SCR64

WHEREAS; Hawaiʻi is experiencing an increasing record number of drug over-dose deaths; and

WHEREAS, within this record number of overdose deaths, greater than thirty percent are caused by opioids, and the majority of the opioid overdose deaths were caused by opioids such as fentanyl; and

WHEREAS, opioids are a class of drugs that act on the endorphin and pain receptors in the human brain, and which include prescription pain medications, as well as heroin and illicitly manufactured non-medical fentanyl; and

WHEREAS, illicitly manufactured non-medical fentanyl is mixed into all known street drugs, including cannabis, and is pressed into fake look-alike pills, including fake oxytocin, Adderall, Xanax, and others; and

WHEREAS, according to the CDC, fentanyl is up to fifty times stronger than heroin and one hundred times stronger than morphine, and, according to the United States Drug Enforcement Administration (DEA), a single two milligram dose, the equivalent of ten to fifteen grains of table salt, can be lethal; and

WHEREAS, the mixing of fentanyl into other substances is a cause of unintentional fentanyl poisoning and overdose deaths in all age groups by persons unaware they are consuming fentanyl, including teens in the State who have been identified in the press and by family members; and

WHEREAS, these overdose deaths from synthetic opioids represent an exponential increase since 2017; and

WHEREAS, this rapid increase mirrors the trajectory of the fentanyl overdose crisis on the continental United States that began in 2013, and can reasonably be attributed to the arrival of fentanyl in the State; and

WHEREAS, the availability and affordability of fentanyl contributes to its dramatically increasing use within the State. According to the DEA, fentanyl has a street price of less than $20 for a single dose; and

WHEREAS, according to the Honolulu Emergency Services Department, currently three out of every ten overdose calls to emergency medical services involve fentanyl, and, according to the CDC, one person in the State dies of an overdose every twenty-eight hours; and

WHEREAS, effective United States Food and Drug Administration-approved medications that treat opioid addition, including buprenorphine, naltrexone, and methadone, are available yet underutilized by Hawaiʻi's health providers, thus further increasing the risk of opioid overdoses and deaths; and

WHEREAS, public health experts, including those at the CDC and the Substance Abuse and Mental Health Services Administration, recommend increasing access of naloxone hydrochloride, a pure opioid antagonist, to prevent death due to opioid overdose; and

WHEREAS, studies have found that providing opioid overdose training and naloxone kits can help people identify signs of an opioid-related drug overdose and can help reduce opioid overdose mortality. Naloxone distribution programs also are endorsed by the American Medical Association as a best practice to prevent overdose-related injuries and deaths; and

WHEREAS, the Legislature has a precedent of enacting laws that support expanded access to opioid antagonists and the role of registered pharmacists in the education, administration, dispensing, and prescription of opioid antagonists; and

WHEREAS, the Legislature also recently passed Act 111, Session Laws of 2023, which decriminalizes fentanyl test strips, thus allowing people to easily detect contaminated drugs and avoid accidental and fatal drug overdoses; and

WHEREAS, because unhealthy drug use is multifactorial, coordinated interagency collaboration and public-private partnerships are also necessary to effectively combat the opioid and fentanyl epidemic through various approaches, including but not limited to education and prevention; screening and early intervention; drug treatment, recovery support, and harm reduction services; and increased drug interdiction and law enforcement efforts; and

WHEREAS, one example of an ongoing interagency collaboration is the Hawaiʻi Island Fentanyl Task Force, which was formed with the mission to reduce the demand and supply of illicit drugs in all age groups through the foregoing coordinated interagency approach; and

WHEREAS, since its establishment, the Hawaiʻi Island Fentanyl Task Force has worked with national organizations, state and county agencies, nonprofit organizations, and numerous individuals to:

(1) Produce public service announcements, print media, and social media awareness and educational campaigns regarding fentanyl;

(2) Present over four hundred educational sessions in schools and to community groups;

(3) Provide over twelve thousand Narcan kits to communities at dozens of pop-up events island wide;

(4) Collaborate with the Hawaiʻi county police and fire departments to develop a drug addiction and overdose resource card for patrol police officers and emergency medical services first responders; and

(5) Convene two Island-wide summits, one in 2022, and one in 2023, and a recent statewide stakeholder training on Fentanyl Task Force engagement and awareness; and

WHEREAS, as evidenced by the accomplishments of the Hawaiʻi Island Fentanyl Task Force, interagency collaboration and public-private partnerships between the State, counties, and other stakeholders should be expanded to address the fentanyl epidemic on other islands as well; now, therefore,

BE IT RESOLVED by the Senate of the Thirty-second Legislature of the State of Hawaii, Regular Session of 2024, the House of Representatives concurring, that the State and counties are urged to prioritize and direct all available resources to supporting coordinated interagency collaboration and public-private partnerships aimed at addressing the ongoing fentanyl epidemic; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to Hawaii's Congressional delegation; the Administrator of the centers for Medicare and Medicaid Services; Governor; Director of Health, who is requested to distribute copies of this concurrent resolution to all hospital medical directors and chief executive officers of hospitals and substance use disorder treatment and recovery programs operating in the State; Director of Human Services; Superintendent of Education; Director of Law Enforcement; State Public Defender; Chief Justice of the Hawaii Supreme Court; Insurance Commissioner, who is requested to distribute copies of this concurrent resolution to all health insurers in the State; Chairperson of the Hawaii Medical Board, who is requested to distribute copies of this concurrent resolution to all medical practitioners licensed in the State; and the Mayors, Chiefs of Police, and Prosecuting Attorneys of each county.

	OFFERED BY:	_____________________________

Report Title:

Interagency Collaboration; Public-Private Partnerships; State; Counties; Fentanyl Epidemic

THE SENATE	S.C.R. NO.	64
THIRTY-SECOND LEGISLATURE, 2024
STATE OF HAWAII