Hawaii Drug and Alcohol Statistics - World Forum for Mental Health

Statistical Data on Drugs in Hawaii

Hawaii faces significant substance abuse challenges, with methamphetamine being the most prevalent drug of concern in the state. While Hawaii’s overall drug overdose death rate remains below the national average, the state has experienced concerning upward trends, particularly with methamphetamine and fentanyl-related deaths. The state’s unique geographic isolation, limited treatment infrastructure, and disparities affecting Native Hawaiian communities create additional complexities in addressing substance use disorders. This report compiles comprehensive statistics on drug use patterns, overdose deaths, treatment capacity, and demographic trends specific to Hawaii.

Drug Overdose Deaths

Current Overdose Death Statistics (2023)

Total overdose deaths: 320 deaths
Death rate: 22 per 100,000 residents
National comparison: 32% lower than US average
Percentage of all deaths: 2.12%
Hawaii’s share of nationwide OD deaths: 0.34%

Hawaii Overdose Death Statistics

While Hawaii’s overdose death rate remains below the national average, the 2023 rate represents the highest level recorded since data collection began in 1999.

Historical Trends in Overdose Deaths

Year	Total Deaths	Death Rate per 100,000
2007	142	11.1
2010	154	11.3
2016	249	–
2017	225	–
2018	226	14.3
2019	265	–
2020	266	–
2023	320	22.0

Drug overdose deaths increased 95% from 2013 to 2023 and 50% from 2018 to 2023. The data shows an overall upward trajectory with some year-to-year fluctuations.

Overdose Deaths by County (2023)

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

Significant geographic variation exists, with Maui County experiencing death rates 70% higher than Hawaii County.

Drug-Specific Overdose Statistics

Methamphetamine

2023 Statistics

Percentage of overdose deaths: 62% of total deaths
Increase since 2003: 7.2 times higher in 2023 compared to 2003

Historical Methamphetamine Death Data (2016-2020)

2016: 136
2017: 136
2018: 161
2019: 182
2020: 197

Methamphetamine has shown consistent growth as a cause of death, with a 45% increase from 2016 to 2020.

Opioids

2023 Statistics

Total opioid deaths: 133
Death rate: 9.4 per 100,000 residents
National comparison: 60.8% lower than national death rate
Percentage of all overdose deaths: 41.6%

Opioid Type Breakdown (2023)

Synthetic opioids (including fentanyl): 85.0% of opioid deaths
Heroin: 10.5% of opioid deaths
Prescription opioids: 15.0% of opioid deaths

Historical Opioid Trends

Increase 2018-2021: 54% rise in opioid-related fatalities
2018 rate: 4.1 per 100,000
2021 rate: 6.3 per 100,000
Fentanyl increase: 6.2 times higher in 2023 compared to 2019

Hawaii Historical Opioid Trends Statistics

Prescription Opioid Deaths (2016-2020)

Year	Prescription Opioid Deaths
2016	81
2017	60
2018	45
2019	34
2020	24

While prescription opioid deaths have declined by 70% from 2016 to 2020, synthetic opioids (particularly fentanyl) have surged dramatically.

Fentanyl

Year	Fentanyl Deaths
2016	13
2017	10
2018	9
2019	19
2020	26

Fentanyl deaths increased 37% from 2019 to 2020 alone. Hawaii is experiencing increased trafficking of counterfeit opioid pills laced with fentanyl, contributing to the rise.

Heroin

Year	Heroin Deaths
2016	20
2017	9
2018	16
2019	19
2020	21

Heroin deaths have remained relatively stable but volatile, ranging from 9 to 21 deaths annually.

Cause and Demographics of Drug Deaths

Manner of Death (2016-2020)

Cause	2016	2017	2018	2019	2020
Accident	227	188	208	229	243
Suicide	15	28	14	28	20
Indeterminate	7	8	4	6	2
Homicide	0	1	0	2	0

The vast majority (91% in 2020) of drug deaths are accidental, though suicides involving drugs represent a persistent concern.

Gender Distribution (2016-2020)

Gender	2016	2017	2018	2019	2020
Male	173	153	168	199	188
Female	76	72	58	66	77

Males consistently account for approximately 70% of drug-related deaths, reflecting gender disparities seen nationally.

