DAY 1: DOWNWARD SPIRAL - THE LURE OF ICE
Crystal meth use
is on the rise
With dire results.
A bag of seized crystal meth.
Drug use and child abuse.
It's a sad fact that 90 percent of Hawaii's reported 2,300 child abuse cases stem from adult use of drugs and/or alcohol.
Many never pull themselves out. For others, even recovery continues to be a fierce struggle.
Today and tomorrow, the Star-Bulletin explores the rise of crystal methamphetamine use in Hawaii: the effects of "ice" on the body and its destructive consequences for families.
We also profile one ohana's fight with drug addiction and the toll it has taken on their family, including the littlest victims, the children.
How ice draggedBy Lori Tighe
one family down
and how they're fighting
their way back
The signs were everywhere in her daughter's home. Dishes were piled up in the sink, trash overflowed, and dirty diapers lay about. Everyone ate whenever they wanted, since they had no regular meal times. They did nothing together as a family except fight.
"There was no order," said Ho'oipo DeCambra, her wide eyes visibly pained behind her big, square glasses. "You wouldn't want to live there. I was afraid for my grandchildren."
Of all the families she helped as executive director of a Waianae drug treatment center, DeCambra never expected she'd have to help her own.
But she forced herself to report her daughter to the state for neglecting her four children because of an addiction to crystal methamphetamine, or "ice." It was the only way to help her daughter into drug treatment and rescue her grandchildren.
Substance abuse by far is the leading cause of child abuse and neglect in Hawaii, accounting for some 90 percent of about 2,300 confirmed cases a year, according to Child Protective Services.
And crystal methamphetamine is the No. 1 drug.
Ice had taken hold of Rhonda DeCambra, 34, and her mate, Bennett Villanueva, 36, nearly costing them everything.
"I was this close to losing my family," said Villanueva, holding his finger and thumb a quarter-inch apart.
"I was ashamed of myself, very ashamed," said Rhonda DeCambra, cuddling her 9-month-old daughter, Paige, and kissing one of the baby's plump bare feet. "I never thought I would be here. But if I can help somebody else ... "
DeCambra and Villanueva lived as a couple in Waianae for seven years. He owned a bulldozer and dug pools in people's back yards. They had three children, Tiffany, 5, Bennett Jr., 3, and Paula Ann, 2.
Villanueva used drugs since high school, and ice for about 12 years. He began getting high "to follow my friends," he said.
Rhonda DeCambra, raised by a powerful mother, stayed straight for years. But the monotonous demands of family life slowly ate at her. Dishes, laundry, feed the kids, wash the kids, food-shop, cook -- the chores seemed endless. She needed energy.
As she prepared for a luau last year, she finally tried smoking "ice" at a cousin's urging. "She painted a glorious picture of it." On ice, the cousin said, she could get everything done.
"It's addictive. It hooks you the first try," Rhonda DeCambra said. "It gives you chaos energy. You run in circles. I cleaned my house all day, and it wouldn't get clean."
She became pregnant with their fourth child but kept smoking the drug. She and Villanueva smoked around the clock, sometimes for three days straight before they crashed and slept for several days.
"Not having it caused violence," said Villanueva, in a soft voice mingled with Hawaiian pidgin. "When I didn't have it, I got mad at anything."
Villanueva knew their lifestyle affected the children.
"But when I was on, I just thought everything was all right," he said. "When I came off, I'd think, 'Oh wow, I could've done this and I could've done that.'"
If Villanueva didn't get high again, he would keep sleeping. "I would sleep two or three days, get up, shower, eat and go back to sleep. I needed to get high to function," he said.
He and Rhonda DeCambra argued frequently, "mainly about drugs."
The children acted out for attention and grew harder to handle, Villanueva said. But the withdrawals felt so bad, they never strayed far from the drug.
Villanueva eventually lost his bulldozer after falling behind in payments due to his erratic lifestyle.
"I just thank God I didn't lose my family," he said.
Ho'oipo DeCambra knew Villanueva used drugs and that it was only a matter of time before her daughter would use them, too.
She hardly saw her daughter during her fourth pregnancy. Rhonda never came around for family functions, but Ho'oipo DeCambra held her tongue.
