Hawaii Drug and Alcohol Statistics - Methadone dot org (NAMA Recovery)

Statistical Data on Drugs in Hawaii

Hawaii faces a persistent and escalating substance abuse emergency with overdose deaths reaching 22 per 100,000 residents in 2023—a 95% surge since 2013—as methamphetamine dominates the crisis, accounting for 62% of all overdose fatalities. The Pacific state’s unique challenges include the nation’s most severe treatment gap with only 18,000 people accessing care annually while 91,000 require intervention, compounded by methamphetamine addiction rates among the unhoused population reaching 74% and fentanyl deaths increasing 6-fold since 2019. Despite maintaining overdose rates 32% below the national average and operating 177 treatment facilities, Hawaii continues confronting geographic disparities where rural counties experience overdose rates 65% higher than urban areas, while Native Hawaiian communities face disproportionate substance abuse burdens in a state where illicit drug use has consistently exceeded national averages by 25% since 2007.

Overall Drug Overdose Statistics

Statewide Overdose Deaths (2023)

Total overdose deaths: 320 deaths (22 per 100,000 residents)
Previous reporting (2020): 242 deaths (15.9 per 100,000 residents)
National comparison: 23.19% below national average death rate (2020), 32% lower than US rate (2023)
Trend analysis: 2.93% annual increase over last 3 years, 95% increase since 2013, 50% increase since 2018

Hawaii Drug Overdose Statistics

Hawaii has experienced a dramatic escalation in overdose deaths, nearly doubling since 2013 despite remaining below national averages. The acceleration in recent years indicates an intensifying crisis requiring immediate attention.

County-Level Overdose Death Rates (2023)

County	Deaths per 100,000
Maui County	33.5
Kauai County	32.5
Honolulu County	20.2
Hawaii County	19.7

Significant geographic disparities exist, with rural counties (Maui and Kauai) experiencing overdose rates 65-70% higher than the more populated counties, suggesting rural areas face greater substance abuse challenges.

Historical Overdose Trends (2016-2020)

Year	Total Deaths	Death Rate
2016	249	2.5% of all deaths
2017	225	1.9% of all deaths
2018	226	2.2% of all deaths
2019	265	2.3% of all deaths
2020	266	2.2% of all deaths

After a dip in 2017-2018, overdose deaths surged in 2019 and remained elevated, indicating a stabilization at higher levels before the dramatic increase to 320 deaths by 2023.

Methamphetamine Crisis

Methamphetamine Dominance

2023: 62% of total overdose deaths involved methamphetamine
2022: 64% of overdose deaths involved psychostimulants (primarily methamphetamine)
Treatment admissions: 48% of drug treatment admissions (2012), 34.2% of substance use disorder cases
Historical progression: 31.9% of treatment admissions (2007) → 48% (2012) → ~45% (2022 estimate)

Hawaii Methamphetamine Crisis Statistics

Methamphetamine-Specific Statistics

Workplace drug positivity: Notably higher than national benchmarks
Geographic concentration: 86% lifetime use among Hawaii County’s unhoused population
Price volatility during COVID-19: $350/ounce (early 2020) → $2,100/ounce (mid-2020) → $650/ounce (end 2020)
Polysubstance use: 28% combined with marijuana, 38.6% combined with alcohol
Prison population: Nearly 35% of men imprisoned in Honolulu had ingested meth

Methamphetamine has emerged as Hawaii’s most severe drug crisis, showing consistent growth in treatment admissions and overdose involvement over two decades. The COVID-19 price fluctuations demonstrate how external factors can dramatically impact drug markets.

Opioid Crisis

Opioid Overdose Statistics (2023)

Total opioid deaths: 133 (9.4 per 100,000 residents)

National comparison: 60.8% lower than national opioid death rate
Percentage of all overdoses: 41.6% involve opioids
Fentanyl involvement: 85% of all opioid overdose deaths involve synthetic opioids (primarily fentanyl)
Heroin involvement: 10.5% of opioid overdose deaths
Prescription opioids: 15% of opioid overdose deaths

Opioid Trends and Prescription Data

Trend increase: 54% increase in opioid-related fatalities from 2018 (4.1 per 100k) to 2021 (6.3 per 100k)
Fentanyl growth: Deaths increased 6.2 times between 2019-2023
Prescription rate: Doctors write prescriptions for 22.6% of residents (33.4 per 100 persons in 2018)
National comparison: Below US average of 51.4 prescriptions per 100 persons
Neonatal impact: 3.2 per 1,000 births diagnosed with neonatal Opioid Withdrawal syndrome (2020)

While Hawaii’s opioid death rates remain below national averages, the rapid growth in fentanyl-related deaths and the dominance of synthetic opioids indicate an evolving and dangerous opioid landscape.

