COLORADO: A DECADES-LONG TREND OF MOUNTING OPIOID DEATHS WITH INCREASING PROVISION OF EXPERT TREATMENTS, REVERSED BY NALOXONE
As with other outliers proving the rule, opioid OD deaths drop only if and when effective, layperson-based Narcan campaigns begin to moderate lethal harm of gold standard treatments
by Clark Miller
Published January 2, 2025
As in Alaska, Iowa, South Dakota, San Francisco, Nevada, Tennessee, Utah and Washington, all states lagging the rest of the nation in effective campaigns for opioid fatal overdose reductions but not in increasing provision of expert gold standard medical cures and other “treatments”: in Colorado, delay and initiation of effective naloxone campaigns determined fatal OD trends and fully account for drops.
From an earlier post at ACD, in June of 2019 and updated April 2021 –
The new evidence from Colorado
is part of a consistent, invalidating, predictable pattern that disconfirms benefit attributable to OST. That expanding pattern is described in detail in multiple posts for locales within and outside the U.S.
And in Colorado
“The number of new admissions at highly regulated opioid treatment programs in Colorado increased from 1,388 in 2013 to 3,566 in fiscal year 2017. According to federal numbers cited by The Denver Post, there were more than 5,000 methadone patients across the state as of last week.”
By additional measures, provision of the medical substitute opioid “treatment” increased over that time frame – number of waivered (approved) prescribers of substitute opioids buprenorphine or methadone had been increasing, to 702 in 2017.
And the average daily census of opioid dependent patients treated with substitute opioids in Opioid Treatment Programs (OTP) was expanding rapidly
Over that same period of expanded provision of the medical substitute opioid “fix” for the medically generated opioid crisis, opioid-involved overdose deaths were also increasing, including for heroin as distinct from OD deaths attributed to fentanyl.
As in other locales consistently, any apparent moderation in increasing trend of opioid-induced OD deaths can be attributed to the directly acting and observed life-saving effects of increasing distribution and use of naloxone (Narcan).
That is, as is consistently evidenced in other locales, emergency responders are saving lives, often repeatedly, by reversing opioid overdoses, accounting for all moderation in lethality trends, leaving none to attribute to OST, while the invalidated medical “treatment” continues to fuel street economies of high-risk opioid use.
The mounting, consistently invalidating pattern was predictable, all along, because there has never been credible evidence to support effectiveness for OST, instead all lines of evidence disconfirm effectiveness and point to increasing harm.
The more medical cure provided to the diseased brains, the more deaths mount.
Back to our current post, and let’s update
From more recent news about Colorado’s opioid crisis and overdose trends, this familiar graphic with 2019 added. (The graphic in the news piece is interactive.)
Overdose deaths from fentanyl and all opioids continued to increase into 2019.
And into 2023 – from a much more recent news report on Colorado overdose trends.
Overdoses in all age groups spiked during the pandemic and only recently started to decrease again, after mass education, reduced stigma and naloxone availability became more common practice.
The age-adjusted rate of drug overdose deaths nationwide increased from 8.9 deaths per 100,000 standard population in 2003 to 32.6 in 2022, according to the National Center for Health Statistics. The rate decreased to 31.3 in 2023. Those rates decreased between 2022 and 2023 for people ages 15–54, but increased for adults aged 55 and older.
Colorado had similar numbers, showing a minor increase in overdose deaths from 1,799 in 2022 to 1,865 in 2023, according to the Colorado Center for Health and Environmental Data. There was a more significant increase in opioid-related deaths from 1,160 in 2022 to 1,292 in 2023. All of the younger age groups decreased from 2022 to 2023, but all age groups older than 35 years increased in overdose deaths during that time.
Then something happened, leading to and into 2024 and beyond.
The deaths caused by synthetic opioids, such as fentanyl, dropped 28.5%, from 1,192 to 852, according to the article. Colorado Consortium for Prescription Drug Abuse Prevention, which is part of CU Anschutz’s Skaggs School of Pharmacy and Pharmaceutical Sciences, said that one reason the fatal overdose rate has declined is that naloxone is readily available for anyone to have.
“Research showed that 73.3% of drug overdose deaths in Colorado in 2023 had at least one potential opportunity for intervention, most often by a bystander,” Tucker said during the meeting. “Which speaks to why the focus on opioid abatement fund strategies is so crucial.”
That’s right, the research is clear, consistently across locales and states – in a potentially fatal overdose, seconds count, and the emergence of intensive, targeted naloxone campaigns that place revival units in the hands of trained bystanders, laypersons, family members, peers and others proximate to high-risk users is what is saving lives and accouting for reductions in opoioid overdose deaths.
As in Colorado.
As compellingly conveyed by Sentinel writer Cassandra Ballard,
AURORA | Someone near you starts to show signs of an opioid overdose. Then they stop breathing. That person has six minutes before their brain cells start to die.
What would you do?
Six minutes is barely enough time to call 911 and for the emergency responders to arrive in time.
Okay, but our picture of what’s been happening in Colorado remains incomplete.
Local, regional and national public health officials say naloxone has become an important tool in pushing back rising numbers of opioid overdose. Denver has installed the vending machines in hospitals and, most recently, police stations.
