 my name is Cheryl Matsuoka, the host of today's show. I am the Executive Director of the Hawaii Restaurant Association and the Hawaii Restaurant Association's Educational Foundation. Mahalo for joining me here on Restaurants of Hawaii on the ThinkTech platform and today we're going to hear all about Honolulu City Council's Bill 28 requiring all liquor license establishments to have two Narcan kids on hand at all times. So I want to first of all thank all of my guests here today for joining me and I'm going to ask everyone to please introduce yourself. You know your name, the organization you're with and maybe a little bit about why this is such an important topic. May I please start with Councilman Tyler Dos Santos-Tam. Well, Aloha and Cheryl, thanks for having me on the show. I'm City Councilmember Tyler Dos Santos-Tam. I represent District 6 which goes from Kakaako to Kalihi and includes a number of bars and restaurants in Kakaako, downtown and Chinatown in particular. And thank you for all that you do Councilman. That is just, it's amazing. It's just amazing for everything that you do. And then have Sal please introduce yourself and share with everyone the organization you're with. I'm Sal Patelos. I'm the administrator of the Honolulu Liquor Commission. Thank you Sal. And Ali, I've been practicing your name. Could you please introduce yourself? It sounds perfect. Thank you. I'm Ali Ihariyama. I'm an administrative specialist for Honolulu Liquor Commission and I was actually put in charge of the whole distribution project for the Narcan Starter Kits. Thank you. Thank you so much. And that is a heavy lift. So thank you for all that you do, dear. Nikos, please introduce yourself. Aloha, Nikos Leverins with Hawaii Health and Harm Reduction Center. I'm a manager. My official title is Grants and Advancement Manager. Hawaii Health and Harm Reduction Center provides homeless and services in urban Honolulu. We also provide syringe access services to reduce incidents of HIV amongst injection drug users across the state in every major county. And finally, we also provide medical case management services to people living with HIV. We can do, I can go on, but we'll just leave it at that for now. Thank you for all that you do. As I said earlier, what you do for our community is so important, Nikos. So thank you. Thank you. So following the Federal Drug Administration's approval of the life-saving opioid overdose reversal medication, and we all know it as Narcan, as an over-the-counter medication, Honolulu City Council member Tyler Dos Santos-Tam introduced Bill 28. Today, we're going to be talking about Bill 28. And I know many of the restaurants who do have liquor licenses, such as my restaurants, Councilmen, are very interested to know more about it. The good thing is, and when I heard the story on the news about zippies and how the employees save someone's life, that's what we're talking about today. So I know it's an ongoing epidemic here, and I'm going to start off with asking Councilmember Dos Santos-Tam, what is Bill 28 and why did you put it into place? Yeah, you know, as you mentioned, the opioid crisis is, we're not immune here in Hawaii. This is something that's happening nationally. And here in Hawaii, we're lucky because we have groups like H3RC and other organizations that have recognized the importance of this and tried to get ahead of it, which is what Bill 28 is all about. Bill 28 requires every on-premises liquor establishment. So that's our bars and nightclubs. That's our brew pubs. But that's also places like restaurants that serve liquor, including our zippies and some of these other establishments that probably we go to fairly often, they're required to have this. And the reason why is we know that opioids and fentanyl is everywhere. But what makes liquor establishments particularly high risk is alcohol and opioids don't mix. And in fact, alcohol exacerbates the kind of symptoms that an opioid in your system would cause. And so sometimes people who maybe are on pain medication might think that they're totally fine, they're feeling good, and they go to a bar restaurant, they have a drink, and that's enough to trigger an overdose. And so we wanted to make sure that our bars and nightclubs and other establishments are protected. They have this in case the worst happens. And also this is a way of getting Narcan out into the community, which is really important just because fentanyl and opioids are just everywhere. Yes. And we became the first city in the United States to do this. And it was like a perfect time because when the zippies manager saved that man's life, it was like perfect timing, right? Councilman. And this is just one of many examples. In fact, when we passed the bill last summer, I went down to the bars in my district and particularly in Chinatown and started giving out these kits. Two weeks later, I ran into one of the managers at one of these bars and asked, I was just chatting with him and asked how it went. And he mentioned that he had to use it just two weeks after we delivered it. And it wasn't because of patron overdose. It was because an employee had overdosed. And we know in the restaurant industry, in our bar industry, a lot of them are in the industry because they're fun people, they're extroverts, they go out, they want to have a good time. But sometimes because opioids and fentanyl is so prevalent, this employee overdosed. And they were able to save that employee as well. There are numerous examples of this. And so we're hoping that this is a positive step. And it's a way that Honolulu can really be a national leader in this space. Exactly. And that's the reason why this conversation is so important, which is why I'm inviting all of you to speak about this. So Sal, now who are included, I know it's the liquor license establishment, who are included that are required to carry the two doses of