Honolulu will mandate that about 850 bars, nightclubs and restaurants serving alcohol in the city be required to have naloxone nasal spray on hand to counteract opioid-­related overdoses.

The City Council voted 7-0 Wednesday — with Council members Andria Tupola and Radiant Cordero absent — to approve the third and final reading of Bill 28, which is expected to take effect Jan. 1.

Adopted by the Council, the measure — introduced in March by Council member Tyler Dos Santos-Tam — is deemed the first of its kind in the country. The measure comes four months after the U.S. Food and Drug Administration granted initial over-the-counter approval to Narcan, the trade name for the naloxone opioid-reversal medication.

Now, Mayor Rick Blangiardi has until July 22 to sign the bill into law.

“This is a significant milestone, but our work is far from over,” Blangiardi said in a written statement Wednesday afternoon. “The dangerous impact of fentanyl on our city cannot be overstated; we have witnessed a staggering rise in overdose deaths, and the profound strain it has put on our healthcare system and our first responders has been especially taxing. We cannot stand idly by while the crisis continues to endanger our residents, and I look forward to signing this bill into law as quickly as possible.”

At the meeting, Dos Santos-­Tam thanked the Honolulu Liquor Commission for helping roll out what amounts to a future public health, safety and welfare program. The city’s controversial Liquor Commission has been under scrutiny in recent months for issues related to chronic under-­staffing, low morale and the questionable policies and practices allegedly employed by its investigators while enforcing liquor laws on Oahu.

“I know they’ve gone through a lot of issues in the media but I think this is a really bright spot in working with them to help get this medication out to our bars and on-premise locations where alcohol is served,” Dos Santos-Tam said. “They’ve done a really good job of working with my office and working with the Emergency Services Department as well.”

To assist affected businesses in acquiring naloxone, HLC has agreed to provide free “starter doses” for all liquor licensees.

Dos Santos-Tam added that between now and the Jan. 1 implementation date “we can get ahead of the curve on this and also help our bar and nightclub owners to get this into their hands for free using the opioid-settlement money.”

The Council’s approving vote on Bill 28 coincides with the state Department of Health and its partnership with nonprofit Hawaii Health and Harm Reduction Center, or H3RC, to provide free doses of Narcan to all Hawaii residents.

According to Dos Santos-­Tam’s office, DOH agreed to provide two doses of Narcan to all liquor licensees in each of the counties in Hawaii.

That action follows a state-level agreement made in July involving two national settlements totaling $26 billion. The settlements were reached as a result of investigations and litigation over pharmaceutical companies that allegedly fueled the nation’s opioid crisis.

In this case, the 50 states signed on to the agreement involving three major drug distributors — Cardinal, Ameri­source­Bergen and McKesson — as well as drug manufacturer Johnson & Johnson.

As a result of the two settlements, the state of Hawaii netted $78 million. Of that amount, Oahu received 9.3%, or about $7.25 million — money now being used to fund free Narcan doses to Hawaii residents, Dos Santos-Tam’s office said.

“For reference, it would cost $27,003.48 to provide a dose of Narcan to all of the businesses affected by Bill 28,” Richmond Luzar, Dos Santos-Tam’s policy and communications director, previously told The Honolulu Star-Advertiser.

One owner of a Chinatown nightclub supports the pending law.

“Overdoses happen, especially when mixed with alcohol. Our bars and nightclubs must be prepared for every contingency. I am grateful that the City Council is taking on this important issue,” Robbie Baldwin, owner of Scarlet Honolulu, said in a written statement. “This bill will protect businesses, patrons and the public at large.”

After the meeting, Baldwin told the Star-Advertiser that his nightclub has had Narcan on-site for approximately a year.

“Hawaii Health and Harm Reduction Center really was ahead of it in getting it and having it available for nightclubs and whoever wanted it,” he said, adding the nonprofit also conducted training in Narcan’s use. “So my view on the matter is that the fentanyl crisis is hitting the mainland super hard right now and it’s only a matter of time before it hits our shores, and getting in front of this problem as quickly as possible, I think, is smart to do for your business, and, I think, it’s good public health.”

Others at the city and state levels also view the rise of opioid-related overdoses with dismay.

DOH reported 59 opioid-overdose deaths in the state from August 2017 to August 2018. By 2020, that number jumped to 274, a 364% increase.

“We are witnessing an alarming increase in the use of fentanyl which has infiltrated into our communities. Our neighbors and friends who should still be here, are no longer with us,” said Dr. Jim Ireland, director of Honolulu Emergency Serv­ices Department, in a written statement. “We believe this bill will save lives.”

At the meeting Wednesday, Council member Val Okimoto voiced support for the bill. However, she said she also wanted to see fewer government mandates placed on local businesses.

“Perhaps ease of access makes more sense,” Oki­moto said of the Narcan requirement, “and we can encourage businesses and hotels and shelters to keep them on their property and we make it more accessible for them to do so.”

Meanwhile, during a May 24 meeting of the Council’s Committee on Housing, Sustainability and Health, EMS Deputy Director Ian Santee said use of Narcan — administered as a nasal spray — is generally deemed safe and is currently employed by Honolulu Fire Department personnel, EMS workers and HPD officers.

And Santee added even if Narcan is mistakenly given to an unconscious person who does not suffer from an opioid overdose, there are no dangerous side effects or health risks.