PILOT PRENATAL HEALTH CLINIC TARGETS 'ICE' USERS

The facility is awaiting state funding and will offer substance abuse
treatment to isle women

A pilot health clinic is planned in Kaimuki to provide prenatal care,
substance abuse treatment and other services to pregnant Hawaii women
who use crystal methamphetamine.

An estimated 5 percent to 6 percent of all pregnancies here -- about
1,200 a year -- involve women who use "ice," said Dr. Tricia Wright,
a UH assistant professor of obstetrics-gynecology and pilot clinic director.

Only about 100 treatment slots are available on Oahu for pregnant
women who abuse drugs, Wright said.

Establishment of the clinic in Kaimuki is pending Gov. Linda Lingle's
release of $400,000 appropriated by the Legislature to the University
of Hawaii John A. Burns School of Medicine for the program.

"The problem is there is no coordinated place where they can get
prenatal care along with substance abuse treatment," Wright said.

As a result, pregnant women using ice or other illegal drugs are
referred to doctors "who have no knowledge or desire" to treat
substance abuse, she said. If they are referred to a substance abuse
facility, they might not get the prenatal care they need, she said.

Nancy Partika, Healthy Mothers Healthy Babies Coalition of Hawaii
executive director, who helped lobby for funding for the clinic, said
it is "much needed in order to provide supportive and responsive
health care and related services to substance-abusing women and their infants."

Wright said the clinic will partner with Women's Way, a Salvation
Army residential drug-treatment facility in Kaimuki.

At the start, the clinic would take about 100 women per year, she
said. "We're hoping with the pilot clinic to get a model that can be
replicated through the community health centers."

Wright, who joined UH two years ago after six years in private
practice, said the concept for the Hawaii clinic is based on the
Milagro clinic in Albuquerque, N.M.

She said she trained in New Mexico, "and when I got there, I said,
'Why don't we have something like this?'"

The Milagro clinic was established in 1989 by University of New
Mexico faculty because of a growing heroin epidemic there. It is
primarily a prenatal clinic that provides pediatric care and
substance abuse treatment.

The local clinic will provide prenatal care, substance abuse
counseling, psychiatric treatment, child care and social services,
according to a draft proposal. It would also provide access to legal
help for women and their families.

"By combining the services, we hope to keep the women in the
health-care system longer than the five to seven months the typical
pregnant woman spends in prenatal care," the statement said.

The legislation for clinic funding said Child Welfare Services
reported two years ago that methamphetamine use was involved in more
than 80 percent of its active cases in Hawaii. Yet, it said, little
is known about adverse effects during pregnancy.

Dr. Chris Derauf, University of Hawaii associate professor of
pediatrics, is working with other groups on a long-term study of the
effects of ice exposure and other drugs on children. He will provide
care for children in the clinic, Wright said.

"There is reason to be concerned," Derauf said at a recent maternal
and infant care conference sponsored by the Healthy Mothers Healthy
Babies Coalition and the medical school's Department of Obstetrics,
Gynecology and Women's Health.

Early findings show a sharp increase in low-birth-weight babies born
to women who used methamphetamine, which can cause developmental
problems, he said.

New research is looking at the effects of methamphetamine on a
child's brain as it relates to development and behaviors, he said.

Wright also is interested in looking at the long-term effects on
women using methamphetamine. For example, she said, "We're seeing
cardiac problems."

She hopes to have five to seven people working at the clinic,
including registered nurses, doctors, substance abuse counselors and
social workers.