'ICE' DEATH TOLL NEARLY QUADRUPLES IN PAST DECADE

Deaths among crystal methamphetamine users have nearly quadrupled in the
past decade to a record 62 fatalities last year, with overdoses and suicides
together accounting for more than half of those deaths, according to new
statistics from the Honolulu Office of the Medical Examiner.

And with 20 deaths of users recorded through the end of April 2003, Honolulu
is on course to match last year's record.

The statistics show deaths among crystal methamphetamine or "ice" users in
Honolulu increased sharply during the past two years.

The number of overdoses among methamphetamine users nearly tripled since
2000, while the number of suicides more than doubled in the same period.

Errol Yudko, who co-authored a book on methamphetamine, said the number of
deaths points to an increase in overall use of the drug over the past five
years, a pattern that is confirmed through a variety of other statistics.

"There has probably always been a few deaths with use all this time," said
Yudko, who is a visiting assistant professor of psychology at the University
of Hawai'i-Hilo. "Now that we're at a historical high, we should also see a
historical high in deaths."

As methamphetamine use has grown in recent years, communities across Hawai'i
have rallied at town meetings or demonstrated with signs by the roadsides to
demand action to deal with the problem. The most recent demonstration
occurred Friday in front of a Kalihi elementary school, where police who
participated in an ice raid joined dozens of students to protest drug use in
the community.

On the Big Island, Mayor Harry Kim's administration declared "war" on ice
about two years ago, and this month state lawmakers agreed to form a joint
House-Senate committee to address the methamphetamine use.

Experts said there is an obvious connection between methamphetamine use and
suicide, a pattern that promises to make the ice epidemic particularly
deadly.

Dr. Barry Carlton, chief of psychiatry at The Queen's Medical Center, said
the chemical effects of methamphetamine on the brain partly account for why
many users become suicidal.

Methamphetamine use depletes the transmitters that control mood in the
brain, causing people who withdraw from the drug to experience "overwhelming
depression," he said.

The drug also tends to cause paranoid delusions triggering fear that may
lead to suicide, he said. Methamphetamine also causes hallucinations that
addicts say sometimes take the form of voices telling the users they are
bad, and should kill themselves, Carlton said.

"For people who have never heard hallucinations, it's hard to fathom how
compelling these voices can be," Carlton said. "It's like having a hundred
people shouting at you, telling you to kill yourself."

Another factor in methamphetamine suicides is the damage that addiction does
to the lives of the users, said Wesley Margheim, director of operations for
the Big Island Substance Abuse Council, the largest drug treatment provider
on the Big Island.

"Ice addiction also destroys other things besides brain cells," Margheim
said. "It destroys careers, it destroys social structure, it destroys the
family, it destroys the relationships, and when you're left with nothing,
your children are gone, your spouse is gone, often times they feel they have
no other way out."

Nearly a third of the deaths last year of people with methamphetamine in
their systems were classified as overdoses. Staff with the medical examiner
said there may have been more than one drug present in the bodies of those
drug users, and it is possible some of those overdoses were actually
suicides.

Alan Johnson, managing director of the drug treatment program Hina Mauka,
said a factor in the overdose deaths is likely the tendency of users to
binge on methamphetamine, staying up for days and ingesting more and more of
the drug.

The euphoria that users feel after first smoking ice wears off after a few
hours, but the stimulant amphetamine is still in the users' system and
acting on their bodies, he said. In an effort to recapture the initial
euphoria, users smoke more, he said.

Methamphetamine also was detected in the blood of 10 victims of homicide in
Honolulu in 2002, which some experts believe further confirms a link between
violence and methamphetamine.

Police have been talking about the ice-violence connection for years as they
encounter addicts who are violent and difficult to control.

Carlton said the drug causes paranoid delusions, making victims extremely
frightened, and some attack out of fear, hurting "what amounts to an
imaginary devil," he said.

However, Yudko cautioned that the link between methamphetamine and violence
may not be as simple as a meth-causes-violence, cause-and-effect
relationship.

While it is clear some meth users are violent, Yudko said it isn't entirely
clear whether the meth is causing the violence, or whether violent people
tend to like to use methamphetamine.