“Colorado ranks 16th in the nation for abuse and misuse of prescription drugs. This campaign is just one part of a coordinated, statewide strategy that simultaneously restricts access to prescription drugs for illicit use, while ensuring access for those who legitimately need them. The messages and tools provided through this effort will help us take on this serious public health challenge, as part of our commitment to becoming the healthiest state in the nation.” ~ Colorado Governor John Hickenlooper in 2015, launching his “Take Meds Seriously” program

Prescription Drug Abuse Statistics in Colorado

Just like the rest of the United States, the State of Colorado has a significant—and growing—problem with prescription drug abuse. In fact, according to the University of Colorado Skaggs School of Pharmacy, over 255,000 Colorado residents over the age of 12 misuse prescription medications every year. That is more than 1 out of every 16 people. Even more tragically, on average, at least one Coloradan dies every day due to a fatal prescription drug overdose, per statistics released by the Colorado Department of Public Health & Environment. Since 2000, 10,544 Colorado residents have died via overdose. To put that number in perspective, that is roughly the entire population of Castle Pines in Douglas County…or Glenwood Springs in Garfield County…or Alamosa in Alamosa County. Try to imagine that for a moment—an entire city’s worth of lives lost, all because of preventable fatal drug overdoses. To get a better understanding of the problem, let’s take a closer look at some of Colorado’s prescription drug abuse statistics.

First Things First – What are Prescription Drugs?

“I’m spending time on the issue because here in Colorado and across the country people … don’t realize the costs in terms of lives, health and economics. The number of deaths that come from overdose is greater than the number of deaths that come from car accidents.” ~ then-U.S. Department of Health and Human Services Secretary Sylvia Burwell in 2015

It seems obvious – prescription drugs are medications that you are given by your doctor or dentist. In terms of medications with a high abuse potential, there are three main types:

• Opioid Painkillers (OxyContin, Vicodin, fentanyl, etc.)
• Benzodiazepine Tranquilizers (Xanax, Valium, Klonopin, Restoril, etc.)
• ADHD Stimulants (Adderall, Ritalin, etc.)

Each class of commonly-abused prescription drug has its own unique risks, side effects, and solutions.

The Good News About Opioid Abuse in Colorado

“… it’s definitely moving in the right direction.” ~ Dr. Larry Wolk, Executive Director for the Colorado Department of Public Health and Environment

In 2016, Colorado overdose deaths involving all opiates – including both prescription opioids and heroin –were lower than they had been in 6 years – dropping from 472 deaths in 2015 to 442 deaths last year. While that may seem to be just a modest 6% decrease, keep two things in mind – FIRST, any downturn in opioid-related deaths is a major accomplishment. In 2000, there were only about 60 recorded fatal opioid overdoses in Colorado, and the number of deaths has climbed sharply ever since. SECOND, the biggest reduction in opioid deaths was realized with prescription painkillers such as oxycodone and hydrocodone. In 2015, those kinds of medications killed 259 Coloradans, but that significantly decreased in 2016, to 188. That is an encouraging 27% year-over-year decrease. Once upon a time – as recently as 2010-2011 – Colorado ranked second in the country for the misuse of prescription opioid painkillers. Now, the state ranks somewhere closer to the middle. That is promising progress.

Bad News About the Good News:

“Now people will tell you, ‘Well, I was taking whatever I could find, whatever I could access. And I would prefer to get prescribed opioids because they’re consistent and I know what I’m getting … But if need be, I will use heroin because it’s cheaper and easier to get.” ~ Dr. Robert Valuck

But as the success of the efforts aimed at curbing prescription opioid abuse is realized, a new, unforeseen, and potentially even more dangerous consequence has arisen – heroin abuse and overdose deaths are skyrocketing in the state of Colorado.

• 2011-2015 – The number of heroin seizures in Colorado increased 2035%.
• At the same time, the amount of heroin seized increased 1562%.
• Heroin-related arrests increased 515%.
• 2001-2016, heroin deaths in Colorado spiked 756%.
• It’s even worse in Denver – 2002-2016, heroin-related deaths in the city rose 933%.
• Heroin-related deaths are highest among the 25-34 age demographic. Within that age group, heroin kills more Coloradans than prescription opioids.
• First-responder use of the anti-opioid overdose reversal drug naloxone increased 240%.
• The number of Colorado residents in treatment for heroin addiction increased 128%.