Marijuana Usage Patterns

Marijuana Usage Statistics

Past-year users: 175,000 people (15.23% of population 12+)
Past-month users: 135,000 people (11.72% of population 12+)
Treatment admissions: 38% (2012), stabilized at 21.8% (2022)
Youth statistics: 133,000 past-year users, 13.73% of 12-17 year olds

Marijuana Perceptions

Risk perception decline: 273,000 individuals view monthly use as high-risk (2020)
Age group differences: 12.95% of 18-25 year olds vs 25.21% of 26+ view monthly use as great risk
Treatment vs alcohol: Marijuana treatment admissions (21.8%) outpaced alcohol-only cases (14.2%) in 2022

Youth Marijuana Usage Trends

Survey Year	Lifetime Use (High School)	Use Before Age 13
2015	~46%	13.8%
2017	~48%	14.2%
2020	~44%	13.5%

Marijuana remains the most widely used illicit substance with relatively stable patterns. However, early initiation rates among youth and declining risk perceptions suggest potential for increased future problems.

Trends and Projections

Historical Patterns (2007-2023)

Illicit drug use: Consistently 10% in Hawaii vs 8% national average since 2007
Methamphetamine: Persistent growth from 31.9% (2007) to 62% of overdose deaths (2023)
Overall overdose deaths: 69% increase from 2013 to most recent reporting
Opioid deaths: 54% increase from 2018-2021

Hawaii Drug Use Historical Patterns Statistics

Recent Concerning Trends

Emergency department visits: 77.5% increase in drug-related visits (2021-2022)
Meth hospitalizations: 39% increase in overdose hospitalizations (2021-2022)
Counterfeit pills: Increasing trafficking of fentanyl-laced oxycodone
Polysubstance use: Growing complexity in substance use patterns

Hawaii’s substance abuse landscape shows persistent and worsening trends across multiple indicators. The combination of increasing overdose deaths, rising emergency department visits, and limited treatment capacity suggests the crisis will continue to intensify without significant intervention.

Youth and Adolescent Substance Use

Overall Youth Statistics (Ages 12-17)

Illicit drug use: 7,000 youth (7.26% of 12-17 year olds) used drugs in past month
Alcohol use: 6.54% used alcohol in past month (4.87% less likely than national average)
Drug use comparison: Equal to national average for teen drug use
Substance use disorders: 5.20% met criteria for drug use disorder, 3.29% for alcohol use disorder

Specific Youth Drug Usage

Marijuana dominance: 71.43% of youth drug users reported marijuana use
Annual marijuana use: 9.70% of 12-17 year olds
Cocaine use: 0.20% annual use
Methamphetamine: 0.13% annual use
Pain relievers: 1.60% annual misuse

High School Polysubstance Use (2025 Data)

Triple use: 5% (1 in 20) used alcohol, nicotine, and cannabis in past 30 days
Dual use: 9.5% used both nicotine and cannabis in past 30 days
Treatment admissions: 67.2% of youth treatment admissions involved marijuana

Youth substance use patterns show marijuana as the primary concern, with concerning polysubstance use patterns emerging. The relatively low rates of hard drug use among youth is encouraging, though early marijuana initiation remains problematic.

Adult Substance Use Patterns

Young Adults (Ages 18-25)

Past-month drug use: 28,000 individuals (25.65% of age group)
National comparison: 10.12% less likely to use drugs than national average
Polysubstance use: 26.5% used combination of alcohol, nicotine, and cannabis
Geographic concentration: Highest prevalence in Hawaii County communities

Hawaii Drug Use Young Adults Statistics

Adult Usage by Substance (2019-2020 Average)

Substance	Past Month Users	Percentage of 12+ Population
Marijuana	135,000	11.72%
Illicit drugs other than marijuana	34,000	2.93%
Past year cocaine	21,000	1.83%
Past year methamphetamine	10,000	0.83%
Prescription pain reliever misuse	32,000	2.79%

Adult substance use shows marijuana as the dominant illicit substance, with concerning levels of polysubstance use particularly among young adults. The geographic concentration in Hawaii County suggests regional factors influencing use patterns.

