Colorado, like many states, is mired in an opioid addiction crisis that gets worse every day. Rural Colorado has been as devastated by opioid addiction as any other part of the country. That’s saying something. Public health officials have called the opiate epidemic the worst drug crisis in United States history.
In the 2010s, Colorado saw a major surge in opioid prescriptions and opioid overdose deaths. In 2013, Colorado had the second highest rate of prescription painkiller abuse in the country, according to the National Survey on Drug Use and Health.
The state experienced many of the trends that are common on a national level. Medical patients who were prescribed opioids to manage pain from injury or surgery were given opioids and got hooked on brand name drugs, such as OxyContin and Percocet.
Many pain patients became addicted, and they began shopping for doctors who would give them opioids. Some doctors take advantage of people with addiction. Instead of referring them to rehab programs, Dr. Kenneth Allen Pettine allegedly wrote fraudulent prescriptions for cash. He was arrested in Johnstown, Colorado in 2016, according to the Greeley Tribune.
The police officers and DEA agents who arrested Pettine may have identified him through a prescription drug monitoring program, which the state implemented in 2013. Doctors and pharmacists are now required to log all opioid painkiller prescriptions in the database, which law enforcement can access to identify doctors who over-prescribe.
Rural areas have become the center of the opiate crisis nationally. In Colorado, rural areas face unique challenges. Public officials in these communities have less experience and fewer resources than their urban counterparts.
Southern Colorado’s main industries include agriculture and transportation services. Both industries are dependent upon strenuous labor that can cause major injuries and disabilities that require pain management.
That may be why the area has such a high rate of opioid painkiller prescriptions from Medicare. Medicare disability benefits are available to people who have been injured or disabled on the job.
Colorado has a higher Medicare opioid prescription rate than the national average, and southern Colorado has an even higher rate of pain prescriptions than the state average, according to the Colorado Health Institute.
Law enforcement officials have struggled to respond to increased drug trafficking, which was not previously a priority in southern Colorado’s small towns. First responders report caring for opiate overdose victims far more frequently than they have in years past. Emergency room workers say the same thing, according to The Denver Post.
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Residents of small towns and farms generally have fewer health care options than city dwellers. Patients must travel long distances to find rehab. Others have to drive long distances to pick up their prescriptions of Suboxone and methadone, medications that wean patients off of opiates. That’s tough for people in early stages of recovery who may not have access to transportation.
Many small towns don’t have professional first responders and are dependent on volunteer firefighters. Colorado has a shortage of qualified volunteers for those positions.
Even experienced volunteer first responders have trouble mobilizing and arriving at remote crisis sites. In Holly, population 800, a volunteer ambulance crew responded to an overdose call but found their patient dead on arrival.
Small town police departments don’t have full time officers to combat the illegal drug trade. The departments also have trouble retaining officers for a long time. Departments in bigger cities usually pay officers more.
Fortunately, police officials in Colorado’s small towns have begun to adopt some of the best practices that big city departments have used for years. These harm reduction policies include coordination with social workers, hospitals and courts. Some departments refer overdose victims to hospitals instead of sending them to jail.
“We realize it’s not just a law enforcement problem,” Otero County Sheriff Shawn Mobley told the Denver Post in 2016. “It’s a community problem.”
Colorado officials and the public have taken several steps to combat prescription drug abuse. Unfortunately, the state’s opioid nightmare has begun to transform itself into a heroin crisis.
Many people addicted to opioids have turned to heroin because it’s less expensive and easier to get than prescription drugs. Heroin and prescription opioids affect the human body in similar ways, so an opioid user can switch to heroin to avoid withdrawal and feel a similar high.
Melissa Morris, a resident of Sterling, Colorado, became addicted to opioids after receiving a prescription during her recovery from a cesarean section.
“You can buy a gram of heroin for 50 bucks,” Morris told NPR. “That’s why so many people here have turned to heroin.”
Policies designed to reduce the supply of opioids have inadvertently created an expanding crisis of heroin addiction nationwide. According to the CDC, three out of four new heroin users in 2015 reported using prescription opioids prior to using heroin.
In 2016, prescription opioid deaths dropped six percent in Colorado. Heroin deaths went up 23 percent.