Denver, Colorado is one of the most popular and populous cities in the US. As the capital of Colorado, the city has been thriving since its founding around the time of the Colorado Gold Rush, which was fueled by homesteaders seeking a new life. Denver burned completely to the ground in 1863, and a flood the following year killed 20 people and resulted in extensively damaged property. However, when the Union Pacific Railroad nearly bypassed the city, residents raised $300,000 to ensure they had access to a railroad, helping to bring more people in from both coasts.
Denver has a central city/county population of 630,564 people. The state was one of the first places to legalize the recreational use and sale of marijuana, leading to a booming industry for locals and tourists. Unfortunately, the city is home to many who struggle with marijuana addiction and abuse, as well as addiction to many other substances, including opioids, alcohol, and meth.
The Landscape of Addiction and Treatment Programs in Denver, CO
The substances of abuse in Denver change over time, although statistics published in January 2014 by the National Institute on Drug Abuse (NIDA) show that the use of heroin, other opioids, and methamphetamine is trending upward in the city. A later Colorado Department of Public Health & Environment (CDPHE) survey on opioid and heroin overdose data in Colorado found that 4.9 percent of the population of Colorado, ages 12 and older, struggled with prescription painkiller abuse; this was similar to the national average of 4.1 percent. This reflects national trends.
Drug overdose is one of the leading accidental killers, surpassing motor vehicle accidents; over 10,550 people have died from drug overdoses in the state from 2000 to 2015, with opioid addiction and overdose being the leading causes behind the deaths. The number of people who die in the state from drug overdoses is significantly higher than the national average, with 880 deaths in 2015 in Colorado, averaging 15.7 percent (the national average is 14.6 percent). Most people who suffered overdose deaths in Colorado were between 25 and 64 years old.
The state of Colorado reports high use of marijuana and alcohol, two legal intoxicants for adults ages 21 and older in the state. It also has statistically higher rates of cocaine and opioid abuse. It is the only state in the US that ranks in the top 10 for consumption of all four dangerous, problematic substances.
The Dangerous Newly Legal High
Colorado legalized the recreational, production, and sale of marijuana in 2012, in spite of federal legislation enforced by the Drug Enforcement Administration (DEA) keeping it a Schedule I regulated substance. The industry launched throughout the state in 2014, creating thousands of jobs and bringing in billions of dollars. The state’s cut from marijuana taxes in 2015 was a reported $135 million.
However, with increased acceptance comes increased risk from drugged drivers and abuse among adolescents. Even before marijuana was legalized across the state, one substance abuse treatment center reported that 95 percent of the teenagers admitted for treatment struggled with marijuana abuse in 2009; this was significantly higher than the national average, which at the time was 67 percent. A research study found that 9 percent of people who try marijuana become addicted to the intoxicating drug; that rate increases to 17 percent among people who try the drug before age 18. Unfortunately, two-thirds of people who try marijuana for the first time each year are below that age.
CDPHE published a report in 2015 that found that 13.6 percent of the adult population of Colorado had used marijuana in the past month, and 33.2 percent of those current users reported consuming marijuana every day, indicating potential addiction or substance abuse problems. Worse, 18.8 percent of those people reported driving after using marijuana, which can be extremely dangerous. The National Highway Traffic Safety Administration (NHTSA) notes that physical response time and driving performance are significantly reduced for the first two hours after ingesting marijuana, and residual effects on motor skills, cognitive abilities, and reaction time can be seen for 24 hours after use.
Marijuana-related traffic data for Colorado is limited since the Colorado State Patrol did not begin keeping statistics until after marijuana was legalized. However, it appears that DUIs for marijuana alone, and combined with other substances, increased between 2014 and 2015: from 12 percent of all DUIs in 2014 to 15 percent the following year. Summons for traffic violations related to marijuana, both alone and in combination with other drugs, in Denver increased from 33 summons in 2013 to 73 summons in 2015.
While there are still few car accident fatalities associated with marijuana in Colorado, that rate is increasing too. In 2013, there were 55 traffic fatalities involving a THC-positive driver; this number increased to 79 in 2014.
The Other Dangerous Legal Intoxicant
Alcohol is legal across the United States, and any adult who is at least 21 years old can consume alcoholic beverages. However, it is one of the most dangerous substances of abuse, with alcohol use disorder, heavy drinking, and binge drinking all causing serious long-term health problems, from liver damage to cancer to dementia. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that 17 million adults, ages 18 and older, in the US had alcohol use disorder in 2012; that same year, an estimated 855,000 adolescents, between the ages of 12 and 17, also qualified for AUD.
People who receive a diagnosis of alcohol use disorder must meet specific criteria as listed in the DSM-5, so there are also numerous people who struggle with alcohol use in some way but who do not qualify for AUD. NIAAA reported that, in 2015, 26.9 percent of adults ages 18 and older reported at least one incidence of binge drinking in the past month, putting them at risk of alcohol poisoning. About 7 percent of adults reported to NIAAA that they engaged in heavy drinking in the past month, increasing their risk of long-term chronic illnesses.