Then her daughter began calling for advice about Tiffany, her 5-year-old. Tiffany stayed up all night and refused to listen. She began acting out in school.
"The child was afraid. She was showing symptoms of psychological stress," Ho'oipo DeCambra said. "She was my barometer."
The concerned grandmother visited her daughter and discovered her worst fears had materialized.
Ho'oipo DeCambra broke down over the irony of it.
"I felt so helpless. What am I doing in this professional work when my own family has this problem? I was feeling like a hypocrite. I was tormented," she said. "Substance abuse touches all of us in this community, and a lot of us directly."
She called the state Child Protective Services in April. But no one would help her unless she could provide proof of physical abuse.
"I was so angry," she recalled. "I realized they don't have enough staff at the intake level. That needs to be corrected."
But Hawaii law prohibited CPS from ordering Rhonda DeCambra to take a drug test, said Susan Chandler, state Human Services director.
"We have no evidence of abuse until the child is born with drugs in their system under our law," Chandler said.
Testing for in utero drug use remains a controversial issue, which the state Legislature debated last session, Chandler said.
CPS workers also couldn't remove the couple's three other children until they had evidence the kids were failing to thrive, injured or sexually assaulted, she said.
"Neglect cases must hit a high level of risk assessment," Chandler said. "If the community wants CPS to expand its mandate, it would have to change our law and give us more resources."
The day before Rhonda DeCambra delivered, she smoked ice. Physicians can test newborns if they have a health concern. Paige, born with a racing heart, tested positive for her mother's drug. The doctor stabilized the infant with medication.
"It was God doing for me what I couldn't do for myself," Rhonda DeCambra said. "It brought CPS into my life."
As soon as the doctor identified Paige as an ice baby, the doctor called CPS. The agency removed all four children from the home a few days later.
"It was a wake-up call, an eye opener," Rhonda DeCambra said. "Just the thought of losing them -- we realized our children are the world to us."
The reality hit Villanueva hard, too.
"I had so much neglected my family. I knew my kids were going to be taken away," he said.
"I was hurt. I never knew that CPS would be in my life."
Tomorrow: With the painful, arduous recovery comes self-esteem.
When isle pot smokers were introducedBy Lori Tighe
to ice, they latched onto a drug that would sear
the nervous system, the heart and
the brain, possibly irreparably
A mother of two, "Deborah" dropped a rock of crystal methamphetamine into a glass pipe, lit it, and inhaled.
"It's like a rush," she said. "It gets you amped up."
But then the snap-back occurred: She felt groggy, depressed, paranoid and sorely agitated, like a train hit her.
The 42-year-old Pearl City woman cannot use her real name because she fears revenge from her former boyfriend, who once, in an ice rage, threw her toddler son "from wall to wall."
"It got really out of hand," said Deborah, who smoked "ice" for eight years. "I was afraid many times for my children and me if I didn't get my boyfriend a hit."
Like many who think they'll just try ice once, Deborah soon realized her mistake. Drug treatment specialists in Hawaii say ice addiction is worse than cocaine, and withdrawal from ice is worse than heroin. The drug can cause violent tendencies and has been linked along with other substances to about 44 percent of the state's homicides. Doctors also fear the drug may cause permanent brain damage.
"Crystal meth is a really dirty drug with nasty side effects," said Mason Henderson, executive director of the Sand Island Treatment Center run by the Hawaii Alcoholism Foundation. "It's the worst drug, because of its psychotic and violent effects."
Hawaii's growing habitSmoking ice is the preferred way to use the drug in Hawaii, over needle injection and snorting it, according to police and drug treatment officials. This is also the most dangerous and addicting method, physicians say.
"Ice took pakalolo's (marijuana's) place, and they smoked a lot," said Patricia Morgan, a University of California at Berkeley professor who studied ice users in Hawaii. "They found out it was a different drug, but in many cases it was too late."
The speed in which ice makes a user high accelerates addiction. The vapors enter the lungs, explode into the bloodstream and shoot to the brain in six seconds. Smoking it delivers the high twice as fast as injecting it, and many times faster than snorting it, said Dr. Pablo Stewart, chief of psychiatry at the Haight-Ashbury Free Clinic in San Francisco.