Narcan on their property? So the ordinance identifies the holders of six classes of the 18 classes of licenses in Hawaii or by statutes as included businesses subject to its provisions. And let me just say that there are two things that are required of these licensees. They have to maintain a minimum of two doses of naloxone on the premises and also provide managers with managers with training on the proper administration naloxone. So the included businesses are holders of, get ready for this, I'm sure everybody's going to fall asleep, class two restaurant licenses, class five dispenser licenses, class nine tour or cruise vessel licenses, class 11 cabaret licenses, class 14 roof hull licenses and class 18 small craft producer public licenses. So it's not the whole panoply of licenses and it's not just restaurants but several others that are required to have this. Thank you. Thank you for informing all of our viewers and members because that's important for them to know. So Councilmember DeSantos Tam, Bill 28, it specifies its consequences. Can you share a little bit about that, especially if they don't have the two Narcan kits on site? Yeah. So first of all, I want to compliment the liquor commission for being a great partner in this. When we pass this bill, and Ali, I'm sure we'll talk about this, you know, we set up a structure to get this out to the bars and night clubs for free. So there's really no excuse for anyone not to have it and to comply. You can also get it over the counter at places like Longs and other pharmacies for about $30 for the two kits and it's good for several years. The consequence is it's a $200 fine. The liquor commission can also make other rules as they see fit. But again, the $200 is not meant to punish anyone. This is really meant to make sure that this gets out into the community, that everyone has it, and they also train their managers who are required to be there anytime liquor is sold to be ready in case, again, the worst happens and somebody overdoses, they can be ready to respond. Thank you. And that's the reason why we're doing this show is to inform our restaurant community that does have liquor licenses exactly what is required. So Ali, what is the number of licensees that are included under this bill? So these six classes of licenses, licensees that sell right off, we have a total of 869 establishments that fall under these classes. I think you have this later in the agenda, but I think to date we've distributed just under 500. And I want to just continue that conversation. So Ali, you do have extra, shall I say extra Narcan? We do. And it's interesting because we've continuously communicated with our licensees to let them know that we still have Narcan for them to come by. And slowly, you know, I think some of them are trickling in more so some of the new establishments that are getting licenses. We did have quite a few calls. This was probably towards the end of last year when we were doing a lot of communication that the bill was going to go into effect us of January 1st. But we were getting quite a few calls from licensees who are not part of the bill. So, you know, namely hotels. You know, after that incident that happened at Outrigger Reef, you know, so you had hotels. So what I pretty much did is I said after the bill goes into effect in January, come January, come February, give us a call. And if we did have extra, we know we want to put it into the hands of people that want it. So we've had some licensees that are not part of the bill come and pick up, but we still do. We still have extra. And the main thing is we just want people to give us a call, find out if we have extra and they can come by and pick it up. Thank you. Thank you for that service that you're providing. Now, Nicos, please share with us. You shared a little bit about the Hawaii Health and Harm Reduction Center, fondly known as HHHR. And do you want to share a little bit more about your organization and are you also providing Narcan to people? Hi, yes. H3RC has been involved in the overdose issue, larger overdose issue. In some respects, since going back to our child days for over 30 years, providing sterile syringes to people who inject drugs in every county in Hawaii. Once upon a time, we used to provide syringe naloxone. Now, we provide, as you can see here, we provide these naloxone, two of them, via our vending machines, which came online last fall. We partnered with the Department of Health in getting those vending machines online. And if people looking at this want to get that, go to hawaiiopioid.org, and they'll have a map of vending machines that are available. We've been very involved in the Hawaii Opioid Initiative since inception, and Executive Director Heather Luss was an elite facilitator of several of the working groups of that initiative and presented the findings of the Opioid Initiative back in 2018. Ms. Luss has extensive experience in the area, and she's been a real leader in getting the word out on opioids and the need for naloxone, because we're not just talking about people who use illicit drugs here. As Council Member Dos Santos-Tam so rightly noted, people can overdose even with prescription opioids, even if they've been using it for some time, even if they've used it with alcohol. When you mix opioids with alcohol, particularly in this warmer climate, there's so many factors that go into why a person overdoses in a given instance. So whenever you have alcohol, you really should not be using opioids or vice versa. If you're using opioids to take pain meds, refrain from alcohol, because that can cause respiratory depression that's fatal. So I encourage people to take advantage of this law in terms of the availability of naloxone. And more importantly, I would hope that city government and state government utilize a portion of its opioid settlement proceeds to ensure that naloxone gets into the