Kauaʻi County Council greenlights use of $361,000 from national opioid settlements

The County of Kaua’i now has the green light to accept and spend more than $361,000 in national opioid settlement funds aimed at curbing the island’s opioid crisis.

At its meeting last week, the Kauaʻi County Council approved an updated agreement with the State of Hawai’i, in which it increased Kauai’s share from $281,000 previously authorized in July 2024 to $361,077, which was authorized on Aug.1, and is expected to be retroactive to Dec. 15, 2024.

“Walgreens made a larger deposit in the state’s account than expected,” said Michael Miranda, re-entry coordinator with the office of the prosecuting attorney, during the Aug. 13 meeting.

The funds are part of long-term national settlements with several pharmaceutical companies, including CVS, Walmart, Walgreens, Kroger Co. and Purdue, according to Miranda and the County of Kauaʻi.

The funds were designated for several thousand counties across the country.

On the Garden Isle, they will assist local organizations such as the Kaua’i Fentanyl Task Force, a multiagency initiative created at the urging of Kauaʻi Prosecuting Attorney Rebecca Like in 2023 to address opioid use disorders, mental health challenges and harm reduction.

The need for the task force became evident after reported fentanyl overdoses quadrupled in 2021 on Kauaʻi, with five resulting in death, and continued to be a major problem. For a 12-month period ending September 2023, Kauaʻi averaged a fatal overdose every 21 days, according to data from the Center for Disease Control.

Since the task force’s inception, about 20 partnering agencies and 75 agents on the island have joined the volunteer team, which convenes monthly to set its priorities and serve the community, Miranda said.

Methamphetamine, also known as “ice,” remains the most problematic drug on Kauaʻi, but fentanyl has rapidly risen to the second position.

Fentanyl is a highly potent synthetic piperidine opioid that is primarily used as an analgesic. It is 30 to 50 times more potent than heroin and 100 times more potent than morphine, according to a study available on the National Library of Medicine website.

The Kauaʻi Fentanyl Task Force is alarmed by the rapid lethality of fentanyl, whose danger also lies in how easily it can be mixed with other drugs, leading to accidental overdoses.

Miranda, who also is chair of the task force and Kauaʻi’s designee to the Hawaiʻi Opioid Settlement Advisory Committee, said the opioid settlement funds “will help fill in the gaps” and “cover services that we lack in the community.”

In 2023, Kauaʻi County had about 188 reported overdose cases, according to the Hawaiʻi Department of Health. That number decreased to 154 overdoses in 2024.

Thus far in 2025, Miranda said “we are hearing from our first responders that there are overdoses happening weekly.”

The Opioid Settlement Fund also will pay for community education and programs, some run by faith-based groups and grassroots coalitions, and support individuals in treatments and their families with an emphasis on prevention and early intervention.

Under the agreement with the state, Kauaʻi County will provide monthly expenditure reports to the Hawaiʻi State Department of Health to ensure compliance with the National Settlement Agreements. Any funds not used for approved purposes must be returned.

Kapa’a resident Tom Loo, who has been clean and sober for 39 years, said he hopes the money will be “put to the best use.”

While there have been many awareness campaigns on the island, Loo said there remains no facility for residents seeking long-term help, which based on his own experience is greatly needed.

“The longest I’d ever been clean was when I was incarcerated,” he said. “I’ve been through the system; for me, my recovery was in Narcotics Anonymous. It worked for me, but it doesn’t work for everybody.”

Councilmember Fern Holland said she lost the love of her life to fentanyl.

“This money is a start,” Holland said.

But she added it’s not enough money “that we need for real on-island treatment facilities and stuff. I appreciate the planning and thought process on how we use it.”

Loo said it is important to discuss ideas for the use of the settlement money that include creating a treatment facility and understanding addiction in the context of post-incarceration or for individuals experiencing homelessness.

“We all need to take a look at how the addiction occurs and create a program that will actually work,” he said.

“Humans are social,” he added. “So if there isn’t a treatment facility, where can they turn to after the halfway house? After the six-month IPO program? I think individuals need that extra motivation, and there should be a center for that, because it is not easy.”

On Sept. 12, Kauaʻi County will host the “Recovery Through Connections and Community” fair with Child & Family Services and other local community organizations at the Historic County Building lawn. It runs from 2 to 6 p.m.

The event aims to connect individuals and families with local support and recovery resources, raise awareness and promote community healing.

Additional awareness workshops include the Community Conversation on Opioid Use Disorder sessions, held by the Office of the Prosecuting Attorney. They are in collaboration with the Hawaiʻi State Rural Health Association, University of Rochester and Kauaʻi Rural Health Association.

Loo adds that these types of meetings are important for the community and for individuals seeking resources.

“These are the places where research and the talking points take place,” he said. “It’s also important that the people who can make things happen are also present. It’s an individual choice to pick up the resources and attend any meeting.”

The academic sessions are centered around the substance abuse stigma. The workshops are aimed at destigmatizing substance abuse disorders and creating an open space to have those difficult conversations.

“The beautiful part of this program is that attendees can apply these tools in their daily lives; whether it’s an intervention or helping anyone dealing with substance abuse,” Miranda said.

Attendees will have the opportunity to connect with local organizations that can assist with treatment, support and recovery services. The public also will learn how to access help for themselves and their loved ones.

The two-day workshop is scheduled for Sep. 17 from 1 p.m. to 4 p.m., and on Sep. 18 from 8:30 a.m. to 11:30 a.m., followed by a second workshop from 1 p.m. to 4:30 p.m., at the Kamehameha Schools Lumi Papa room.

“Events like this remind us that there’s hope and support for those who need it, and that Kaua‘i takes care of its people,” Kauaʻi Mayor S.K. Kawakami said in the press release.

“I encourage everyone to come out, learn more and enjoy time together.”

Loo adds that he just celebrated his 28th wedding anniversary, “looking back, wow, what a journey I’ve had, walking into my first meeting at Salvation Army ATS not wanting to change, to now, what a difference.”

“Without a controlled environment, individuals struggling with addiction don’t have the support or resources to navigate the process.”

He encourages those who are struggling to overcome the stigma, seek available resources, and find their nearest Narcan machine. Narcan blocks the effects of opiates on the brain and restores breathing for people who have it in their system.

Miranda said vending machines with free Narcan are available for the community at the Piʻikoi building at the Līhuʻe Civic Center and at the Kapaʻa Community Center. They are in collaboration with Kauaʻi Health & Harm Reduction Center.

“It starts with one day and a new direction, surround yourself with love, it’s hard when you’re in that place to see any kind of light, and the first step is always the hardest, but there is a light,” Loo said. “There are success stories.”

Councilmember Felicia Cowden said: “Every county struggles with this. I hope we can really make something with this.

“What I saw in Kentucky, they were focused on clean and sober houses and they were setting them up all over the place, and I was happy to see people there not resisting it. I hope there is community acceptance because we need to keep our people healthy and getting better.”

Loo now cares for his wife and stays busy: “I have a beautiful life with my wife. I volunteer as much as I can. And, I surf a ton.

“Your addiction will affect every part of your life and all the people you love, but your recovery will affect every part of your life and all the people you love, too. And, if you want to keep what you have, you have to give back. I am in the light now.”

To learn more about Narcotics Anonymous meetins on Kauaʻi, click here

For more information on Narcan and instructions on how to administer the nasal spray, click here.

For a comprehensive overview of substance use, mental health, and crisis summary in the State of Hawaiʻi, click here.