“I don’t think she was a lost cause”
How one Colorado overdose victim fell through the cracks
Even as she lay on a friend’s floor in Wheat Ridge, unconscious from the effects of the drugs she’d taken, Rachel Skanron still had people who believed she could overcome her addictions — if only she could find the right help.
Her father, living on the other side of the international date line, wouldn’t step back and wait for her to hit rock bottom. A former boyfriend in New York had sent her a plane ticket to get her away from the people she used drugs with. And a childhood friend was ready to talk her through any crises and to fly to Denver to help if necessary.
They all expected a long road ahead, because Rachel had spent years cycling through treatment and homelessness. They remembered the creative, nurturing person they had known before methamphetamine and fentanyl took over her life, and they wanted her back.
But they’ll never get her back. Rachel died May 3 on that friend’s floor at age 34, one of the more than 1,600 people in Colorado lost to drug overdoses in 2023.
Her father, Rick, knew people could recover from addiction — he had been there himself. The difference with Rachel, he said, was that her mental health afflictions sapped her of the ability to believe her life could change and the motivation to get better.
“There is nothing available that helps people with mental health issues get to the ‘ want’ phase” of seeking recovery, he said.
The Denver Post is telling Rachel’s story after extensive interviews with her friends and parents, and a review of medical records shared by her father, to show how people battling addiction in Colorado can fall through the cracks of the systems meant to help them. Denver- area emergency rooms repeatedly flagged Rachel’s drug history and need
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for treatment over the past two years of her life but could never connect her to help. Sometimes they couldn’t find an open bed. Sometimes she left the hospital without telling anyone where she was going. Once, she started treatment, but it lasted less than two weeks.
The majority of people who misuse drugs also have a mental health condition, with about half experiencing depression symptoms and an unknown number of others living with other conditions, according to the Substance Abuse and Mental Health Services Administration.
People who have both a mental illness and a substance- use disorder often struggle to get treatment that addresses all their needs, because most providers still primarily focus on one or the other, said Vincent Atchity, president and CEO of Mental Health Colorado. Mental health facilities often won’t admit people in active addiction, he said.
Skanron believes the only thing that could have saved his daughter was a long period of involuntary treatment, but she never met the legal standard of being a danger to herself or others. Advocates for people who use drugs and those with mental illnesses generally oppose involuntary treatment, because of the potential for trauma and civil rights violations.
“It takes years to get into the densely forested woods of addiction,” Skanron said. “You don’t expect people to get out in five days” of detoxification.
Stability, then struggle
Rachel wasn’t a kid you worried about too much, said her mother, Eileen Mcallister, who lives in upstate New York. She was generally happy, dressing up as Disney characters with her brother, and liked to help out with cooking, cleaning and caring for the family’s pets. It was only after she was diagnosed with Lyme disease as a teenager that she started to struggle, Mcallister said.
She had depression, anxiety and other mental health conditions for her entire adult life, and had used heroin as a teenager, Skanron said. But she reached stability with the right combination of medications, including benzodiazepines for her anxiety and buprenorphine, which prevents opioid withdrawal. She earned her nursing degree in New York and lived independently throughout her 20s, he said.
Michelle Flotard, who met Rachel when they were 5 and remained in touch until about a month before she died, said her friend had a difficult start in life: her parents wrestled with substance use, although her father got into long- term recovery, and she started experimenting with marijuana as a preteen. Rachel also had a painful connective tissue disorder. Still, she and Rachel shared good times, traveling to visit Skanron when he was working in the Czech Republic, she said.
James Lechmanski, a boyfriend during some of those good years, said he remembers coming home to find Rachel sanding an old piece of furniture she found at a garage sale or inlaying glass on the surface of a desk to create a piece of art. Rachel had a creative streak, and she liked to fix broken things. She was also a nurturer, planting flowers, seeking out home nursing jobs and taking care of three cats and a dog, he said.
Rachel also had a certain resilience when she was well. They moved in together just days before Superstorm Sandy hit New York in October 2012, Lechmanski said, and she approached living without electricity for three weeks as an adventure. Their relationship lasted only two years, but she was fine after they broke up, he said.
