Colorado is a western state, home to about 5.3 million people as of 2013. It is the 22nd largest out of the 50 United States by population and 8th largest by land mass and area. The state was admitted to the U.S. in 1876, during the country’s major period of western expansion. The capital city is Denver, and other large cities include Colorado City, Aurora, Fort Collins, Lakewood, and Thornton.
Like other parts of the country, Colorado struggles with a serious drug overdose problem, particularly involving opioid narcotics — both prescription and illicit opiates. Heroin overdose accounts for 25 percent of allopioid-related death in the state, and the rate of fentanyl poisoning and death in Colorado is also on the rise. Although the state has legalized recreational and medical marijuana use, this drug is a problem across the big state. Residents struggle with abuse of marijuana, alcohol, narcotics, and other substances, and they can get help through treatment programs, legal ramifications, and government assistance.
Places to Get Help in Colorado
There are several places in Colorado that can provide help to overcome addiction to drugs and alcohol. Psychology Today has a list of treatment providers ranging from low cost to luxury. Alcoholics Anonymous (AA) meetings are always free, and they are a great way for Coloradans to start getting help, maintain abstinence after completing rehabilitation, or return for help after they experience cravings, a lapse, or a relapse. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides an online treatment finder, along with a national hotline, for you to call and ask about help for yourself or a loved one.
Drug and Alcohol Abuse in Colorado
The state of Colorado prioritizes evidence-based treatment to reduce addiction and drug overdose. Colorado ranks in the top 20 in the nation for abuse of alcohol, marijuana, opioids, and cocaine, and it is the only state in the heaviest use category for all of these drugs among residents ages 12 and older.
The state reports that 912 people died from drug overdoses in 2016. While the prescription drug overdose rate stopped increasing that year and in fact decreased from a high of 318 deaths in 2014 to 300 deaths in 2016, other drug problems continued to build. This included illicit abuse of heroin, cocaine, and meth, all of which were associated with continuing high rates of overdose and death in 2017. Figures from 2017 reported that 959 people died from drug overdoses across Colorado.
Most-Abused Drugs Across the State
· Alcohol: Like nearly every other state in the U.S., alcohol is the most widely abused drug in Colorado, including among adolescents. The Healthy Kids Colorado 2015 report on youth in the state found that 59 percent tried alcohol at least once. However, rates of ongoing alcohol abuse among young people in Colorado are dropping. In 2005, about 47.4 percent of youth reported consistent drinking, but by 2015, that rate dropped to 30.2 percent, which is similar to the national average of 32.8 percent. Still, the 2015 numbers mean that about one in three high school students in Colorado drinks alcohol; two in five high school seniors drink alcohol.
· Marijuana: Although recreational marijuana use was made legal for people ages 21 and older in Colorado in 2014, youth rates of abuse have remained stable. The Healthy Kids Colorado 2015 report also found that marijuana was the second most-abused drug among youth under the age of 18, in the state, as 38 percent of young people reported that they had tried marijuana at least once. Current marijuana abuse among young people in the state has hovered around 20 percent for the past decade. Like the national average, about one in five Colorado high school students abuses marijuana.
Since legalization of recreational marijuana use in Colorado, 8 percent of adults who had children ages 15 and younger reported having marijuana in their homes; about 16,000 homes may have exposed their children to second-hand marijuana smoke or vapor; and 6 percent of new mothers in the state abused marijuana during pregnancy.
· Opioids: In many states, including Colorado, heroin is a growing problem that has led to higher rates of opioid addiction, overdose, and death. In 2013, the state had 69.8 opioid prescriptions for every 100 people, which represents about 3.7 million painkiller prescriptions. In 2016, the state reported that there were 228 heroin-related deaths, up from just 68 in 2015.The overdose death rate from heroin is about 4.1 people out of every 100,000, which doubled since 2012.
Young people, under the age of 18, abuse prescription drugs at lower rates than adults, at about 14 percent for narcotics and other prescription medications. Heroin abuse was at about 2 percent.
Because of the increasing adult opioid abuse rates in Colorado, neonatal abstinence syndrome (NAS) is on the rise. In 1999, the rate was 0.4 out of every 1,000 births; by 2013, that rate rose to 2.9 out of every 1,000 births in the state. However, this rate is lower than the national average of 6 out of every 1,000 births.
· Other illicit drugs: About 6 percent of people under the age of 18 in Colorado abuse cocaine, inhalants, and ecstasy; about 2 percent abuse meth. Among all age groups, methamphetamine contributed to the highest overdose death rate; this rate has increased fivefold since 2010, hitting 3.5 out of every 100,000 people in 2016. Non-medical abuse of tranquilizers, particularly benzodiazepines, increased to 2.2 out of every 100,000 people by 2016.
A report published in 2017 found that several illicit drugs contributed to increasing rates of death from overdose in Colorado. For example, in 2015, cocaine was involved in 60 overdose deaths, but in 2016, that number rose to 101. Fatal meth overdoses rose from 139 in 2015, to 196 in 2016, and then to a startling 280 in the first half of 2017.
Adolescent Substance Abuse
Although both alcohol and marijuana are legal for recreational use in Colorado, you must be at least 21 years old to purchase either of these substances. Anyone younger than that is considered a minor per these drug laws. A new report published in 2017 found that teen drug use in Colorado is declining overall after marijuana legalization.
