Hawaii Islandʻs Fentanyl Crisis Response

Hawaii Islandʻs Fentanyl Crisis Response
Community Driven Addiction and Overdose Prevention

Hosted by Tanya Yamanaka, Ola Ka Moku is a podcast for and about the people and places of Hawaii Island. Today, guest Kimo Alameda shares our communityʻs response to the fentanyl epidemic that was responsible for at least 17 overdose deaths in 2022. Kokua is the word.

Mahalo for listening to Ola Ka Moku. For more information about the Hawaii Island Fentanyl Task Force, visit HIFTF.org. Fentanyl is a potent synthetic opiod that is 50-100 times more potent than morphine and is the #1 cause of death for Americans age 18-45. If you need help now with addiction, call the CARES line of Hawaii at 1-800-753-6879. The Hawaii Island Fentanyl Task Force is a community coalition made up of 75 organizational representatives and members. Theyʻre working with our friends, neighbors and fellow islanders to raise awareness, inform and empower us to prevent addiction, drug overdose and other consequences of drug use on Hawaii Island. Thank you for supporting their work. 

https://www.hiftf.org/

This program has been sponsored by E.F. Cash-Dudley, Waimeaʻs estate planning attorney. When do you need a lawyer? In crisis or change. Visit https://efcashdudleylaw.com/

Transcript

This community podcast has been brought to you by EF Cash Dudley Law. Waimeaʻs family law attorney. Eddy Cash-Dudley has been practicing law since 1982 and has been licensed in Hawaii since 2008. Her current law practice of estate planning includes transfer upon death deeds, advance healthcare directives, wills and trusts. When do you need a lawyer in crisis or change? For more information, visit EFCashDudleylaw.com or call 808-854-5912.

Welcome to Ola Ka Moku, Our Island Thrives, Hawaii Islandʻs Community Podcast. I'm your host, Tanya Yamanaka. 

Today we're gonna be talking about a community issue that has surged over the last couple of years. The fentanyl epidemic was first identified on Hawaii Island around 2017. According to the State Department of Health, fentanyl is now the leading cause of opioid related death in Hawaii, and was responsible for at least 17 overdose deaths on our moku in 2022. 

Last year, many of us read about our local police identifying what's called rainbow fentanyl. Now, we might not be able to stop the manufacturers amd dealers from targeting children, but our community does have solutions and interventions. One of my favorite quotes is by author and civil rights activist, Coretta Scott King, “the greatness of a community is most accurately measured by the compassionate action of its members.” Again, itʻs my hope that you feel the greatness of our community despite our shared challenges as you listen in today. My guest today is a licensed psychologist, educator, and coach and was CEO of what was Bay Clinic, the largest nonprofit, federally qualified community health center on Hawaii Island, serving nearly 20,000 patients annually. Bay Clinic recently merged with West Hawaii Community Health Center, and that's probably another podcast altogether. Kimo is a graduate of St. Joe's High School, a basketball coach at Hilo High, serves in many other capacities AND he's also a parent of seven. Dr. Kimo Alameda is no stranger in turning crisis into opportunity. He now leads the Big Island Fentanyl Task Force. Welcome to Ola Ka Moku Kimo.

Kimo: Thank you. Welcome.

Tanya: So Kimo, let's get started first with how did this issue touch you deeply so that you've gone from psychologist and teacher to administrator, and now to community-based prevention and outreach strategies for our fentanyl crisis here.

Kimo: Yeah, I think, you know, I, I think addictions, I don't know what family addiction does, does not touch so the fentanyl crisis is bigger than just the substance fentanyl. It's, it's really, it's really the crisis of addiction. And so, you know, every family is touched, touched by it, whether it's a direct family member or cousin, an auntie, you know, sibling. And so for me growing up, you know, I, I, I had siblings who struggled with addictions. And, you know, then I've seen the, the good, the bad, the ugly of it, and the sad, mostly. And then, you know, in our community so, and then now fentanyl took it to a different level. You know, this is addiction that can be deadly, immediately. So that's why the concern for, for me originally at the Bay Clinic as the CEO but then, you know, we merged with Hawaii Island with West Hawaii. Now we're Hawaiian Island Community Health Center. So that allowed me an opportunity to, to kind of tackle the community issue that I felt is most paramount. And, you know, at that time when we did the merger, it was fentanyl. I mean, so, you know, I asked the new CEO, Mr. Richard Taffe. He says, “Oh yeah”. You know, ʻcause he knew that that was my, my passion. The community is where I'm at. That's where I feel most comfortable in, in helping to solve community problems. And this is a big one. So I'm very fortunate and honored to, to have this role as Fentanyl Task Force leader on our island.

Tanya: So how did, what happened with you and Richard? How did you get this going?