Treatment Statistics and Capacity

Treatment Demand vs. Capacity

Annual treatment capacity: 17,000 people accessed treatment (2015-2018 average)
Unmet need: 91,000 people met clinical criteria for treatment
Treatment gap: Only 18.7% of those needing treatment received it
Historical data: 98% of those needing substance use disorder treatment did not receive it (2010-2012)

Hawaii Drug Treatment Demand vs Capacity Statistics

Treatment Facility Distribution

Total facilities: 177 substance abuse facilities (105 in 2006)
Geographic concentration: 67% of treatment facilities on Oahu
Annual patients served: 5,217 total patients
Service breakdown: 4,511 outpatient patients, 706 residential patients
Free treatment: 78 facilities offer free treatment
Specialized services: Only 3 methadone clinics statewide (2023)

Treatment Costs

Service Type	Individual Cost	State Ranking
Residential treatment	$58,810	41st (cheapest to most expensive)
Outpatient services	$1,536	3rd cheapest nationally

Federal Funding

Per capita federal grants: Trail national averages by 31%
Outpatient spending: $6.93 million (0.3% of US total)
Residential spending: $41.52 million (0.8% of US total)

Hawaii faces a severe treatment capacity crisis, with less than 20% of those needing treatment able to access it. The geographic concentration of services on Oahu leaves rural populations particularly underserved, despite having some of the highest overdose rates.

Demographics and Vulnerable Populations

Treatment Demographics

Gender distribution: 65.5% male, 34.5% female in treatment (2010)
Age of first use: 11.8% began before age 12, 53.8% began ages 12-17
Ethnic composition: 44.6% Native Hawaiian, 15.9% White, 11% Pacific Islander, 8.9% Filipino

Native Hawaiian Disparities

Youth drug use: 2-3 times higher than some Asian subgroups
Historical rates: 12.5% past-month illicit drug use (2007) vs 8.1% for white peers
Treatment admissions: Overrepresented in youth treatment programs

Unhoused Population (Hawaii County Survey)

Methamphetamine use: 86% lifetime use, 74% current addiction
Prescription pills: 60% illicit use
Heroin use: 33% lifetime use
Opioid addiction: 12% screened positive (6 times US population rate)
Mental health: 57% clinical depression, 56% anxiety disorder
Overall health: 86% reported fair/poor health

Gender-Specific Statistics

Category	Male	Female
Overdose deaths (2020)	188	77
Treatment admissions (2010)	65.5%	34.5%
Women’s prescription misuse (18-49)	N/A	12.8%

Significant demographic disparities exist, with Native Hawaiian populations facing disproportionate substance abuse challenges. The unhoused population shows extreme levels of substance use disorders, indicating the intersection of homelessness and addiction requires targeted interventions.

Geographic Variations

Regional Substance Use Patterns

Hawaii County: Highest community prevalence of substance co-use and poly-use
Northern Hawaii County: 18.4% co-use cannabis and alcohol
Statewide cannabis-alcohol co-use: 11.4% of Hawaii Island residents
Treatment facility distribution: Severe rural-urban divide with 67% of facilities on Oahu

County-Level Treatment Needs

Rural access: Some rural areas have significantly limited recovery support
Meth accessibility: Higher in rural Oahu and Maui, impacting Native Hawaiian youth
Emergency services: Limited specialized drug treatment in outer islands

Geographic disparities create a two-tiered system where urban residents have significantly better access to treatment resources, while rural populations face both higher substance use rates and fewer treatment options.

The data reveals Hawaii faces a complex and intensifying substance abuse crisis characterized by methamphetamine dominance, significant treatment gaps, and stark geographic disparities. While some indicators like prescription opioid deaths show improvement, the overall trajectory indicates a public health emergency requiring comprehensive, culturally appropriate interventions that address both the immediate crisis and underlying social determinants of health.

Statistical Data on Alcohol in Hawaii

Alcohol abuse presents a multifaceted public health challenge in Hawaii, with the state recording 526 annual alcohol-related deaths while maintaining paradoxical patterns that include below-national-average mortality rates yet the nation’s highest excessive drinking rates among seniors at 11%. Hawaiian residents demonstrate complex consumption behaviors, including binge drinking affecting 20.9% of adults with particularly intensive patterns among heavy users who consume a median 9.2 drinks per binge episode, while simultaneously achieving the 7th lowest youth drinking rates nationally. The economic toll reaches $1.265 billion annually when adjusted for inflation, with taxpayers bearing costs equivalent to $2.13 per alcoholic drink consumed, as over 113,000 residents require but cannot access specialty alcohol treatment services. These statistics illuminate a state experiencing a 48% surge in alcohol death rates since 2015 alongside persistent treatment gaps affecting nearly 10% of the population, creating urgent demands for targeted interventions that address Hawaii’s unique demographic vulnerabilities and geographic barriers to care.

