HAWAI'I SUFFERING FROM CRYSTAL METH, VIOLENCE

When Christopher Aki was charged with the murder of Kahealani Indreginal --
an 11-year-old who had come to think of him as an uncle -- many in law
enforcement weren't surprised to hear he had used crystal methamphetamine.

"It's not surprising at all," said U.S. Attorney Ed Kubo. "In fact, I've
come to expect it. I'm never surprised when I hear it is a factor in these
extremely violent cases."

The use of the drug often called ice has reached epidemic proportions in
Hawai'i. Its effects, some of which linger for years after use has stopped,
include psychosis, paranoia, agitation and extreme irrationality.

Several indicators suggest Hawai'i's meth problem is the nation's worst,
including a state comparison of federal drug cases and a national study of
drug use by prisoners.

"Drug use is down nationwide," Kubo said. "But that is not the case here in
Hawai'i. In fact, drug use is increasing here because of the highly
addictive nature of crystal methamphetamine."

Kubo said 44 percent of Hawai'i's homicides are connected to ice use. Drugs
are involved in 90 percent of the state's 2,300 confirmed cases of child
abuse each year, with crystal meth as the main culprit.

"Hawai'i is generally recognized as the No. 1 ice-using state in the
country," Kubo said.

Officer Roy Fuata of the Honolulu Police Department's Special Services
Division, O'ahu's version of a SWAT team, said he has come to expect ice
involvement when his team is called to deal with the most dangerous armed
standoffs or hostage situations.

"I'd say the majority of our situations like that are related to crystal
meth," Fuata said.

Nor does the link between violent crime and crystal meth use come as a
surprise to Daniel Smith, an emergency physician at The Queen's Medical
Center

Queen's, the city's trauma center, has one of the few emergency rooms
equipped to deal with acute psychosis. Authorities regularly bring in
psychotic ice addicts, Smith said.

"We have locked psychiatric rooms equipped with cameras, restraints and some
very large people to help out," he said. "I don't think a day goes by
without at least a couple of those people being back in there."

William F. Haning III, a Queen's psychiatrist who runs the Pacific Addiction
Research Center at the University of Hawai'i, said methamphetamine abuse in
pill or injectable form has been around for years, but it wasn't until the
late 1980s that physicians in Hawai'i began to recognize lung disorders
connected with a new, smokable form of methamphetamine that was unknown in
the rest of the country.

Inhalation by smoking, Haning said, turned out to be the most effective
means of delivering meth to the heart and brain; the highs are immediate,
intense and euphoric, he said. But the depressions that follow are
miserable, and addiction can occur with just a few uses.

Agitation and obsessive behavior are common. Paranoia and other forms of
psychosis, such as hearing voices and hallucinating, develop quickly with
continued use. Unlike most people who suffer from psychosis, meth addicts
tend to realize their thinking is not normal, Haning said.

"They say, 'Oh, it is because I'm using meth. It'll go away in a little
while.' "

And it does go away, at first, Haning said. But each episode seems to hang
on a little longer, and eventually it can turn into something that hangs on
for months or years -- or maybe a lifetime. Researchers don't know exactly
how meth works on the brain, Haning said, so they can't predict when or if
the psychosis will end.

"They're leaving (a drug rehabilitation program) and saying, 'I'm still
hearing voices. Are they going to go away?' And you cross your fingers and
say, 'Yeah,' but to yourself you're saying, 'I hope,' " Haning said.

In a recent federal study comparing crystal methamphetamine use by inmates
in cities across the country, Honolulu came in first by a wide margin,
according to a U.S. Department of Justice report on drug use in Hawai'i,
published in May through the National Drug Intelligence Center. Forty
percent of people arrested in Honolulu tested positive for crystal meth. No
other city approached even 30 percent.

Another study compared federal court cases involving methamphetamine use.
Hawai'i came in first there as well.

Kubo said state statistics show 90 percent of Hawai'i's prison inmates are
drug addicts. Only 6 percent get treatment.

Aki is being kept at the O'ahu Community Correctional Center in a special
housing unit where inmates with drug addictions are isolated from the
general population, said Warden Clayton Frank.

"We put them in under observation and leave them there until we believe they
can be put back into the general population," Frank said. Some may never
leave isolation, especially those with long-term addictions to crystal meth,
he said.

In recent months, Hawai'i judges have tried to address the problem by
developing a strategy to send more offenders to drug treatment centers
instead of jails. The judges soon discovered the centers were overloaded,
primarily with crystal methamphetamine addicts.

Even if there were plenty of openings in drug treatment centers, Haning
said, and every meth addict got the best treatment available, the addiction
rate would be high. Recidivism is frustratingly predictable, and researchers
do not know how to prevent it.

"Behaviorally, they cannot resist the craving," Haning said. "They get out
of the treatment center and they are magnetically drawn to 'A'ala Park. They
are like little zombies, turning toward whatever source of ice they can
find."

Although crystal meth can be made in home laboratories, most of what is
found in Hawai'i comes from Mexico, the Mainland and Asia, according to the
Department of Justice report. Couriers fly it in aboard commercial jets, and
street gangs distribute it. Ice is relatively cheap compared to other
illegal drugs. And sales are high.

More than 1,500 Hawai'i residents belong to gangs, according to the
Department of Justice. As the state's drug trade has grown more lucrative,
gang members from Los Angeles and San Francisco have moved here to compete.

Kevin Lima, Honolulu police narcotics vice division captain, said at least
half of his unit's drug investigations center on crystal meth. But it isn't
only the vice officers who are likely to encounter the drug and its
aftermath.

Traffic stops sometimes turn up paraphernalia such as the distinctive glass
pipes lined with residue. Other officers tend to see the drug in less benign
settings.