage an entire community. Umatilla, a rural county 200 miles east of Portland, makes up 2 percent of the state's population but accounted for nearly a quarter of meth lab seizures last year.

Hansell says local governments pay to clean up toxic waste left by home meth labs, to care for the neglected children of addicts and to provide treatment.

In September, the White House drug czar's office named Umatilla a High Intensity Drug Trafficking Area entitled to federal money. Tom Riley, the drug czar's spokesman, says grants and vouchers are offered to communities with drug problems.

"We are tailoring programs to be responsive to local needs," he said. "In some parts of the country, meth is a burning program. In other areas, mercifully not. And we think we're meeting with some success with this approach."