Hawaii Meth Mania:

DRUG SUMMIT, MEDIA PUSH TARGET "ICE"

Wednesday night, every television station in Hawaii turned its
airwaves over to a documentary on "ice," as the Aloha State refers to
the smoked methamphetamine popular there, followed by a statewide
series of townhall-style meetings on the "ice menace." The collective
examination of the state's methods of dealing with methamphetamine use
was only the reprise for a more formal gathering last week, the Hawaii
Ice Summit. And the summit in turn was preceded by months of
increasingly shrill and ubiquitous mass media coverage of what it
almost always referred to as the ice "epidemic."

But while the coverage was shrill, the problem is real, according not
only to law enforcement and treatment professionals, but drug
reformers and academic researchers as well. According to Dr. David
Friar, an addiction psychiatrist working in the public sector in
Honolulu who has tracked meth use in the islands, Hawaii ranks at the
top when it comes to the stimulant. "Here, 44% of all arrestees test
positive for meth," he told DRCNet. "This is the highest rate in the
nation, although we also see high use in some areas on the mainland,
San Diego and Kansas City, for example."

And methamphetamine abuse shows up in other indicators, as well, Friar
said. "Meth is involved in 90% of Child Protective Service cases where
children are removed from the home. Abuse and neglect rates are
staggering. Roughly 50% of all ER visits are meth-connected -- the
presentation often being of someone who is highly agitated, paranoid
and violent, the so-called meth warrior," the researcher explained.
"The fact that these folks are out there makes for a climate that
feels less safe, on the roads for instance. Crime also has increased
greatly in the past few years. Also there have been quite a few
heinous violent high-profile crimes where the perpetrator was tested
positive for meth."

Meth abuse indeed is a problem, agreed Pamela Lichty, head of the Drug
Policy Forum of Hawaii (http://www.dpfhi.org). "There are some
arguments about the numbers," she told DRCNet, "but we cannot hide the
fact that this is a real problem. It's been a long time coming, but
has been building for 15 or 20 years, since about the time marijuana
eradication took off. The ice problem has been growing and growing
since then."

Although you wouldn't know it from following the local media, which is
currently in something approaching an "all meth, all the time" mode,
Hawaii does suffer other social problems, some of which may even be
helping to fuel meth abuse. "We have a budget deficit like every other
state," said Lichty, "and tourism has not bounced back from 9/11 and
the Iraq war. We're very low in per capita education spending, our
schools are poor, and the social safety net is eroding. The rise of
crystal meth is a consequence of the deterioration of the safety net,
along with attendant poverty, and the main response is the
over-incarceration of native Hawaiians and Pacific islanders," she
said.

But those issues are complicated and intractable. It's easier to get a
grasp of concepts like the demon drug, and that is what a broad
spectrum of interested Hawaiians attempted to do with last week's meth
summit. Some 400 people representing law enforcement, treatment,
education, prevention and harm reduction perspectives gathered in
Waikiki to seek solutions. While one day was spent listening to
speeches from the likes of Lieutenant Governor James Aiona, who has
made meth a pet project, the real action was in the second and third
day's break-out sessions, where small groups met to grapple with
specific parts of the big picture. The resulting recommendations,
which will be forwarded to Governor Linda Lingle (R), include:

Create a Hawaii Substance Abuse Commission to, among other
responsibilities, ensure collaboration and cooperation between
stakeholders.

. Appoint a temporary director to follow up with summit
recommendations and establish an executive branch level office or body.

. "Ensure adequate funding and services from public and private
sources to provide a full continuum of comprehensive, appropriate,
effective and efficient substance abuse disorder treatment to all
people who want/need services without discrimination."

. An effective treatment approach that includes a "person-centered"
model, diverse services and adequate financial support. . Increased
money could come from asset forfeiture, parity for drug treatment,
dedicated grant writers and private sector initiatives.

. Refine domestic abuse laws, enact laws to allow parents to guide
their children's behavior, and review and enact laws regarding
wiretaps and search and seizures, effective police tools and mandatory
treatment.