Age Statistics (2020)

Largest age group: 50-59 years old (97 deaths)
Average age: 51 years
Age range: 15 (youngest) to 98 (oldest)
Adolescent deaths: 1

Hawaii Deaths Age Statistics

The concentration of deaths among those in their 40s-60s suggests long-term substance use patterns rather than primarily affecting young adults.

Youth Drug Use Statistics (Ages 12-17)

Current Drug Use

Past-month illicit drug use: 7.26% to 9.36%
7,000 youths (12-17) reported drug use in past month
Ranking: 32nd among states for youth illicit drug use (8.2%)
Comparison to national average: Equally as likely as average American teen

Marijuana Use Among Youth

Past-month use: 7.49%
Past-year use: 13.73%
Lifetime use (high school): 48%
Early initiation (before age 13): 14.2%
Among recent users: 71.43% reported marijuana use

Other Substances – Past Year Use

Marijuana: 9.70%
Pain relievers: 1.60%
Cocaine: 0.20%
Methamphetamine: 0.13%

Substance Use Disorders

Drug Use Disorder (DUD): 5.20%
Alcohol Use Disorder (AUD): 3.29%

Youth marijuana use is particularly concerning, with lifetime use rates reaching 48% among high school students by 2017.

Young Adults Drug Use Statistics (Ages 18-25)

Past-month illicit drug use: 25.65%
Past-month marijuana use: 23.66%
Past-year marijuana use: 34.11%
Past-year cocaine use: 4.80%
Past-month illicit drugs other than marijuana: 5.55%
28,000 young adults used drugs in past month
Comparison: 10.12% less likely to use drugs than average American in same age group

Young adults show substantially higher drug use rates than other age groups, with one in four using illicit drugs monthly.

Adults Drug Use Statistics (Ages 26+)

Past-month illicit drug use: 10.54%
Past-month marijuana use: 10.64%
Past-year marijuana use: 13.01%
Past-month illicit drugs other than marijuana: 2.71%

Adult drug use remains elevated but significantly lower than the 18-25 age group, suggesting some reduction in use with age, though rates remain concerning.

Drug Use Perceptions and Risk Awareness

Marijuana Risk Perception (2019-2020)

Age Group	Number Who Perceive Great Risk	Percentage
12-17	21,000	22.44%
18-25	15,000	12.95%
26+	237,000	25.21%
Total 12+	273,000	23.73%

Young adults (18-25) have significantly lower risk perception of monthly marijuana use compared to other age groups, which correlates with their higher usage rates.

Cocaine Risk Perception (2019-2020)

Age Group	Percentage Perceiving Great Risk
12-17	52.88%
18-25	61.14%
26+	70.05%
Total 12+	67.73%

Heroin Risk Perception (2019-2020)

Age Group	Percentage Perceiving Great Risk
12-17	58.51%
18-25	80.95%
26+	84.98%
Total 12+	82.42%

Risk perception for harder drugs like cocaine and heroin remains high across all age groups, with adults showing greater awareness than youth.

Demographic Disparities

Native Hawaiian Population

Youth Drug Use

Native Hawaiian adolescents show drug use rates 2-3 times higher than some Asian subgroups
In rural Oahu and Maui, meth accessibility is higher, further impacting Native Hawaiian youth initiation rates

Historical Comparison (2007)

Native Hawaiians: 12.5% past-month illicit drug use
White population: 8.1% past-month illicit drug use

Treatment Demographics (Overall)

44.6% identify as Native Hawaiian
15.9% identify as White
11% identify as Pacific Islander
8.9% identify as Filipino

Native Hawaiians are disproportionately affected by substance use disorders, representing 44.6% of treatment admissions while being a smaller percentage of the overall population, reflecting significant health disparities.

Women’s Drug Use (Ages 18-49)

12.8% reported misusing prescription psychotherapeutics or using cocaine, heroin, hallucinogens, inhalants, or methamphetamine in past year
Hawaii rank: 43rd among states

Age of Substance Use Initiation

Hawaii vs. National Comparison

11.8% of substance use cases began before age 12 (Hawaii)
53.8% began between ages 12-17 (Hawaii)
Hawaii shows earlier initiation compared to national patterns

Over half of those in treatment began using substances during adolescence, emphasizing the critical need for youth prevention and early intervention programs.