Overall Alcohol-Related Deaths and Mortality

Annual Alcohol-Related Deaths

Total annual deaths: 526 deaths attributable to excessive alcohol use
Under 21 deaths: 2.3% of all alcohol deaths (approximately 12 deaths)
Death rate: 8 per 100,000 residents (2020)
National comparison: Below national average of 13.1 per 100,000 residents
Adult death rate: 4.59 deaths per 10,000 adults (1 death per 2,767 adults aged 18+)

Hawaii Alcohol Overdose Statistics

While Hawaii’s overall alcohol death rate remains below national averages, the state still experiences over 500 preventable deaths annually, indicating significant public health impact despite relatively favorable mortality statistics.

Historical Death Rate Trends

5-year increase (2015-2019): Up to 48% increase in excessive alcohol death rate per capita

5-year average deaths (2015-2019): 204 deaths per year

155 males over 21
49 females over 21
8 males under 21
3 females under 21

The dramatic 48% increase in alcohol death rates over just four years indicates an accelerating crisis, despite maintaining below-average national rates.

Demographics of Alcohol Deaths

Demographic	Percentage	Analysis
Male deaths	72.6%	Significantly higher than female deaths
Chronic causes	61.2%	Primarily Alcohol Use Disorder
Adults 35+	87.8%	Overwhelming majority are older adults
Under 21	2.28%	Relatively low youth mortality

Specific Cause Breakdown (5-year average 2015-2019)

Cause of Death	Annual Average
Alcohol Dependence Syndrome	19 deaths
Coronary Heart Disease (alcohol-related)	36 deaths
Suicides due to alcohol	48 deaths
Homicides due to alcohol	16 deaths

Alcohol-related suicides represent the single largest category of specific alcohol deaths, highlighting the mental health dimensions of alcohol abuse in Hawaii.

Risk Perceptions and Behavioral Patterns

Risk Perception Statistics

Perceive 5+ drinks as great risk: 506,000 people (43.98% of population 12+)
Adults perceiving risk: 464,000 people (43.86% of adults)
Alternative measure: 47.62% perceive drinking 5+ drinks in one session as great risk

Age-Based Risk Perceptions

Age Group	Great Risk Perception	Behavioral Correlation
12-17 years	45.18%	Higher awareness, lower use
18-25 years	40.47%	Lowest risk perception, highest use
26+ years	44.28%	Moderate perception and use

Young adults demonstrate the lowest risk perception (40.47%) while simultaneously showing the highest consumption rates, indicating a critical disconnect between awareness and behavior in this demographic.

Geographic and Demographic Variations

Community-Specific Patterns

Rural communities: Alcohol primary driver in 59.1% of treatment admissions
Pacific Islander populations: Higher alcohol treatment admission rates in rural areas
Binge drinking variations: 33.8% binge drinking rate (2017-2019) aligned with national figures

Gender Disparities

Male alcohol deaths: 72.6% of all excessive alcohol deaths
Male vs. female risk: Males face significantly higher mortality risk
Gender-specific treatment needs: Require targeted gender-specific interventions

Hawaii Alcohol Geographic and Demographic Variations Statistics

Significant disparities exist both geographically and demographically, with rural Pacific Islander communities and male populations facing disproportionate alcohol-related harms requiring culturally appropriate and gender-specific interventions.

Historical Trends and Comparative Analysis

Long-term Patterns (2005-2020)

2005-2006 baseline: All age groups at or below national rates
2015-2019 trend: Up to 48% increase in death rates
Current status: Below national death rates but concerning local increases
Youth success: Maintained position among lowest 10 states for youth drinking

National Comparisons

Metric	Hawaii Rate	National Average	Hawaii Ranking
Youth drinking (12-17)	6.2%	Higher	7th lowest
Excessive drinking	20.1%	Higher	44th
Death rate	8 per 100,000	13.1 per 100,000	Below average
Senior excessive drinking	11%	Lower	Highest nationally

Hawaii presents a paradox – maintaining below-average death rates and youth consumption while experiencing rapid increases in mortality and leading the nation in senior excessive drinking, suggesting evolving patterns requiring adaptive public health responses.

Alcohol Consumption Patterns

Adult Consumption Statistics (2019-2020 Average)

Past-month alcohol use: 520,000 people (45.10% of population 12+)
Adult use (18+): 513,000 people (48.46% of adults)
Binge drinking: 247,000 people (21.46% of population 12+)
Adult binge drinking: 244,000 people (23.02% of adults 18+)

Age-Specific Consumption Patterns

Age Group	Past-Month Use	Binge Drinking	Population Impact
12-17 years	7,000 (7.62%)	3,000 (3.55%)	Low youth rates
18-25 years	63,000 (53.41%)	36,000 (30.47%)	Highest consumption group
26+ years	450,000 (47.83%)	208,000 (22.14%)	Largest absolute numbers

Young adults (18-25) show the highest consumption rates, with over half using alcohol monthly and nearly one-third engaging in binge drinking, indicating this demographic requires targeted intervention.

