Data published by the Department of Health show use of drugs commonly associated with painkillers is rising.
Opioid related deaths also jumped.
Residents between the ages of 50 to 59 had the highest number of fatal overdoses.
Research found a majority of overdose deaths occurred in Puna, Hilo, Makawao and Waianae.
"Issues around poverty and stuff like this definitely have an impact. What happens when people are struggling in their lives, they want to get out of that struggle and sometimes often, the way to get off of that struggle is the use a mind altering substance," Eddie Mersereau, Hawaii Department of Health said.
Various members from the medical field and law enforcement briefed state lawmakers on a proposed plan to counteract opioid misuse.
Initiatives include improving treatment and ramping up efforts to educate the public.