Unhoused Population Substance Use

Survey Results (162 community surveys)

Lifetime Use

86% reported lifetime methamphetamine use
60% reported illicit prescription pill use
33% reported heroin use

Current Addiction Screening

74% screened positive for methamphetamine addiction
12% screened positive for opioid addiction (6 times greater than 2% U.S. population rate)

The unhoused population in Hawaii faces extreme substance use challenges, with rates far exceeding the general population.

Substance Use Disorders and Treatment Needs

Substance Use Disorder Prevalence (2020)

Age Group	Illicit Drug Use Disorder	Substance Use Disorder (All)
12-17	7.25%	6.08%
18-25	12.88%	22.38%
26+	4.96%	12.68%
Total 12+	5.96%	13.14%

Absolute Numbers (2020)

Illicit Drug Use Disorder: 68,000 people
Prescription Pain Reliever Use Disorder: 9,000 people
Total Substance Use Disorder: 151,000 people

One in eight Hawaiians aged 12+ met criteria for a substance use disorder in 2020, with young adults showing the highest rates at over 22%.

Treatment Gap Statistics

Unmet Treatment Needs (2020)

Category	Number Needing Treatment	Percentage
Illicit Drug Use – not receiving specialty treatment	63,000	5.54% of population
Substance Use – not receiving specialty treatment	144,000	12.57% of population

By Age Group (2020)

Age Group	% Needing Drug Treatment Not Receiving	% Needing Substance Treatment Not Receiving
12-17	8.70%	7.16%
18-25	12.94%	26.47%
26+	4.30%	11.37%

Historical Treatment Gap (2010-2012)

92.7% of people needing alcohol use disorder treatment did not receive it
98% of people needing substance use disorder treatment did not receive it

Treatment Access (2015-2018)

17,000 people accessed treatment annually
91,000 people met clinical criteria for treatment
Treatment gap: 81% of those needing treatment did not access it

The treatment gap is massive, with over 80% of those meeting clinical criteria for substance use disorders not accessing treatment.

Treatment Infrastructure and Capacity

Treatment Facilities

Current Capacity

177 substance abuse facilities statewide
105 facilities (2006 baseline)
67% of treatment facilities are on Oahu

Facility Types

78 facilities offer free drug rehab treatment
3 methadone clinics statewide (as of 2023)
17 facilities offered residential care (2006)
3 facilities offered opioid treatment programs (2006)

Hawaii Drug Facility Types Statistics

Treatment capacity has expanded since 2006, but remains heavily concentrated on Oahu, leaving rural islands underserved.

Patient Volume and Services

Annual Treatment Numbers

5,217 patients serviced annually across all facilities
6,618 people went to treatment in 2010 (65.5% male, 34.5% female)

Outpatient Services

4,511 patients enroll annually
Cost per patient: $1,536 average
Total spending: $6.93 million (0.3% of U.S. total)

Residential (Non-Hospital) Services

706 patients enroll annually
Cost per patient: $58,810 average
Total spending: $41.52 million (0.8% of U.S. total)

Rankings

41st in cost for residential treatment (cheapest to most expensive)
3rd cheapest state for outpatient drug rehabilitation services

Hawaii’s treatment system serves approximately 5,200 patients annually despite over 90,000 needing care.

Treatment Admission Patterns

Primary Substances in Treatment Admissions

2012 Data

Methamphetamine: 48% of admissions
Marijuana: 38% of admissions

2022 Data

Methamphetamine: ~45% of admissions
Marijuana: 21.8% of admissions
Alcohol only: 14.2% of admissions

2010 Specific Numbers

Marijuana dependence: 2,049 people (64% male, 36% female). Largest age group: 12-17 at 72.8%
Amphetamine addiction: 1,834 people (63.8% male, 36.2% female)
Other opiates (not heroin): 247 people

Historical Methamphetamine Admission Trends

Year	% of Admissions
2007	31.9%
2012	48%
2022	~45%

Youth Treatment Admissions (2022)

67.2% involved marijuana
Often combined with methamphetamine use

Methamphetamine has dominated treatment admissions for over 15 years, peaking at 48% in 2012.

