Across Colorado and the United States, rates of opioid addiction and overdose are devastating communities, families and individuals. Colorado recorded 543 opioid overdose deaths in 2018 from both prescription opioids and illegal opioids such as heroin. The opioid epidemic is a result of a number of challenges, including a sharp and steady increase in opioids such as hydrocodone and oxycodone prescribed for patients by their doctors, limited access to treatment especially in rural areas, increased use of heroin and injection drug use, deadly additives to the heroin supply such as fentanyl and carfentanil, stigma and the cost of treatment.
Nationwide, an estimated 11.8 million people misused opioids in 2016, including 11.5 million pain reliever misusers and 948,000 heroin users, according to the National Survey on Drug Use and Health. A White House Council of Economic Advisers analysis said the opioid epidemic cost between $293.9 and $622.1 billion in 2015, with a preferred estimate of $504 billion.
The Behavioral Health Administration provides oversight of and purchases opioid treatment services, including traditional substance use disorder treatment and opioid treatment programs (OTPs). The BHA provides some oversight for office-based opioid treatment (OBOT), and training support for primary care providers who prescribe or would like to prescribe buprenorphine. In May 2018, the Colorado Department of Human Services' Office of Behavioral Health launched Lift The Label, a public awareness campaign that strives to remove damaging labels and stigmas that prevent those with opioid addiction from seeking effective treatment.
- What are Opioids?
What are Opioids?
Opioids are a class of drug that includes illegal drugs like heroin and prescription drugs or painkillers such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine and many others. Prescription opioids are often prescribed for short periods of time to address acute pain, but can lead to addiction or chemical dependence in as few as 7 days. Among people misusing the drug, most people are getting their opioids from a doctor, friend or family member. This is why Colorado and many other states are working to reduce the number of opioid prescriptions and support safe prescribing methods.
Misuse of prescription opioids can also lead into heroin use. Among heroin users in Colorado, 70 percent say they started their drug use with prescription medications. If you or a loved one is misusing prescription medications or heroin, treatment works and recovery is possible.
- Treatment for Opioid Use Disorder
Treatment for Opioid Use Disorder
Medication-assisted treatment is considered the gold standard because the three types of medicine commonly used to treat opioid addiction -- methadone, buprenorphine and naltrexone -- have been found effective in clinical trials. Medication-assisted treatment (MAT), including opioid treatment programs (OTPs), combines behavioral therapy and medications to treat substance use disorders. Those receiving medications as part of their treatment are75 percent less likely to die because of addiction than those not receiving medications. To understand how medication-assisted treatment works in the brain, you can watch this short video from The Pew Charitable Trust.
Medication-assisted treatment can be found in Colorado by:
- Looking through Colorado's list of Opioid Treatment Programs. Click here to learn more about Opioid Treatment Programs.
- Finding a local provider by searching Colorado's list of providers
- Downloading the app OpiRescue to find a treatment provider near you
- Looking through SAMHSA's list of buprenorphine prescribers
Need to find treatment outside of Colorado? Click here.
- Paying for Treatment
The Behavioral Health Administration (BHA) funds treatment for individuals without insurance and pays for inpatient substance use treatment for individuals with Medicaid. Health First Colorado (Medicaid) and most commercial health insurance pay for outpatient substance use treatment, including MAT. If you cannot pay for treatment, most substance use providers use a sliding scale based on income and have financial counselors that can help you get health insurance.
Substance use providers may have a wait to get in. If you need immediate assistance, including access to a professional counselor, the Colorado Crisis Line is available 24/7. Call 1-844-493-8255 or text "TALK" to 38255.
Research on Opioids in Colorado
- Colorado Prescription Drug Profile, July 2017 (Updated)Colorado Department of Public Health and Environment
- Miles Away From Help: The Opioid Epidemic and Medication-Assisted Treatment in Colorado, May 2017 Colorado Health Institute
- Heroin in Colorado (April 2018). Colorado Prescription Drug Consortium- Heroin Response Work Group
- Opioid Use in Colorado: Colorado Medicaid Addresses Addiction, March 2017. Colorado Department of Health Care Policy and Financing
- State of Colorado Substance Abuse Trend and Response Taskforce Thirteenth Annual Report, January 2019
- Policy Analysis of State Legislation and Response to the Opioid Crisis, September 2017. Office of Behavioral Health
- Needs Assessment for the SAMHSA State Targeted Response to the Opioid Crisis Grant, July 2017.Colorado Health Institute
- Fact Sheet: Medication-Assisted Treatment Improves Outcomes for Patients With Opioid Use Disorder, November 2016.Pew Charitable Trusts
- Fact Sheet: Addressing the Opioid Crisis, February 2018. Office of Behavioral Health
Resources Related to Medication-Assisted Treatment, Opioid Treatment Programs, and Opioid Use Disorders
- Substance Abuse and Mental Health Services Administration | Publications
- National Institute on Drug Abuse
- National Institute on Alcohol Abuse and Alcoholism
- The National Alliance of Advocates for Buprenorphine Treatment
- Medicaid | Substance Use Disorders Tools and Resources
- Prescription Drug Monitoring Program Colorado Department of Regulatory Agencies
- Colorado Consortium for Prescription Drug Abuse Prevention
- Lift The Label Behavioral Health Administration
- Community Reinforcement and Family Training with Prevention (CRAFT-P)
The Behavioral Health Administration is utilizing State Opioid Response (SOR) funding to support the friends and family members of loved ones struggling from substance use disorders. The two evidence-based practices being used to support family members and friends with an addiction include the Community Reinforcement and Family Training with Prevention (CRAFT-P) and the Incredible Years! Program. These programs are being implemented via telehealth and in-person throughout Colorado. These programs are free for participants and are supported in a group format. Both programs are being implemented on a weekly basis.
