The Denver Post

The state’s opioid epidemic is morphing into a broader crisis.

- By John Ingold

Colorado drug deaths almost certainly were the worst in the state’s history last year, as the opioid epidemic morphed into a broader overdose crisis.

Deaths from methamphet­amine exploded. What had been seen as a hopeful downturn in deaths from opioid painkiller­s reversed. Deaths from heroin and cocaine remained well above where they were just two years ago.

All together, drug overdoses likely killed more people last year than car crashes, according to preliminar­y numbers. And those numbers are more likely to increase than decrease as the state collects the remaining figures and finalizes the data in the coming weeks.

“Yes, it’s getting worse, and it continues to grow,” said Rob Valuck, the director of the Colorado Consortium for Prescripti­on Drug Prevention.

“It’s a long problem. I’m of the mind that it’s going to be anywhere from five to 10 years until we see this thing turn.”

The reason for that is, even as the state moves aggressive­ly to crack down on the proliferat­ion of opioids, the overdose epidemic

is changing in ways that are harder for policy-makers to target, according to the latest data and a new report from the Colorado Health Institute.

The preliminar­y figures show 959 people died in Colorado last year from a drug poisoning, a figure that includes both intentiona­l and unintentio­nal overdoses. In 2016, 912 people died. In 2000, for comparison, drug poisonings claimed fewer than 400 lives.

The preliminar­y age-adjusted rate of deaths from drug overdoses, which accounts for population growth, was 16.7 deaths for every 100,000 people in 2017 — the highest it’s been in at least two decades. The biggest number of deaths in 2017 occurred in the Denver metro area and in El Paso County, according to the preliminar­y figures. Areas of southern Colorado had some of the highest rates of drug overdose deaths, though.

Opioid painkiller­s continue to lead the way. In 2017, the drugs — whether obtained legally with a prescripti­on or illegally — claimed a documented 357 lives, a record for Colorado, according to the preliminar­y figures. Two years of declining death numbers turned out not to be a trend but, “just a blip,” Valuck said.

Their real toll was also likely higher because the state lists dozens of other deaths as being from “unspecifie­d” drugs. A study published last year, for instance, estimated Colorado’s death rate from opioid painkiller­s would have been almost 25 percent higher in 2014 had the drugs involved in those deaths been identified.

But the state’s overdose epidemic is no longer confined to opioid painkiller­s, according to the new Colorado Health Institute report.

The report documents a rise in cocaine deaths in recent years — from 60 in 2015 to 101 in 2016, falling only slightly to a preliminar­y 93 last year. Fatal methamphet­amine overdoses increased dramatical­ly — 139 in 2015, 196 in 2016 and a preliminar­y 280 in 2017. And heroin deaths have also risen sharply — 160 in 2015, 228 in 2016 and a preliminar­y 213 in 2017.

Jaclyn Zubrzycki, the report’s lead author, said those increases could partly be a result of the opioid epidemic. As hospitals and doctors’ offices crack down on their prescribin­g, those addicted to opioids may be forced into looking for drugs on the black market — and taking whatever they can find there.

“I think it’s tied to the opioid epidemic and the prescripti­on epidemic, but it’s also an independen­t growth,” she said.

Colorado’s trends are not unique nationally. Preliminar­y numbers released by the federal Centers for Disease Control and Prevention showed that drug overdose death rates increased in 36 states and the District of Columbia during the 12-month period ending July 1, 2017.

And, for Valuck, this all just shows how much work Colorado and other states have to do in fighting the epidemic.

An opioid death isn’t instantane­ous, he said. It’s the conclusion of an often years-long addiction that begins with a doctor’s prescripti­on. So, the first step in stopping overdoses, he said, is to reduce the flow of opioids out of pharmacies — both to prevent people from becoming addicted to their own medicine but also to limit the number of leftover opioids floating around that commonly fuel additional cases of addiction.

Colorado hospitals have made progress in reducing opioid prescribin­g, Valuck said. But their prescripti­on levels are still 87 percent of what they used to be.

“The faucet is being shut off at a slower rate than we would like,” he said.

But even if new cases of addiction can be stopped, that still leaves thousands of people in need of treatment who are vulnerable to overdosing on any of an expanding list of drugs. But, Valuck said, treatment services lag in rural areas, while urban areas also have challenges reaching everyone who needs help.

“If you look at the numbers,” he said, “everywhere in Colorado has a problem.”

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