Kimo: Yeah. Well, you know, the West Hawaii Community Health Center had a grant about maybe almost two years ago now. And part of the grant, it was an opioid grant. Cause opioids has, has been an issue for our nation. Seven going on, I dunno, seven, eight years. But reached our shores about two years ago mostly through fake pills. So then we applied for a grant, we, being West Hawaii Community Health Center. And at the end of the grant was to create a, a task force. But it was never intended to be a task force such as the nature that we have now. I mean, this thing just exploded and we have a lot of input. So the question was, you know, for our first annual we had a small summit in, in, in, in West Hawaii. And, and you know, we had about 30 participants and, I was the emcee. And so, you know, following that event, people were like, “Hey, Kimo, maybe you should take this on,” you know, so I said, “I think I can do this,” part of my many responsibilities. But then it became the responsibility because the deaths just started increasing. And so that's how kind of we, we, we, we started the, the task force through the, the final outcome of, of a grant that we applied for.

Tanya: So, exactly what is fentanyl? How do people use it? How do they get it, and what does it do? I, I've just heard like really scary statistics, like such a small amount can cause death.

Kimo: Absolutely. So, so fentanyl is a, is a pain medication. If you look at pain medications, I mean, you could just start off with Tylenol or Ibuprofen, you know, and then you can work your way up. You know, if you have a knee surgery or back pain, doctor might give you Percocet. Or Vicodin or hydrocodone or oxycodone. You go to the dentist, they might give you codeine. You might have a small surgery, doctor might give you morphine. Well, after morphine is fentanyl, you know, for major surgery or, or serious chronic pain, back pain or stage two cancer where everything's in pain. You know, so it's a blessing actually. It's, it's a strong drug and if it's monitored it, it can be a blessing, but with all pain medications that it can also be a curse. 

So fentanyl is like a white, powdered substance. And all pain medication kind of trace its roots back to the opium plant. And you know, so like morphine is, or heroine is kind of like straight from that heroin and codeine, but then we can synthetically mix some of the plant mixture with some chemicals and that's how you make oxycodone, hydrocodone, Vicodin. But then you also can, can just make it 100% in a laboratory because you, you figured out the, what the opium plant contains, and you can make that outside of a lab. You can mimic it. And that's how fentanyl is made. It's, it's not even going back..

Tanya: Itʻs a hundred percent synthetic.

Kimo: It's a hundred percent that that's how it's made.

Tanya: So why would people turn to Fentanyl? If they don't need, you know, like the pain, like are people taking it because they have mental health issues or are they taking it just-

Kimo: Good question. Thank you, Tanya. That's a great question. So why, why do people take it? Well, why do people take pain medication in the first place? What? It's really to alleviate the pain, but all medication has a side effect, and that side effect is this euphoric reaction. You know, when I had a knee surgery, I doctor gave me Percocet, you know, for the pain. Cuz I had to take out my acl. There was like some screws in my knee and it was painful. And so by the third day I, yeah, the pain was gone, but this euphoric reaction was there and I was like, wow, you know, I was double shocked. You, I'm like, my kids, I mean, I was like, you know, love, I love every, love everybody hugging people, you know, so, It's, it's weird. It's a, it's a, it's a weird feeling. I, I didn't like it. I mean, it was interesting. I was like, well, what's this? And then I, I called the doctor and I said, well, what's going on? And he said, well, that's the side effect. I said, wow, this is like, I felt like I was in Lala land, you know? And that feeling for a kid say, who broke up with a. A girlfriend or a boyfriend or who's getting problems with their parents, or maybe an adult who just got laid off, you know, and they're just down, you know? And so that's one way you, you, you can get addicted is because you try to self-prescribe. But the other way is, is maybe it's just an, can be anybody, you know, go through surgery, the doctor saying, Hey, take this per- like, if I kept taking Percocets and wasn't having self-discipline and kind of liked the feeling and maybe my, my, my 30 day supply ran out. And, you know, I'm like, Hey Doc, I think my niece still saw. And he'd be like, no, it's not. And I'd be like, yes it is. And he'd be like, no. And then I'll be like, okay, where can I get this? You know? And then of course then I'll go look around and that, that, so there's a, like, 30% of people who become addicted to pain medication are just a everyday person who just completed the regimen of surgery. You know, the, after the, the post-surgery. And then they, they, they like the feeling they want to continue it, and they don't have the self-discipline to stop it. And so then they start to ask friends and it's sooner or later they're getting fake pills from the streets. And that's where the danger lies.

Tanya: So did the recent pandemic maybe have something to do with that in you know, increase of use? I, I know it had an effect on overall substance abuse and like food addictions, I gained, you know, I gained several pounds.

