Highlight on Hawaii: Lawmakers say aloha to stronger overdose measures

More people in Hawaii die from drug overdoses than car crashes—a reality that is driven by an excess of opioid abuse. However, recent efforts are directed at reducing the state of Hawaii’s opioid crisis. A key component of the state’s fight against drug abuse is a piece of legislation (S.B. 2392) which creates immunity for those who describe and dispense overdose reversal medication such as Naloxone. Additionally, the law authorizes a greater range of individuals to administer such medications to individuals experiencing an overdose.

Drug abuse

In 2015, Hawaii saw 158 deaths from drug poisonings/overdoses, adding to the total of 1,523 over the past 10 years. Drug overdoses are a greater problem in Hawaii than in other U.S. states. For example, drug overdose deaths increased by 83 percent between 2006 and 2014—an increase which more than doubled the 37 percent average rise nationwide. There is speculation that Hawaii may be particularly susceptible with respect to overdoses due to its isolation and the inconsistency in the quality of drugs brought to the islands.

Naloxone

The FDA approved Naloxone to prevent overdose by opioids such as heroin, morphine, and oxycodone. The drug reverses the toxicity of an overdose by blocking opioid receptor sites. The medication is administered when a patient is showing signs of an opioid overdose. The drug is an important life-saving medication, according to a community health outreach worker who has heard stories about “people trying to help friends overdosing on narcotics like opioids, injecting them with everything from saltwater to milk.”

Law

The law encourages the prescription, distribution, and administration of Naloxone through a variety of measures. A key provision of the law is immunity that it provides for health care professionals and pharmacists who prescribe, dispense, distribute or administer overdose medications like Naloxone. The legislation also authorizes several kinds of individuals—police, firefighters, lifeguards, all emergency medical technicians, family, and friends—to administer drugs like Naloxone to individuals experiencing opioid-related drug overdoses.

Bigger than Hawaii

The opioid crisis is a problem that stretches far beyond the island chain of Hawaii, with overdose deaths from prescription painkillers claiming 165,000 lives in the U.S. since 2000. Part of the problem is the widespread prescription and use of opioids. In 2015, 227 million opioid prescriptions were written, enough for 9 out of 10 American adults to receive a bottle of opioids.

Influence

An investigation by the Associated Press and the Center for Public Integrity discovered that the prevalence of opioid use and abuse may be, in no small part, related to the financial efforts of pharmaceutical manufacturers. For example, the investigation found that “drug companies and allied advocates spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade.” The figure is staggering when juxtaposed with the $4 million spent by organizations advocating for limits on opioids and the fact that the pharmaceutical lobbying is eight times higher than spending by the gun lobby over the same period. Additionally, the pharmaceutical industry maintains an average of 1,350 lobbyists covering all 50 state capitals.

A step forward

However, despite these significant and growing challenges, states like Hawaii are taking steps to reduce the impact of opioids. Authorizing greater utilization of drugs like Naloxone is an important move in the journey towards eliminating opioid abuse, one that all states can benefit from.