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:
Lichty, too, pronounced herself generally satisfied with the make-up of the conference and the tenor of the recommendations. "It was really heartening to see the outcry for treatment, even from law enforcement," she said. "We came to the summit specifically to make counter-proposals to police recommendations, but we were also really pushing for treatment opportunities. We formed a group called Heart and we had buttons saying things like 'treatment protects communities' and 'drug testing is not prevention.'"
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.