Kimo: Absolutely. I mean, I, at one point I was, I was telling myself maybe I should put this mask over my mouth, stop eating so much, but No, for sure. It's like, yeah, I, I think the isolation has caused some depression, actually, nationwide actually worldwide. You know, that lack of social interaction is, is not healthy. I think so. So that may have, Caused it not caused it, but what do you call exacerbated it? But, but all but, you know, addictions has been around since the beginning of time, so,

Kimo: You know, I just don't wanna blame Covid on it. You gotta figure, so we are America, right? So we, we represent 5% of the world's population, but we consume 75% of the world's drugs. So welcome to the, to the United States of Addictions, everybody. You know, we have an addiction issue. So it's interesting cause you know, you asked me the question, Kimo, what, what gave you this passion? You know, when I present at the schools, I ask kids, I, you know, when I talk about addictions, you know, and how I talk about it is, you know, you, you go from kind of break it down and you go from, I like it, whatever it is. Could be an alcohol addiction, maybe these seltzers. I like it, I truly you know, then you go to, I want it, a glass of wine or whatever. Whiskey cards, and then you go to, I need it, and when you're in, I need it. You're stuck. Okay. That, that's addiction. And so I've asked kids, I said, Hey, so how many of you, how many of you guys know anybody's stuck in addiction? You know, stuck in, I need it. Yeah. About 60% of the kids raise their hands. So this is like every school, charter school, public school, private school. I'm like, wow. So that's 60% of people on this islandpotentially, theoretically. Could be stuck in an addiction. That's, and the biggest dream killer, if you like, if you like kill all your dreams, go get stuck in an addiction. Right. So it's a national, international concern.

Tanya: Absolutely. So, but people can buy Fentanyl online, right? Like I read in the paper that one of the gals, that one of the young girls that suffered an overdose she ordered it online and it came right to her house.

Kimo: Yeah. Yeah. So that, on that one, her brother ordered it. So how that, how that works too is okay, so for that particular situation, which is, might, might be good to know. So thanks for bringing it up, Tanya. Yeah. And that is okay, so these video games, so how, how that played out? So the, the older, I think the family, family members playing, you know, and these kids, they play video games, right. Call of Duty, Fortnite, Minecraft. And, and apparently you can, I haven't seen this, but, but you can chat, you can like, like you play against somebody else. You become a friend with somebody else from anywhere in the world, and then you make fr like you make friends. I think what happened was like you make friends, like you, you can make friends and then the, then you start to chatting and so, oh, oh, you live in Hawaii? Oh yeah. I heard that a lot of people smoke marijuana in Hawaii. Oh yeah, we do. He said, well, we, I got something that kind of feels like marijuana. But itʻs a- itʻs a pill? Like an oxy. Oh, you wanna try it? Sure. What's your address? I'll mail you. I'll mail you something for free. Boom. Right? And then you really liked it? Next, maybe next couple weeks say, well now it's gonna cost you, you know, so if you send me money, I send you some pills, you know, a 30, 30 day, whatever. So I think that's how it got in initially. And then, and then and then she might have taken. Thinking that it would relax her. Because there are, you know, again, self-medication, right? And there's like a combination of effects. It's like the perfect storm. Cause we have a shortage of mental health professionals, a shortage of psychiatrists. So if a kid's waiting for an appointment and it's out two months and they gotta deal with the anxiety and a big brother or cousin says, hey, I got these pills. It makes you relax. Which is I think what, what happened. and, and that's, that's the dangers because even the cops, they tell us, you know, chemo from all the fentanyl pills that we're seizing from the, our drug bus, eight 60% are coming back through these toxicology reports. 60% of them has enough fentanyl to kill somebody. 

Tanya: I mean, you can't blame people for self-medicating. The world is a little bit crazy right now. You know, so this, it's great that we have a task force specifically on this because this is not gonna be the last drug that comes through, right, our community. So tell us about some of the innovative stuff you guys are doing with the task force because you guys have like a overdose prevention strategy basically..

Kimo: Yeah. Yeah. Cause we're not gonna incarcerate ourselves or even bury ourselves out of this. Right. We, we, we gotta, we gotta work on prevention. And so, one of our priorities is basically education and prevention, because we found that nobody goes from chocolate candy to fentanyl. Okay. There, there's a little gateway action that's happening over there. So kids gotta be aware of that. You know what, alcohol, there's something in alcohol that mimics what we have in our brain. There's an alcohol neurotransmitter. Same thing with with cannabis. We have a cannaboid transmitter, a neuron, we have a nicotine neuron, and that's what make these gateway drugs dangerous. It's because if you keep consuming it and that part of that natural reward, that dopamine reward system that we have in our brain, you know, that releases feel good chemicals every time we meet somebody new or we do something fun or somebody tells us a great joke or we eat something that just chocolate or whatever, you know it, we have this natural feel good chemicals, but, but what's gonna happen is, If you start to replace it when your mind's still developing at, at, at a age where it's like under the age of 25, cause our brain's not fully developed until age 25, then the, that part of the brain will shut off and it's gonna expect you to go get your fear good chemicals on the outside. And that's called craving. And that's when you know somebody is in, in the stage of I need it. And so when, when you're stuck in that stage of I need it, that's addiction. So we want, so our, our big priority is, is let's educate these kids. I think they gotta, no, and it's not enough just to say no, just say no to drugs that didn't work through the Nancy Reagan, you know, big initiative where this is your, this is your-

Tanya: I remember that. Right. We were kids that just say no campaign.