Doctors also suspect that the chemical compound used to turn the powdered drug into a crystal rock for smoking heightens the psychotic side effects.
"This is scary stuff, in all honesty," said Stewart, who recently led a crystal methamphetamine conference in Waikiki. "Ice is so addicting. The habits are huge."
Honolulu is among the top eight U.S. cities with the fastest growth of ice use, according to the latest annual report by the National Institutes of Health and the National Institute on Drug Abuse. The other cities are Denver, Los Angeles, Phoenix, San Diego, Detroit, Minneapolis/St. Paul, and St. Louis.
Ice peps people up, so they turn to it for energy. They work several jobs, and need to stay up all night to work. Some with large families use it to fulfill their domestic responsibilities, said Doug Althauser, who has served as chemical dependency coordinator at Kaiser Permanente of Hawaii for eight years.
"It's very seductive. The high is intense and long, it can last hours or days," he said. "It's more addictive than cocaine."
Hawaii's poor economy is also a considerable factor for the ice growth, Morgan said: The higher the unemployment rate, the higher ice use rises.
"The biggest argument for reducing ice usage is improving the economy. In California, 'crack' use went down when the economy went up," Morgan said, referring to the smokable form of cocaine.
Ice cycleIce is to methamphetamine, what crack is to cocaine: a crystallized and more addictive version of a drug which affects the central nervous system. But because the ice high lasts about 12 hours compared to the crack high, which lasts less than an hour, ice's payback is also much worse, Althauser said.
Ice, a manufactured stimulant drug cooked in a lab or kitchen, revs up the body's dopamine, a neurotransmitter that fires off nerve impulses to run the human engine.
People who have too little dopamine have Parkinson's disease; people with too much dopamine suffer from hallucinations and delusions, such as schizophrenics.
The constant firing of dopamine heightens thinking and sensations, said Deborah, a recovering ice user. "You think you can perform as a normal person. But you can't."
Clinically diagnosed effects include euphoria, decreased fatigue, increased libido, decreased appetite and decreased distraction in kids, Stewart said.
In the long run, ice disrupts the body's ability to sleep. The drug forces the body to run on energy it doesn't have.
"It's a circular addiction. You get high. You deplete your neurotransmitters. You don't return to normal. You're at a lower state and feel like hell," Stewart said. "You get high to feel normal and soon develop a tolerance. You never get as high, and your lows are even lower."
Usage leads to premature aging of the body and skin, and malnutrition from not eating, Althauser said. Many ice users' teeth fall out at a younger age. Some users also experience asthma symptoms -- difficulty breathing, sore throats and wheezing -- Henderson said.
"But I see the effects socially and legally before they get in trouble physically," Althauser said. "A lot of people are involved in crime: robbing, purse snatching, prostitution and stealing cars, all for money to buy the drugs."
Violence and schizophreniaDeborah first tried ice out of curiosity because her friends smoked it. Then she began seeing her friends become different people.
"I noticed changes in everybody. I saw a lot of abuse. It made people, especially men, really vicious," she said.
Smoking ice sparks violent tendencies for two reasons, Stewart explained. Ice affects a part of the brain responsible for impulse control, which causes violence. It also leads to psychotic episodes, or misinterpreting of reality, which also induces violence.
Ice problems include tremors, involuntary movements, restlessness, hearing voices, hallucinating and paranoia, leading the user down a path of destruction, Stewart said.
Ice is the No. 1 drug among 90 percent of parents who abuse or neglect their children, according to Johnny Papa, Child Protective Services supervisor. There are about 2,300 confirmed cases a year in Hawaii, statistics show.
Psychiatrists in Hawaii have also noticed a constant increase in the last few years of ice users suffering psychotic episodes, said Dr. Bill Haning, director of psychiatry at Hawaii State Hospital and chief of addiction for Queen's Medical Center.
"It's a straight-line correlation to the increased use of ice," Haning said.
A disturbing discovery which leads some doctors to believe ice causes brain damage is the small percentage of patients who appear to develop permanent schizophrenia-like symptoms after they stopped using ice.