7 out of 10 people in drug rehab in Colorado for heroin abuse report that they first abused opioid painkillers, but then switched to heroin because it was cheaper and easier to obtain. The increased demand for heroin in Colorado has led to a massive increase in the available supply, most of it flowing in from Mexico, and that has made prices drop. In 2013, a gram of pure heroin in Denver would cost an addict an average of $308, but by 2015, the price had fallen to $123.

Prescription Drug Abuse Statistics – Opioids

“Coloradans, along with the rest of our nation, are experiencing a deadly opioid public health crisis. We can’t sit by and watch the horrible disease of opioid addiction claim more lives in our local communities.” ~ Colorado State Attorney General Cynthia H. Coffman

It’s not all good news—as other statistics show, there is still a lot of work to be done. Colorado still faces a lot of challenges concerning opioid drugs.

• From 2013 through the first quarter 2017, more than 36 MILLION prescriptions were written for Colorado residents.
• Approximately 56% of those were for opioids.
• That equates to over 20 MILLION opioid prescriptions dispensed in Colorado in a little more than 4 years.
• Based on Colorado’s population, that means there were enough painkiller prescriptions written during that span to give 3 out of 4 state residents their own personal bottle of opioids.
• 2014-2017, nearly 60% of opioid patients were female.
• Across ALL age groups, Colorado women have higher rates of hospitalization due to prescription opioid poisoning.
• The highest rate is among women age 65 and older.

This last statistic highlights the fact that Colorado women face greater risks from opioid drugs than men, because while women are hospitalized for opioid poisoning at higher rates, it is MEN who have greater rates of overdose from ANY drug. Here’s the scariest fact – a 12-year study reports that nationally, 91% of patients who suffer a nonfatal opioid overdose continue to be prescribed opioids. And 70% of those still receive painkillers from the same doctor they were using before their overdose. Not surprisingly, patients who continue to take opioids after their overdose are twice as likely to overdo again within 2 years.

Opioid Dangers in Colorado by County

“We have an epidemic, not just in this country, but in the state of Colorado.” ~ Senator Cheri Jahn, Wheat Ridge, Jefferson County

According to the Colorado Department of Public Health & Environment, certain counties have rates of opioid poisoning deaths far exceeding other regions in the state. At highest risk:

• Chaffee
• Clear Creek
• Las Animas
• Otero
• Teller

Second-Highest Risk Tier:

• Adams
• Alamosa
• Denver
• Pueblo
• Routt

“Where benzodiazepines are dangerous really involves their addictive potential and their overdose potential. There are risks with these medications, they are control substances for a reason.” ~ Dr. Patrick Fehling, Addiction Specialist, University of Colorado Hospital

With all the media coverage about the ongoing “opioid epidemic”, people often forget that 30% of prescription medication overdoses are due to another dangerously-addictive class of drugs – benzodiazepines. Benzodiazepine medications are tranquilizing sedatives usually dispensed to treat anxiety or insomnia. Some of the most common “benzo” drugs include:

• Xanax/alprazolam
• Valium/diazepam
• Klonopin/clonazepam
• Ativan/lorazepam
• Restoril/temazepam

Benzo abuse interferes with normal production of dopamine – a neurotransmitter associated with motivation, learning, and pleasure. When a person misuses their benzodiazepine medication, their brain releases massive amounts of dopamine, they feel a euphoric “high”, and, in essence, they “learn” to continue using.

• Between 2013 in the first quarter of 2017, nearly 8.7 MILLION benzodiazepine prescriptions were written for Colorado residents.
• Annually, approximately 800 Coloradans are hospitalized because of benzodiazepines.
• In fact, more Colorado residents go to the emergency room each year because of benzodiazepines than for prescription opioids, heroin, or cocaine.
• Benzodiazepines are so addictive that even taking them “as needed” can lead to misuse.
• Benzo use can lead to dependence in under 4 weeks.
• 75% of benzodiazepine-related overdose deaths also involve opioids.
• Using opioids and benzodiazepines together TRIPLES the risk of psychiatric hospitalization.

“People feel like (ADD/ADHD medication) helps them concentrate and focus and, again, if you are going to pull an all-nighter and you feel like you don’t have time, they will keep you awake longer…people think they are safer because they are prescription drugs, but…it isn’t really a safe alternative.” ~ Andrea Coryell, Assistant Director of Alcohol and Other Drugs with the Colorado State University Health Education and Prevention Services.