Kimo: Yeah, it didn't work. So why now we wanna replace the word no with the word, with the word k n o w. Because knowledge is power and with youth knowledge is a superpower. So I show 'em pictures of what cocaine looks like. I wanna know, I want, I show 'em a picture of what, what vaping does to their bodies and, and, and, and and the chemicals that goes into a vaping device. You know, a vaping device is, is, is up. You can get the nicotine is up to 42 cigarettes. So the potential for addiction is really high because what we're trying really high, 

Tanya: Itʻs really high.

Kimo: Yeah, super high. And here's the deal, once you see when you can get addicted to a vaping parent or a marijuana joint, or you just keep drinking, it's, it's kind of easy to get to that next level of drugs, which is meth. Meth is still the biggest drug of choice on, on our island, and so, and that's where Fent is being laced now, fentanyl's, not just in pain pills, that that's a-

Tanya: And these aren't the same level of drugs that we're, we were exposed to, you know.

Kimo: Yeah, exactly. Yeah, yeah, exactly. Yeah, yeah, yeah. Take away the, the fentanyl. I mean, marijuana is super toxic.The, the way more toxic than what it was when we were, you know, back in the day. And vaping is super toxic, just like I shared with you, up, up to 42 cigarettes, one vaping device. So, so they've conditioned their brain to, to have these addictive habits. So, The worst. Well, people say, what is the worst drug? Well, the worst drug is the one you're addicted to. 

Tanya: Good answer.

Kimo: But, but the one that can get you stuck real quick is meth. So, so education's a big component. I've been around to about, you know, 58 schools almost going on 70 schools on the island. Charter schools, public schools-

Tanya: So you're focusing in that like, like younger age group before they even get started?

Kimo: Yeah, well the thing is, I, I started, my first presentation was at Kamehameha School- High School, and then one of the teachers was like, Hey, maybe you should do this in the middle school. Then I did it at the middle school and then my parents said, you know, I have a fifth grader. Could you do it at the elementary school? I just kept going and the same presentation, you know, I thought it was kind of graphic and very to the point at the high school level, but, I guess cuz kids can get it through the, get that information through the internet anyway, you know? Then we might as well give them that information in the correct-

Tanya: I mean, they all got one of these (phones) nowadays.

Kimo: It's true. It's true. Yep.

Tanya: Well, I think that's great that you know, cuz the overdose prevention is so important. I read on the CDC website that like 40 and I, or maybe it was verified by Johns Hopkins University, 42% of overdose deaths, someone else is present with them. And so if we have the Narcan, or maybe you should talk a little bit about the Narcan, but if there is something that can help someone when they're in the midst of an overdose, that would, that's gonna save, you know, possibly 40% of the people if someone else is there.

Kimo: yeah, yeah. Well, yeah. So for, so in our island, one person every 11 days are dying from an overdose mostly associated with that drug, fentanyl. But, but three people every 11 days kind of roughly speaking are being saved through what you mentioned, the overdose reversal drug medication which is, which is Narcan. And right now it's being made available, well, you know, in pharmacies. But it's gonna be made available over the counter pretty soon. And it looks like this. So there's a box that looks like this. See, but let's see. Turn light up this way. Yeah. So, and what it is, is so there's you know, there's like one of these nasal sprays,

Kimo: And then you just, well first, you know, if somebody's passed out, you say, hey, call 9 1 1. Right. But while you waiting for the paramedics, you know, you can do something and you could, you could give them nasal, you could give this nasal spray and you wait. Two minutes. If they don't come back to life or start breathing again, then you give a, you give them a second dose. And if it's an opioid overdose, which is our statistics telling us on this island, for everybody who's unresponsive and you, you get to call this paramedics, 30% of 'em is an opioid overdose. How we know? Cause our paramedics, every time they had our p- our paramedics do two things now. Standard operating procedure, once somebody's unresponsive, one, is they give them sugar. Two is they give them Narcan while, and this is while they're setting up to do CPR and within and like 30% of 'em will come right back alive. We don't have even have to do CPR. In fact, if, if you're a somebody who's a caregiver or somebody in the presence of somebody who's having an overdose, we don't recommend mouth to mouth CPR. You can leave that up to the paramedics because if they're having an overdose of fentanyl say, cause now fentanyl's laced in cocaine, heroin, and meth. Right? So nd how, how there, there was an incident where six college students, football players actually ended up dying from a fentanyl overdose, but four of 'em died directly because they're snorting cocaine and in the cocaine had fentanyl. But two of them tried to give them out to mouth. And they didn't snort cocaine, but they had the residue on top of the, on the lips, and they ended up ingesting it and died from it. So we don't recommend mouth to mouth. We say just call 9 1 1 while you waiting. Give them the Narcan and, and just wait till the paramedics arrive. 

