Micki Brailo was shopping in a convenience store in Wahiawa recently when she noticed it had glass pens for sale. She immediately recognized them as drug paraphernalia.

"I confronted the individual (behind the counter) and said, ‘Do you know this is a crack pipe?’" Brailo said. "She just kind of giggled it off, and I was like, ‘It’s not funny that you’re selling them for $1.99.’ I said, ‘You’re promoting drug use in the neighborhood.’"

So Brailo, manager of the critical care unit at Wahiawa General Hospital, decided to take things into her own hands. She organized "Not Even Once" Fridays for her staff, when they wear wristbands and T-shirts from the Hawaii Meth Project. She invited Meth Project officials to make a presentation to staff and volunteers, all in an effort to raise awareness about the dangers of meth.

"If there’s one T-shirt, and if somebody asks me about it, and I make a difference, then I’ve done my job," she said. "This is my community, I love these people, I consider them my family."

Brailo has a personal connection with the impact of drug abuse. She has a niece on the mainland who is addicted to crack, becoming homeless as a result. At Wahiawa General, she has seen hundreds of drug addicts wind up on her ward.

"They can be agitated, aggressive, hallucinating, almost getting into fights with the staff."

Cindy Adams, executive director of the Hawaii Meth Project, welcomed Brailo’s initiative. "Wahiawa is the first hospital that’s doing this in a kind of aggressive way, trying to reach out in their own community," she said. "The timing was right for Wahiawa General to take this on."

Meth, the popular name for methamphetamine, is an extremely addictive drug that exploded in popularity in the 1980s and 1990s, probably because the chemicals used to produce it were available in over-the-counter drugs. Though limits on those drugs have been imposed, meth’s addictive quality continues to makes it a danger.

Adams said Hawaii ranks fifth in the nation in meth use, and that an estimated $500 million is spent annually on such things as incarceration, treatment, foster care and lost productivity.

Recent evidence suggests meth use is on the rise in Hawaii. Diagnostic Laboratories, the largest drug-screening company in the islands, has found that meth is the only recreational drug to show a rise in use over the past year, said Carl Linden, the company’s director of toxicology. Diagnostic Laboratories conducts from 5,000 to 10,000 drug screenings every three months.

Though the overall number of positive meth tests remains small — 1.2 percent in the second quarter of 2010, up from 0.7 percent the previous year — the trend is significant given how easy it is to hide meth use, Linden said.

"Drugs like methamphetamine and cocaine are undetectable after about three or four days," he said. In comparison, marijuana, which surfaces most frequently in drug tests at 2.4 percent, remains detectable for two to three weeks, he said.

Dr. Lauren Okamoto, a resident in family medicine at Wahiawa General Hospital, said she has seen meth addicts suffering from health problems such as stroke, emaciation, and tooth and gum decay. Many of these problems have long-lasting or even permanent effects.

"The most devastating thing I’ve seen is people in their 30s with end-stage heart failure," she said. "(They) have the heart of a 90-year-old at age 30.

"I just had a patient … whose heart was so bad he couldn’t even walk from one part of his house to another without being short of breath."

The Meth Project’s presentation attracted a large crowd of staff, administration and volunteers at the hospital, Okamoto said.

"For the most part doctors are pretty well informed about meth use in the clinical setting, but not so much in terms of the social consequences of meth use," she said. "They talked a lot about children being exposed in the house, how it affects them in school, how it affects education, family functions."

Coincidentally, one of Okamoto’s patients was at the hospital that day. He was wearing one of the Meth Project wristbands, which prompted him to tell her that he had once been an addict.

"Now that I know his history, I’m more in tune with some of the … health consequences he may face," she said.