Pubdate: Mon, 21 Dec 2015
Source: Honolulu Star-Advertiser (HI)
Copyright: 2015 Star Advertiser
Author: Susan Essoyan


A Nonprofit Group Has Ranked Hawaii No. 6 for the State's Rate of 
Fatal Substance Use

We don't have nearly the extreme kind of heroin epidemic that you see 
on the mainland. ... What we most commonly see kids overdose with in 
Hawaii is still alcohol poisoning." Colleen Fox Director of 
adolescent programs, Hina Mauka

Hawaii has the sixth-lowest rate among the states of youth dying from 
drug overdoses, but the figure is trending upward across the country, 
according to a new report from the Trust for America's Health.

The rate of deadly overdoses more than doubled in the islands between 
2001 and 2013, said the report, "Reducing Teen Substance Misuse: What 
Really Works." In 12 states the figure more than tripled, and in five 
states it more than quadrupled during that time.

The rate of fatal drug overdoses in Hawaii was 4.6 per 100,000 people 
age 12 to 25, compared with the national average of 7.3 per 100,000. 
The figures are the most recent available, a three-year average of 
20112013 data. In the three years ending in 2001, the Hawaii rate was 
1.6, while the national rate was 3.1.

"In Hawaii we are fortunate that we tend to have lower rates of 
substance abuse than what you see among youth on the mainland," said 
Colleen Fox, director of adolescent programs for Hina Mauka, which 
offers substance abuse prevention and treatment. "There is a lot of 
family support, which is a protective element here. And the 
Department of Health and our legislators are really committed to 
youth, and that really makes a difference."

West Virginia witnessed the highest toll, with 12.6 youths per 
100,000 dying of drug overdoses. North Dakota was lowest at 2.2 per 
100,000, according to the report.

The Trust for America's Health is a nonprofit, nonpartisan health 
advocacy organization based in Washington, D.C.

"While there is still work to be done, we feel that the state has 
made good progress and will continue our efforts," said Edward 
Mersereau, chief of the Alcohol and Drug Abuse Division of the state 
Department of Health. He pointed to the state's prescription drug 
monitoring program and expanded Medicaid coverage of substance abuse 
treatment, among other factors.

The increase in youth drug overdose deaths nationwide stems largely 
from prescription drug misuse and use of heroin as an alternative, 
the group said. While heroin does reach Hawaii's shores, it has not 
taken hold as it has in some mainland communities.

"We don't have nearly the extreme kind of heroin epidemic that you 
see on the mainland," Fox said. "That is where a large amount of 
these overdoses are coming from. ... What we most commonly see kids 
overdose with in Hawaii is still alcohol poisoning."

Prescription drugs do present a problem in the islands as young 
people raid medicine cabinets and sample the contents without knowing 
what they are using.

"Kids often don't know what they're taking," Fox said. "They buy them 
from other students. They are mixing. So they are particularly 
dangerous and can cause overdoses because of that."

There have also been more overdoses involving Spice, a form of 
synthetic marijuana that can be quite toxic, she said.

The report, released last month, scored each state on its efforts to 
prevent substance abuse. Hawaii placed near the middle of the pack 
with 5 out of 10 possible points. Minnesota and New Jersey came out 
on top with 10 out of 10.

Hawaii got points for policies such as preventing smoking in public 
places, treatment for prescription drug misuse and good-Samaritan 
laws to encourage seeking help in overdose cases.

But it came up short on other factors, including insufficient 
treatment for teen depression and mental health funding, according to 
the report.

"More than 90 percent of adults who develop a substance-use disorder 
began using before they were 18," said Jeffrey Levi, the trust's 
executive director. "Achieving any major reduction in substance 
misuse will require a reboot in our approach - starting with a 
greater emphasis on preventing use before it starts, intervening and 
providing support earlier and viewing treatment and recovery as a 
long-term commitment."

The report advised investing in evidence-based programs that reduce 
risk factors for substance abuse, in the community and schools. It 
also calls for more money for sustained mental health and substance 
use treatment and recovery.

In Hawaii, substance abuse treatment is available to students in 
almost every middle and high school, Fox said.

The report said that screening via age-appropriate questionnaires and 
intervention by trained professionals should be routine for preteens 
and teens in doctor's offices, emergency rooms and schools.

"Brief interventions - even a few minutes of counseling - have been 
shown to help reduce alcohol and drug misuse in youth," it said.
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MAP posted-by: Jay Bergstrom