Summit County is deploying several strategies to combat the opioid epidemic
The opioid crisis has burned across the nation, taking tens of thousands of lives each year and creating a public health nightmare that has been officially labeled an epidemic. Nearly 400,000 people died in the U.S. between 1997 and 2017. Opioids and overdoses now claim the lives of 130 Americans per day. In Colorado, opioid deaths keep reaching record highs year after year.
The magnitude and depth of the crisis led federal, state and local governments to start a full-court press in 2017 to prevent opioid deaths, and the measures are being put into action in places like Summit County, which ranks 11th out of the state’s 64 counties in per-capita opioid overdose deaths.
Summit County public health director Amy Wineland has been the point person behind the county’s local response on opioids. Wineland said that the county has a health improvement plan that makes opioid overdose reduction a priority in the county for the forseeable future, and it has several different strategies at work.
“We want to increase community resources for those struggling with addiction, while limiting opioids available for diversion, misuse and abuse,” Wineland said. “The approach involves a continuum of efforts, such as educating prescribers and providers on how to improve opioid prescribing, while also educating the consumer and getting patients to ask questions, like why they’re being prescribed certain medications.”
Wineland said that prescriber and provider education on prescription practices that avoid misuse is key, as the crisis was sparked from pharmaceutical companies pushing opioids as a non-addictive pain reliever in the late ’90s.
The unregulated prescriptions resulted in dependence for many pain sufferers, and then addictions that led to non-medicinal use and, for many, death. The overprescribing of prescription opioids led to a second deadly wave of addiction with heroin in the early 2000s. The country is now in the midst of a third deadly wave of overdoses involving synthetic opioids like fentanyl.
Wineland said that the county has also been working with local partners, including St. Anthony Summit Medical Center and the sheriff’s office, to deploy education programs, drug takeback programs and medicine assisted treatment with drugs such as buprenorphine to get opioids off of the streets and to help those who have already been caught in the clutches of addiction.
Aside from prevention, there is another weapon at use on the other side of addiction: naloxone. To understand how the treatment works, it’s important to first understand how opioids interact with the body.
Opioids relieve pain by sedating the central nervous system, latching on to receptors in the brain and blocking signals such as pain by releasing huge amounts of dopamine, a brain chemical that induces euphoria. Opioids are incredibly addictive because of the way it changes the brain and the way dopamine is distributed. Misuse leads to dependence on opioids to get the same high, setting off a runaway train that can lead to addiction and eventually overdoses.
Overdosing on opioids leads to a total shutdown of the body’s detection systems for things like carbon dioxide buildup. Some of the body’s autonomous actions, such as breathing, stop functioning on their own. At a certain point, the brain stops receiving enough oxygen from blood to keep operating, and death occurs.
Naloxone works to “reverse” the effects of opioids by blocking them from attaching to receptors in the brain and spine, normalizing the flow of “alarm signals” to the brain. This is why when naloxone is successfully administered to a person overdosing they wake up with a gasp. The body crashes out of a deadly slumber and the brain jolts back into the waking world. It is a drug that quite literally turns a person back on.
Cristen Bates, director of strategy, communications and policy for the Colorado Office of Behavioral Health, said that naloxone distribution to clinics, law enforcement and other public-facing service providers has been a critical aspect of the state’s plan. The program has already saved hundreds of lives at a pittance of a cost.
“We have released 11,000 naloxone kits costing $75 each to jails, hospitals and other providers, wherever we can reach opioid abusers,” Bates said. “Since we began distributing, we’ve saved 808 people across the state.”
Bates also wants the public to know of several tools and websites useful to combat opioid overdoses, such as the OpiRescue app, which can pull up treatment locations, emergency information and resources instantly, as well as websites such as StopTheClockColorado.org, which provides information on where to get naloxone along with other resources.
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