Tanya: Wow. So, right, so now vent that you just hit on another point. That fentanyl's being laced into, it's being put into other drugs. So people who are using other illicit, like intravenous drugs usually, but I guess don't, not cocaine, if they're snorting it.

Kimo: Yeah. No, no. It's been, it's mostly not being laced in cocaine, meth, and heroin. And why, why, why is it being laced? So, so so fat a, it's kinda like a downer, what you call it. And then a, and then a meth is a stimulant, so, you know, so So when somebody gives you morphine, you know, the, the, the re the, the potency time is, is short. Yeah. What they're trying to do, so if you put it in cocaine, it ex expands it a little bit. So the high gets to be longer. So you're up and you feel in la la land. So the, those who are stuck on a drug, they like it. That's the problem they're in. I, I, I, I, you know, I want it. I need, they're in, I need it. And, and once you get stuck on it, the withdraws are really bad. I mean, as if those other drugs weren't addictive enough and now, now you're really, they're really, so they really there were some mad scientists out there, some mad chemist out there who created this.

Kimo: Yeah. And, and now you got the drug dealers creating it. And it's mostly the cartels actually. You know? I mean, that's how it's coming into to our island, 

Tanya: Like from Mexico and-

Kimo: -T hrough the border and then mailing, it's not, you know, there's this dark web and that's, that's why they call it a web, the dark web. It's cause you could get, and then you can use cryptocurrency. You can pay through different ways to, to, it's hard for the police to track it.

Tanya: So do you have ways to evaluate how your education strategies are working? You know, like how, like how do you know you're decreasing the demand?

Kimo: Yeah, good point. Yeah. So decreasing the supply is, is good. You, you, you have it in possession, right? You can be like, Hey, and which is true in the past three years, our federal agents and police and homeland security, they seized 53 pounds of fentanyl statewide. On the big island that, you know, out of the 53 pounds, 30 pounds came from the big island.

Tanya: Whoa.

Kimo: So that's why the task force is much needed on this island cuz drug dealers like to experiment on this island. The island's big, there's a lot of places to hide. So we got the police decreasing the supply. So yeah. How do we know we're, we're decreasing the demand? You know, we don't have the data yet to, to tell us. So we gotta wait and see on that. But, but we do know that with our giveaways of Narcan, cuz we gave about 4,000 boxes away. That it's saving lives, because people are telling us Yeah. Anecdotally they're, they're, they're telling us how much lives that it's, it's saving and so that's good.

Tanya: So you also mentioned more user-centered risk reduction. So when these, when fentanylʻs getting laced into other drugs, I think you mentioned test strips where drug users can actually test the drugs that they're getting.

Kimo: Absolutely Tanya. So when you look at our task force and the priorities that we have, one I'm gonna is to, you know, increase the awareness of what drugs are in general and then talk a little bit about the gateway and, and then let kids be, be aware that hey, you don't wanna get on that track, right? So kinda like decrease the demand through education. You can also decrease the demand through what's called harm reduction. So you trying to reduce the harm, I mean, you're already in a harmful situation. We're gonna try and reduce it. How are we gonna try and do that one? There's two devices. Two tools. One of ʻem is Narcan. So if you have an overdose, we're gonna keep you alive, you know? And hopefully, and what I'm hearing is about 50% of people who be become revived from the dead, you know, start, you know that that's kinda like a turning point. Maybe I should stop. The other 50%, they're just so stuck on it. It's not a deterrent. And then the second deterrent that is, is fentanyl test strips. So, yeah, it is kind of like testing your drug. So, because some, now it's laced in heroin, meth, cocaine if you're a cocaine user or a meth user and you wanna test that drug, you could take a little bit of it, put it in a, a cup of water, and then you put the fentanyl test strip in. And if there comes out two lines, that's fentanyl. One line is no fentanyl. So what they're finding is that because you see, if you're stuck on a drug, it's very difficult to quit cold turkey because the withdrawal is so bad. In fact, even with alcoholism, doctors don't recommend quitting cold turkey. Like physically, you could die. So, so, because the withdrawals are so bad. So but what's happening is, even with the fentanyl test strip something like 30% to 40% when they realize like, oh my gosh, there's fentanyl in cocaine. Who's my drug? Well, you know, then they start to question the drug dealers. Like you, like you're sneaking in things in here that I, you know. And then that could be a turning point for change. ʻCause nobody wants to be stuck in an addiction and, and addiction sucks. You know, life sucks. You, you, it, it robs you from everything that you hope for or dream for.

Tanya: Absolutely. So what would you say some of the, like if we haven't touched on, what are some of the misunderstandings about drug addiction? Like, I mean, one of them I guess would be that it can't happen to my family, you know what I mean? Or it can't happen to me except at this point I think all of us have someone you know that, that we know that it has already affected or is affecting.

