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Hawaii Opioid Summary

Revised March 2019

Opioid-Related Overdose Deaths

Hawaii has one of the lowest age-adjusted rates of drug overdose deaths involving opioids. In 2017, there were 53 drug overdose deaths involving opioids—a rate of 3.4 deaths per 100,000 persons. There has been no overall change in the number of overdose deaths involving prescription opioids in the last decade, with 40 deaths reported in 2017. Ten deaths involving heroin were reported in 2017 and like those involving prescription opioids, no significant change has been seen since data collection began in 2013.  Even less data is available on deaths involving synthetic opioids other than methadone (mainly fentanyl) with no reported deaths submitted in 2017.

See textFigure 1. Number of overdose deaths involving opioids in Hawaii, by opioid category. Drug categories presented are not mutually exclusive, and deaths might have involved more than one substance. Source: CDC WONDER.

Opioid Pain Reliever Prescriptions

In 2017, Hawaii providers wrote 37.0 opioid prescriptions for every 100 persons (Figure 2), compared to the average U.S. rate of 58.7 prescriptions. This was among the lowest rates in the United States that year (CDC). This was also the lowest rate in the state since data became available in 2006. The age-adjusted rate of overdose deaths involving opioid prescriptions has also followed a decreasing trend from a peak of 4.8 deaths per 100,000 deaths in 2007 to 2.5 deaths per 100,000 persons in 2017.

See textFigure 2. Hawaii age-adjusted rate of overdose deaths involving prescription opioids and the opioid prescribing rate. Source: CDC and CDC WONDER.

Neonatal Abstinence Syndrome (NAS)

NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOWS births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).

Recent rates of NAS/NOWS in Hawaii are not available. The most recent findings were reported for 2013 when the rate was 0.7 per 1,000 hospital births (CDC).

See textFigure 3. NAS/NOWS Incidence rate and hospital costs for treatment in the United States. Source: T.N.A. Winkelman, et al., 2018.

HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)

See textFigure 4. Hawaii: Estimated percent of male vs. female with new HIV diagnoses, by transmission category, 2016. Source: CDC and www.AIDSVU.org.
  • U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among males, 6.3 percent (2,530) of new cases were transmitted via IDU or male-to-male contact and IDU. Among females, 2.3 percent (950) were transmitted via IDU (CDC).
  • U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,4661) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
  • State Incidence: Of the new HIV cases in 2016, 82 occurred in Hawaii. Among males, 13.7 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 22.2 percent of new HIV cases were attributed to IDU (Figure 4)(AIDSVu).
  • State Prevalence: In 2015, an estimated 2,788 persons were living with a diagnosed HIV infection in Hawaii—a rate of 233 cases per 100,000 persons. Of those, 13.0 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 25.1 percent were living with HIV attributed to IDU (AIDSVu). 

Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use1

  • U.S. Incidence:In 2016, there were an estimated 41,200 new cases of acute HCV2 (CDC). Among case reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
  • U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
  • State Incidence: This data is not available for the state of Hawaii (CDC).
  • State Prevalence: In Hawaii, there are an estimated 6,800 persons living with Hepatitis C (2013-2016 annual average), a rate of 610 cases per 100,000 persons (HepVu).

Additional Resources

NIH RePORTER FY2018 NIH-funded projects related to opioid use and use disorder in Hawaii: 0


  1. Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
  2. Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.

This page was last updated March 2019

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