METH CLINIC TREATS CHILDREN

DES MOINES, Iowa - 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 recently. ``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 - mostly infants - 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 of the program, 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 - underscoring the drug's rapid rise in
the state.

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, a 57-year-old mother of three. ``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
methamphetamine laboratories busts - 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 the ages of six or seven, 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.''