Kimo: Yeah. I think one of the biggest myths is that you choose addiction. You know addiction is, you know, you have a lifestyle that leads itself to addiction, but nobody chooses addiction. Just like nobody chooses heart disease. You know, you eat a bacon, bacons and burgers and all of a sudden you're not, you're not exercising and now you have heart disease. Same thing with diabetes. Nobody chooses that either. But addictions, yeah, you're drinking with your friends today. You smoke a joint next week and the following week maybe you snort cocaine and all of a sudden you don't know when your brain goes. See, we don't know when our brain jumps to, I need it. And if you have a history of addiction, cause there is some genetic components. If you're predisposed to addiction,  through our brain chemistry, you might get it. So that's the first thing. And, and the second thing is, is an adult disease. We're, we're finding addictions nine, over 90% of all addictions started before the age of 25. So really it's a pediatric disease and then it's a brain disease. So that's the, the, the other myth. So that's why I tell kids, if you can wait to experiment with these gateway drugs, wait till you're 25. We're not telling you, no, I'm not telling you don't use, I'm saying wait till you're 25. If you wanna experiment it that way, your brain's fully developed you can make better decisions cause that frontal lobe was also developed. You know, you, if you hang around for 25 years with somebody who doesn't use any drugs, you probably have a better cohort of friends. So, yeah, that, that's kinda where we're at now.

Tanya: That's a really good point, although I'll have to tell you when I was younger than 25, which someone told me, try, wait. I don't know.

Kimo: Yeah. It's hard. A hard one. Yeah. And, and

Tanya: We know everything when we're younger, don't we?

Kimo: Right. And, and we know they're not gonna wait. Right. But, but at least we're not saying no, because you just tell 'em, no, that's even worse, just say no. This way, we're saying, Hey, look, look at the dangers, right? At where your brain's at. So just look that every time you drink and you party, ʻcause we know you're gonna party, youʻre playing kind of Russian roulette. ʻCause if it jumps to an addiction, you stuck.

Tanya: It's definitely a more empathic way of reaching out to people. You know, like we, we know. You know what I mean? Like you can't just say no. You know what I mean? We know most people are already saying yes to something.

Kimo: Yeah. Oh, especially alcohol by, by the senior year, 98% of kids have tried it. So we just gotta keep reminding them, you know, we, like, we, we, we know that they're exposed to all these temptations and peer pressures and parties, especially now graduations coming up, you know, so, yeah.

Tanya: So what have you learned the you know, in this whole What have you personally learned, you know, and what have you changed or have you changed course on something personally or, you know, in regards to the task force?

Kimo: Yeah, I, I think what I've learned is many hands make the work lighter. You know, that there, there's no one agency that can tackle this epidemic all by itself, and it's not, it's not just a treatment provider issue. Can't just blame the cops or, you know, for like, well, why is it getting here? You know, that's the problem. It's like, it's, it's a multifaceted problem, which requires multi-discipline approaches. You know, so psychologists, therapists, social workers, surveillance you know, the, the whole nine yards. So that, that reminded me of, of the Kilauea eruption. You know, there's just, not one agency's gonna gonna help in the recovery process, gonna a number of agencies gonna, and that's kind of how how we mobilize. I, I think people are asking us, how did you mobilize so quickly? You know, we're the only county with a task force. I was on Maui yesterday talking to the, the assistant police chief and you know, they're thinking about having a task force addressing this issue as well. And I, I was last week I was in Kapolei cause they, they asked me to come up to present. ʻCause they don't have a task force. They don't have presenters. So, you know, so I went up there and, and they're like, wow, how do you guys mobilize so quickly? How do you get, I said, “Hey, big island.” You know, we, we've been through a lot: Hurricane Lane,  Hurricane Iselle, the Mauna Loa eruption, the Kilauea eruption. Know, so we, we've been there. So this is just an man-made what you call disaster, same players, different issue. So that's what, so that's one, one thing I, I really appreciate about the big island and I learned that wow, it, it's gonna take everybody to make it happen.

Tanya: So you said that, you know, like you're going to Maui in Oahu, right? To help them. So where do you get your training? Where's your mentorship coming from? Who are the innovative leaders in this issue that you are learning from, you know,

Kimo: Yeah, well, I'm a psychologist, so in my training we specialize in substance abuse and mental health issues. So, so I get it from my own academic background. But also I've been a private practitioner for eighteen years, you know as part of my Saturday, Sunday, kinda after work employment, my second job. ʻCause I've been in government most of my life and, and so I got some had, you know experience in helping people with addictions. But our island is super fortunate to have this national, international expert by the name of Dr. Kevin Kunz. Or if you're from the east side, Kunz. And he's remarkable. You know, he's almost at retirement. He's been in the field for over 40 years. He's an MD who specialized in addictions. He gets to travel all over the world sharing his expertise. He's very well, well versed in the literature. Just an amazing, remarkable, compassionate individual. Very fortunate that he lives in here in Volcano. So we, we tap him his expertise all the time, you know, and he's very like I said, you know, he is a community advocate, so this is dear to his heart. And we're very fortunate to have him on, on board.

