State leaders are focusing on a data-driven response to improve care for people struggling with substance abuse in Hawaii. The Alcohol and Drug Abuse Division (ADAD) within the Department of Health recently launched a webinar series to review the Hawai‘i State Plan for a Data Driven System of Care on Substance Use.
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The webinars are meant to inform stakeholders and seek feedback for future iterations of the plan. Community members are also encouraged to join the discussion and provide feedback on additional study areas they would like to see incorporated in the plan.
The state plan is effective from June 2019-December 2022 and uses a discovery-oriented, data-driven approach to promote a comprehensive system of care around substance use in Hawaii, according to John Valera, Acting ADAD Administrator.
ADAD and the state plan on substance abuse have evolved since its original structures were first established by the state legislature in the 1970s. Before the 2019-2022 version, the plan had not been updated since 2000, Valera explained, when it focused more on treatment rather than prevention.
“There’s the realization that in order to reach all of those who need services, we can’t just focus on treatment alone,” he said. “We have to also educate community groups as a whole in order to talk more about how to build up those protective factors and minimize risk factors that lead someone to misuse or to use in the first place.”
The most current state plan includes workforce development initiatives, such as recruiting prevention specialists, counselors, and social workers. ADAD is also working to integrate substance use services in primary care settings.
The data-driven approach also ensures ADAD can focus services on the communities most in need. Without a comprehensive approach to substance use, Valera said, there are gaps in the system of care or care coordination. For example, lack of wraparound resources in the criminal justice system can prolong or prevent an offender with a substance use disorder from reentering the community.
ADAD partnered with the Center on Aging at the University of Hawaii School of Social Work and the John A. Burns School of Medicine’s Department of Psychiatry and developed the current state plan, seen below.
The base tier, Protocol 1, focuses on building out the state’s data infrastructure to better process information gathered about substance abuse demographics. The Hawaii Substance Use Data Inventory (SUDI) includes surveys, claims and clinical data, and datasets from human services, homelessness, criminal justice, and law enforcement-involved state agencies.
Protocol 2 uses implications from the data to identify gaps in the substance use system of care, keep an eye on trends, and emphasize intersection with other areas of the broader health system.
The remaining protocols analyze the needs of specific communities and their intersection with substance abuse. Protocol 3 is the Adult Treatment Needs Assessment which “explores needs, support, barriers and gaps, and areas for improvement in the system of care,” according to a description from the Pacific Health Analytics Collaborative, which operates within the UH Thompson School of Social Work & Public Health’s Center on Aging.
Protocol 4, a Culture Case Study Among Youth in a Native Hawaiian Community, involves a collaboration with a rural community organization to take a Native Hawaiian approach to substance abuse treatment.
ADAD is also in the process of sharing findings from its 2022 Statistical Report. Using information from nearly a dozen state and national datasets, the report provided insights into substance use, hospitalizations, mortality, and crime rates in the state.
According to the report, psychostimulants such as methamphetamine were the leading cause of death in Hawaii from 2018-2021. In 2021, psychostimulant use resulted in about 12.2 deaths per 100,000 Hawaii residents, compared to 8.7 deaths per 100,000 U.S. residents.
The report used data from 2005-2014 and found an overall increase in substance use-related emergency visits, with alcohol being the leading cause of visits. Psychostimulants and opioids were also prevalent emergency visit causes.
Victoria Fan, ScD, Director of the Pacific Health Analytics Collaboration, said during the presentation that she hopes to conduct more frequent reporting.
“This work utilizes a standardized analytic framework, which enables us to do reproducible updates in the future. It minimizes the effort that’s needed to do this type of work rather than doing a big data analysis every 10 or 15 years.”
ADAD and its partners will delve more extensively into different sectors in the statistical report over the next few weeks, which explore the intersection of substance use with homelessness, the criminal justice system, Native Hawaiian and rural communities, and more. Interested participants can see the full schedule and sign up for future webinars here.