Colorado addiction experts prioritize care for individuals leaving carceral settings


Shane Ersland


Helping Coloradans who struggle with addiction, particularly for individuals transitioning out of a carceral setting, will require greater availability of adequate treatment services in the state, according to health leaders.

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Harm Reduction Action Center Executive Director Lisa Raville and Mental Health Colorado President and CEO Vincent Atchity discussed the state’s addiction-related challenges at the 2023 Colorado State of Reform Health Policy Conference last month.

“At Mental Health Colorado, we acknowledge that humans have used a wide variety of substances, ranging from caffeine and tea to things that grow on plants and in the ground,” Atchity said. “Part of human nature is to use all kinds of substances. Overuse of some of our substances can be harmful. Underuse of certain substances, like insulin, can be deadly. It’s all about striking balance in our substance use. The compass I use for harm reduction is, what is the health of the individual?”

Like many other states, Colorado has seen concerning trends due to fentanyl and other opioids. The state’s age-adjusted opioid overdose death rate rose from eight per 100,000 individuals in 2011 to 21.7 per 100,000 individuals in 2021. Last year in Denver, 453 people died of an opioid overdose, with more than half of those deaths resulting from fentanyl use.

“People are dying at a very high rate, and publicly in Denver,” Raville said. “(It had) the most public overdoses (from June through September) we’ve ever had.”

Prioritizing the criminalization of those who are addicted to substances exacerbates the issue, Atchity said.

“We’ve got five percent of the world’s human population, and 25 percent of the world’s incarcerated population. That’s a higher rate of incarceration than any other country. We readily arrest and incarcerate some people more than others based on some substances.”

— Atchity

People who have been incarcerated in state prisons are 129 times more likely (compared to the general public) to die from an overdose in the two weeks following their release, Raville said.

“The largest detoxes we have in the state are jails,” Raville said. “And the largest treatment [center] we have is the Department of Corrections. And we know that drugs get into jails and prisons. There’s actually a few countries around the world that do syringe exchanges in prison, knowing drugs are getting in, and they don’t want folks to acquire HIV.”

All Colorado jails are now required to offer opioid treatment to inmates who need it, due to the passage of House Bill 1326 last year, Atchity said.

“In recent years, Colorado took the step [to extend] access to medication-assisted treatment in jail settings. As a big consumer advocacy organization, we were supportive of that. To not provide state-of-the-art, medication-assisted support for your inevitable detoxification process while you’re held in a jail cell is inhumane. That’s like depriving someone of insulin if they’ve got diabetes.”

— Atchity

Raville and Atchity said education will be key in addressing the state’s addiction challenges. Raville said a new Drug Policy Alliance curriculum called Safety First: Real Drug Education for Teens can help parents communicate with their children about substance use. It is the nation’s first harm reduction-based drug education curriculum for high school students.

“We need to get smarter about this and understand that, if your kid is 13 and you want them to live, thrive and make it to 27, you need to equip their hard drive with the best possible software and intelligence so that they can make life-preserving decisions when they’re calculating risk at every turn as they proceed through high school and college,” Atchity said. 

They need to be able to recognize substances that they may be offered at any turn, and know health and legal consequences. You can’t hide behind an abstinence-only, don’t-ask-don’t-tell policy with regard to your kid’s survival in this substance-rich landscape.”