Honolulu may become the first city to require bars and nightclubs to keep naloxone, known by brand names such as Narcan, on-site to minimize opioid overdose deaths in high-risk areas.
"The opioid crisis is real," said Tyler Dos Santos-Tam, the councilman who proposed the bill that passed the Honolulu City Council on Wednesday.
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"Just a month ago, two people died in a mass overdose in Waikiki. That’s two families that lost a child, a sibling, or an uncle. Three more were sent to the hospital. ... This bill takes action: it puts a life-saving medication in the places that need it. It will prevent more tragedies, like what happened in Waikiki, from happening again," Dos Santos-Tam said.
In March, the Food and Drug Administration granted approval for a 4-milligram dose of naloxone to be dispensable over the counter without a prescription due in part to the rising rate of opioid overdoses nationwide.
Although taking naloxone is effective in a majority of cases in reversing the effects of opioid overdose, patients still need emergency medical care to ensure that enough of the medication has been administered to prevent further complications or relapse.
To help with this, several states have enacted good Samaritan laws for witnesses of illicit drug overdoses to call 911 to obtain emergency services without retribution for participating in illegal activity. These laws have been found in some cases to lower the number of opioid overdose deaths by as much as 15%.
Several states and municipalities have also established programs to provide naloxone for free to those who might benefit from access to the lifesaving drug, but Honolulu is the first to make it mandatory. Every business with a liquor license in Honolulu will receive a free naloxone starter pack from the Honolulu Liquor Commission, which will be responsible for enforcing the naloxone requirement.
"We are witnessing an alarming increase in the use of fentanyl which has infiltrated into our communities. ... We believe this bill will save lives," said Jim Ireland, director of the Honolulu Emergency Services Department.
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The Centers for Disease Control and Prevention reported a total of 253 overdose deaths in the state of Hawaii from February 2022 to February 2023, 168 of which were caused by either natural or synthetic opioids. Psychostimulants were the second-highest overdose category at 165 deaths.
The measure passed by the City Council has been sent to Mayor Rick Blangiardi, who has until July 22 to sign the bill into law.