Posted on: Sunday, June 8, 2003

'Ice' death toll nearly quadruples in past decade

By Kevin Dayton
Advertiser Big Island Bureau

Deaths among crystal methamphetamine users have nearly quadrupled in the past decade to a record 62 fatalities last year, with overdoses and suicides together accounting for more than half of those deaths, according to new statistics from the Honolulu Office of the Medical Examiner.

And with 20 deaths of users recorded through the end of April 2003, Honolulu is on course to match last year's record.

The statistics show deaths among crystal methamphetamine or "ice" users in Honolulu increased sharply during the past two years.

The number of overdoses among methamphetamine users nearly tripled since 2000, while the number of suicides more than doubled in the same period.

Errol Yudko, who co-authored a book on methamphetamine, said the number of deaths points to an increase in overall use of the drug over the past five years, a pattern that is confirmed through a variety of other statistics.

"There has probably always been a few deaths with use all this time," said Yudko, who is a visiting assistant professor of psychology at the University of Hawai'i-Hilo. "Now that we're at a historical high, we should also see a historical high in deaths."

As methamphetamine use has grown in recent years, communities across Hawai'i have rallied at town meetings or demonstrated with signs by the roadsides to demand action to deal with the problem. The most recent demonstration occurred Friday in front of a Kalihi elementary school, where police who participated in an ice raid joined dozens of students to protest drug use in the community.

On the Big Island, Mayor Harry Kim's administration declared "war" on ice about two years ago, and this month state lawmakers agreed to form a joint House-Senate committee to address the methamphetamine use.

Experts said there is an obvious connection between methamphetamine use and suicide, a pattern that promises to make the ice epidemic particularly deadly.

Dr. Barry Carlton, chief of psychiatry at The Queen's Medical Center, said the chemical effects of methamphetamine on the brain partly account for why many users become suicidal.

Methamphetamine use depletes the transmitters that control mood in the brain, causing people who withdraw from the drug to experience "overwhelming depression," he said.

The drug also tends to cause paranoid delusions triggering fear that may lead to suicide, he said. Methamphetamine also causes hallucinations that addicts say sometimes take the form of voices telling the users they are bad, and should kill themselves, Carlton said.

"For people who have never heard hallucinations, it's hard to fathom how compelling these voices can be," Carlton said. "It's like having a hundred people shouting at you, telling you to kill yourself."

Another factor in methamphetamine suicides is the damage that addiction does to the lives of the users, said Wesley Margheim, director of operations for the Big Island Substance Abuse Council, the largest drug treatment provider on the Big Island.

"Ice addiction also destroys other things besides brain cells," Margheim said. "It destroys careers, it destroys social structure, it destroys the family, it destroys the relationships, and when you're left with nothing, your children are gone, your spouse is gone, often times they feel they have no other way out."

Nearly a third of the deaths last year of people with methamphetamine in their systems were classified as overdoses. Staff with the medical examiner said there may have been more than one drug present in the bodies of those drug users, and it is possible some of those overdoses were actually suicides.

Alan Johnson, managing director of the drug treatment program Hina Mauka, said a factor in the overdose deaths is likely the tendency of users to binge on methamphetamine, staying up for days and ingesting more and more of the drug.

The euphoria that users feel after first smoking ice wears off after a few hours, but the stimulant amphetamine is still in the users' system and acting on their bodies, he said. In an effort to recapture the initial euphoria, users smoke more, he said.

Methamphetamine also was detected in the blood of 10 victims of homicide in Honolulu in 2002, which some experts believe further confirms a link between violence and methamphetamine.

Police have been talking about the ice-violence connection for years as they encounter addicts who are violent and difficult to control.

Carlton said the drug causes paranoid delusions, making victims extremely frightened, and some attack out of fear, hurting "what amounts to an imaginary devil," he said.

However, Yudko cautioned that the link between methamphetamine and violence may not be as simple as a meth-causes-violence, cause-and-effect relationship.

While it is clear some meth users are violent, Yudko said it isn't entirely clear whether the meth is causing the violence, or whether violent people tend to like to use methamphetamine.