Be Akamai Project
In response to the growing number of accidental opioid overdose deaths in Hawai'i, the Department of Health Adult Mental Health Division ("DOH/AMHD") teamed up with Hawai'i Health & Harm Reduction Center ("HHHRC") to create the Be Akamai ("B-Akamai") Project in 2020 to provide naloxone kits and opioid & overdose trainings throughout the state. "Akamai" in Hawaiian means to be smart and/or skilled which aligns with the project's goal of educating the people of Hawai'i on ways to reduce opioid overdose deaths.
What is naloxone?
Naloxone, also known by the brand name Narcan®, is a Food and
Drug Administration (FDA) approved, non-narcotic medication
designed to rapidly reverse an opioid overdose. It is an opioid
antagonist - it binds to opioid receptors and can reverse and
block the effects of other opioids, such as heroin, morphine,
and oxycodone. It is administered to an individual who is
showing signs of an opioid overdose and acts as temporary treatment
to restore breathing. Therefore, it is critical to obtain medical
intervention as soon as possible after administering or receiving naloxone.
The medication can be given by intranasal spray (into the nose),
intramuscular (into the muscle), subcutaneous (under the skin), or
intravenous injection. The most common form in Hawai'i is the nasal
Is it safe?
Yes. There is no evidence of significant adverse reactions to naloxone. Naloxone only works if a person has opioids in their system and has no harmful effect if opioids are absent. Naloxone is so safe, the FDA recently approved it being sold over the counter.
Administering naloxone in cases of opioid overdose can cause withdrawal symptoms when the person is dependent on opioids. Opioid withdrawal symptoms may include:
Feeling nervous, restless, or irritable
Dizziness or weakness
Diarrhea, stomach pain, or nausea
Fever or chills
Sneezing or runny nose
Does it work on non-opioids?
Naloxone is effective if opioids are used in combination with other sedatives or stimulants. It is not effective in
treating overdoses of benzodiazepines or stimulant overdoses involving cocaine and amphetamines.
Who should carry naloxone?
People who use drugs and/or take high doses of opioids for long-term management of chronic pain;
People who have been discharged from emergency medical care following opioid overdose or intoxication;
People who take certain extended-release or long-acting opioid medication;
People who have had a period of abstinence from opioids to include those recently released from incarceration;
Friends and family of people who use drugs or are on rotating opioid medication regimens;
Law enforcement such as police departments, county jails and probation;
Fire, EMS, and other first responders;
Schools and universities;
Bars and clubs;
County public health and behavioral health departments; and
Community organizations such as harm reduction organizations or substance use treatment facilities.
where can i
677 Ala Moana Blvd., Suite 226
Honolulu, HI 96813
P: 808 521 2437
74-5620 Palani Road, Suite 101
Kailua-Kona, HI 96740
P: 808 331 8177
101 Aupuni Street, Penthouse 1014C
Hilo, HI 96720
P: 808 982 8800
1935 Main Street, Suite 101
Wailuku, HI 96793
P: 808 242 4900
vending machine sites
HHHRC in collaboration with DOH/AMHD are placing vending machines throughout the state.
An interactive map of vending machine locations is currently being worked on.
Pharmacists can prescribe naloxone and is expected to be over the counter by the end of 2023.
What about storage and replacements?
Ideally, naloxone should be kept between 40° F and 80° F (5° C to 25° C) in a dark, dry place. Naloxone is sensitive to temperature, and prolonged storage at temperatures above or below those recommended by the manufacturer may decrease the effectiveness of the drug. If your naloxone is left in freezing temperatures, make sure hold it in a warm hand to thaw prior to using it. Naloxone stored at high temperatures may lose some of its effectiveness but can still be used in an emergency.
Naloxone has a shelf life of about two years. Make sure you check the expiration date listed on your naloxone and replace it if it has expired. If you are responding to an overdose and you notice that your naloxone has expired, you can still use it. Expired naloxone may still be effective enough to save a life and it will not hurt anyone if you use it. It is important to replace the naloxone when the expiration date passes.
How to administer naloxone?
First and foremost, call 911 IMMEDIATELY.
Naloxone is only active in the body for 30 to 90 minutes and its effects could wear off before those of the opioids, causing the user to stop breathing again. People who are given naloxone should be observed constantly until emergency care arrives.
HHHRC provides free virtual 1-hour opioid overdose response and prevention trainings every third (3rd) Thursday of the month. It also offers comprehensive agency trainings at a nominal fee.
Click here if you are interested.
What are Hawai'i's naloxone laws?
Act 217 
Provides legal immunity for any bystander or "good samaritan" seeking medical aid for someone experiencing an opioid overdose.
Act 68 
Provides immunity for those who distribute or administer opioid antagonists such as naloxone to person at risk of or who are experiencing an opioid-related overdose.
Act 255 
Allows pharmacists to prescribe naloxone without a prescription.
How can my organization become a distribution site?
B-Akamai supports increasing access to naloxone throughout Hawai'i and welcomes all interested organizations to become a partner. As a distribution site you would be provided free naloxone (as supplies last) for distribution to clients and community members, overdose recognition and response training, and technical assistance on distributing naloxone. If you are interested in applying, please email us.