People are dying of opioid overdose at an alarming rate across the country. In Hawaii, one-fourth of accidental deaths are caused by drug overdose, and most of those cases involve opioids.
Hawaii has not experienced the opioid crisis to the same degree as other states, but we are taking action now before the problem escalates. Already, deaths from drug overdose in Hawaii outpace those from motor vehicle accidents. The people who are dying are our neighbors, our friends and our family. They are dying from both street heroin and other illicit opioids as well as common prescription opioids such as OxyContin. Our entire nation is facing a crisis.
Opioid addiction is an extremely complex illness. To reverse this trend, Gov. David Ige has called for the Hawaii Department of Health to lead a coordinated and comprehensive strategy based on four strategic cornerstones.
Prevention is key. This is the first cornerstone: to integrate better screening into general health care settings so we can spot emerging problems and get people help early. This is called Screening Brief Intervention and Referral to Treatment, SBIRT for short. It’s like taking a person’s blood pressure or other vital signs to spot diseases before they become chronic and require costly intervention or emergency care. This year, Hawaii received more than $11 million in new federal funding for substance abuse programs. About $8 million of this new funding will be used for SBIRT. Addressing problems before they become difficult and expensive to treat makes better financial sense and creates better outcomes.
The second cornerstone is a more cohesive and collaborative effort among government agencies to confront the problem. We recognize we cannot tackle this problem if agencies operate in silos. The Hawaii Department of Health and Department of Human Services are working closely with law enforcement entities to implement policies that keep public health and public safety in mind.
The Department of Health, the Department of the Attorney General, the Department of Public Safety’s Narcotics Enforcement Division, and the Hawaii Poison Center are now working together on a statewide prescription drop-off program. This will allow people with legitimate opioid prescriptions for pain management to drop off any unused medications for safe disposal. It ensures medications are safely diverted from the black market and kept out of the hands of curious children. In addition to these preventive measures, the Hawaii Poison Center’s toxicologist, available 24/7, is a valuable resource for healthcare providers and the public when dealing with opioid overdoses.
The third cornerstone is to raise awareness and educate our community about opioid use and abuse and to increase responsibility and accountability. This means creating systemic, upstream change within the medical community so that people with prescription opioid addiction are less able to “doctor shop” and get multiple prescriptions from multiple doctors. It means educating our first responders and social service personnel to be better equipped to spot and assist those who are at risk or who already have an opioid abuse problem. Opioid kits have proven to be effective in emergency response. It also means educating patients to avoid becoming addicted to these medications, and instructing their family members on how to administer Naloxone, an overdose reversal medication.
The fourth cornerstone is data collection. It is vital that we continue collecting, evaluating, and expanding our use of data so that we can make proactive, informed decisions on the best care options for patients. Data-informed decision-making allows us to direct resources where they are most needed and provide the best outcomes. The Prescription Drug Monitoring Program (PDMP), for example, is an excellent way to collect, monitor and analyze drug prescription and dispensing data. This data helps to identify providers who are prescribing opioids, the reasons for the prescriptions, and the frequency with which they are prescribed to patients.
Together, all of these cornerstones help to build a stronger foundation to address opioid abuse. Focusing on prevention, breaking down silos for better inter-agency collaboration, creating heightened awareness and stepping up educational efforts, and documenting our findings to make sound, data-based decisions are all critical steps to stop opioids from claiming more lives in Hawaii. And these processes will help our state become stronger and more resilient into the future.
Dr. Virginia Pressler is the director of the Hawaii Department of Health.