Detailed Binge Drinking Patterns

Overall binge drinking rate: 20.9% of adults 18+ binge drink monthly
Median drinks per binge: 5.7 drinks
Heavy binge drinkers (top 25%): 9.2 drinks per binge
Binge frequency: Median 1.9 times per month
Heavy binge frequency: 4.3 times per month among top 25% of binge drinkers

The data reveals not just widespread binge drinking but intensive patterns among heavy users, with the most active quarter of binge drinkers consuming nearly double the drinks and binging over twice as frequently.

Youth Alcohol Statistics

Underage Drinking (Ages 12-20)

Past-month alcohol use: 20,000 youth (14.86% of ages 12-20)
Alternative data: 15.25% of ages 12-20 (slight variation in reporting)
Binge drinking: 10,000 youth (7.43% of ages 12-20)
Alternative data: 7.30% binge drinking rate

Youth-Specific Rankings and Comparisons

Ages 12-17 alcohol use: 6.2% (Hawaii Rank: 7th lowest nationally)
Historical context: Rates for 12-17 year olds were among 10 lowest in country (2005-2006)
National comparison: Below national rates for all youth age groups

Hawaii demonstrates relatively successful youth alcohol prevention, ranking among the lowest states for underage drinking, though nearly 15% of 12-20 year olds still report monthly alcohol use.

Senior Citizens and High-Risk Demographics

Senior Alcohol Consumption (2022)

Excessive drinking among seniors: 11% of older adults
National ranking: Highest rate of any state
Public health significance: Represents emerging crisis among elderly population

Hawaii’s distinction as having the nation’s highest rate of excessive drinking among seniors represents a critical and unique public health challenge, potentially linked to social isolation and healthcare access issues.

Alcohol Use Disorders and Treatment Needs

Alcohol Use Disorder Prevalence (2020)

Age Group	Number with AUD	Percentage	Treatment Gap
Total (12+)	111,000	9.69%	High unmet need
Ages 12-17	2,000	2.63%	1,000 need treatment
Ages 18-25	17,000	14.67%	17,000 need treatment
Ages 26+	92,000	9.75%	95,000 need treatment
Adults (18+)	109,000	10.31%	111,000 need treatment

Treatment Access and Gaps

Need treatment but not receiving: 113,000 people (9.81% of population 12+)
Adult treatment gap: 111,000 adults (10.55% of adults)
Young adult crisis: 14.25% of 18-25 year olds need but don’t receive treatment

The treatment gap is nearly universal – almost everyone with alcohol use disorder needs but doesn’t receive specialty treatment. Young adults face the highest disorder rates (14.67%) and largest treatment gaps.

Historical Treatment Data (2010)

Alcohol-only treatment: 1,051 people
Alcohol plus secondary drug treatment: 1,078 people
Total alcohol-related treatment: 2,129 people
Rural treatment patterns: 59.1% of rural treatment admissions were alcohol-primary, especially among Pacific Islanders

Historical data shows nearly equal split between alcohol-only and poly-substance treatment needs, indicating complex addiction patterns requiring comprehensive treatment approaches.

Economic Impact and Public Health Costs

Economic Burden

2010 economic impact: $937.4 million
2022 adjusted value: $1.265 billion
Cost per drink: $2.13 (2022 US dollars)
Per capita impact: Significant taxpayer burden

Hawaii Alcohol Economic Impact Statistics

Public Health Metrics

Years of potential life lost: 12,193 years annually
Healthcare system impact: Substantial burden on medical facilities
Crime correlation: 16 annual homicides, 48 annual suicides attributable to alcohol

The economic impact of over $1.25 billion annually represents a massive drain on Hawaii’s resources, equivalent to over $2 per alcoholic drink consumed, highlighting the broader societal costs beyond individual health impacts.

Hawaii’s alcohol landscape reveals a state in transition, maintaining historically favorable mortality statistics while confronting emerging challenges including the nation’s highest senior drinking rates, significant treatment gaps affecting over 113,000 residents, and economic costs exceeding $1.25 billion annually. The dramatic 48% increase in alcohol death rates from 2015-2019, combined with high alcohol use disorder prevalence among young adults (14.67%) and universal treatment access deficits, indicates an escalating public health crisis requiring immediate, comprehensive intervention strategies tailored to Hawaii’s unique demographic and geographic challenges.