Opioids in Hawaii
Hawaii had the 8th lowest rate of drug overdose deaths in the country from 2012-2015. Drug and opioid-related fatalities have been relatively stable since peaking in 2010, which differs from national numbers that show a year-over-year increase.
However, there are warning signs that the opioid crisis could get much worse here. Hawaii has a problem with addiction and misuse of other drugs. Annual deaths caused by drug overdose (average of 150) already outnumber traffic fatalities (average of 113). Workplace drug tests positive for methamphetamine were over 400% higher than the national average in 2011, and the state has one of the highest rates of incarceration from methamphetamine-related convictions. From 2010-2014, impaired driving deaths in Hawaii were 39.4% compared to the national average of 30.0%.
There are almost 490,000 dispensed prescriptions for oxycodone and hydrocodone alone, which is enough to cover one-third of the state population. Each opioid overdose in Hawaii costs an average of $4,050 for emergency medical services and $40,100 for hospitalization. In 2016, opioid overdoses created $9.8 million in hospital bills.
Seeing the opioid epidemic on the mainland and knowing that Hawaii usually experiences a lag compared to national trends in substance abuse has spurred proactive measures to prevent the spread of opioid addiction. In July 2017, Governor David Y. Ige tasked the Department of Health with developing a Statewide Action Plan on opioids and other substance misuse issues.
“Fortunately, Hawaiʻi has not yet experienced the magnitude of the opioid crisis seen in other parts of the country,” said Gov. Ige. “While emerging issues and concerns in the state are on the rise, we have been given a relatively unique opportunity to proactively respond, prepare and prevent the crisis from reaching the same magnitude.”
In the process of creating the action plan, several needs became apparent and objectives were developed to address one or more of the following needs:
Data needs to be effectively collected, organized, and communicated to continually evaluate the status of the opioid situation in Hawaii.
Public awareness to prevent misuse, addiction, and overdose needs to be continued and expanded. Use of naloxone to combat opioid overdose is considered part of prevention activities.
Training and Education
The medical community and other related parties needs to be well informed about the risk of prescription opioids and help to educate their patients.
Stigma prevents users from seeking help and also perpetuates negative perceptions that impact policy and treatment availability. This stigma needs to be reduced among health care professionals and the general public.
Improve Treatment Capacity
Capacity of facilities to treat those suffering from opioid use disorder (OUD) and substance use disorder (SUD) needs to be expanded.
Tackling the opioid and substance misuse crisis requires a collaborative response effort to ensure that efforts are not being duplicated and OUD sufferers receive the best possible support.
The following six key focus areas were developed as a groundwork for combating the opioid and other substance abuse in Hawaii:
1. Treatment Access: Improve and modernize healthcare strategies and access for opioid and other substance misuse treatment and recovery services.
2. Prescriber Education: Improve opioid and related prescribing practices by working with healthcare providers and payers.
3. Data Informed Decision Making: Implement system-wide routine data collection, sharing and dissemination to increase knowledge and inform practice.
4. Prevention and Public Education: Improve community-based programs and public education to prevent opioid misuse and related harms.
5. Pharmacy-based Interventions: Increase consumer education and prescription harm management through pharmacy-based strategies.
6. Support Law Enforcement and First Responders: Coordinate operations and services, support specialized training for first responders and assure effective laws and policies.
Action items and objectives were formed under each focus area, some of which have already been implemented. The plan is designed to be a “living document” that will be assessed and modified as needs and circumstances change.