Polysubstance Use in Treatment (Recent Treatment Data)

28% of cases involved polysubstance use with meth and marijuana
38.6% of cases involved meth and alcohol

The majority of methamphetamine cases in treatment involve concurrent use of other substances, complicating treatment approaches.

Additional Health and Safety Statistics

Neonatal Impacts

3.2 per 1,000 births diagnosed with neonatal opioid withdrawal syndrome (2020)

Prescription Patterns

Doctors write prescriptions sufficient for 22.6% of residents
2018: 33.4 opioid prescriptions per 100 persons (vs 51.4 national average)

HIV/AIDS Connection

3.8 new HIV/AIDS diagnoses per year connected to intravenous drug use (2023)

Emergency Department Visits

77.5% increase in drug-related emergency department visits from 2021 to 2022
39% increase in overdose hospitalizations from 2021 to 2022

Federal Funding

Federal grants (per capita) for substance use treatment in Hawaii trail national averages by 31%

Hawaii faces significant barriers in addressing substance use, including underfunding relative to national averages and limited healthcare infrastructure to handle the growing crisis.

Final Words

Hawaii faces an escalating substance abuse crisis driven primarily by methamphetamine, while also experiencing a dangerous surge in fentanyl-related fatalities. Despite maintaining below-average national overdose rates, the state’s drug deaths have nearly doubled since 2013, and a critical treatment gap leaves 81% of those needing care without access to services. The concentration of treatment facilities on Oahu, combined with severe disparities affecting Native Hawaiian communities and the unhoused population, creates urgent challenges that demand expanded infrastructure and targeted intervention programs across all Hawaiian islands.

Statistical Data on Alcohol in Hawaii

Alcohol remains a significant public health concern in Hawaii, though the state’s overall death rate from excessive alcohol use is below the national average. However, Hawaii exhibits unique patterns, including the highest rate of excessive drinking among seniors in the nation and the highest percentage of alcohol-related deaths among males in the United States. Binge drinking affects over one-fifth of adults, with young adults showing particularly elevated rates of alcohol use disorder. The economic burden on the state is substantial, with nearly $1 billion spent annually on consequences of excessive alcohol use. This report compiles comprehensive statistics on alcohol consumption patterns, related deaths, treatment needs, and demographic variations specific to Hawaii.

Alcohol-Related Deaths

Overall Mortality Statistics

Total deaths attributable to excessive alcohol use: 526 deaths per year
Deaths under age 21: 2.3% of total (approximately 12 deaths)
Death rate: 8 per 100,000 residents (2020)
National comparison: Below the national average of 13.1 per 100,000
Deaths per capita: 1 death for every 2,767 people aged 18 and older
Deaths per 10,000 adults: 4.59 deaths

Hawaii Alcohol Annual Deaths Statistics

While Hawaii’s alcohol death rate is 39% below the national average, the state still experiences over 500 preventable deaths annually from excessive alcohol use, representing a significant public health burden.

Demographic Distribution of Alcohol Deaths

Gender

Male deaths: 72.6% of all excessive alcohol use deaths
Female deaths: 27.4% of all excessive alcohol use deaths

Note: Hawaii has the highest percentage of alcohol-related deaths among males in the United States (excluding territories).

Age Distribution

Adults 35 years and older: 87.8% of deaths
Under age 21: 2.28% of deaths

5-Year Average Deaths by Gender and Age (2015-2019)

Male over 21: 155 deaths
Female over 21: 49 deaths
Male under 21: 8 deaths
Female under 21: 3 deaths
Total: 204 deaths (5-year average)

The overwhelming concentration of deaths among males and adults over 35 indicates that chronic, long-term alcohol use is the primary driver of alcohol-related mortality in Hawaii.

Causes of Alcohol-Related Deaths

Type of Death

Chronic causes (e.g., Alcohol Use Disorder): 61.2% of deaths
Acute causes: 38.8% of deaths

5-Year Average Specific Causes (2015-2019)

Suicides due to alcohol: 48 deaths
Homicides due to alcohol: 16 deaths
Alcohol Dependence Syndrome: 19 deaths
Coronary Heart Disease due to alcohol: 36 deaths
All causes attributable to alcohol: 204 deaths

Nearly two-thirds of alcohol deaths result from chronic conditions, particularly Alcohol Use Disorder, suggesting opportunities for intervention through treatment and long-term care programs.

