The pain and loss caused by the national epidemic of opioid addiction will be all the more tragic if resources newly available to fight the scourge are squandered.
It is heartening, then, to hear Hawaii’s top leadership commit to the challenge ahead: On Tuesday, Gov. David Ige and the state’s four mayors pledged to make the most of the allotment of $78 million to Hawaii from a national opioid litigation settlement.
The mission of spending down this money effectively must remain a priority for some time, given the plague that uncontrolled use of this class of painkilling drugs has generated across the country.
The most horrifying stories about individuals dying and families destroyed have been chronicled in other states, but Ige said there is disturbing evidence of a looming crisis here as well. Drugs are the cause of 9 out of 10 poisoning deaths, according to the state Department of Health.
”Warning signs are appearing,” Ige said. “Fatalities from drug poisoning have outpaced auto accidents in Hawaii this year.”
The patient’s problems generally begin with a doctor’s prescription of an opioid to relieve pain from a health condition or surgical procedure. There are controls on the books, here and in other states, to limit the amount and duration of the drug use, but with lax enforcement and the illicit drug pipelines that have developed, overuse of the drug can quickly tip into addiction, with fatal overdoses often the sad consequence.
So even if this state ranks 37th in America for drug overdose deaths, taking action to keep that trend line from rising must be the focus. Hawaii seems to be lagging a bit in setting up its management of an opioid program, numbering among 16 states that haven’t yet enacted enabling legislation for the fund.
That job will fall to the next administration and lawmakers, who should give it a spot near the top of their priority list once they take office.
The nationwide fund, totaling $26 billion, is meant to be spent gradually over the course of 18 years. The aim is to bring treatment to sufferers now, but also to ensure that long-term solutions are developed and that strong preventive measures are implemented to arrest opioid abuse before it consumes generations to come.
Before the spending can begin, an advisory committee will be convened, enlisting state and county representatives in equal number, the governor said. That’s because at least 15% of the funds will be controlled and spent at the county level, which is smart policy. Not unlike the COVID-19 crisis, in which states and counties also shared the custody of recovery funds, conditions can vary by island, with interventions often best directed by local officials.
When the state does form the committee, it’s crucial that a substantial number of the members come from the fields of treatment and prevention, with direct experience in managing these clinical cases. Their experience will be essential in setting the criteria for choosing programs to receive the funds.
About $66 million will be reserved for treatment and prevention of opioid abuse specifically, but Ige said the balance can be spent on other substance-
abuse problems.
Viewed broadly, drug overdose is the cause of nearly one-quarter of the state’s fatalities, a massive problem requiring relentless effort by community leaders. Thanks to the settlement, they will be armed with $5.2 million annually for the first nine years, and $3.5 million a year after that.
This is a lot of money, but it could easily be misspent. Hawaii must strengthen enforcement of its drug controls, treatment and outreach, learning from past mistakes and avoiding repeating them.