Magnitude of the Problem
If intent is not considered (i.e. suicides), drug poisonings is the leading mechanism of fatal injuries among Hawaii residents, surpassing deaths falls and motor vehicle crashes as of 2007. There was an average of 171 fatal drug poisonings among residents each year, with consistent increases from 148 in 2013 to 200 in 2017. At least 36% of these deaths were related to opioid overdoses, mostly prescription pain relievers. Poisonings involving methamphetamine are also thought to be common, although these are difficult to detect through death certificate coding. Relative to the U.S. as a whole, however, drug poisoning fatality rates are significantly lower for Hawaii residents, and not increasing at the same alarming rate. These generalizations are specifically true in the context of opioid overdoses, where Hawaii has yet to experience the dramatic spike in deaths involving heroin and synthetic opioids such as fentanyl. Linkage of autopsy data from Honolulu County and the Prescription Monitoring Program indicate that cost (73%) of the opioid overdose victims had legally prescribed access to opioids, including about half (49%) with prescribed supply within 3 months of their death. For every fatal opioid overdose, there are nearly others nonfatal overdoses treated in Hawaii hospitals, and nearly 4 calls to the Hawaii Poison Hotline.
The EMSIPSB places a priority on having injury prevention strategies recommended by a community-driven action plan or informed by key implementing partners. Because a multitude of factors influence individual behavior, the strategies in the below table are framed across the individual, relationship, community, and policy levels.