2021 Hawai'i State Harm Reduction Conference

January 7-9, 2021

This year, we came together to celebrate 25 years of our conference and broadening the reach of harm reduction in the islands. Mahalo for your attendance!  Please find an archive of our conference program and recordings of our sessions below.


"The Future Is Harm Reduction"


Harm Reduction is a philosophy and set of strategies for working with people engaged in potentially harmful behaviors. The main objective is to reduce the potential dangers and health risks associated with such behaviors, even for those who are not willing or able to completely stop. Harm reduction uses a non-judgmental, holistic and individualized approach to support incremental change & increase the health and well-being of individuals and communities.

The 2021 conference theme is “The Future is Harm Reduction.” Our sessions will explore how current societal issues can be aided by a harm reduction approach to mitigate the complexities individuals and communities contend with as they advocate for social change.

DAY 1: JANUARY 7, 2021

Morning Plenary: Hoʻopaʻa i nā wa i hala, hoʻonoʻonoʻo pono no kēia manawa, a me ka ʻike i nā wa ma hope

Speakers: Dr. Kamanaopono Crabbe – The Kohala Institute

Dr. Jamee Māhealani Miller – ʻEkolu Mea Nui

Overview: This presentation is anchored in Native Hawaiian values and practices. The presenters will share different concepts that provided solutions for families and communities in traditional times that are relevant today and in the future.

How Healthy is Public Health: A Moderated Debate

Moderator: Peter Silva – Hawaiʻi Island HIV/AIDS Foundation

Speakers: May Rose Dela Cruz – University of Hawai‘i at Mānoa, Office of Public Health Studies Program

Thaddeus Pham – Hawaiʻi Department of Health, Harm Reduction Services Branch; Hep Free Hawaiʻi

Overview: During the ongoing COVID-19 pandemic, an emergent theme for the general public and the media has been (mis)trust in public health leadership. Considered in the historical context of horrors like the Tuskegee experiments on black bodies and the syphilis experiments on Native Hawaiians at Kalaupapa, mistrust of health systems is often higher among black people, indigenous people, and other people of color. As an institution grounded in a capitalist, colonial culture of outcomes, quantitative data, cost-savings, and bureaucracy, there are persistent if less dramatic harms that are often perpetuated with good intentions. This moderated debate will explore to what extent Public Health, the institution, continues to harm and help communities and to what degree it can effectively operationalize the values of harm reduction.

Harm Reduction 101

Moderator: Tiare Sua – Maui AIDS Foundation


Kekoa Kealoha – Hawaiʻi Island HIV/AIDS Foundation

Bianka Tasaka – Mālama Pono Health Services

Overview: Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. In today's world, we see the principles and tenants of harm reduction being applied in all areas of life. This session will provide attendees an overview and understanding of the tenants of Harm Reduction. This session will also provide 2 dynamic examples of harm reduction being implemented locally and virtually.

Mindful Forgiveness: Breathe and Let Go to Live Life on Purpose

Speaker: JoYi K. Rhyss, Mindful Forgiveness Institute; Moxie Fitness LLC

Overview: The Mindful Forgiveness workshops is a professional development training program funded in part by The Office of Youth Services designed to teach & promote mindfulness and forgiveness as foundational daily living skills using the two research based tools: “Forgive for Good” by Dr. Fred Luskin and “Mindfulness in Daily Living” by Dr. Thao Le. Participants will be introduced to concepts, tools and practices that will allow them to implement a daily mindfulness practice and learn the steps to the Forgive for Good process. Participants will leave with a better understanding of how to let go of unhelpful thinking and be freer to have a more productive relationship with coworkers, family members and clients.

Harm Reduction & Law Enforcement

Speaker: Kaipo Paiva – Honolulu Police Department

Overview: In this session, you will hear an officer share his experience on how harm reduction and law enforcement can work together toward a common goal of peace.

Stigma Kills

Moderator: Leilani Maxera – Hawaiʻi Health & Harm Reduction Center

Speakers: PaijBritt Emmanuel – Hawaiʻi Health & Harm Reduction Center

Leanne Simon – Hawaiʻi Health & Harm Reduction Center

Overview: People who use drugs, and who have been homeless and/or incarcerated face discrimination in most areas of their lives. This workshop features health outreach workers who have both witnessed firsthand and experienced for themselves how detrimental discrimination is to marginalized people, and will discuss some of the ways we can change ourselves and the systems in place to fight stigma in our communities.