"It's a case of which came first, the chicken or the egg. We don't know if ice caused the 'schizophrenia,' or if the schizophrenia led the person to use ice," said Dr. Tom Leland, one of Hawaii's ice experts and medical director of Community Care Services in Honolulu.
"Why do people stay psychotic after speed (methamphetamine) disappears from the system? No one knows why," Stewart said. "Speed-induced psychosis lasts days, weeks, months and years."
Brain 'holes'Extended use of ice also causes "holes" in the brain, or spots where the brain doesn't function, said Dr. Alan Buffenstein, assistant professor of psychiatry at the University of Hawaii.
He began studying ice users' brains out of frustration from seeing a dramatic rise in psychotic ice users who were suicidal, homicidal and hallucinating at the Queen's Medical Center emergency room.
"We felt so helpless, and we wanted to understand what was happening," said Buffenstein, who has scanned about 150 psychotic ice users in the past few years.
The holes appear on CT scans which take a picture of the brain's activity using a dye injected into the ice user's body. Doctors don't know if the holes are caused by ice restricting blood flow to the brain, or by its dopamine effect. Sometimes the holes go away after the person stops using ice. Other times they don't.
Ice also affects the heart, killing some users through heart attacks. Cardiologists see heart problems in ice users ranging from enlarged hearts to irregular heart beats, Buffenstein said. However, unlike the brain, the heart appears to return to normal after the drug leaves the body, Stewart said.
"What's missing in our understanding of ice is the follow-up," Leland said. "We don't know what happens to these people after they leave the hospital. We can only hope they survive."
Problematic recoveryWhether voluntary or forced by the judicial system, more ice users are turning to treatment centers for help. Ice treatment admissions in Honolulu increased 48 percent to 1,345 in 1997, according to the National Institutes of Health and National Institute on Drug Abuse.
Ice users are medically and psychiatrically stabilized for the first seven to 30 days in treatment, Henderson said.
"Withdrawal from ice is much more problematic than heroin withdrawal," Henderson said. Unlike heroin, ice has no treatment drug such as methadone.
Ice users in recovery can hallucinate, act agitated, hear voices, scream at night, and can't sleep, Henderson said. The side effects intensify with longer usage.
"It's not easy. Success is on a case-by-case basis. Somebody who wants to recover can do it," he said.
"They deserve a lot of respect."
Deborah said recovering from ice isn't just about staying off the drug. "It's about changing your lifestyle."
At the Sand Island Treatment Center, Deborah developed coping skills to handle her emotions. She learned to be aware of her personal red flags, including times she feels overwhelmed or overconfident. She developed a set of interventions to prevent her from reaching for the ice pipe.
"I feel blessed to be an addict because it taught me life skills," she said.
She left Sand Island on May 30 after 14 months of residential treatment, and still attends four meetings a week. She repeats an affirmation each morning when she wakes up: "Every day and in every way, I'm getting better and better."
"I'm really lucky to be alive," she said. "I want to make the most of it."
Deadly tollThe number of Oahu adult deaths related to crystal methamphetamine, or ice, according to the Honolulu Medical Examiner's office:
1997 -- 36
1996 -- 23
1995 -- 38
1994 -- 36
1993 -- 12
1992 -- 18
1991 -- 9
1990 -- 11
Seek help from your doctor to fight the addiction. For treatment referrals, call ASK-2000, (808) 275-2000. Treatment centers also offer help. Here's a partial statewide list, courtesy of the Coalition for a Drug-Free Hawaii; call 545-3228 or interisland at (808) 845-1946 for more information.
OAHUAnodyne Addiction Treatment Programs, Honolulu, 545-7706. Target: adults and youths.
Bobby Benson Center, Kahuku, 293-7555. Target: youths 13-17.
Castle Medical Center -- Kailua, Honolulu, Pearl City, Haleiwa, Kaneohe, 263-5394. Target: adults & teens.
Drug Addiction Services of Hawaii, Inc. (DASH), Honolulu, 538-0704. Target: adults.
Drug Demand Reduction, Hickam AFB, 449-5892. Target: adults and youths.
Fresh Start Inc., Waipahu, 678-0660. Target: adults.
