Hawaii County and state policymakers urge public engagement in protecting Big Island keiki from the scourge of fentanyl.

The Hawaii Island Fentanyl Task Force held its third annual Fentanyl and Addictions Summit on Monday, bringing together over 200 representatives of state and county agencies, health care organizations, nonprofits and more to discuss the ongoing fentanyl crisis, its impacts and potential solutions.

According to statistics presented by Dr. Kevin Kunz, fentanyl was responsible for more than 80% of overdose deaths for people under 24 years old in 2021 and was the No. 1 cause of death for all Americans between ages 18 and 45. The drug is extremely potent, with 2 mg a fatal dose for users with bodies unused to opioids.

Kunz added that victims of fentanyl overdoses would have been safer if they had taken the same amount of cyanide: Hydrogen cyanide is lethal at about 60 mg, while potassium cyanide kills at 200 mg.

Much of the summit discussed the drug’s unexpected impacts upon at-risk keiki, whose youthful experimentations with drugs are much more dangerous than in previous generations.

Kunz joked that his generation may have illicitly indulged in cigarettes, alcohol and cannabis, but today’s youth have “a full buffet table” of drugs available online, many of which could be laced with fentanyl without users’ knowledge.

Kymmie Gentry was one of several attendees who spoke about her own tragic encounter with fentanyl: Her 14-year-old daughter died of an overdose in 2022, after the drug was mixed into cannabis.

“My daughter experimented with drugs once, and she died,” Gentry said. “This generation’s challenge with drugs is different.”

Dan Galanis with the state Department of Health’s EMS and Injury Prevention System Branch showed that fentanyl overdoses are on the rise in Hawaii. Drug overdoses involving fentanyl accounted for about 15% of all overdoses statewide in 2020; in 2023 they made up about 34%.

Although methamphetamine overdoses still make up the lion’s share of Hawaii drug deaths, about half of the state’s 2023 fentanyl overdoses also involved methamphetamines.

State Department of Education consultant Benjamin Kilinski summarized the most effective strategy: “prevention, prevention, prevention and naloxone.”

The Task Force praised its partners for helping to spread awareness of naloxone — commonly known under the brand name Narcan — as a vital lifesaving measure for treating an opioid overdose. Attendee Laura Aquino told the summit that she had received a Narcan kit from attending a previous fentanyl summit for work, which ultimately saved her son’s life when he overdosed at home.

Task Force member Pua Carriga estimated that about 22,000 cases of Narcan have been distributed throughout the island, including several vending machines. Those machines carry more than 60 cases, are restocked twice a month and dispense kits for free.

Between 2022 and 2024 there have been 244 reported Narcan administrations on the Big Island, said Hawaii Fire Department Captain Michael Lam, although he did not state how many of those resulted in the overdose victim surviving.

Several speakers said public awareness of the medication is improving, with Narcan now being carried by more people and establishments, while education efforts to reduce the stigma of overdose and addiction are ongoing.

Gentry said many people still have self-defeating attitudes toward drug overdoses, believing that they happen only to drug addicts and that drug addicts deserve it in some way.

“They’re not all drug addicts, and even if they are, they still deserve a life,” Gentry said to applause.