hands of as many people as possible who need it. We know that there's always a lot of politics around that, but H3RC has distributed over 50,000 doses of naloxone over the past five years. And our Executive Director has said that it's time for us to get out of the reimbursed business of naloxone distribution. So we hope that the state and the city can step up its efforts. Thank you, Nicos. Such important work that you do, as I said, thank you for all that you do. Councilmember Dos Santos-Tam, bill 28 requires blue card holders to be trained, right? And so what is the responsibility of those blue card holders under the Liquor Commission Certificate of Registration requirements? Yeah, so under bill 28, the blue card holders, which are basically the bar managers, they're required to be on site anyway, anytime alcohol is served. They need to be trained in the use of Narcan. And that means also being trained in simple things like recognizing an overdose. Nicos actually, through H3RC, they have a lot of resources available on their website. And Narcan, because it's a nasal spray, this is not, it's not as difficult as CPR to be trained in. It's not all that complicated. It's a little plunger that goes into the nose and you spray it. But the key is also understanding the signs of an overdose and also how to care for somebody even after administering the Narcan. The most important thing also is calling 911. And these are things that all managers, in case of any kind of emergency, whether it's an overdose or not, should be ready for and should be akamai enough to do. Thank you. And I heard that it's a video. Am I correct that the blue card holder, maybe Sal or Ali, is that what I understand? Yeah, so we actually give out a resource. So I created a resource card for all of our licensees. So they get one of those with the kit when they pick that up. And there's a bunch of QR codes. We have QR codes on there that goes to H triple of RC, as well as the video. And I tell my staff at the front, just we recommend that everybody that works at the licensee to watch the video. It's a pretty short video. There's a few little quiz questions. But it's really important information to know. So also included in our server training. So bartenders and managers are all required to take server training with us before we issue the liquor ID card. The server training is good for four years. So obviously, we're recycling people through server training every four years. But there is definitely a Narcan piece in server training. It doesn't go into a lot of detail, but it gives lots of resource information as well as the training of blue card holders information to everybody that's coming through our our server training program. And that's what I heard from all of the card holders. You know, they show it's Cheryl, it's watching a video and it seems like it's what do you call that when you have like an allergy or a sinus? Councilman? It's just like a blown is or something, right? A lot of people are familiar with that. That's exactly what they said to me. It's like when you have a cold or an allergy or a sinus, right? So it's as simple as that, right? Yeah, but again, oh, Nico's, please. It's a really, again, it's a really simple method of administration. When I first started working at H3RC, we gave people vials and syringes. And that can be very cumbersome. And a lot of people are needle phobic and, you know, are have concerns about that. So having, having this, having this plunger, sometimes you need two doses too. So this is why the law has required two doses, because sometimes one is not enough. So again, mahalo to Councilmember Dos Santos Tam and the Honolulu City Council for for being a national leader on this. Hopefully, you know, we can get this kind of a similar law passed statewide this session and that Hawaii can tell the rest of of the United States that we are doing all that we can to prevent fatal overdoses. Just because somebody overdoses doesn't mean they have to die. And, you know, mahalo again, to those restaurants and establishments, our many licenses that those hundreds of licenses, they may be for for taking, you know, a public health approach in case one of their patrons or consumers, you know, collapses and potentially, you know, has has the ability to to perish and let's let's stop that if we can. Thank you. And that's why this is such an important conversation for me, Nicos, because as you know, right, that's what it's all about is that we have to, you know, it's our own, it's our community, we have to really, really do everything we can. And you're right. The public needs to know my my restaurants and my liquor license holders need to know all about this. And I'm going to give everybody an opportunity to do a final statement. And again, this is a very important conversation. And if anybody has any questions, please reach out to the Hawaii Restaurant Association. I'm going to start with councilmember dos Santos 10. What does the public need to know about the opioid overdoses and about bill 28? Well, what the public should know is this is a national crisis, but Honolulu is taking steps to become a leader in preventing this. You know, we need to work together with our state and federal government to get this under control. But for our part, we're making sure that patrons in our bars and nightclubs have have access to this, they're going to be protected in case there's an overdose for restaurant owners and nightclub owners. We also want to make sure that if somebody were to overdose that you're ready to respond. And so there aren't there's not disruption to, you know, your operations. I also want to note the bill 28, the idea of this came from a nightclub owner. And so this wasn't something that we just thought up out of thin air, but it really came from the advocacy of a lot of forward thinking establishments themselves. I think in closing, this