Overdose Awareness Day draws attention to deadly toll of substance use
Harm reduction experts push for supervised injection sites, ‘safe supply’
Cards bearing the names of people lost to drug overdose are strung together with flowers outside the Harm Reduction Action Center in Denver on Aug. 31, 2021. (Faith Miller/Colorado Newsline)
A wall at Harm Reduction Action Center’s Denver office is nearly covered with framed photos of people lost to drug overdose. In front of the wall sits a table with roses, tissues and hand sanitizers.
It’s Aug. 31, Overdose Awareness Day, and HRAC is hosting its annual event to mourn lives lost, pass out free resources, and advocate for methods of reducing harm for substance users, such as clean syringes, supervised injection sites and access to a “safe supply” of drugs.
The person leading a tour of HRAC’s facility tells visitors to brace themselves because they may recognize someone they know on the wall.
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Last year, substance use killed more people than ever recorded — not just in Denver and in Colorado, but in the country as a whole. CDPHE reported 1,477 deaths due to drug overdose in 2020, a 38% increase from 2019.
Harm reduction agencies such as HRAC do their best to save lives by providing clean syringes, referrals to addiction counseling and medication-assisted treatment, free opioid overdose reversal drugs, and information about how the safest ways to use drugs to prevent overdose and the spread of diseases. HRAC’s staff members meet people where they’re at, literally and figuratively — literally by visiting sites like homeless encampments where substance use is most concentrated, and figuratively by exercising patience with people who might not be ready to start treatment or even accept help right away.
But hundreds of people are still dying of drug overdoses every year in Colorado.
“Simply put, the system in its current form is not working,” Lt. Gov. Dianne Primavera said at a news conference commemorating Overdose Awareness Day at the Colorado Capitol building. “We must pursue bold reform to save lives and ensure that every Coloradan can receive timely, affordable, equitable and high-quality services in their communities.”
While Primavera didn’t provide specific examples of what that “bold reform” could look like, a huge influx of incoming money for behavioral health provides plenty of opportunity for policy makers to consider new strategies. Colorado will get $450 million from federal coronavirus relief legislation, which a lawmaker-appointed behavioral health task force will make recommendations on how to spend, and as much as $400 million from legal settlements with pharmaceutical companies that state governments accuse of getting countless Americans hooked on opioids. Attorney General Phil Weiser on Friday announced a framework for distributing the settlement proceeds.
Speakers at the news conference Tuesday morning highlighted some of the state’s current programs for addressing substance use prevention, treatment and recovery, most of which were implemented in the last few years.
Colorado's Naloxone Bulk Purchase Fund, established through 2019 legislation, allows local public health agencies, harm reduction agencies, school districts and law enforcement to purchase the opioid reversal drug naloxone — which comes in an injectable form or as the nasal spray with brand name Narcan — at low or no cost.
In 2020, 90 Colorado agencies signed up to purchase naloxone through the fund, distributing more than 10,000 doses of the life-saving drug statewide.
An additional 133 agencies signed up in the first half of 2021, said Andrés Guerrero, manager of the Colorado Department of Public Health and Environment's Overdose Prevention Unit. Those 133 agencies represent nearly two-thirds of the 233 agencies that signed up since the program was launched.
Colorado also has six mobile units that specialize in medication-assisted treatment for opioid use disorders. The vans — carrying a nurse, licensed addiction counselor and peer recovery coach — travel to rural parts of the state that lack resources for substance use treatment. They provide telehealth access to a doctor who can prescribe medications that help people stop using illicit drugs.
The mobile health units also distribute naloxone and can refer people to other services.
Dying of preventable overdoses
Keith Hayes, director of recovery at 5280 High School in Denver, works with teens who've dealt with substance use disorders. As a person in recovery from drug and alcohol addiction who has experienced homelessness, Hayes knows their pain all too well, he said at Tuesday's news conference.
"We need more opportunities for our youth to find a safe place to be able to learn how to live," Hayes said. "They’re starting much and much younger. I have students today who were sticking needles in their arms at 10 years old, and now today they have (been) two and three years sober. It’s real."
The Harm Reduction Action Center hosted its own event Tuesday to call attention to Colorado's overdose crisis. Staff and volunteers passed out test strips that people can use to test drugs for fentanyl, a powerful opioid that can be deadly in small amounts and increasingly is turning up in illicit substances.
They honored those lost to overdose by stringing cards bearing their names together with flowers in an outdoor display.
We need overdose prevention sites, and we need a safe supply of drugs.
– Lisa Raville, executive director of HRAC
Lisa Raville, HRAC's executive director, wants policy makers to think outside the box when looking for ways to use the new funding to tackle addiction. For her that means providing supervised injection sites to prevent overdoses, as well as a "safe supply" of government-regulated stimulants and heroin that has been tested for fentanyl. Both strategies are currently in use in Canada.
The past year has been "deeply troubling," Raville told Newsline. "People we know, love and serve are dying of preventable overdoses, and right now we don’t have the decision makers and legislators helping us out when we need that."
While the Denver City Council and Mayor Michael Hancock approved legislation in 2018 allowing a supervised injection site in Denver, the Colorado General Assembly has yet to pass a bill that would permit the practice under state law. The movement for a safe injection site in Denver was dealt another blow this year when the Third Circuit Court of Appeals ruled against a proposed site in Philadelphia, which would have been the first of its kind in the U.S.
Last year, 540 Coloradans died of overdose tied to fentanyl, which has begun showing up in not just heroin and meth but also counterfeit pills, cocaine and ecstasy. The number of fentanyl-associated overdose deaths has increased more than fourfold since 2018.
In Denver alone, fentanyl killed 223 people over the last three years.
"We need overdose prevention sites, and we need a safe supply of drugs," Raville said, "because fentanyl in the drug supply is unpredictable and toxic, and it’s killing people, and we can do better."
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