5-Year Change (2015-2019)

The annual rate of excessive alcohol deaths per capita increased by 48.0% from 2015 to 2019

The substantial 48% increase in alcohol death rates over just four years represents an alarming acceleration of the problem, despite Hawaii maintaining below-average national rates.

Years of Potential Life Lost

12,193 years of potential life lost to excessive alcohol use each year

This metric captures the premature nature of alcohol-related deaths, representing thousands of years of productive life lost annually.

Youth and Underage Alcohol Use (Ages 12-17)

Past-Month Use

6.2% of youth aged 12-17 reported drinking alcohol
Hawaii rank: 7th among states (indicating lower youth drinking rates)

Past-Month Alcohol Use (Ages 12-20)

14.86% reported alcohol use
20,000 youth aged 12-20 used alcohol in past month

Past-Month Binge Drinking (Ages 12-20)

7.30% to 7.43% reported binge drinking
10,000 youth aged 12-20 engaged in binge drinking

Comparison to Adults

Youth (12-17) are 4.87% less likely to use alcohol than the average American in their age group

Hawaii performs relatively well in preventing youth alcohol use, ranking 7th nationally with only 6.2% of adolescents drinking.

Young Adult Alcohol Use (Ages 18-25)

53.41% (63,000) past-month alcohol use
30.47% (36,000) past-month binge drinking

Young adults show substantially elevated alcohol consumption, with over half using alcohol monthly and nearly one-third binge drinking.

Adult Alcohol Use (Ages 18+)

General Consumption

Past-month alcohol use: 46.34% of adults
520,000 people aged 12+ used alcohol in past month
513,000 adults aged 18+ used alcohol in past month

Hawaii Adult Alcohol Use Statistics

By Age Group – Past Month Use

Age Group	Number (thousands)	Percentage
12-17	7	7.62%
18-25	63	53.41%
26+	450	47.83%
Total 12+	520	45.10%

Over half of young adults used alcohol in the past month, significantly higher than other age groups.

Binge Drinking Statistics

Overall Binge Drinking

20.1% of adults reported binge drinking (excessive drinking)
20.9% of Hawaii adults over 18 binge drink at least once per month
Binge drinking rates (2017-2019): 33.8%
Hawaii rank: 44th among states (indicating lower rates)

Definition

Females: 4 or more drinks on one occasion
Males: 5 or more drinks on one occasion

Binge Drinking by Age Group – Past Month

Age Group	Number (thousands)	Percentage
12-17	3	3.55%
18-25	36	30.47%
26+	208	22.14%
Total 12+	247	21.46%
Total 18+	244	23.06%

Young adults show binge drinking rates 38% higher than the overall adult population. One in five Hawaii adults engages in binge drinking monthly, affecting approximately 247,000 residents.

Binge Drinking Intensity and Frequency

Drinks Per Binge

Median drinks per binge: 5.7 drinks
Top 25% most active drinkers: 9.2 drinks per binge median

Binge Frequency

Median frequency: 1.9 times per month
Top 25% most active drinkers: 4.3 times per month

Hawaii Binge Drinking Intensity Statistics

The most active quarter of binge drinkers consume 60% more alcohol per session and binge more than twice as frequently, representing a high-risk subset of the drinking population.

Senior Population Excessive Drinking (2022)

11% of older adults in Hawaii reported excessive drinking
Ranking: Highest rate of any state in the United States

Hawaii’s distinction as having the nation’s highest rate of excessive drinking among seniors represents a unique and concerning public health challenge.

Risk Perception (2019-2020)

Perception of Great Risk from 5+ Drinks Once or Twice a Week

Age Group	Number (thousands)	Percentage
12-17	42	45.18%
18-25	48	40.47%
26+	416	44.28%
Total 12+	506	43.98%

General Population

47.62% of residents perceive drinking more than 5 drinks in 1 session as a great risk

Less than half of Hawaii residents perceive heavy episodic drinking as a great risk, with young adults showing the lowest risk perception despite having the highest rates of actual binge drinking and alcohol use disorder.