is a really good opportunity for us as the government to work with other agencies like the liquor commission to work with our nonprofits like H3RC, as well as with our business community to really do something positive. Thank you so much, such as the Hawaii Restaurant Association, who we represent so many of the eateries and and establishments that have liquor licenses. And the other thing you said that just reminded me, I also heard that if somebody is having maybe a seizure or maybe, you know, when you have like, is it is it like a blood sugar? And so let's say they faint or something. And if you do administer the Narcan, somebody answered this question. Evidently, it's not it's not going to affect them in any way. It's totally safe. If you're not sure if the person's having a seizure or an opioid episode to administer the Narcan. That's correct. In fact, if a person is in a diabetic coma and is shaking the way people do under diabetic comas, unfortunately, I've seen people in my my own household do that deceased now. But to look for the signs of opioid overdose is one thing is very important. So again, if they're if they're if they're having seizures, it's probably not an opioid overdose and an opioid overdose. You have a limp body, you know, unresponsive, very shallow breathing, and they might be making choking or gurgling sounds. So if we run our our our knuckles against the sternum, and they're not responsive, that might be in an indicator that they've overdosed. So that's one way to kind of check to see if somebody has overdosed. Thank you. And thank you for confirming that if it is another episode of some sort and not an overdose, if there's no harm in any way that will, because I know many people would be hesitant, right? Like, how do I know? Because I'm not trained, you know, in the medicine, I wouldn't know, right? All right, so how so what does the public need to know all about this whole bill 28 and our opioid overdoses and situation here in Hawaii? I think we've managed to discuss all the technical aspects of the bill of the ordinance. The one thing that I'd like to say right now is we're kind of ending the session here. I'd like to thank the Department of Health, alcohol and drug abuse division for providing the for providing the the Narcan gets to the liquor commission. I think that they were the ones who supplied it for us. And as Ali says, we've been able to distribute close to 500 of those, either by licensees coming to the office to pick up kids or giving them, giving some of them to Council Member DeSantis time's office to to to distribute to to his to his district. Another thing too that I just something to build on what Ali said. We still have some and we're providing those in the first come first serve basis. And I think the only thing that Ali didn't say was the phone number that they need to to use. And that's 808-768-7333. And with that, I'll leave it to Ali and Nicos. Go ahead Ali. Thank you. Yeah, it's just the easiest thing is to call our office first before coming down. You know, we have people make appointments for other things, liquor IDs card, but but to come and pick up the kid just come and pick up the kid if you need one. I can also say because I've taken a ton of phone calls and answered a lot of questions. I think the biggest fear was just when do I give it? What if I give it at the wrong time? I mean, those were some of the comments that were coming or questions that were coming from our licensee people. So, you know, I did my best in research, referred them a lot to the HHHRC website so they can read up. We've got a bunch of information on our website as well. But we are just very pleased to do our part to distribute to the people that need it. And I think it's gone really well. Thank you. Thank you, Ali. Thank you so much for all that you do there. All right, Nicos. Any closing statements? Yes, I just, yeah, I just wanted to express sincere gratitude to Council Member Tam and the others on this call and especially people who are watching this from the business community. You know, here in Hawaii, things are pretty special. We take care of ourselves and we take care of one another. And this really represents, you know, an opportunity for the community to come together and rally around public health and to take a very proactive approach to accidental overdoses. You know, every overdose need not be fatal. Unfortunately, some will go by the wayside. But to the extent that we can save lives, this is such a necessary response. And we're just so grateful to have, you know, political buy-in and now the buy-in of the business community. Because if a patron isn't alive, they can't come to the establishment, right? So mahalo to everybody on this call. And to the leadership of our state and local officials as well for authorizing and green lighting, widespread naloxone distribution, even though jurisdictions on the continent aren't doing it quite as robustly as we are. So mahalo, everyone. Thank you. Thank you, everyone, and to all my guests. And in closing, I just want to inform our viewers, according to the Cleveland Clinic, a drug overdose is the leading cause of accidental death in the United States, with opioids being the most common cause. And Hawaii isn't any different. According to some of our health officials and the stats that has been collected over the past five years, fatal fentanyl overdoses in Hawaii increased 400%, which is just shocking to me. But I just want to thank my guests again today. And this is a very important conversation. Please, if anyone has any questions, reach out to me at the Hawaii Restaurant Association. And again, the Hawaii Restaurant Association is the organization unifying, representing and supporting the Hawaii restaurant and food service industry. Please remember, nourish your connections, save your life, eat well and live well. We'll see you at the next show.