About 88,000 people in the United States die every year from alcohol-related causes; in 2014, there were 9,967 deaths in the US caused by drunk driving. Researchers reported in 2014 that heavy drinking had increased 17 percent in the US since 2005.
Among parts of the country with high rates of drinking, Colorado ranked in the highest for any kind of problematic drinking, including heavy drinking and binge drinking, as published by the University of Washington’s Institute for Health and Metrics. In Pitkin County, CO, 78 percent of respondents were considered problem drinkers of any kind, and Summit County, CO, had close to 79 percent. The Centers for Disease Control and Prevention (CDC) found that alcohol caused the deaths of one in seven adults in the state. In Denver, in 2010, there were 152 deaths related to substance abuse overdoses or poisonings, and 34 percent of those deaths were due to alcohol in some way.
Denver, Colorado, and the Opioid Epidemic
Colorado’s Health Department reported that overdose deaths from opioid drugs surpassed both motor vehicle deaths and homicides in 2015. Heroin abuse in the first half of 2013, per NIDA, was the fourth cause of drug abuse treatment and admissions and accounted for 9.1 percent of all substance abuse admissions in Colorado.
Denver area heroin treatment admissions increased along a similar pattern, to 12.7 percent of all substance abuse admissions in the metro area, including alcohol. In Denver, heroin was present in 27.9 percent of alcohol- and drug-related deaths. In 2015, the rate of heroin-related overdose deaths in Colorado was 9.7 percent for ages 25-34. The primary driver for heroin treatment admissions in Denver, the state of Colorado, and the nation is switching from prescription drug abuse to this more available, less expensive, and more intense substance.
In the first half of 2013, other opioids (which mostly consist of prescription analgesics) rose to the fifth leading cause of drug abuse treatment admissions in Colorado, surpassing cocaine. In Denver, other opioids were the sixth leading cause of admissions to drug treatment. In 2003, the mortality rate for overdosing on non-heroin opioids was 5.4 per 100,000 people; this number rose to 11.3 per 100,000 people in 2012. By 2015, opioids other than heroin were responsible for 9.3 percent of overdose deaths among people ages 25-34.
Colorado Experiences Increasing Problem with Meth
The western state, and the Mile-High City, have seen an increase in problems with methamphetamine. Between 2010 and 2014, Denver and nearby Aurora experienced a 140 percent increase in arrests for meth possession. While the state cracked down on small labs scattered throughout remote areas, Mexican cartels have rapidly filled the demand for meth in the US. Border agents reportedly seized 15,000 pounds of meth in 2013 alone. Between 2009 and 2014, drug police in Colorado reported that they seized 2,000 pounds of the stimulant.
The NIDA survey with 2013 data found that meth accounted for the third largest proportion of admissions and treatment throughout Colorado, representing 16.7 percent of admissions in the first half of the year. The greater Denver area saw a high of 15 percent of admissions from meth abuse in 2007, but that percentage dropped to 12 percent in the first half of 2013. There were 20 meth-related deaths in 2011, which was the largest number reported in the NIDA survey.
Nationally, there were 103,000 emergency department visits in 2011 related to meth abuse, and like in Colorado, it is one of the top four drugs found in ER admissions, with heroin, marijuana, and cocaine comprising the top three. However, the number of people struggling with meth abuse is either dropping or fewer seek treatment – 8.1 percent of treatment center admissions in 2005 involved meth, but that fell to 5.6 percent in 2011. While meth is trending down nationally, there are regional variations for abuse, with Colorado hitting the top of that list.
Mental Health and Co-Occurring Disorders in Denver, Colorado
People who experience both a substance use disorder and a mental illness have co-occurring disorders, and symptoms of one condition will exacerbate problems associated with the other. A Denver report on public health and behavioral issues found that many people struggling with co-occurring disorders began experiencing these conditions in adolescence. Between 2009 and 2013, children (ages 14-18) entering treatment programs for co-occurring disorders were found to have:
Getting Treatment in Denver, Colorado
In 2014, the State of Colorado’s Substance Abuse Trend and Response Task Force found that alcohol, methamphetamine, marijuana, and heroin were the top four drugs abuse by people who sought addiction treatment across the state.
Denver represented 56 percent of the people seeking help ending substance abuse and addiction. Denver’s percentages were slightly different compared to larger state trends. Cocaine was the primary drug of abuse in the city, driving 61.9 percent of admissions; heroin abuse followed at 57 percent; marijuana was 46.4 percent; prescription opioids were 44.8 percent; and meth addiction represented 38.7 percent.
