OUD continues to disproportionately impact different groups such as older adults, men, certain ethnic groups, low-income individuals, and Medicaid beneficiaries.
A significant contributor of these costs is the higher utilization of health care resources, with the national average cost to an employer for an OUD patient of $10,627 per year. In the U.S., the estimated overall economic burden of opioid use disorder was $78.5 billion in 2016. Opioid use disorder (OUD) also has significant economic consequences. In 2018, 213 people died from a drug overdose in Hawaiʻi, killing more people than kidney disease (183 deaths), making OUD a significant public health challenge.
Nevertheless, opioid misuse continues to needlessly kill and harm people in Hawaiʻi. In 2018, the drug overdose death rate (age-adjusted) in Hawaiʻi was 14.3 deaths per 100,000 people, compared to a national age-adjusted rate of 20.7 deaths per 100,000 people. Granted, the epidemic in Hawaiʻi continues to be less severe than the continental U.S. The opioid epidemic continues to be a major public health and safety challenge impacting thousands of people in the State of Hawaiʻi. In 2020, increasing member diversity, cultural competency, project alignment, evidence-informed strategy, current programming and additional policy-driven programming are recommended to sustain the success of the HOI. Two policies from the 2019 legislative session directly impact the HOI: Act 154 “Relating to Pharmacists Prescribing and Dispensing of Opioid Antagonist” and Senate Concurrent Resolution 103 “Urging the Inclusion of Native Hawaiian Cultural Intervention Treatment Programs, Wellness Plans, and Holistic Living Systems of Care in the State of Hawaiʻi’s Response to the Rise of Misuse and Abuse of Opioids or Illicit Substances in Hawaiʻi.” An overarching goal of this evaluation is to gather feedback for HOI capacity-building and policy enforcement. Major successes of the HOI include education and training initiatives, interagency collaboration, and continuing a process of desiloizing our health system that may be replicated to address other complex public health problems. Highlights focus on naloxone training and distribution, the Prescription Drug Monitoring Program, “Mocha Minutes” prescriber education, Take Back Boxes, a pilot of Maui Police Department’s Overdose Detection Mapping Application Program (ODMAP), and the launch of the Hawaiʻi CARES (Coordinated Access Resource Entry System) line. Presented as a series of infographics, this section inventories progress made on the HOI 1.0 and 2.0 objectives as documented by the evaluation team through survey, interview, and attendance of all HOI Work Group meetings. Topic areas include alternative pain management therapies, care coordination, Medication-Assisted Treatment, prescriber education, and cultural competency. The synthesis of evidence has been summarized in standalone infographics, which may be requested by the Work Groups as part of their objectives. This section presents current evidence and literature was reviewed for selected priority areas identified in the HOI Scorecards. Anyone interested in supporting the HOI is encouraged to join a work group by contacting the co-chairs. They include contact information for each focus area’s co-chairs. The scorecards track 2018’s 1.0, 2019’s 2.0 objectives, and 2020’s 3.0 objectives which are currently in progress. Following this, a Hawaiʻi-focused data dashboard from the National Survey of Drug Use and Health is introduced.Įach year the HOI sets work objectives for the year by focus area. The context of OUD in Hawaiʻi is established with a series of data-informed inquiries about OUD, exploring factors associated with opioid overdose such as prescription pick up timing, comparison to other substance use disorders and barriers to treatment and primary care in rural areas. This evaluation report represents progress made by the Behavioral Health Administration’s Hawaiʻi Opioid Initiative (HOI) based at the Alcohol and Drug Abuse Division (ADAD) of the Department of Health and reflects the work of 193 volunteer members from 106 organizations located across the Hawaiian islands to mitigate the impact of opioid use disorder (OUD) on patients, communities and systems of care.