Marijuana abuse among Colorado’s adolescents is about the same as the national average: 21.2 percent of Colorado’s young people compared to 21.7 percent nationally. There is some concern that marijuana legalization in the state would increase abuse of this drug among teenagers, but so far, that has not been true. As of 2015, about 43 percent of teens 15 to 16 years old initiated marijuana abuse; this was the highest rate for any age group. In addition, 6 out of 10 high school students reported it was easy for them to get marijuana.
Rates of cigarette smoking are dropping among young people in the state. In 2005, the rate of smoking among adolescents was about 18.9 percent, but in 2015, that dropped to just 8.6 percent. This is similar to the national trend, although currently about 10.8 percent of teenagers in the U.S. smoke cigarettes.
About one in seven teenagers, or 13.7 percent, abuse prescription drugs, including painkillers like Oxycontin, sedatives like Xanax, and stimulants like Adderall. One in four adolescents states that they think it would be easy for them to get prescription drugs without a prescription. Illegal drugs like ecstasy, heroin, and meth are abused by teens in Colorado at about the same rates as their peers nationally. Trends in opioid abuse, both prescription and illicit, are driven by adults, but adolescent trends reflect their parents; heroin overdose deaths are increasing while rates of prescription abuse are leveling off.
Colorado Is Working Hard to Provide Better Drug Treatment Access
· Good Samaritan laws and naloxone access: Colorado passed Good Samaritan laws, allowing people rendering aid to those suffering a drug overdose or alcohol poisoning to get emergency medical help without suffering legal consequences if they were also abusing drugs. The state also provides easy access to naloxone, a drug that temporarily stops opioid overdoses.
· Colorado consortium for prescription drug abuse prevention: Since this program began, nonmedical abuse of prescription narcotics among people ages 12 and older dropped. In 2013, the rate was 5.1 percent, and by the next year, it was 4.9percent. In people ages 18 to 25, who abuse drugs and alcohol at the highest rates, opioid abuse dropped from 10.7 percent in 2013 to 9.3 percent in 2014.
This organization is managing a series of pilot projects to increase pharmacy and medical provider use of prescription drug monitoring programs (PDMPs) to reduce prescription misuse and abuse. The group is partnering with the state’s Department of Public Health (DOH) to expand medication take-back programs, allowing for safe disposal of unused prescription drugs like painkillers or benzodiazepines, which may be abused if they are left in the home.
· Chronic pain management program: Although opioids have been used for more than a decade to help people with chronic pain conditions, these drugs are not appropriate treatment for everyone, and they should not be the sole approach to managing pain. CDOH and the Department of Health Care Policy and Financing (HCPF) partnered to create this program, which uses interactive video technology to connect doctors to pain management specialists who advise on several approaches to treating chronic pain conditions. They also offer buprenorphine management assistance to help patients who struggled with opioid addiction.
· Medication-assisted treatment: A task force to combat drug abuse, particularly opioid addiction and overdose, in Colorado reported on the importance of expanding evidence-based treatment including medication-assisted treatment (MAT) for opioid addiction. In 2017, the Colorado General Assembly allocated funds to expand programs offering MAT.
Prevention, Education, and Treatment as the Focus
CHCPF implemented a new policy for pharmacies and prescribing physicians on August 1, 2017, mandating that they must limit opioid-naïve patients to a seven-day (one week) supply of opioid narcotics. The focus of this policy is to reduce the number of people who may become addicted to narcotics through a prescription, especially when they do not need these potent medications for very long after an injury or surgery.
CHCPF also reduced morphine milligram equivalency (MME), the measurement of potency equivalents for pain medications and narcotics, from 300 MME to 250 MME as ofOctober 2017. This means that people who need 300 MME or more of medication per day need prior authorization.
The Colorado Department of Public Health and Environment (CDPHE) launched a program in 2015 called Protect What’s Next to reduce incidence of young people abusing marijuana after the drug was legalized for recreational use in the state. Alongside this campaign, the state has tough enforcement for businesses that produce and sell marijuana for medical and recreational use, including identification spot checks and other enforcement actions.
This large western state is also providing better access to treatment programs for people who need help. If you are struggling with substance abuse in Colorado, there are many resources available you can access.
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Making the Wise Investment: Statewide Needs Assessment of Primary Prevention for Substance Abuse. (February 2018). Colorado Office of Behavioral Health (OBH) and Colorado Health Institute.
Reduce Incidence of Substance Use Disorder: Why Is This Important to Colorado? (2018). Colorado.gov, Performance Management & Operations.
More Coloradans Died Last Year From Drug Overdoses Than Any Year in the State’s History. That Shows How the Opioid Epidemic Is Changing. (April 4, 2018). The Denver Post.
Colorado Opioid Summary: Opioid-Related Overdose Deaths. (February 2018). National Institute on Drug Abuse (NIDA).
Following Marijuana Legalization, Teen Drug Use Is Down in Colorado. (December 11,2017). The Washington Post.
Colorado Good Samaritan Law. Colorado Mesa University.
Naloxone Standing Orders. (February 2017). Colorado Department of Public Health and Environment, Law Enforcement Officers.
State of Colorado Substance Abuse Trend and Response Task Force, Twelfth Annual Report. (January 2018). Colorado Attorney General.