Manuel Borling became homeless about a year ago, but it wasn't because he lost a job, saw his rent double or faced some other economic sucker punch.

He became homeless because of drug abuse.

An ice user for 10 years, the 28-year-old Makaha resident took up residence on a Wai'anae Coast beach to spare his parents the "chaos" he said his substance abuse was causing while living with them.

"It was a tragedy what I was doing to myself and to them," Borling said recently as he wrapped up a two-month residential drug treatment program at Ho'omau Ke Ola, a nonprofit service provider in Wai'anae.

Although economic factors have been the primary reasons for the recent surge in the coast's homeless population, the menace of substance abuse still plays a large role and seems to be on the rise, according to healthcare workers and others who deal with the homeless on a daily basis.

If people who become homeless already don't have a drug or alcohol problem, they are at risk of developing one because of the despair, depression and low self-esteem that homelessness often spawns, and because such substances are so readily accessible among the homeless encampments, providers say.

As in other parts of O'ahu, the Wai'anae Coast has struggled to combat substance abuse and the health problems it causes.

Despite millions spent statewide on anti-drug programs, anecdotal evidence suggests that substance abuse remains pervasive along the coast, including among the homeless, healthcare providers say.

"The alcohol and drug problem is huge," said Benjamin K. Kaneaiakala III, who heads the substance abuse treatment program at the Wai'anae Coast Comprehensive Health Center, where many of the region's homeless get care.

Karen Young, a nurse practitioner at the center, said it used to be rare to find pregnant women abusing drugs. Now, finding one who isn't doing drugs is rare, she said.

"We have so many more grandparents raising grandchildren because their children are on drugs," said Pua Kaiwi, manager of a federally funded program that provides nutrition services to women, infants and children along the coast.

Dr. Richard Price, an emergency room physician at the Wai'anae facility for the past 10 years, said all the attention and money devoted to fighting the drug problem doesn't seem to be working — at least based on the patients he sees in the ER, the only one along the coast.

"It has had no impact," Price said. "Not that I can see."

Keith Yamamoto, chief of the Department of Health's Alcohol and Drug Abuse Division, said substance abuse treatment data show that slight progress has been made the past two years statewide in the fight against ice, though numbers are not available for the Wai'anae Coast.

The percentage of adults treated in DOH-funded programs who said ice was their primary drug dropped from 50.2 percent in fiscal 2004 to 49.6 percent in fiscal 2006, while the comparable numbers for adolescents declined from 5.5 percent to 2.6 percent, according to Yamamoto.

He also mentioned that law enforcement agencies are reporting a decline in ice arrests.

Despite the severity of the ice problem, the coast has only 16 beds — eight for males, eight for females — in a licensed residential drug treatment program in Makaha run by Ho'omau Ke Ola.

"There is a huge shortage" of residential treatment facilities, said Dr. Fred Dodge, a pain management specialist at the Wai'anae center.

Homeless drug abusers who went through Ho'omau Ke Ola's program said it was instrumental in helping them turn their lives around.

Kalei Kaawa, 35, suffered through two bouts of homelessness over the past decade, once when she and her husband couldn't afford to rent a home and the other time when a friend kicked them out of his home because they were abusing drugs.

With the help of Ho'omau Ke Ola's Native Hawaiian-based treatment, Kaawa, who is 75 percent Hawaiian, has been "clean and sober" for more than two years. She is renting a townhouse in Makaha with her husband and their two boys and is working as a therapeutic residential counselor for Ho'omau Ke Ola.

"It was really, really important," Kaawa said of the program. "It got me connected back with my roots. A lot of us, when we turn to drugs, we tend to forget where we came from and the morals we were given as we grew up. Those are pretty much taught back to us again."

Borling likewise said the program provided a solid foundation for his recovery and helped him realize how damaging drugs were to his life. Since graduating, Borling has returned to work as a certified electrician.

Reach Rob Perez at rperez@honoluluadvertiser.com.