There is a great need for more treatment specializing in co-occurring disorders in Denver. As of 2015, there are reportedly 112 designated, licensed substance abuse treatment facilities, 23 mental health facilities, and just seven facilities that cover both, according to Denver Health: Vital Signs. While many people can find treatment for mental health or substance abuse issues, there is a need for specialists who understand and can treat co-occurring disorders as well as facilities that offer licensed therapists and drug addiction counselors.
Laws regarding Substance Abuse and Treatment
Colorado passed a Good Samaritan law in 2012, allowing people to report heroin or opioid overdoses without facing criminal prosecution for drug sale, use, or possession themselves. In 2013, the state passed legislation expanding the use of naloxone, allowing non-healthcare workers to receive a prescription for this medicine to reduce overdose fatalities. The state also passed initiatives to expand the use of the Prescription Drug Monitoring Program (PDMP) to prevent doctor-shopping and other ways of acquiring prescription painkillers for non-medical use.
The CDPHE’s chief medical officer has the ability, as of 2015, to issue standing orders for naloxone, so that it is easily available to pharmacies and harm reduction organizations. The government agency is also expanding the state’s medication take-back programs, so unused prescription drugs, including narcotics, will be less widely available in people’s homes.
Regulations on Treatment Credentials and Accreditations
The Colorado Department of Regulatory Services protects consumers by licensing professionals and businesses. This includes regulations for addiction counselors and requirements for training, education, and experience. The Mental Health Practice Act protects people struggling with mental illness, substance use disorders, their families, and others by clearly stating the requirements to practice this type of medicine.
The Association of Addiction Professionals (formerly the National Association for Alcoholism and Drug Abuse Counselors, or NAADAC) provides guidelines to members. These standards are in addition to federal, state, and city specifics around licensing, certification, and regulation. NAADAC also provides addiction specialists with further education resources.
Denver Human Services Office of Behavioral Health can be contacted for help with mental health responses, trauma-informed practices, pretrial assistance, homeless services, and medication-assisted therapy. These groups intersect with mental health and substance abuse prevention services in some way.
The State Colorado Judicial Department keeps a long list of private, low-cost, free, and even faith-based treatment options for mental health and substance abuse. While it is not all-inclusive and is intended as a reference for professionals to help their clients after moving through the court system, it can benefit those seeking help ending addiction, reducing the impact of mental health problems, or both.
Colorado’s Medicaid program, called Health First Colorado, has community behavioral health services for members who need assistance. Access Behavioral Care is the primary provider located in Denver. Medicaid recipients can contact that group for:
In addition, the group offers other options that benefit the mental and emotional health of the community.
Veterans residing in Denver qualify for Veterans Affairs benefits. Since these are federal benefits, further details and application information can be found online at Benefits.gov. With rising rates of PTSD, substance abuse, and suicide among veterans, the VA is working hard to provide assessment, treatment plans, and long-term help to this demographic.
The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains extensive lists of private and public behavioral health services using their online, interactive map. Services provided in Denver, Colorado, can be narrowed down by whether they treat substance abuse, mental health, or both, and whether they provide buprenorphine for maintenance therapy, in addition to other specifics.
The National Alliance on Mental Illness (NAMI) offers volunteers and peer-led programs to help people end problems associated with mental health, including substance abuse. In Colorado, NAMI runs a crisis hotline and a more general helpline for those who want help but are not in crisis.
Psychology Today maintains large databases of behavioral health, substance abuse, and mental health treatment services, which can be searched by zip code, city, or state. The Denver, Colorado, listing of treatment centers for addiction, detox, rehabilitation, and more can be found through this link.
Denver Health is an organization that provides important healthcare services, including substance abuse and mental health treatment, to people residing in Denver, regardless of their ability to pay. They state that about 25 percent, or around 150,000 people, use these services in Denver. Services include Substance Abuse Treatment Education & Prevention (STEP) for adolescents, Outpatient Behavioral Health Services including Comprehensive Addictions Rehabilitation and Evaluation Services (Denver CARES), methadone clinic and Suboxone treatment options for maintenance therapy, and evidence-based recovery services for women and families.
Religious or Spiritual Assistance
Denver is not considered a religious center for any particular group, but for people who are spiritual or religious, charitable faith-based options exist. Of course, the Denver Area Central Committee of Alcoholics Anonymous and the Mile High Area Service Committee of Narcotics Anonymous provide Christian-based spirituality along with the 12 Steps to recovery. Catholic Charities provides family counseling services; the University of the Rockies, a Christian college, maintains a list of emergency hotlines for mental health or substance abuse crises; and further Christian-based treatment optionscan be found through the Psychology Today website.
Non-Christian options exist in Denver too. Chabad Jewish Center of South Metro Denver provides a drug and alcohol residential treatment center. In addition, the Secular Organization for Sobriety (SOS) is working on a directory of secular meetings to support those in recovery from addiction.