DRUG PROBLEM IN MIDWEST TOO

(Des Moines, IA) - A decade ago, when Dr. Rizwan Shah decided to open
a clinic to treat children exposed to drugs, she thought it would take
up just a fraction of her work schedule - five hours a week, at most.

But with the rapid rise of methamphetamine use in the Midwest, running
the one-of-a-kind program has become a full-time job.

"This is beyond what I could have anticipated," she said. "In 1989,
when I started my clinic, perception of people in Iowa and people
anywhere in the United States was that Iowa, the Midwest, is not the
place where you have drug-abuse problems. Ten years later, we find out
that rural communities and small towns are as likely to have an
epidemic of substance abuse among pregnant women as big cities."

Methamphetamine use has spread rapidly since the mid-1990s, forcing
doctors like Shah to learn how to treat children exposed to the drug
while in the womb.

Born in Pakistan, Shah came to Iowa in the early 1970s with her
husband, who also is a physician.

After noticing growing numbers of pregnant women taking drugs, she
started the infant treatment program at Blank Children's Hospital. In
the first four years, about 70 percent to 80 percent of her patients
were babies exposed to cocaine.

Since 1993, when she treated her first infant exposed to
methamphetamine, she's examined 368 other such cases.

Shah estimates about 90 percent of the children she now treats are
methamphetamine cases.

"The ability with which methamphetamine became an epidemic was a
surprise," said Shah, 57. "One of the reasons is its popularity among
the rural populations. It's just like a wildfire."

In Iowa in 1994, 629 people were arrested for drug possession that
included methamphetamine, according to the Iowa Department of Public
Safety. Last year, that number surpassed 1,700.

The drug's popularity also has led to a striking rise in the number of
busts of methamphetamine laboratories - jumping from eight such busts
in 1995 to 374 already this year. The state's division of narcotics
expects the number to surpass 400 by year's end.

Signs of meth exposure in children include overstimulation of the
brain, muscle-tone problems, periodic shaking and tremors, difficulty
with coordination and an intolerance to human touch.

Some of her older patients, between ages 6 or 7, are often susceptible
to hyperactivity, attention deficit disorder, learning disabilities
and "unprovoked anger fits" in which children become destructive for
short periods of time.

Medical experts around the state are pressing for more funding to deal
with the scope of the problem.

Shah wants to study and compare children affected by cocaine with
children exposed to methamphetamine. She has proposed a formal study
through the National Institutes of Health and hopes to begin research
next year.

Cheryll Jones, health-services coordinator at a clinic in Ottumwa,
agrees that more studies are needed.

"They've looked at cocaine fairly closely, but not really at meth,"
she said. "We need funds to follow these children over time so we can
more accurately say what is the outcome of these children over time."

Aside from health problems, another consequence of the drug epidemic
is that the children often wind up separated from their natural
parents. Shah says about 68 percent of her patients have been adopted
or placed in foster care.

But there are those willing to take in the children.

For one Iowa couple, taking care of their adopted daughter who had
been exposed to methamphetamine is a blessing. Doctors said the girl
had suffered a heart seizure hours before she was delivered.

"We just wanted to give her the most normal life possible," said the
father, who asked that his name not be used.

"For us, she's a miracle baby."