Two more names have been added to last year's record tally of ice-related deaths in Honolulu. The additional deaths, which bring the grim total to 87, were added in late January after toxicological tests were finished on the two cases, Chief Medical Examiner Dr. Kanthi De Alwis said.

De Alwis considers deaths linked to the use of crystal methamphetamine a growing epidemic in the city.

Last year's record follows a previous high in 2004, when the city recorded 67 ice-related fatalities. When last year's record tally was thought to be 85, De Alwis expressed a keen frustration at the drug's continuing spread into the community, calling it a public health issue.

Now, she has two more deaths added to the benchmark.

"It's alarming," she said. "I am hoping we won't see the same thing by the end of this year. I just hope that people get the message. These are preventable deaths."

The medical examiner tallies crystal methamphetamine deaths under four categories: toxic effects, homicides, suicides and accidents.

Victims of toxic effects — the leading category the past five years — die of heart attacks from coronary arteries narrowed by the drug, blood vessels that rupture in the brain because of high blood pressure and suffocating asthma attacks.

One of the additional cases brought the tally for toxic effects to 49 for 2005. The victim's body was in an advanced state of decomposition and a blood sample had to be sent to a Mainland lab.

The other death was added to the accident category because it involved the crash of an automobile. Terance D. Lee, a 35-year-old attorney admired for his work with domestic violence victims, died Dec. 28 after his speeding sports car struck a barrier on the Kailua side of the Pali Highway tunnels.

De Alwis said Lee had crystal methamphetamine and alcohol in his bloodstream. At 0.14, his blood alcohol content was nearly twice the legal limit of 0.08.

The medical examiner said Lee died of multiple traumatic injuries, including a fractured neck. But she had to list the death as an ice fatality because the drug was a contributing factor she could not ignore.

"We cannot rule out what effect the drug had for him to speed and to be in that accident," she said. "We just don't know. But because we can't rule it out, we include it as a contributing cause. The drug can cause an altered state of mind."

Lee had used the drug within 24 hours of his death, but De Alwis could not say definitively if he was a long-term user.

Lee's death underscores the widening reach of the highly addictive drug, the medical examiner said.

"I didn't expect him, as an attorney, to have crystal meth in his system and be driving under the influence," De Alwis said. "So no one is immune."

Lee's family was similarly surprised.

"That really angers me," his mother, Patty Lee, said. "You've made me so furious at him. I don't understand why anyone in their right mind would put themselves at risk with that kind of stuff."

Patty Lee has struggled to cope with the death of her only son, whom friends called Toby. And against an outpouring of charitable donations in her son's name — thousands of dollars — the drug use was difficult to reconcile.

"It's a terrible thing," she said. "It causes the brain chemistry to change. They are no longer the same person. You'd think I would have seen some of that."

In hindsight, there were signs.

"I noticed there were differences, but I thought it was stress," she said. "He would get angry. Then he would come in and apologize."

In the wake of her son's death, friends and admirers have donated money to various organizations, his mother said. About $6,000 was given to the the Domestic Violence Clearinghouse and Legal Hotline, where Lee had done pro bono work for battered women and served on the board of directors for two years.

"It really goes to demonstrate the point that it is not just a drug that people who are unemployed or uneducated or on the down-and-out are using," said Nanci Kreidman, the organization's executive director.

"If someone like Toby could be using it as a recreational drug, I suppose anyone can. Toby was a functioning professional and a generous man. I am surprised."

Reach Mike Gordon at mgordon@honoluluadvertiser.com.