As stronger forms of opioids continue to flood the black market and can now be found in a variety of other drugs such as marijuana, Percocet, cocaine, MDMA and methamphetamine, opioid overdoses have greatly spiked in the last five years, and only began reducing after Colorado took strong preventive measures, according to state health officials.
[emphasis added]
Uh oh! Another rent in the Matrix, another fissure leaking truth.
The “rising numbers of opioid overdose” is a consistently widespread thing, precisely what is requiring the widespread, desperate, emergency naloxone campaigns to reduce fatal overdoses, to reverse some of the mounting “numbers of opioid overdose” to limit those that become fatal, to reduce harm of America’s expert, gold standard treatments. The persistently rising numbers of opioid ODs are due to rising high-risk opioid use, which, in turn, is incontrovertibly, unavoidably a measure of lethal failure of American expert substance use treatment, reduction of high-risk use the only possible means by which those treatments could be effective.
And those “strong preventative measures” whose effects were required, were necessary before there would finally be reductions in the persistently mounting opioid ODs?
Were those the expert, gold standard treatments increasingly dispensed over the past decades in Colorado, somehow without explanation suddenly becoming effective after decades? And coincidentally at the point in time when effective, targeted, naloxone campaigns began to directly account for fatal OD reductions?
Okay, I’ll stop. I don’t mean to offend. (Or maybe I do?)
Let’s explore a bit more.
Those persistent expansions of medical gold standard treatments in Colorado – of dispensing of buprenorphine and methadone – perhaps not surprisingly, continued.
In 2018, Colorado was slated to gain $30 million over the following 2 years in new funds for opioid crisis treatment expansion.
DENVER – Colorado will receive $30 million in federal grant money over the next two years to fight the opioid epidemic, with most of the money meant for medication-assisted treatments and the addition of new mobile health units that will be deployed in rural parts of the state.
[emphasis added]
And per this late-2025 report –
Fulfilling the Promise of Medication-assisted Treatment
Excellent strides have been made in expanding the number of Opioid Treatment Programs for methadone treatment in Colorado. …
Medication-assisted treatment (MAT) combines medication and behavioral therapy to manage behaviors and symptoms related to opioid use disorder. MAT is a vital evidence-based way to reduce overdose deaths, promote recovery, and should be available to whoever needs it, throughout the state.
Since 2017, the Consortium has worked with multiple partners to expand access to treatment in areas that would otherwise have a shortage of providers. What began as a small pilot program grew into a robust system that in 2024-25 provided treatment at 34 sites in 21rural and frontier counties
Because of this program, 672 people were able to initiate MAT treatment over the past year, and hundreds more continued their treatment. The program also assisted grantees to develop new policies to expand in-person and telehealth services, increased capacity to address social needs through care coordination and peer support, and strengthen inter-agency connections to increase referrals.
Over pandemic years, Colorado was among top states in relaxing safety standards to more recklessly dispense the substitute opioids methadone and buprenorphine, established as fueling the crisis.
And was among top states in dispensing methadone.
Colorado has indeed been ‘Fulfilling the Promise of Medication-assisted Treatment”, with predictably lethal outcomes.
Until effective (= targeted, layperson) naloxone campaigns were implemented
In Denver, a “leave behind” program begun in early 2024 resulted in more than 2.400 Narcan kits being provided to laypersons who were at the site of an opioid overdose that first responders were called to.
That’s targeted, layperson provision.
Also in early 2024, increased focus began on placement of “custom vending machines” for free Narcan kits, in community settings targeting need and potential for anonymity to minimize effects of stigma.
Healthcare professionals from the CU Anschutz Medical Campus want to get the overdose reversal treatment Naloxone into the hands of the public by distributing them in vending machines.
The medical school operates substance abuse treatment clinics in Arvada, Aurora, and Denver through the School of Psychiatry in a program called Addiction Research and Treatment Services (ARTS). …
Ishida from ARTS said vending machines are less intimidating for someone seeking help with an addiction that carries a lot of stigma.
“It’s just a lot easier for them to access these resources through a machine, through an interface that’s not personal, but at the same time, anonymous, and I suppose, objective and neutral,” he said. “There’s no judgment, there are no labels.”
In late 2023, increasing numbers of Colorado schools began keeping a supply of naloxone at school, reducing time to respond, that is, reducing opioid overdose deaths.
More powerfully and more effectively, Colorado took the lead in early 2024 among states in not just supporting Narcan kits in schools, but allowing students to carry Narcan, empowering students as described in this news piece, to become “Students as emergency responders“, further reducing response time and more effectively placing units right where they are needed – carried on the persons of peers whether in or out of school.
In 2024, “Narcan Leave Behind” programs were being implemented throughout the state, again, placing Narcan units where they are needed most and where response times are minimized.
Those life-saving principles – getting naloxone kits in the hands of those most proximate to areas of high-risk opioid use – had taken hold at the state level by May of 2024, when prioritization for distribution of funds for Narcan kits became “based on how frequently an entity directly encounters people who are most at risk of experiencing or witnessing an overdose”.
That should paint a picture for us.
In Colorado, as elsewhere, as everywhere, opioid crisis death trends and worsening high-risk use are driven primarily by two opposing forces: 1) the established lethal failure of expert guidance and longstanding medical opioid and substance use “treatments”, and 2) effective, emergency, targeted naloxone campaigns to moderate harms of those pathological systems.
As deaths mount and Narcan’s days are numbered.
