We just marked International Overdose Awareness Day on Aug. 31. Kickstarted in Melbourne, Australia, in 2001, the day is focused on raising awareness about the risk of overdose, stimulating discussion about overdose prevention and drug policy, and commemorating those who have been lost to drug overdose.
Hawaii has the third-lowest overall overdose rate in the nation. Yet recent data from the state Department of Health show a significant increase in fatal opioid poisonings, from 54 in 2019 to 118 in 2023.
Overdoses also significantly impact Hawaii’s rural communities and neighbor islands. According to the Kauai Fentanyl Task Force, data from the federal Centers for Disease Control and Prevention indicate that the county averaged a fatal overdose every 21 days for the 12-month period ending September 2023. Hawaii island’s Fentanyl Task Force reports one fatal overdose every 12 days.
Under the terms of just one multistate settlement with pharmaceutical opioid manufacturers, Hawaii should receive at least $82 million over the next decade-plus. More funds are likely on the way with other legal settlements.
In the forthcoming legislative biennium Hawaii should strive to put the state’s opioid settlement funds to the best possible use, prioritizing overdose prevention and care services, including detoxification, stabilization and treatment for those with opioid use disorder. The process for apportioning settlement funds should be open to legislative, county and public input.
The theme of this year’s Overdose Awareness Day is “Together We Can.” This theme reflects the best possible approach to public health problems. It also embodies the kind of collaboration that’s already taking place across the state.
Hawaii continues the proactive response to overdose undertaken over the past decade, dating back to the passage of a Good Samaritan law in 2015 that provides legal immunity to those calling medical responders in the case of an accidental overdose from drugs obtained on the illicit market.
Last year the Department of Health brought vending machines online across the state to distribute nasal naloxone at no cost, with the most recent at the Kauai County Building in Lihue. The legislature decriminalized fentanyl test strips so that those using drugs of uncertain quantity and potency can immediately determine the presence of fentanyl.
Honolulu became the first city in the nation to require certain businesses that serve alcohol, including bars and nightclubs, to carry nasal naloxone to help prevent accidental opioid overdoses from becoming fatal overdoses. Mixing alcohol with opioids, including prescription opioids, can lead to respiratory depression and death.
Mayor Rick Blangiardi declared Aug. 31 Overdose Awareness Day in Honolulu, with Honolulu Hale lit purple in the evening. Those impacted by overdose include people and families from every economic and social category.
Overdose has taken the lives of Hawaii residents who have excelled on the national and world stage, including University of Hawaii Quarterback Colt Brennan and surfing legend Andy Irons.
Hawaii’s proactive approach to overdose should be subject to continuous improvement, and informed by service providers and those receiving services. More effective overdose prevention includes increases in drug checking services and supplies and other harm reduction services, expansion of detox and stabilization beds in every county, and recalibration of state laws and policies that advance a more comprehensive public health approach to behavioral health issues.
Together we can!
Heather Lusk is executive director of Hawaii Health & Harm Reduction Center; state Rep. Della Au Belatti chairs the House’s Health and Homelessness Committee.