-Find a group by city (or use the filters to search by day of the week or county)
-Find an online CRAFT Group through We The Village, scroll down to “Find A Group To Join”
CRAFT-P is an evidence-based program that supports the family members and friends of people struggling with substance use disorders. This behavior modification program helps loved ones of a person struggling with a substance use disorder accomplish the following goals: 1) reduce substance use within the family, 2) encourage the person struggling with substance use disorder to engage into treatment (if already engaged, encourage to stay engaged in treatment program), 3) help family members enrich their own lives through teaching self-care techniques.
Research has shown that seven out of ten family members who participate in the CRAFT program are successful in engaging their loved one into a treatment program. This program works across the continuum of care (prevention, treatment, recovery) and aims to collaborate with community partners and existing resources in communities. CRAFT-P is currently being implemented in a number of different settings: outpatient substance use disorder clinics, mental health centers, recovery communities, harm reduction centers, psychiatric settings, schools, and therapists with private practices. Some family graduates of the CRAFT program have become trained in this model and are now implementing groups in their communities.
The Incredible Years! Program is an evidence-based practice focused on strengthening parenting competencies and fostering parent involvement in children’s school experiences, to promote children’s academic, social and emotional skills and reduce conduct problems. The parenting program from children 0-12 years old.
- Naloxone (Narcotic Overdose Reversal Drug) Standing Orders, February 2017. Colorado Department of Public Health and Environment, Law Enforcement Officers.
- Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs A Treatment Improvement Protocol TIP 43, Revised 2017. Substance Abuse and Mental Health Services Administration
- Healthcare Brief: Medication-Assisted Treatment for Opioid Addiction, 2012. Office of National Drug Control Policy
- Medication Assisted Treatment Joint Bulletin, 2014. CMS, SAMHSA, CDC, NIDA, and NIAAA
- SAMHSA Opioid Overdose Prevention Toolkit, 2016. Substance Abuse and Mental Health Services Administration
- Medication-Assisted Treatment of Opioid Use Disorder Pocket Guide, 2016. Substance Abuse and Mental Health Services Administration
- CDC Guideline for Prescribing Opioids for Chronic Pain, (updated 2017). Centers for Disease Control and Prevention
- Federal Guidelines for Opioid Treatment, 2015. Substance Abuse and Mental Health Services Administration
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition), 2012. National Institute on Drug Abuse
- Managing Chronic Pain in Adults With or in Recovery from Substance Use Disorders, A Treatment Improvement Protocol, TIP 54, 2012. Substance Abuse and Mental Health Services Administration
- Advisory: Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update, 2016. Substance Abuse and Mental Health Services Administration
- Opioid Prescriptions: What to Ask, 2019. Georgetown University School of Nursing
Services and Supports
Education and Training Resources
- Colorado Community Reference Guide for Prescription Drug Abuse Prevention Office of Behavioral Health and Colorado Consortium for Prescription Drug Abuse Prevention
- Medication Assisted Treatment Education and Training. Providers' Clinical Support System for Medication Assisted Treatment
- Knowledge Application Program (KAP)Substance Abuse and Mental Health Services Administration
- The ASAM Treatment of Opioid Use Disorder Course. ASAM American Society of Addiction Medicine
- American Academy of Pain Medicine - Education AAPM American Academy of Pain Medicine
- Opioid Stewardship Center for Health, Work and Environment, Colorado School of Public Health
- American Academy of Pain Medicine, AAPM
- American Society of Addiction Medicine, ASAM
- American Academy of Addiction Psychiatry, AAAP
- American Association for the Treatment of Opioid Dependence, AATOD
For more information about Colorado's State Targeted Response to the Opioid Crisis programs and services, please contact:
Amy Cooper, Associate Director of Adult Treatment and Recovery
Behavioral Health Administration