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Hawaii authorizes syringe exchange when the director of health establishes it or designates a private provider to run one, though the law only permits strict one-for-one exchange rather than a needs-based model. Fentanyl test strips became legal statewide in June 2023, when Governor Green signed Senate Bill 671 exempting them from the drug paraphernalia law, though the change did not fully settle the issue in practice: reports in 2024 of law enforcement confiscating test strips from registered syringe exchange participants prompted a follow-up bill (House Bill 431) meant to strengthen the existing protection. Hawaii's Good Samaritan law protects anyone who provides naloxone at the scene of an overdose.
The Hawaii Health & Harm Reduction Center (HHHRC) has partnered with the state Department of Health's Harm Reduction Services Branch for five years, providing naloxone distribution, wound care, substance use treatment, and mental health services together. The Harm Reduction Services Branch itself coordinates statewide work across viral hepatitis, HIV, STIs, and opioid overdose prevention, while the broader Hawaii Opioid Initiative brings public health, public safety, and healthcare partners together on strategy, and the Opioid Settlement Project directs settlement money toward abatement efforts across the islands.
Given the gap between the 2023 law and how it has sometimes played out with local law enforcement, it is worth carrying documentation or checking with HHHRC directly about current practice in a specific county.
Last reviewed September 2026 by Penny Beach, PRS.
Recently added agencies in Hawaii
Showing 8 recently added agencies in Hawaii out of 19 total — search a city above to narrow it down
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Find agencies that offer these critical services
Safe syringe exchange programs that reduce disease transmission and provide a connection to care.
No Cost or low-cost naloxone (Narcan) distribution to reverse opioid overdoses.
Confidential testing for HIV and Hepatitis C with connections to treatment.
Basic wound care services to prevent infections and complications.
Fentanyl test strips and drug checking services to reduce overdose risk.
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Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. It is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
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