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Nicolais: Some sun in the dark clouds of the opioid epidemic

Government programs and healthcare innovators, including many in Colorado, have begun introducing potential solutions to combat the myriad of problems created by opioid misuse

Colorado lost 578 people to opioid overdoses in 2017 according to the National Institute on Drug Abuse. Five hundred and seventy-eight friends, family members, neighbors and co-workers.

And that is just the surface of the opioid epidemic we hear about so often but have so much difficulty combating.

The Colorado Sun has an entire tag for columns and articles that discuss opioids.

Mario Nicolais

Those 578 people translated to a rate of 10.0 people per 100,000, the standard measurement value for healthcare research. Better than the national average (14.6) or neighboring states Utah (15.5) and New Mexico (16.7), Colorado falls toward the low end of the spectrum that tops out in West Virginia at 49.6 deaths per 100,000 people.

But losing less lives is an awful way to measure relative “success.” It also misses the myriad, daily devastating consequences to people suffering from opioid addiction — both the users and their loved ones — and fails to do much to help us develop a plan to address the underlying problems.

Systematic faults in our country’s delivery of healthcare have created an environment primed for opioid over-prescription, overuse, improper use and addiction.

Worse, the longtime failure to prioritize mental and behavioral health, including substance-use disorders, has left both our state and country unprepared to combat the crisis.

But a few rays of sun may be shining through these dark clouds, including several emanating from here in Colorado.

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First, raising awareness and increasing education form the cornerstone of all long-term healthcare solutions. Of course, you’d have to be willfully obtuse to have avoided all mention of the opioid epidemic over recent years; but knowing there is a problem is only a first step. 

Programs like Colorado’s Recovery Cards Project aimed at destigmatizing opioid addiction help ensure that the number of people who seek treatment will increase. The U.S. Substance Abuse and Mental Health Services Administration’s (SAMHSA) free helpline can help them find it. Even the beloved and always thoughtful Sesame Street has recently debuted a character whose mother suffers from addiction.

More important, healthcare professionals have begun to formulate and implement tools and strategies targeted at the underlying structural problems in the healthcare system. 

Recognizing that the number of days for which a prescription is written, the total number of pills prescribed and the dosage all contribute to increased risk of prescription opioid misuse, providers have begun to cut back on prescriptions. The U.S. Centers for Disease Control and Prevention credited that change with a correlated drop in overall deaths due to drug overdose across the country in 2018.

Even the most diligent providers have been hamstrung by a fragmented system of health care data and records. Into that void companies like Colorado’s own OpiSafe have stepped in help coordinate information.

By working with health systems, pain practices, behavioral health counselors, first responders and patients, OpiSafe intend to streamline the process for tracking and checking opioid prescriptions and reduce the potential for abuse.

Their efforts will likely be boosted by changing governmental policies designed to recognize limitations imposed by laws meant to protect confidentiality of patient records, a critical stumbling block that has hampered prior efforts to put necessary information into the hands of providers. 

Even as these innovations progress and help stem the exponential increase in opioid misuse, though, long-term solutions will need to help backfill our woefully underfunded and undermanned mental and behavioral health systems.

Long the overlooked stepchild of the healthcare system, the substance use disorder programs they often run have been inundated by people desperately needing help.

That is particularly true as more individuals stricken by prescription opioid addiction turn to the cheaper, illicit drugs, most notably heroin.

The good news is that there are many smart people working hard on the problem. Furthermore, funds from pharmaceutical companies that cultivated the environment for misuse and addiction may help propel solutions, even if it will take far more than the companies will likely pay.

There is an opioid crisis in our country and in Colorado. But now we’ve at least begun to formulate some solutions.


Mario Nicolais is an attorney and columnist who writes on law enforcement, the legal system, health care and public policy. Follow him on Twitter: @MarioNicolaiEsq


The Colorado Sun is a nonpartisan news organization, and the opinions of columnists and editorial writers do not reflect the opinions of the newsroom. Read our ethics policy for more on The Sun’s opinion policy and submit columns, suggested writers and more to opinion@coloradosun.com.

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