The nation’s opioid crisis continues to overwhelm Colorado communities. Deaths due to opioid overdose have reached historic highs devastating nearly 1,000 Colorado families in 2020 alone.

As a result of the pharmaceutical industry’s culpability, multi-billion-dollar lawsuits have been settled to support communities across the nation in fighting back. Colorado is set to receive nearly $400 million in opioid settlement funds over the next 18 years, with local and regional governments soon receiving a combined infusion of $18 million dedicated to reversing the tide of the opioid scourge.

The duration and quantity of these settlement funds offer a unique opportunity to address the opioid problem. With these funds, community leaders can think big and implement strategies that will have sustainable, long-term, positive effects on the health and well-being of Coloradans. Colorado is truly on the cusp of unleashing opioid abatement efforts with the potential to save thousands of lives and millions of dollars.

However, vast sums of sustained funding do not guarantee that abatement efforts will move the dial on the opioid epidemic. In fact, far too often, well intentioned, would-be solutions to society’s grandest challenges are unsupported by research and are almost exclusively concentrated on addressing problems and their consequences after they occur.

Clearly, treatment, recovery, law enforcement, and other approaches to opioid abatement are needed. Public awareness campaigns and harm reduction strategies, — including increased access to Naloxone, a drug that can reverse the effects of an opioid overdose, — are essential to combat the torrent of opioid overdoses facing communities every day.

However, to end the opioid epidemic, Colorado must complement these efforts and invest in proven, cost-effective, and sustainable prevention efforts that, collectively, are the only behavioral health approach that can decrease the incidence of new opioid use disorders. 

The power of prevention

Prevention is an approach to opioid abatement that addresses the individual-, family-, and community-level predictors of future opioid misuse. Research shows that fostering healthy youth development, supporting family resilience, and strengthening communities effectively decreases the use and misuse of several substances, including opioids.

The past 30 years have experienced an explosion in the number of research-proven substance use prevention programs that can be implemented for youth and families in several community contexts. Registries of proven effective prevention programs, including Blueprints for Healthy Youth Development and What Works Clearinghouse allow communities to search and select evidence-based programs that are the best fit for their community’s unique context and culture.

Prevention is also cost-effective. When it comes to opioid abatement, an ounce of prevention is worth a pound of cure. The costs associated with preventing a loved one from developing an opioid use disorder are substantially less than the steep costs associated with treatment and recovery or criminal justice system involvement.

Prevention also adds money back into communities. For example, for every dollar spent on Lifeskills Training, $13.49 is returned to the community in the form of future labor market earnings and healthcare costs. 

Despite prevention’s immense promise, increased fiscal and public support are needed for communities across Colorado to reap its benefits. Despite prevention’s ability to save lives and taxpayer dollars, state agencies responsible for substance use disorder services spend approximately 7.5 times more on treatment than prevention. By devoting opioid settlement funds to prevention, communities can help correct this imbalance to the benefit of Colorado families.

Recommendations for allocating opioid abatement funds for prevention

  1. Devote at least 30% of opioid settlement funds to prevention. That leaves 70% of funds for other important abatement strategies. If your region (see page 3 of this document) has already decided to devote less than 30% of settlement funds during the current cycle, consider devoting 30% of funds to prevention in future funding cycles.
  2. Select research-proven programs for implementation. Communities often choose unproven prevention programs, increasing the risk for wasting precious resources on prevention efforts that either do not work or are harmful. Use evidence-based registries to select programs. Blueprints for Healthy Youth Development is managed by the University of Colorado, Boulder.
  3. Evaluate for sustainability. Evaluating your prevention efforts will help you improve programs and make decisions related to keeping or replacing programs that are not performing as desired.
  4. Partner with prevention support systems like the Colorado State University Prevention Research Center to help you implement, evaluate, and sustain prevention efforts for long-term success.

Prevention is not the only solution to the opioid crisis. However, as the only behavioral health approach that can reduce the incidence of new opioid use disorders, it is among those that are absolutely necessary. By selecting prevention approaches that work and implementing them effectively, there can be no doubt that prevention will save lives in Colorado and help turn the tide of this public health emergency.

Nathaniel Riggs is executive director of the CSU University Prevention Research Center.

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Nathaniel Riggs is executive director of the CSU University Prevention Research Center.