More than 20 years ago, Hawai‘i was an early adopter of drug court—allowing nonviolent substance abusers to avoid prison with a program of supervised treatment, work and regular drug testing. Today, 85% of those cases involve crystal methamphetamine—and it’s overwhelming the system. There’s a waiting list for drug court, and a waiting list to get into treatment centers helping users of crystal meth. Hospital emergency rooms taking care of crystal methamphetamine users often face financial charges running to the tens of thousands of dollars, largely absorbed by taxpayers. Treatment professionals say a bigger role for primary care physicians could help deal with earlier stages of the use of this drug—and also help a movement toward a more honest and realistic dealing with Hawai‘i’s crisis of crystal methamphetamine use.

In this episode, we hear more from people who have had the drug at the center of their lives. HPR reporter Noe Tanigawa talked story with three women who have come through meth addictions, and we hear about their experiences, their perspectives and how their lives have been changed.

Many people think of crystal methamphetamine users as homeless addicts with deep-seated mental health issues. While that describes some users, it’s a much broader spectrum of people who have issues with crystal meth. From blue collar workers seeking energy to work multiple jobs to white collar employees, crystal meth in Hawai‘i cuts across demographic lines. Job applicants in the state consistently test positive for crystal meth at more than three times the national average.

This episode looks at how and why crystal meth has reached so deeply into local culture here---as well as where it comes from and how it gets here. This podcast is produced by Hawaii Public Radio with help from Honolulu Civil Beat.

Dr. Daniel Chang estimates 45 patients a day come to the emergency room at Queens Medical Center for some type of methamphetamine-related complaint. The use of crystal methamphetamine is a medical, legal and social crisis that has now entered its third generation in Hawaii.

A dozen years ago, Congress held hearings on the topic, calling them "The Poisoning of Paradise." But despite a dip in publicity, meth hasn't left the islands.