In 2019, Rachel started struggling with suicidal thoughts after a different romantic relationship ended on bad terms, although electroconvulsive therapy ( formerly called electroshock) brought those under control, Skanron said.
Rachel spent time in hospitals for her mental health and substance use multiple times while she was living in New York but couldn’t stick with outpatient treatment after each release, Mcallister said. She wanted to help people as a nurse, but didn’t seem to understand when she was the one who needed help, her mother said.
“I was so mad ( when she wouldn’t go to treatment), because I just wanted her to get better,” she said.
After a stint in residential treatment for her mental health, Rachel moved to Texas to stay with Skanron and recovered enough to start working again. He hoped she was on a path to stability as 2020 started.
It was only later that Skanron would learn someone she met in treatment had introduced her to methamphetamine.
“It was downhill” after that, he said. “It changed her depression, because she felt good.”
Methamphetamine, a stimulant, produces feelings of energy and euphoria. The drug also changes the brain in ways that make it even more difficult to quit than other recreational drugs, according to the National Institute on Drug Abuse. Unlike people who misuse opioids, those who take methamphetamine don’t have a medication option to help with their cravings.
People commonly use recreational drugs to medicate mental health problems, whether that’s stimulants for depression or alcohol for social anxiety, said Dr. James Besante of the Santa Fe Recovery Center in New Mexico. The strategy works for a while, so people typically keep using those drugs until the negative effects outweigh the positives enough that they seek help, he said.
A new start in Colorado
Skanron said he told Rachel she couldn’t stay at his home if she kept using drugs, so she moved to Colorado for a fresh start in mid- 2021. She said she knew people she could stay with, but, unknown to him, some of them were friends she used drugs with.
Lechmanski said Rachel told him she thought she would be able to get treatment more easily in Colorado than she could in
Skanron arranges mementos of Rachel at his home in Port Melbourne. Among them is a framed photo from a holiday in Prague, accompanied by a pair of socks. Skanron, an avid bicyclist, received these socks as a humorous gift from Rachel, inspired by his love for his Bianchi bike. He cherishes them as precious reminders.
Texas, which was the first step toward getting a job and leaving homelessness behind.
“She thought it would be more welcoming,” he said of Colorado.
But the waiting list for housing, specifically for women trying to get into sobriety in Denver, lasted six months or longer, and Rachel didn’t feel safe in shelters. So she would bed down on the streets or with friends, some of whom were engaging in petty crime to buy drugs, Lechmanski said. She texted him frequently over the next two years about the difficulties she would run into in Colorado and her efforts to get some sort of job, even if it was just a part- time cleaning gig.
Skanron sent Rachel money for housing, and Lechmanski occasionally paid for a hotel room on cold nights, but during an emergency room visit for suicidal ideation in November 2021, she reported she had been homeless since that February, according to her medical records. She also admitted to using methamphetamine regularly.
The licensed clinical social worker who assessed Rachel at Lutheran Medical Center in Wheat Ridge determined she didn’t have a plan or the means to kill herself, which would have allowed the hospital to hold her temporarily. The hospital did provide her with a dose of an antidepressant she previously had taken, a referral to the Jefferson Center for Mental Health to get her medications more regularly, a bus pass, and a list of addiction treatment resources.
Those visits became a pattern. People repeatedly stole the backpacks where she kept her medication, so the only option to get refills was to go to an emergency room, Lechmanski said. Without consistent doses, she could never stabilize her brain chemistry, and the feeling of being constantly unsafe made it worse, he said.
“What she went through, it just started compounding itself,” he said.
Dr. Kiara Kuenzler, CEO of the Jefferson Center for Mental Health, said she couldn’t share any information about whether Rachel was a patient there but that patients who are homeless often struggle to stay in care. Unhoused people deal with barriers like lack of transportation, losing
their phones or having difficulty keeping track of days, which make it harder to follow through with appointments, she said.
The center and other organizations have been working to try to increase the number of apartments available for homeless patients so they can begin to stabilize their lives, Kuenzler said. They also are working on getting people into the next stage of treatment immediately, or giving them a safe place to go so they can get support and avoid returning to drugs while waiting for a bed to open up, she said.
“It’s in those gaps that we’re losing too many people,” Kuenzler said.