By Peter Boylan
The Honolulu Star-Advertiser
HONOLULU — The state Department of Health issued a warning Saturday about “a dangerous batch of fentanyl-laced cocaine” after five people between the ages of 22 and 32 overdosed in Waikiki early Thursday morning.
Emergency Medical Services technicians responded to a call of three people down at a bar on Lewers Street at 1:21 a.m. Thursday. Honolulu Police Department officers responded first and were able to administer Narcan nasal spray to try and counter the overdose.
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Dr. Jim Ireland, director of the city Emergency Medical Services Department, told the Honolulu Star- Advertiser in an interview that a Thursday, 1 a.m. call for three people down at a nightclub in Waikiki, “that’s already unusual.”
“Now if these people were by themselves in a hotel room or house or something, all of three of them may have … died. But because they were in a public place, somebody called 911,” said Ireland, noting EMS sent three ambulances and a supervisor in an SUV. “Police had already given some Naloxone. It worked but it didn’t work enough to wake them up. They needed additional doses of the Naloxone from the paramedics.”
At 2:08 a.m. Thursday, EMS got called again to the McDonald’s on Kuhio Avenue where two more people went down with suspected overdoses.
Ireland said call 911 if someone is overdosing and then administer Narcan. If an initial dose of Narcan does not work, you can keep giving it to a suspected overdose patient until help arrives. Keep the person awake, breathing and lay them on their side.
“Of those five people, all of them went to the hospital, all of them were in serious condition. They all responded to Narcan. But what a couple of them said was, ‘We did cocaine.’ So very clearly they caught a narcotic and we suspect it was fentanyl in a powder form that they thought was cocaine,” Ireland said. “The message is don’t do drugs. If you do do drugs, know what you’re getting. You are obviously not buying this from a pharmacy. You don’t know what’s in it.”
On Saturday, state health officials posted a warning on the department’s social media feeds about the potentially deadly batch of blow.
The message said the state “recently learned of a dangerous batch of fentanyl-laced cocaine circulating in Honolulu that has led to suspected overdoses.” It urged drug users to “assume there is fentanyl in all illicit drugs,” don’t use drugs alone, always carry naloxone (distributed as Narcan), and use fentanyl test strips.
“Spread the word,” the DOH social media post read.
HPD said the overdose cases remain under investigation, and at this time, neither “fentanyl nor any other specific substance has been confirmed as the cause of the suspected overdoses.
”The public safety announcement was issued as a precautionary reminder about the dangers associated with consuming unknown substances, including the possibility that illicit drugs or counterfeit medications may contain fentanyl or other dangerous substances,” Maj. Jerome Pacarro, head of HPD’s Narcotics/Vice Division, told the Star-Advertiser
Hawaii Department of Health officials said “there have been incidents” recently involving drug overdoses.
“… However, DOH does not disclose numbers less than 10 due to concerns about privacy and identification,” officials said in a statement.
“Some recent severe overdose cases involving individuals who ingested a white powder believed to be cocaine prompted the warning. DOH learned about the cases from the Hawaii Emergency Medical Services Information System, the statewide electronic repository for EMS responses,” officials told the Star-Advertiser. “DOH currently is not working with law enforcement.”
On Jan. 1, 2024, Honolulu became the first U.S. city to mandate that its more than 860 alcohol-serving bars, nightclubs and restaurants keep naloxone nasal spray on hand to counteract opioid-related overdoses. The law was spurred by a June 5, 2023, mass overdose incident in a Waikiki hotel room that killed two Hawaii island paddlers and sent four people to the hospital.
In 2025, 75% of the 374 general drug-related deaths statewide involved meth, while fentanyl deaths declined “after experiencing an upward trend since 2019,” according to the Hawaii High Intensity Drug Trafficking Area’s 2027 Drug Threat Assessment.
Fentanyl deaths in Honolulu fell from 52 in 2024 to 32 last year. Methamphetamine deaths statewide rose from 260 in 2024 to 280 in 2025, while fentanyl deaths dropped from 103 to 76.
“Hawaii law enforcement believes methamphetamine is Hawaii’s greatest drug threat, followed by fentanyl; whereas the Hawaii Health and Harm Reduction Center believes fentanyl is equivalent to meth as Hawaii’s greatest drug threat,” the HIDTA threat assessment determined.
Ireland said EMS has seen about one drug overdose a day since Thursday. The spate of overdoses reminded Ireland of a stretch during 2023, when EMS saw about 10 suspected fentanyl overdoses a day, and about half of the people thought they were doing methamphetamine or cocaine. It ended up being fentanyl and people lost consciousness.
“What’s difficult is people that think they’re doing cocaine or methamphetamine, don’t carry Narcan because … that’s not an antidote for stimulants, it’s an antidote for narcotics; heroin, morphine, OxyContin, and fentanyl,” Ireland said.
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