Take steps now to stem opioid abuse

There’s no need to panic about opioid addictions in Hawaii, but it does deserve some rational attention, before it becomes an actual crisis here as it is in many mainland states.

So it’s encouraging to see Hawaii officials turning toward the issue, perceiving correctly that while opioid abuse here remains well below national averages, it’s still on the increase. It’s better to get ahead of this concern now, before it becomes the vexing, uncontrolled problem it is elsewhere.

Opioids — narcotics such as morphine, methadone, hydrocodone and oxycodone — are powerful drugs that can be effective but also are highly addictive.

State officials say that dependence on such pain medications affects about 150,000 Hawaii residents, struggling with addiction. While Hawaii ranks eighth lowest in the U.S. for opioid mortalities, the startling observation is that this figure is way up from the 50,000 people addicted to opioids a decade ago.

That assessment came from Edward Mersereau, chief for the state Alcohol and Drug Abuse Division, an agency of the state Department of Health. Mersereau unveiled a plan to lawmakers that the state hopes, starting in January, will begin to reduce opioid abuse in the islands.

The plan was designed with a $200,000 grant lawmakers approved last session. The Health Department plans to seek another $200,000 next legislative session.

Although more details are needed on how this money would be spent, the outline Mersereau described was of creating a new law enforcement diversion program. This would allow officers to intercept suspects of low-level substance abuse crimes and divert them to treatment instead of arresting them.

Officials also are working on a unified phone system to simplify finding appropriate treatment, and establishing prescription drug drop boxes within police stations statewide.

It’s all well worth a discussion. Opioids are prescribed to roughly 400,000 patients in Hawaii annually, so the exposure to potential problems is plain.

At the heart of the state’s strategy, Mersereau said, is treating addiction like a chronic illness, such as diabetes or cancer. The expenditures on a new program will require careful examination. Tools already exist that could be used to full potential.

For example, the state has an online Hawaii Prescription Monitoring Program that could help physicians and pharmacists anticipate patient vulnerability to addiction. Only about 10 percent of the health care providers have signed up for the monitoring program, despite the fact that state law mandates that they do so.

That has to change, and the state needs to intensify education campaigns.

Another law passed last session limits new opioid prescriptions to seven days. That’s because a patient can become dependent on the drug in about three weeks. Habitual use can stop a patient’s breathing and heart, which can be fatal when combined with other depressants.

Among other possible course corrections would be a drive to promote better insurance coverage for the use of non-opioid treatments for ailments. Attorneys general from 37 states, including Hawaii, sent a letter to the president of America’s Health Insurance Plans promoting alternatives such as acupuncture.

Beyond the AGs’ initiative, more study is needed to evaluate another chronic-pain treatment that can divert patients from opioids: medical cannabis. In Colorado, where even recreational marijuana is legal, a new study found that since legalization, there’s been a significant decline in opioid overdoses.

Rightly, medical professionals in that state are withholding judgment — more data are needed.

But the time has come to think about opioid addictions in a new way. Investment in solutions would be wise, the payoff being the suffering that’s prevented and the lives that can be saved.