Abolition and Abundance: Living Beyond Punishment

Speakers: Tatiana Kalaniopua Young, University of Hawai‘i at Mānoa; Trans Hawaiʻi; UTOPIA Hawaiʻi

Laurel Mei-Singh, University of Hawai‘i at Mānoa, Department of Ethnic Studies; Hawai‘i Peace and Justice

Overview: Abolition imagines a world beyond punishment, encompassing efforts to transform the conditions that allow society to cast certain lives as disposable. It works toward a world that supports abundance, reconciliation, healing, and the well-being of all. In this workshop, participants will learn basic tenets of abolition, discuss abolition as a practical project and how it applies to our daily work, and brainstorm on paths forward for building an abolitionist future for Hawai'i.

L.E.A.D.--A Hope for Harm Reduction in a Punishment-Oriented System

Speakers: David Shaku – Hawaiʻi Health & Harm Reduction Center

Greg Payton – Mental Health Kokua

Dorene Toutant – Mental Health Kokua

Overview: In this session we will explore how L.E.A.D. (Let Everyone Advance with Dignity/formerly Law Enforcement Assisted Diversion) works in collaboration with non-traditional partners to reduce the harm of individuals cycling through the criminal justice system by working with law enforcement officials, providing wrap arounds services, and relying on harm reduction as an intervention model.

Creating Resilience During a Crisis with Trauma-Informed Care Principles

Speaker: Tia Roberts Hartsock – Hawaiʻi Department of Health, Child and Adolescent Mental Health Division; University of Hawaiʻi at Mānoa, Myron B Thompson School of Social Work

Overview: This workshop will focus on how to utilize trauma-informed care principles to create more resilience in our daily lives. TIC principles can help us establish better approaches and responses, with others and with ourselves, and better inform our ability to emotionally regulate and create balance during challenging times.

DAY 2: JANUARY 8, 2021

De-Escalating Hawaii’s Drug War: Defelonization, Decriminalization, Police Reform & Beyond

Moderator: Nikos Leverenz – Hawaiʻi Health & Harm Reduction Center

Speakers: Jacquie Esser – Hawaiʻi Office of the Public Defender

Sonny Ganaden – Hawaiʻi State Representative

Justice Stephen Levinson –Supreme Court of Hawaiʻi (Ret.)

Bob Merce – HCR 85 Prison Reform Task Force

Overview: This panel will address the ongoing overcriminalization of poverty and behavioral health concerns in Hawaii and solutions to reduce the burden of crowded jails and prisons and long periods of criminal legal supervision. Native Hawaiians remain disproportionately represented in the state’s criminal legal system. Administrative responses to COVID-19 failed to adequately protect the health and safety of those incarcerated and public employees. What are the current prospects for the reform of sentencing, probation, and parole, as well as police and prosecutor practices, in the wake of the COVID-19 pandemic and resulting budgetary pressures? How can Hawaii best reduce the harmful impact of criminalization on underserved and vulnerable communities?

Racism, Social Justice, Ho‘oponopono, & Restorative Justice


Sandra Simms – Hawai'i State Board of Bar Examiners & retired judge

Lorren Walker – Hawai‘i Friends of Restorative Justice

Malina Kaulukukui – University of Hawai’i, John A. Burns School of Medicine

Overview: This interactive session will include short descriptions by the presenters of the below objectives and a breakout session by the participants to engage in an exercise to help improve social justice skills. A whole group discussion on the workshop experience will also be provided.

Grief During a Pandemic

Speaker: Leilani Maxera – Hawaiʻi Health & Harm Reduction Center

Overview: We are currently living in a state of collective trauma, brought on by global pandemic, racial and economic upheaval, and an uncertain future. This workshop will talk about the types of grief that people are dealing with and how people who serve our communities can better support ourselves, other workers, and the participants/patients in our programs.

Native Hawaiians and Incarceration

Speakers: Dr. Jamee Māhealani Miller – ʻEkolu Mea Nui

Overview: This presentation will provide an overview of Historical/Cultural Trauma from a Native Hawaiian perspective. The connection of the disparate treatment of Native Hawaiians within the criminal legal system will also be discussed. Several examples of solutions to counter the trauma individuals, families and communities experience will be shared.

