Drug abuse in Colorado is often fatal. In 2015, 904 Coloradans died from drug use, and 847 died because of alcohol use. That year, more people in Colorado were killed by drug and alcohol abuse than by car crashes.
Colorado’s substance abuse problem keeps getting worse. From 2002 to 2014, fatal overdose rates increased significantly statewide, according to CDC data. Twelve Colorado counties, including Denver, have some of the worst rates of drug deaths in the country.
A growing opioid addiction epidemic is one of the primary causes of Colorado’s drug crisis. The rate of fatal opioid overdoses in the state — which includes both heroin and opioid painkiller deaths — increased about threefold from 2000 to 2015. Opioid addiction has become increasingly common in urban counties and rural areas in southeast Colorado.
Until recent years, heroin addiction was mainly confined to the Front Range urban corridor, which includes Denver, Pueblo and other urban counties. Now, the crisis is statewide, and many rural areas do not have the health care or first responder resources to save lives and help struggling people into substance abuse treatment.
The rate of fatal opioid overdoses in the state — which includes both heroin and opioid painkiller deaths — increased about threefold from 2000 to 2015.
Experts hope the opioid addiction epidemic will not be as pervasive and long-lasting as the ongoing methamphetamine crisis. Meth has been a major drug of abuse in Colorado since the 1990s. Meth abuse seemed to be in decline in the late 2000s, but a second meth epidemic has begun in the state’s rural counties, compounding the damage and strain on community resources caused by opioids.
Colorado is well known for producing and consuming more common drugs. The state has a long-established and influential brewing industry. It was one of the first states to legalize recreational marijuana use since states started banning the drug in the 1910s. The state is now home to a growing pot industry.
Colorado has long been a major transportation hub. Denver is the large city it is today because it was a rail hub for the Rocky Mountain and Plains regions. It still serves that function. Denver is also home to a massive, bustling international airport. The Denver area is a junction point for major highways that connect California, the Southwest and the U.S.-Mexico border region to Midwest and East Coast states.
For these reasons, Mexican cartels covet Colorado as a transshipment site for methamphetamine, heroin and other drugs. According to the Drug Enforcement Administration, Colorado is a major distribution hub for the Juarez Cartel. Mexican cartels have begun to use rural western Colorado in particular as a distribution hub.
Across the United States, organized crime organizations have moved out of cities and major towns to rural areas. The strategy seems to be working so far: Colorado’s rural law enforcement agencies have struggled to fight the influx of illegal drugs into their communities. Cartels have seemingly unlimited resources, far more than the typical rural sheriff’s department.
Small towns and rural counties have also struggled to provide adequate health care for Coloradans suffering from addiction. Rural areas generally have a limited number of traditional health care providers.
Small towns often don’t have support meetings or detox facilities, which are essential for achieving and maintaining sobriety. Small towns also tend to rely on volunteer first responders. Colorado has a chronic shortage of volunteer paramedics who are needed to respond to the growing number of opioid overdoses, according to a 2016 article published in The Denver Post.
Opioid abuse has spread far and fast in Colorado, devastating rural communities. Many Coloradans have become addicted to prescription pills such as Oxycontin, Vicodin and Percocet since the late 2000s.
A 2014 article published in the American Journal of Public Health hypothesized why opioid abuse is more prevalent in rural communities than in urban areas.
According to the authors, opioids are prescribed more regularly in rural areas. That’s certainly true in Colorado: Rural counties have the highest Medicare prescription rates for opioids in the state.
Another potential explanation for the rural opioid crisis is one of the cultural factors that makes small towns so resilient. People living in the countryside tend to have stronger social connections than people living in cities. As a result, people in rural areas are more likely to have a family member or close friend who can provide prescription opioids.
There’s a silver lining to this hypothesis. Tight communities and strong social ties might cause addiction to spread like a virus, but community support, family, true friendship and making amends are valuable assets in recovery from addiction.
Heroin is easier to acquire illegally than prescription opioids. Pain medication users most often acquire the drugs with a prescription. Meanwhile, heroin can be bought more cheaply than opioids on the streets of any town in Colorado, partly because of the inroads cartels have made into all parts of the state.
When crackdowns on fraudulent pain clinics reduced the availability of painkillers, Coloradans shifted from using prescription opioids to using heroin, and rates of heroin use have continued to increase.
Coloradans have to decide whether they will implement new harm reduction policies. These policy options include establishing needle exchange programs and increasing collaboration among law enforcement officers, social workers and drug counselors.
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Methamphetamine continues to be a major drug of abuse in Colorado. The percentage of primary treatment admissions for the drug peaked in the second half of 2005 and declined until 2008. The percentage remained steady from 2008 to 2012 at 14 to 16 percent.
Meth production has largely moved out of the United States. The drug that was once made cheaply in home labs is now primarily produced in other countries and brought to the United States by international criminal groups. In Colorado, Mexican drug cartels bring meth north from the border.
In some ways, the meth epidemic is the inverse of the opioid epidemic. Historically, heroin abuse was perceived as an urban issue. The drug was associated with bohemians such musicians and writers. Meth, on the other hand, was considered a rural problem.
Now, meth abuse has spread to cities such as Denver and Boulder. The DEA and Colorado police report that high-purity methamphetamine is readily available, and the DEA Denver Field Division ranks meth as a top drug threat.
Colorado placed itself at the heart of a roiling national debate when it legalized marijuana in 2012. The state was actually one of the first to criminalize marijuana in the 1910s, when states and municipalities all over the Southwest began to ban cannabis during a backlash against Mexican immigrants.
However, Colorado’s beat and hippie communities began to soften attitudes about the drug in the middle of the 20th century. The state underwent a long political process toward legalization starting in the 1970s, when provisional medical marijuana laws were passed but not implemented. Medical marijuana eventually became common in Colorado.
Medical cannabis laid the foundation for the legal pot industry that can be seen in almost every Colorado town. Coloradans are ambivalent about the issue, but legalization seems to be here to stay.
Addiction has become part of the fabric of Colorado. Compassion and evidence-based policy must be central in efforts to turn the tide of drug abuse. People struggling with addiction need ample time and professional treatment to start the road to recovery.