Alcohol Use Disorder

Prevalence by Age Group (2020)

Overall Statistics

111,000 people aged 12+ met criteria for Alcohol Use Disorder
9.69% of population aged 12+ has AUD
10.31% of adults aged 18+ has AUD

By Age Group

Age Group	Number (thousands)	Percentage
12-17	2	2.63%
18-25	17	14.67%
26+	92	9.75%
Total 12+	111	9.69%
Total 18+	109	10.31%

Young adults (18-25) have an alcohol use disorder rate 51% higher than the statewide average, with nearly 15% meeting clinical criteria.

Treatment Gap for Alcohol Use Disorder (2020)

Unmet Treatment Needs

113,000 people need but do not receive treatment at a specialty facility
9.81% of population aged 12+ needs treatment but doesn’t receive it
10.55% of adults aged 18+ need treatment but doesn’t receive it

Hawaii Unmet Treatment Needs Statistics

By Age Group

Age Group	Number Needing Treatment (thousands)	Percentage
12-17	1	1.50%
18-25	17	14.25%
26+	95	10.07%
Total 12+	113	9.81%
Total 18+	111	10.55%

Historical Treatment Gap

92.7% of people needing alcohol use disorder treatment did not receive it (2010-2012)

The treatment gap for alcohol use disorder mirrors the drug treatment gap, with over 90% of those needing specialty care not receiving it.

Treatment Admissions and Demographics

Alcohol Treatment Admissions (2010)

Primary Alcohol Abuse

1,051 people entered treatment for alcohol abuse alone
1,078 people entered treatment for alcohol combined with a secondary drug
Total alcohol-related admissions: 2,129 people

Gender Distribution (2010)

65.5% male
34.5% female

Alcohol treatment admissions are split roughly equally between alcohol-only cases and polysubstance cases involving alcohol, with males representing two-thirds of admissions.

Regional and Demographic Patterns

Rural Communities

59.1% of treatment admissions cited alcohol as the primary driver
Pacific Islanders particularly affected in rural areas

Overall Treatment Demographics

Treatment admissions for alcohol only: 14.2% (2022)
Alcohol remains significant but represents smaller proportion than marijuana (21.8%)

Rural communities show higher proportions of alcohol-driven treatment needs, particularly affecting Pacific Islander populations, indicating geographic and ethnic disparities in alcohol use patterns.

Economic Impact

2010 Costs

$937.4 million spent by Hawaii taxpayers due to excessive alcohol use
Inflation-adjusted (2022): $1.265 billion
Cost per drink: $2.13 (2022 dollars)

Hawaii Financial Burden Statistics

The economic burden of alcohol abuse approaches $1.3 billion annually when adjusted for inflation, representing substantial costs to taxpayers through healthcare, criminal justice, lost productivity, and other consequences.

Final Words

Hawaii faces a dual substance abuse crisis, with alcohol-related deaths claiming 526 lives annually and a treatment system that fails to reach over 90% of the 111,000 residents with alcohol use disorder. The state’s unique challenges include the nation’s highest rate of excessive drinking among seniors and the highest percentage of alcohol-related deaths among males in the United States. Despite ranking 7th nationally for low youth drinking rates, the 48% increase in alcohol death rates from 2015-2019 and the $1.3 billion annual economic burden demand immediate expansion of treatment infrastructure and targeted interventions for high-risk populations.

Conclusion

In general, Hawaii confronts a severe substance abuse crisis marked by 320 drug overdose deaths and 526 alcohol-related deaths annually, driven primarily by methamphetamine and compounded by a surging fentanyl epidemic that increased 6.2-fold since 2019. The state’s treatment infrastructure is critically inadequate, with over 90% of the 262,000 residents suffering from substance use disorders unable to access specialty care, while facilities remain heavily concentrated on Oahu, leaving rural communities and disproportionately affected Native Hawaiian populations underserved. Despite maintaining below-national-average death rates, Hawaii’s unique challenges—including the nation’s highest senior excessive drinking rate, dramatic increases in both drug and alcohol deaths, and a combined economic burden exceeding $1.3 billion annually—demand immediate, comprehensive expansion of treatment capacity and targeted interventions across all islands.