Tanya: Right. I mean, if we were having, I saw a quote by him. I, I, maybe it was an article or something. But he said you know, if we were having this kind of epidemic where someone was being killed every 11 days by firearms or what, you know, other ways we'd be on it like immediately. And so it, you know, that's why I wanted to do this podcast. I think more people need to know what a crisis this is. Especially if you have, you know, kids at home under 30. You know, our kids are already having kids, you know, at my age. So it's affecting us in ways that we don't even know. Like my, you know, my kids' friends are affected by this. So it's really important for people to know it before it, before it affects you in an adverse way so that we can all be just ready, poised to help.

Kimo: That's true.

Tanya: It seems just like such a more proactive approach. It's not reactive. We're so used to in this challenging world that we live in right now, it looks like everything's reactive. Right? And so it's really good to see a proactive approach. Do you think it's easier on an island or more difficult to help with substance abuse and, and this kind of, you know, drug prevention?

Tanya: Thank you, Tanya. Good, great question. No, so in fact, I was asked by the KITV news reporter. She's like, well, what, what, what's the good thing about about all of this? I said, well, you know how they say Hawaii's ten years behind? In, in some respects, technology or, you know, well, if that's true, thank goodness. Because when it comes to a drug addiction and, and the type of this, this issues, it, it's great to be separated by water, from the continent. Because we have time, you know, we have time to, to, to ready ourselves. So that, and that, in fact when I'm at the schools presenting, some teachers, every once in a while, teachers are like, why are you, does any students die yet? And I said, no, not at school. There's a lot of school age children that have passed from fentanyl on our island. You know, I can count 12 you know, but none, none in school. But why, why are we gonna wait for that to happen? Right. I mean, we, we know it's happening on the continent, and that's why I'm here. I'm, I'm presenting. Yeah, it's dangerous. No, we didn't see any school incidents yet, but we don't wanna wait for that. So, yeah, you're right, Tanya.

Kimo: So that, that's really great. So another question I had was what are the indispensable skills you think that you and your task force have to have so that you could be at your optimum? You know, like, cuz how are we training like the next people, you know, like how, how do you make sure that people don't get burnout and things like that? I mean, when you're dealing with this, it's the level of compassion you have to have in the pain you might see in families. It's hard, it's hard to hold, right? It's hard to be present with.

Kimo: That's tough. Yeah. You know, we call it aloha fatigue. You can get tired of aloha-ing everybody all the time, every day. So you gotta aloha yourself too. You know, so I always encourage our providers and people I work with, colleagues to make sure you have an exercise regimen. Try not to be an emotional eater, stress eater. ʻCause the food that we put in our mouth under those circumstances are probably unhealthy. You know, and just adopt a lifestyle of, of health, which means you're gonna have to dedicate some time out of the day. Right. And the, it's like, it's like not enough hours in a day when, when you're feeling super busy, but, but you gotta make that time. So yeah, cuz if you don't have nothing in your cup to give, then you know, you can, you kind, you kind give so, so you gotta fill your cup with, with whatever it takes to rejuvenate yourself.

Tanya: So what do you do to rejuvenate yourself?

Kimo: I try to work out. Last night I, I have a walking regimen, so right around my block is about two miles maybe. And so whenever I feel anxious or you know, like, like I ate too much or something, then I just go, go walk around the block and that, that kind of, that gives me more c circulation and makes at least me, I may not be sweating. You know, my kids tell my kids, tell me, you should, you should jog. Why are you just walking? You know? But I, I don't want it to be a stressful event. That's why I'm, I'm trying to reduce my stress, so I'm figuring, I'm just walking, talking to myself, playing music. You know, last night I was listening to this kid from Hawaii Iam Tongi with an American Idol. You know, I like that for me. That, that that's what I do.

Tanya: Yep. I love watching those kids too, on The Voice and American Idol when we got Hawaii folks there. So what kind of resources does the Big Island Task Force have at their disposal or need? Like how, how do you keep this program perpetuating as long as we need it?

Kimo: Yeah. Well, we just finished a website that I'd like to direct everybody's attention to. You know, it's a one of a kind website. It's actually Hawaii Island Fentanyl Task Force, but it's not the whole spelling, it's just hiftf.org. And what you'll see is you'll see the, the six priority areas that we are focusing on, on this island. Like we talked about, prevention, treatment, harm reduction. You also see bio of the leadership. So you know, you know that this is real. People who live here who is addressing this head on. And then you'll, you'll see a link to a summit that we're gonna be having May 9th, I think. Yeah. May 9th is National Fentanyl Awareness Day. So we're gonna do a summit on that day in Waimea. And this is a, a one of a kind summit. And so we're inviting some key treatment providers the police, the fire department, HPD, mayor's office. Mayor Mitch Roth will be kind opening us up. Invite Josh Green or somebody from his team to come over. So, yeah, so on the website, you know, you, you'll, you'll see that, you'll see some information. You'll, you'll see my training that I've done with, with, with the students as well. So a lot of information. 