. "Provide law enforcement with the laws and means necessary to arrest
and prosecute drug dealers; and provide judges with the laws and means
for appropriate sentencing of drug dealers and users, consistent with
civil liberties."

. "We the communities of Hawai'i, in the spirit of aloha, will be
equal voices and partners in designing, developing and deciding
strategies, resources and systems of allocation to attain and sustain
all our agreed upon goals."

. Create and develop community action groups/summits to mobilize
resources that will foster and support safe and healthy local
communities.

But Lichty also pointed to the summit's shortcomings. "A lot of key
players were not invited," she noted. "They didn't invite the Honolulu
City Council, which was a mistake because they control the police,
they didn't invite the head of the needle exchange program, they only
invited the chairs -- not the members -- of the legislative drug task
force, and they didn't invite the woman running the federal Matrix
study of meth users -- now that's outrageous!"

And, according to Lichty and Friar, legalization remained the drug
policy that dare not speak its name. "There was plenty of talk about
harm reduction," said Lichty, "but no one got up to talk about
legalization." Neither were the putative subjects of the summit --
methamphetamine users -- invited, with the exception of ex-users or
users in treatment. "There was no one to get up and say I'm a current
user," Lichty reported. "It's a pretty scary atmosphere for something
like that."

"No, there was no mention of legalization," agreed Friar. "But there
was plenty of recognition, even among law enforcement, that we can't
arrest our way out of this."

Still, Lichty said, the summit was an opportunity to dialogue with and
rein in law enforcement on the margins. "You see in that
recommendation about providing law enforcement with effective means
where it says 'consistent with civil liberties'?" Lichty asked. "That
was us."

Keeping the cops in line will be a continuing battle for Hawaii
reformers. While the summit produced some general recommendations to
ease restrictions on police, the legislature's Joint Senate House
Committee on Ice and Drug Abatement is following a parallel course and
is expected to present its own package of anti-meth policing bills
when the next session begins in January. "The police want to undo some
of our state constitution privacy provisions so they can question
people without any suspicion at airports," Lichty said, "and the US
Attorney here wants to amend the wiretap statutes to make it easier to
do drug investigations. There has also been some talk about
criminalizing pregnant women who use substances. I think we can beat
that back, but every time we get a 'children of ice' story on the
local news, it gets more difficult."

And even for the non-police recommendations -- treatment, education,
harm reduction -- the key question is follow-up, and follow-up
requires funding. "Really, it's going to come down to where we're
going to put our few precious dollars, as a community, as a state,"
Nanci Kreidman, executive director of the Domestic Violence
Clearinghouse, told the Maui News. "The dicey part of course, is
always carrying it out," Kreidman said. "There are so many competing
demands."

Elaine Wilson, chief of the Department of Health's Alcohol and Drug
Abuse Division, told the News the summit left her optimistic about
funding. Her pleas for more treatment and prevention money had fallen
on deaf ears for years, she said, "but never before have the governor
and lieutenant governor had this much focus on the need for treatment
and the need to really make an impact on the substance abuse problem.
"Not that in the past people haven't helped us, but this is fabulous."

Lichty's take was a bit less enthused. "Yes, there is an overwhelming
consensus for treatment, and it's all very politically correct, gender
specific, culturally sensitive and all that, but this is all about
following the money. We will support more money for treatment, yes,
but we will also have to counteract the heavy law enforcement
emphasis, we will have to argue that speed is like other drugs, that
its users are amenable to treatment and prevention, broadly defined to
include harm reduction approaches."

And someone might want to look at the social components of
methamphetamine abuse in Hawaii. "People often work two or three jobs
here, so that makes ice attractive," said Friar. "Of course, it also
leads to spectacular crashes. Poverty and cultural factors also have
something to do with it, and so might the emphasis on marijuana
eradication in the 1980s. But those causative factors are complex."

Visit http://www.hawaii.gov/ltgov/drugsummit/ for more on the Hawaii
drug summit.