Online sales, fentanyl-laced pills: Outreach workers struggle to tackle Hawaii’s evolving drug crisis

HONOLULU (HawaiiNewsNow) - Drug use is changing in Hawaii.

Deals aren’t just hand-to-hand transactions in the shadows anymore. More powerful drugs are instead being purchased online ― oftentimes on social media ― and sent directly to homes.

And oftentimes, people are getting much more than they asked for.

“The pills we’re seeing on the street, that people are getting via the internet and social media, are not the real Adderall, not your real Oxycodone, not your real Xanax,” said Leslie Tomaich, assistant special agent in charge at the Hawaii office of the Drug Enforcement Administration.

“They’re pills laced with fentanyl.”

Fentanyl is a synthetic opioid. It is a prescribed drug, but increasingly it’s being made and used illegally because it is cheap and highly addictive.

“Drug traffickers are, I believe, targeting kids simply because their goal is to get as many people addicted to these drugs as possible, so they have lifelong clients for job security,” Tomaich said.

The DEA urges parents to be aware of what their kids are buying online ― and what they’re sharing with friends.

And it’s not just the prescription pills that are being laced with fentanyl.

Street drugs, even meth, now have it.

A drug 100 times more potent than morphine

Paij Nakamura, who works the syringe exchange van for the Hawaii Health & Harm Reduction Center, said meth injectors are telling her their drugs have made them feel sleepy at times ― a sign it could be laced with fentanyl. The syringe exchange van has now started distributing fentanyl test strips.

Two heroin users who visited the van tested their drugs before using and showed Hawaii News Now the results.

“Positive, it’s positive,” one of the users, a woman, said after the test strip indicated her heroin was laced with fentanyl.

Fentanyl is 50 times more potent than heroin and 100 times more potent than morphine. The test strips allow people to adjust the amount they use based on the results.

The woman who tested her drugs filled three clean needles that she got from the exchange van with her heroin. She used alcohol wipes that she also got from the van to clean a small area on her foot, then she injected one needle full.

A man who she was sharing the heroin with injected it into his arm, a muscle shot, because his veins are no longer easily accessible.

Both are grateful for the HHHRC syringe exchange program.

“If it wasn’t for them, there’d be dirty needles all over the place,” the woman said.

The exchange program helps keep needles from ending up in the parks or beaches.

The two who were using said they have tried quitting heroin many times, but couldn’t handle the painful withdrawals.

‘I made the mistake of trying it’

Nakamura knows that pain.

A former heroin addict, Nakamura was once homeless, living among those who now visit the van.

“I lived in the tunnel underneath the Kuakini bridge,” she said. A drug-related arrest that came with an open 10-year prison sentence is what convinced her to get sober.

Now she focuses on others.

She knows she cannot make them quit using, but she can help them stay safe.

“Without it there would be a lot more diseases going around,” said one of the visitors to the van, who did not want his name used.

He said dirty needles would be shared if they weren’t able to exchange them.

One of the visitors, Dave Hogan, is also a recovering heroin addict who used to live on the streets of Chinatown. He and Nakamura have become friends as both try to help the users who were once their neighbors.

Hogan said drugs made him a thief. He made the choice to quit when he, too, was staring down a long prison sentence.

Hogan’s addiction started with prescription opioids.

“It became harder and harder to find these pills and when you did find them, they’re over priced,” he said. “My dealer at the time recommended that I try heroin and that was always something I told myself I wouldn’t touch.” But suffering from withdrawals and being broke, he did.

“I made the mistake of trying it,” he said.

Staying sober is still a struggle for Hogan, but he has a lot to lose now and that’s keeping him on his current path.

He is working on getting a master’s degree in social work from the University of Hawaii and volunteers as a drug rehab counselor.

Meth fatalities up in Hawaii

Some of his outreach work was done with Dr. Mark Baker, an emergency room physician who started a website called endmeth.org. Baker has treated many patients suffering from long-term meth use.

“The most common thing we see is someone’s got a heart condition because they’ve been using meth for years. The heart is overworked, it gets big, it doesn’t pump well, fluid backs up in the lungs,” he said.

Meth is still the drug of choice in Hawaii and is overwhelmingly the cause of most drug-related deaths.

In 2020, the High Intensity Drug Trafficking Area program reports that 197 people died because of meth use, more than the previous three years.

Fentanyl was blamed for 26 deaths last year. In 2019, that number was 19 and in 2018 it was nine.

Experts believe those numbers are climbing this year with an increase in fentanyl-laced prescriptions.

Baker said meth users primarily still smoke the drug, but recently he’s learned, many have started injecting it. And it is being mixed with other substances, including fentanyl, despite the fact the drugs have opposite effects on people.

Baker and the other outreach workers say it’s a challenge to keep up with the evolution of drug use in Hawaii, but they are committed to be there for those who want their help.

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