December 2, 2019

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Colorado Wants to Help 400,000 Recovering Substance Abusers – But First, It Must Find Them

By Kara Mason

Senior News Editor | @karanormal

(AP Photo/Jeff Chiu, File)

A recent report outlines how the state should move forward in expanding resources for substance abuse recovery.

The opioid epidemic didn’t happen overnight. And so recovery, especially through the lens of public health, won’t be particularly quick either.

Colorado health officials and organizations have created the beginnings of a statewide plan for those in and facing recovery from substance abuse, but the challenges they face, especially in hard-hit southern Colorado, revolve around non-existent data and infrastructure hurdles. A report published in October, directed by the state legislature, lays the groundwork for supporting the resources needed for recovery.

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Between 2013 and 2017, Pueblo County had 61 prescription opioid overdose deaths – about eight deaths per 100,000 people. In Huerfano County during the same period, there were four deaths, which translates to a rate of about 13.4 deaths per 100,000 people. Only Conejos County saw a higher rate at 13.6 deaths per 100,000 people.

Before any of that happens, however, there’s a need for more data. Currently, about 400,000 Coloradans are in recovery for substance abuse, according to the state. But it’s largely unknown where those people live or what types of recovery resources they’re in need of.

“The number of people leaving treatment can be tracked, but it provides an inaccurate look at recovery, because the majority of people in recovery never enter formal treatment,” the plan says. “These data provide a rough estimate of the potential need for services, but decision-makers lack data to understand how recovery happens in Colorado communities, how people access services, and how many people are not being served.” What is known, however, is that communities are in need.

Southern Colorado communities, like Pueblo and Huerfano counties, have seen particularly high numbers of substance abuse and overdoses, which have traditionally been much easier to track.

Between 2013 and 2017, Pueblo County had 61 prescription opioid overdose deaths – about eight deaths per 100,000 people. In Huerfano County during the same period, there were four deaths, which translates to a rate of about 13.4 deaths per 100,000 people. Only Conejos County saw a higher rate at 13.6 deaths per 100,000 people.

Even more devastating than prescription overdose deaths have been heroin-related deaths. In that five year period, Colorado saw a 77% increase in overdose deaths. In southern Colorado, Conejos, Pueblo and Las Animas counties experienced heroin overdose death rates higher than the state average. Data for Huerfano and Costilla counties were unavailable.

Much of Colorado’s focus on reversing the opioid epidemic has been on short-term treatment, like Pueblo state Sen. Leroy Garcia’s legislation that created and expanded a medication-assisted treatment pilot program in counties hardest hit by the epidemic.

While important, treatment is different than recovery, health officials say. Recovery is a working process that never truly ends. It’s a process that’s unique to each person and each community.

“Recovery is more than clinical treatment, although treatment can be a component of recovery. Recovery is about reclaiming a person’s everyday life. People in recovery need stable housing, purpose, health, and community support. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines these as the four pillars of recovery, and this plan builds on those pillars,” Robert Werthwein, Director of the Colorado Department

of Human Services Office of Behavioral Health, wrote in the report.

The plan, which was released by the Colorado Health Institute in partnership with the state and the Colorado Consortium for Prescription Drug Abuse Prevention, focuses on three objectives: creating a recovery-oriented system of care, providing recovery-oriented clinical care, and equipping communities with support, including fostering discussions with criminal justice agencies.

Michael Davidson, a spokesman for the Colorado Consortium for Prescription Drug Abuse Prevention, said stakeholders in the plan all recognize that different regions of the state will need different resources. “What works in Denver might not work in Pueblo,” he said, adding that community outreach is a big goal.

The plan is the result of 2018 state legislation, HB18-1003, which directed state agencies and partners to continue to study policies that aim to prevent opioid and substance abuse. Jalyn Ingalls, the lead writer from the Colorado Health Institute on the report, describes the document as a guide for recovery efforts across the state.

“Without each of the three pillars outlined in the report, recovery is a lot more difficult. Especially as recovery efforts have long relied solely on grassroots organizations,” she said.

But what ties the plan together is its recommendations, which include things like implementing data collection, increasing education for clinicians, and examining the barriers associated with recovery.

Among those barriers, and most noted across several communities is funding. “Today, funding is inadequate to promote a comprehensive recovery system. Funding is oriented toward treatment, which creates barriers to receiving recovery support services. Historically, most substance use disorder funding has supported treatment, but not people in recovery after they leave treatment (or go into recovery without going through formal treatment),” the report says. “While substance use treatment is increasingly likely to be reimbursed by insurance, the cost of recovery support services is almost never covered.”

In looking at recovery across communities, the report highlights that there are needs for other resources too, like adequate housing, supporting families and educating law enforcement on its role in recovery.

While the plan serves as a roadmap, Ingalls said it’s the glue that people most familiar with recovery think is necessary. The Recovery Advisory Committee — which was made up of a bevy of organizations and experts — heard from communities across the state about what resources they are in need of.

Davidson said hopefully an outcome of the plan is more funding, so that existing groups can work better and new resources can be created.

“This will help guide resources as it becomes available and we’re hopeful more will become available,” he said. “One of our next steps is to dig deep and see what resources we have.”

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