Homeless Youth Outreach - A Harm Reduction Approach

Moderator: Carla Houser – Residential Youth Services and Empowerment (RYSE)

Speakers: Lee Miyashiro – Residential Youth Services and Empowerment (RYSE)

Jasreal Feeny – Residential Youth Services and Empowerment (RYSE)

Malia Packer – Hale Kipa YO!

Overview: Using a low barrier, harm reduction approach to engage youth who are experiencing homelessness.

Decolonizing Recovery by Reconnecting through Foundations of Indigenous Healing


Lilinoe Kauahikaua – Mālama Project

Kuʻulei Salzer – Mālama Project

Overview: Mālama Project stemmed from the awareness that often times, “recovery spaces” do not resonate with indigenous peoples, indigenous ways of healing, and indigenous perspectives. Many times, “recovery spaces and recovery language” can feel exclusive to individuals of color, and those whose cultural backgrounds are deeply rooted in community, pilina, or connections, and ʻohana. We aim to address that dichotomy of individualism on the western spectrum, as opposed to a more holistic, whole healing, or ola, that well-being of the whole unit.

Domestic Minor Sex Trafficking: Beyond Victims and Villains

Moderator: Tracy Ryan – Harm Reduction Hawaiʻi

Speaker: Alix Lutnick – University of California, Berkeley, School of Social Welfare

Overview: A lecture presentation with discussion focusing on Dr. Lutnick’s book of the same name.

Nonbinary Identities and Harm Reduction

Speaker: Avvri Rathsack – Hawaiʻi Health & Harm Reduction Center

Overview: This presentation will provide information on how Nonbinary (Enby) identities are impacted by and/or impact Harm Reduction techniques and methods of care in mental health, medical services, recovery programs, and other venues of care.

Overdose Prevention, Recognition, & Response

Speaker: Leilani Maxera – Hawaiʻi Health & Harm Reduction Center

Overview: This workshop will teach you harm reduction methods to prevent opioid overdose, how to recognize the signs of an overdose, and how to respond. You will learn how to use naloxone, the opioid overdose reversal drug, and will be able to receive a free overdose prevention kit upon completing the training.

Mental Health, Substance Abuse, & Recovery Panel

Facilitator: Kathleen Merriam – Hawaiʻi Department of Health, Adult Mental Health Division

Speakers: Eddie Mersereau – Hawaiʻi Department of Health, Behavioral Health Administration

Trisha Kajimura – Sutter Health Kahi Mohala

Overview: This panel will discuss the importance of hope, resiliency, and continuity of care when systems of care breakdown during crisis. Discussion will range from micro-level interventions to macro-level systems change. After this session, participants will be able to activate skills necessary to navigate the various methods for advocating for quality consumer care; increase their knowledge about consumer-driven care and consider the consumer voice more; practice some best practices in dealing with individuals that have mental illness and substance abuse disorders.

DAY 3: JANUARY 9, 2021

Harm Reduction and Humility: Providing Medical Care for Special Populations

Speakers: Christina Wang, DNP, MPH, APRN-Rx, AGPCNP-C – Hawaiʻi Health & Harm Reduction Center

Overview: In its Code of Ethics for Nurses with Interpretive Statements, the American Nurses Association (ANA) established provisions that call on nurses to address health disparities as a matter of social justice and human rights. In Hawaii, such health disparities are especially apparent among people who are houseless and/or use drugs. To adhere to the ANA Code of Ethics, nurses must actively work to ensure that these marginalized and often medically fragile communities receive quality care without stigma. This session will explore the successes and challenges of a local community model of care that centers cultural humility and harm reduction in its planning and implementation, thereby leading to improved health, social, and economic outcomes.

CNE Learning Outcomes:

  • Describe nursing models of care for special populations that address social and health inequities.
  • Identify practices that can reduce stigma and increase healthcare engagement for hard-to-reach populations.
  • Develop actionable steps to integrate practices of cultural humility and harm reduction into existing healthcare practices.