Prescription stimulants like Adderall, Concerta, Vyvanse, and Ritalin are typically given as a treatment for Attention Deficit Hyperactivity Disorder (ADHD). However, these drugs are also extremely popular among college students, who take them as supposed study aids. Here’s the thing – recent research strongly suggests that prescription stimulants offer very little cognition enhancement. Instead, their euphoric effects make the user overestimate their performance. Even worse, the corollary effects of stimulant abuse – binge-drinking, skipping class, risk-taking behavior etc. – negate ANY positives. In fact, one dangerous trend among college students is to take ADHD stimulant medications to stay awake longer so they can drink more. Prescription stimulants are highly addictive – nearly 9 out of 10 stimulant medication abusers suffer withdrawal symptoms within the first day of attempting to quit.

• From 2013 through the first quarter of 2017, there were more than 3.6 MILLION stimulant prescriptions written in Colorado.
• By the time they graduate college, 62% of students will have been offered a stimulant.
• 31% of college students will use a prescription stimulant non-medically at least once.
• 95% of college students who abuse prescription ADHD stimulants fake their symptoms in order to obtain their drugs.
• Right now, 1 in 16 Colorado college students regularly abuse ADHD medications.
• ADHD medication abusers have an OCTUPLED risk of benzodiazepine abuse.
• They also have a QUINTUPLED risk of opioid abuse.

“So, they’re either taking it from their own medicine cabinets or they’re taking it from a friend’s medicine cabinet – or they’re just getting it from friends or family.” ~ Laurie Lovedale, Prescription Drug Abuse Prevention Program, Peer Assistance Services, Denver

But when you are talking about prescription drug abuse, you might be surprised to learn where addicts actually get their drugs. According to the Colorado Consortium for Prescription Drug Abuse Prevention, among people who abuse prescription medications:

• 55% get them free from a family member or friend
• 17.3% are prescribed them from just one doctor
• 11.4% purchase them from a family member or friend
• 4.8% steal them from a family member or friend
• 4.4% purchase them from a drug dealer or stranger

That’s right – despite the stereotype of shady, back-alley drug deals, that is the least likely way for a prescription medication abuser to obtain their drugs.

“The CDC characterizes [the drug overdose crisis] as one of the top four epidemic facing the United States right now at the level of cancer, obesity and heart disease.” ~ Dr. Rob Valuck, Pharmacy Professor, University of Colorado, and Coordinating Center Director for the Colorado Consortium for Prescription Drug Abuse Prevention

One popular misconception is the mistaken idea that the misuse of medications ISN’T really drug abuse – that prescriptions are somehow safer than illicit street drugs. On the contrary, almost 60% of fatal drug overdoses involve prescription medications. That means that if preliminary estimates for 2016 are correct, then, there were up to 39,000 overdose deaths in America last year specifically because of prescription drugs. But that’s not all – for each ONE fatal prescription overdose, there are:

• 32 trips to the Emergency Room
• 130 people abusing/dependent on benzodiazepines
• 825 people abusing/dependent on opioids
• Just 10 people admitted to substance abuse treatment

Abusing one substance also increases the likelihood of abusing another. 75% of all overdoses – and 98% of those that are fatal — involve multiple substances.

What Can Be Done about Prescription Drug Abuse in Colorado?

To protect yourself and the people you care about from the dangers of prescription medication abuse, there are several steps you should take:

• Honestly discuss with your doctor any personal or family history of substance use of any kind.
• Ask if there are any alternatives to potentially-addictive medications.
• Inform your doctor of any other medications, vitamins, supplements, or illegal substances you are taking.
• Take your medications exactly as prescribed.
• NEVER share medications – yours or someone else’s.
• ALWAYS properly safeguard your medications – this means performing regular inventory, and, if necessary, locking them up.
• Learn the warning signs of prescription drug abuse.
• Properly dispose of any excess, unwanted, or expired medications. Here is a list of all of the drug take-back locations in Colorado.
• Never mix medications and alcohol.

Most importantly, if prescription drug abuse is impacting your life, DON’T FACE THE PROBLEM ALONE – get specialized professional treatment. With timely intervention and evidence-based recovery strategies, it IS possible to step back from the edge before it is too late.