Habilitat, Kaneohe, 235-3691, 800-872-2525. Target: adults and teens 15-plus.
Hawaii Alcoholism Foundation Sand Island Treatment Center, 841-2319. Target: adults.
Hawaii Counseling & Education Center, Kailua, 254-6484. Target: adults and youths 4-19.
Hina Mauka Recovery Center, Kaneohe, Waipahu, 236-2600. Target: adults and teens.
Ho'omau Ke Ola Hawaii Addiction Center, Waianae, Waipahu, 696-4266. Target: adults.
Institute of Human Services, Honolulu, 845-7150. Target: adults and children 6 months to 18 years.
Kahi Mohala Behavioral Health Center, Ewa Beach, 671-8511. Target: adults and youths.
Kalihi-Palama Health Care for the Homeless Project, Honolulu, 531-6322. Target: adults.
Kalihi YMCA, Honolulu, 848-2494. Target: youths 10-18.
Narcotics Anonymous, 734-4357. Target: adults and youths.
New Horizons, Waianae, Aiea, 696-2668. Target: adults and youths.
Po'ailani Inc., Kailua, 236-1065. Target: adults.
Queen's Medical Center, 547-4352. Target: adults.
Safe Haven, Honolulu, 941-5797. Target: adults.
Salvation Army, Honolulu, 595-6371. Target: adults and youths.
St. Francis Medical Center, Women's Addiction Treatment Center of Hawaii, Honolulu, 547-6117. Target: women.
Teen Challenge of Hawaii/Oahu, Mililani, 456-3311. Target: adults 17+
Waianae Coast Comprehensive Health Center, Waianae, 668-2277. Target: adults, youth, pregnant women.
MILITARYAdolescent Substance Abuse Counseling Service, Mililani, 655-9944. Target: adults and teens 12-18.
Alcohol & Drug Abuse Prevention & Control Program, Schofield Barracks, 433-8700. Target: Army personnel, family members, civilians, National Guard members and retired personnel.
Mental Health Clinic, Hickam, 449-9192. Target: active-duty military, family members, Air Force employees.
Substance Abuse Counseling Center, Kaneohe, 257-3910. Target: USMC, dependents and Department of Defense employees.
LANAILanai Family Resource Center, Lanai City, 565-9566. Target: adults and youths.
MAUIAloha House, Makawao, 579-9584. Target: adults and youths 12-17.
Castle Counseling Services, Wailuku, 242-9733. Target: adults and youths 11-17.
Maui Youth & Family Services, Makawao, 579-8414. Target: youths 12-17.
Narcotics Anonymous, Wailuku, 242-6404. Target: adults and youths.
MOLOKAIHale Pomaika'i Clean & Sober House, Kaunakakai, 553-9092. Target: adults.
Narcotics Anonymous, 553-9092. Target: adults and youths.
HAWAIIABC Institute, Addictions, Behavioral Counseling and Prevention, Kailua-Kona, 334-0222.
Big Island Substance Abuse Council, Hilo, 935-4927. Target: adults, youths 13-17, and pregnant and postpartum women.
Bridge House Supportive Living and Vocational Skill Building Program, Kailua-Kona, 322-3305. Target: adults.
Narcotics Anonymous, Hilo, Kona, 969-6644. Target: adults and youths.
Ohana Counseling Services Inc., Hilo, 935-3764. Target: adults and youths.
KAUAIKe Ala Pono Recovery Centers, Lihue, 246-0663. Target: adults and youths 12-17.
Narcotics Anonymous, 828-1674. Target: adults and youths.
Po'ailani Inc., Lihue, 245-7082. Target: adults and youths 12-17.
Department of Veterans Affairs, Kauai Veterans Center, Lihue, 246-1163. Target: military veterans.
The littlest victims
Reubyne Buentipo is one of them. The 5-year-old cannot see, hear or talk now. His mother goes on trial in January for his attempted murder. Friends and relatives have said she smoked ice.
The case load
The HPD's Child ABuse Unit has tracked 940 cases since its November 1997 formation.
Over the years
Child abuse and neglect cases have soared over the years, doubling since 1980.
To report abuse
You can help if a child is being abused or neglected due to crystal meth or any other reason.