No Longer All or Nothing: From Abstinence to Harm Reduction

Moderator: Kunane Dreier – Hawaiʻi Health & Harm Reduction Center

Speaker: JP Moses, MBA, MSN, RN, APRN-Rx, FNP-BC, CARN-AP – Hawaiʻi Health & Harm Reduction Center

Overview: This session will highlight the personal and professional journey from abstinence to harm reduction. For many, abstinence is required. So how do you find a balance. How do you work within the realm of harm reduction with a goal of abstinence? How do you live in the realm of abstinence and provide harm reduction services? Join us to hear the amazing journey of balance.

CNE Learning Outcomes:

  • Describe how abstinence is a harm reduction approach.
  • Identify at least 2 ways to implement harm reduction with a goal of abstinence.

Access, Navigation and Medical Care for the Transgender Community

Speakers: Kai Fuhriman, APRN FNP-C – Hawaiʻi Island HIV/AIDS Foundation

Natalie Mark, RN, BSN – Waikiki Health

Maddalynn Sesepasara – Hawaiʻi Health & Harm Reduction Center

Overview: According to recent DOH data reports, the health inequities for TG/GNC youth are stark, with higher rates of suicidality, substance use, and physical and sexual violence than their cisgender counterparts. Gender-affirming care by the whole healthcare team can improve health outcomes and enhance resiliency for this population. Quality TG/GNC care will be discussed by nurse providers in community settings, including opportunities and challenges.

CNE Learning Outcomes:

  • Increased understanding of the health outcomes for transgender individuals.
  • Increased understanding of the specific needs for Female to Male (FTM) transgender patients.
  • Describe successful models of transgender healthcare navigation.

Mental Health and Harm Reduction

Speaker: Courtny Tanigawa, APRN-Rx, CSAC – Hawaiʻi Health & Harm Reduction Center

Overview: This session will provide an overview of the most common mental health diagnoses seen in street medicine, correctional settings and harm reduction-based nursing practice. Examples of harm reduction techniques and resources will be shared along with the latest in evidence-based practices to support people struggling with both mental health and substance use.

CNE Learning Outcomes:

  • Identify the most common mental health diagnoses seen in street-based nursing.
  • List at least three harm reduction practices that may be effective in building rapport.
  • Describe the resources available to nurses for behavioral health challenges.

Harm Reduction in the Emergency Department and Hospital

Moderator: Ashley Shearer, LCSW, CSAC – Queen’s Care Coalition at The Queen’s Medical Center

Speakers: Brandee Webb, APRN – Queen’s Care Coalition at The Queen’s Medical Center

Caryn Hilmes, LCSW – Queen’s Care Coalition at The Queen’s Medical Center

Joele Alameida, CHW – Queen’s Care Coalition at The Queen’s Medical Center

Overview: Substance use, behavioral health diagnoses, houselessness and trauma can significantly impact a person’s health and wellbeing, their ability to access to care and their trust in medical staff. When vulnerable people are hospitalized, they often have needs beyond standard medical care. This presentation will provide an overview of how healthcare providers can integrate harm reduction techniques to increase patients’ health outcomes.

CNE Learning Outcomes:

  • Identify three health issues that vulnerable people may experience.
  • Provide an example of stigma that people living with substance use disorder, behavioral health, and/or homelessness may face in healthcare settings.
  • Explain harm reduction techniques that can be applied in a hospital setting.

Pharmacology of Substance Use Disorder

Speakers: Christina Wang, DNP, MPH, APRN-Rx, AGPCNP-C – Hawaiʻi Health & Harm Reduction Center

JP Moses, MBA, MSN, RN, APRN-Rx, FNP-BC, CARN-AP – Hawaiʻi Health & Harm Reduction Center

Overview: Medications currently used in the treatment of substance use disorder will be presented in the context of Office Based Addiction Treatment. Focus is on screening for appropriateness, legal requirements, recommended dosage guidelines, ADRs, and tapering.

CNE Learning Outcomes:

  • Identify the FDA approved medications and starting doses for buprenorphine, buproprion, naltrexone, varenicline, disulfiram, and acamprosate.
  • Identify the indications and cautions for medications used in the support of substance use disorder (SUD): ondansetron, chlordiazepoxide, hydroxyzine, topiramate, alprazolam, dicyclomine, thiamine, folic acid.
  • Describe the difference between opioid agonist, partial agonist, and antagonist.



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