1. Initiatives Toward A Public Health Approach
Wellness
Alcohol and Drug Abuse Division
Hawaii State Department of Health

2. State Trends In Substances – Other Than Opioids
Alcohol
Methamphetamine

3. Alcohol Comparison of Indicators – Hawaii vs. National Adults
Measure
Hawaii Value
National Value
Binge drinking among adults
18.9%
16.3%
Alcohol impaired driving deaths
39.4%
30.0%
Drinking and driving
4.1%
1.8%
Adolescents
Measure
Hawaii Value
National Value
Binge drinking
Girls11.2% / Boys 8.8%
Girls 16.8% / Boys 18.6%
Rode with driver who had been drinking
37.1%
28.3%
Any alcohol use
25.1%
32.8%

4. Source: Center for Disease Control’s Behavioral Risk Factor Surveillance System, 2013

5. Source: National Survey on Drug Use and Health, 2016

6. Methamphetamine
Meth use and treatment admissions in Hawai’i are considerably higher than the national average1
Estimated cost of meth abuse is $500 million/year2
Positive meth workplace drug testing is 410% higher in Hawai’i than the national average3
79% of drug-related crimes are related to meth abuse1
More than 4,500 Hawai’i high school students reporting using meth at least once4
1. Treatment Episode Data Set (TEDS) 2002 – 2012 National Admissions to Substance Abuse Treatment Services.
2. Estimate based on RAND, The Economic Cost of Methamphetamine Use in the United States, Published in February 2009.
3. Quest Diagnostic Drug Testing Index – September 2, 2011.
4. Center for Disease Control Youth Online: High School YRBS Hawaii 2013 Results.

7. Percent of Meth-Related Drug Convictions in Federal Court, 2015
Nationally, methamphetamine played a role in 28.5% of drug convictions in federal court. In Hawaii, meth was part of nearly 94% of such cases.
Percent of Meth-Related Drug Convictions in Federal Court, 2015
SOURCE: U.S. Sentencing Commission.

8. Primary Substance Used at Admission for Adults 18-49, 2010-16
In 2014, methamphetamine, also known as “ice,” was the most frequently reported primary substance at the time of admission (49.9%), followed by alcohol (21.4%). The same trend was held for the 5-year period (42.4% % and 21.4% %). The percentage of adults 18 to 49 years reporting methamphetamine as the primary substance increased from 44.3% in 2010 to 49.9% in In contrast, the percentage of adults reporting alcohol as primary substance declined from 30.0% in 2010 to 21.4% in 2014.
Primary Substance Used at Admission for Adults 18-49,
SOURCE: Alcohol and Drug Abuse Division (ADAD), Hawai’i Department of Health.

9. Primary Substance Used at Admission for Adults 18-49 by Gender, 2016
The most frequently used substance at admission was methamphetamine for both males and females (48.7% and 52.7% of males and females, respectively), followed by alcohol (22.2% and 19.7% of males and females, respectively). Higher percentages of males reported alcohol and marijuana as the primary substance used at the time of admission compared to those of females (22.2% and 17.3% of males vs. 19.7% and 15.6% of females for alcohol and marijuana, respectively). In contrast, a higher percentage of females reported methamphetamine as the primary substance compared to that of males (52.7% of females vs. 48.7% of males).
Primary Substance Used at Admission for Adults by Gender, 2016
SOURCE: Alcohol and Drug Abuse Division (ADAD), Hawai’i Department of Health.

10. Meth Use Nearly Doubles among Older Adults in Hawaii
While the news about the effectiveness of Hawaii drug treatment programs has been positive, there has been one disturbing trend: the percentage of adults 50 years and older that reported methamphetamine as their primary substance has nearly doubled in the past five years. This is according to the state Dept. of Health’s newly published 2015 Alcohol and Drug Treatment Services Report.
Meth Use Nearly Doubles among Older Adults in Hawaii
SOURCE: Alcohol and Drug Abuse Division (ADAD), Hawai’i Department of Health.

11. For adults 50 years and older, alcohol was the most frequently used primary substance at the time of admission (43.7% %), followed by methamphetamine (22.5% %) across the five reporting years. Although this trend held across all reporting years, unlike previous years, in 2014, the differences between percentages of adults using methamphetamine and alcohol was minimal (43.7% reporting alcohol vs. 41.1% reporting methamphetamine). The percentage of older adults using methamphetamine as the primary substance has significantly increased from 22.5% in 2010 to 41.1% in In contrast, those using alcohol as the primary substance declined from 58.1% in 2010 to 43.7% in 2014.
Primary Substance Used at Admission for Adults 50 Years and Older,
SOURCE: Alcohol and Drug Abuse Division (ADAD), Hawai’i Department of Health.

12. In 2014, marijuana was the primary substance for the majority of adolescents (61.2%), followed by alcohol (28.1%). Across all reporting years, the same trend was observed (59.5% % and 28.1% % for marijuana and alcohol, respectively).
Primary Substance Used at Admission for Adolescents Under Age 18,
SOURCE: Alcohol and Drug Abuse Division (ADAD), Hawai’i Department of Health.

13. Nationally, drug overdose deaths involving psychostimulants with abuse potential, which include drugs such as methamphetamine, increased from 5% in 2010 to 11% in 2015.
Heroin 8 23 25
Natural and semisynthetic opioids 24 26 29
Methadone 6 7 12
Synthetic opioids excluding methadone 18
2010
2014
2015
Cocaine 11
12 13
Psychostimulants with abuse potential 5 9 10 15
Percent 20 30
Hedegaard H, Warner M, Miniño AM. Drug overdose deaths in the United States, 1999–2015. NCHS data brief, no 273. Hyattsville, MD: National Center for Health Statistics

14. State Response and Initiatives
Focus on Addiction as a Chronic Disease
Impact on wide spectrum of social problems facing the State
Coordinated approach across systems

16. Thinking in “WE” gives us a broader view of the way things are so we can be better systems engineers.

21. Focus on Addiction as a Chronic Disease
Public Wellness Approach
Expand prevention component and scope
SBIRT
Opioid STR
Impact on wide spectrum of social problems facing the State
Homelessness
Criminal Justice
Law Enforcement Assisted Diversion (LEAD)
Coordinated approach across systems
Coordinated Service Contracts
Outcomes driven resource allocation

22. Questions?