Tanya: And just kudos to the mayor's office cuz they moved really quickly on this. Right? In response to supporting you guys what you're, when you came up with this.

Kimo: Yeah, absolutely. Yes. Yes, they have. And so we're very, very happy for their support.

Tanya: Do you have anything else you wanna add?

Kimo: Well, you know, Tanya, I mean, this is the first podcast, you know, so I gotta go hats, hats off to you for, for seeing this as a, as an island issue, as a county issue, and, and, and for allowing me to share you know, my thoughts how important it is for us to be aware of, of these drugs, especially gateway drugs. Again, kind of highlighting the idea that, you know, nobody goes from, very seldomly, there's an accident, but that occurs too. But most of these fentanyl deaths are those with those folks who are already addicted to a drug. And so, you know, we, if we can make people aware of not getting on that addiction track and those who are already addicted, just know this, that treatment is available that recovery is possible. You know, I've seen success stories. And once, you know, and, and we, so we know people who are, you know that addiction, but we also know people who we, who are in recovery.

Tanya: I mean, the vaping seems like it's, you know, when we were, I don't remember being pushed cigarettes when I was a kid, but the vaping is really pushed to the elementary school kids. I mean, they taste like Skittles. They smell like candy.

Kimo: Yeah, no, I, and so don't be tricked. You got good adults and you got bad adults. And those bad adults are, you know, we, we never have cotton candy flavor cigarettes and Jolly Rancher flavor secrets, you know? So, but now, now they got this li hing mui flavor, you know, you know, cotton lifesaver flavor. And, and that's the problem. So we, we, as a community, we, we gotta fight back. It's unacceptable to be targeting our kids.

Tanya: Right. We, we gotta fight back. We gotta come to our common denominators and just realize that you know, our kids' future and our kids' kids' future is really important. So thank you for all the work you do. You know, I just, kudos to you. What's next for the big island fentanyl Task Force?

Kimo: yeah. Well, we're, we're getting all wrapped up for this summit coming up on May 9th in Waimea. So, so, so that's big on the list, but also now, you know, we are reaching out to other, other counties. So, so that's big because we feel like, you know, the, the only thing that's separating us from the other islands is water. So, you know, we know that people visit the big island and we visit a while when our kids are exchanging. So if every county can address it like we are, we're just gonna be one better Hawaii and that's what we're looking for and hoping for.

Tanya: Okay. You have anything else you wanna add?

Kimo: No, I think that's great. Thank you so much for allowing me to be, to be here and, and just tell everybody you gotta be safe, you know, 

Tanya: I just have one more question for you, then I wanna know, what is one of your favorite songs that is relevant to this conversation? Let's just put a, put some notes in people's ears.

Kimo: You know, I've been listening to Tracy Chapman lately. Iʻm dating myself though, but, but she has a song, “Gimme one reason to stay here and I'll turn this right around.”

Tanya: And I'll turn it back around. Yep.

Kimo: I'm, we, the just came out of the pandemic and now itʻs fentanyl, but we also have a housing crisis, right? There's and affordable crisis, things are not affordable anymore. I got, I got seven of my own children. Three of 'em are living, you know, not by choice, being priced out of paradise, right? So, so on, on a larger scale, I want, I want our future generations to have a reason to stay here. And, and, and it can't just be family cuz, cuz if that was the case, I would have my three kids back home. It has to, it has to be cost of living, quality of life and, and such. And, and addictions is one thing that can impact one's quality of life. So, so we wanna make sure we check that box. We are addressing it, but also there are a lot of other issues that we need to address on this island. And, and we need to give our kids that one reason to stay here.

Tanya: Absolutely. Well, that's a great note to end on. And then I just wanna thank Dr. Kimo Alameda here from the Big Island Fentanyl Task force for being our guest today. And just thanks for increasing the quality of life of everyone on our moku. It's really important the work that you're doing, and I look forward to what you guys do and what you're gonna be doing in the future as well.

Kimo: Thank you so much.

Tanya: Thank you everyone for listening. Aloha.

Mahalo for listening to Ola Ka Moku. For more information about the Hawaii Island Fentanyl Task Force, visit HIFTF.org. Fentanyl is potent synthetic opiod that is 50-100 times more potent than morphine and is the #1 cause of death for Americans age 18-45. If you need help now with addiction, call the CARES line of Hawaii at 1-800-753-6879. The Hawaii Island Fentanyl Task Force is a community coalition made up of 75 organizational representatives and members. Theyʻre working with our friends, neighbors and fellow islanders to raise awareness, inform and empower us to prevent addiction, drug overdose and other consequences of drug use on Hawaii Island. Thank you for supporting their work. 

https://www.hiftf.org/

This program has been sponsored by E.F. Cash-Dudley, Waimeaʻs estate planning attorney. When do you need a lawyer? In crisis or change. Visit https://efcashdudleylaw.com/