As fentanyl overdose deaths continue to rise, Tri-County Health Department ramps up prevention efforts

AURORA | The news that three women and two men were found dead in a Commerce City apartment in late February due to apparently ingesting fentanyl-laced cocaine was sobering to many, so law enforcement and health agencies are encouraging people to be more aware and prepared.

Among the dead were the parents of a four-month-old baby who was found alive at the scene, along with another woman who survived.

It’s the kind of tragedy that Tri-County Health Department’s harm reduction and HIV prevention program is trying to fight, as Colorado continues to grapple with an increasingly deadly drug supply.

“No drug is safe right now,” 17th Judicial District Attorney Brian Mason said in February while discussing the case.

America’s long addiction crisis is showing no signs of stopping, and according to data from the Colorado Department of Public Health and Environment, drug deaths have increased during the pandemic. In 2020 1,477 people died of a drug overdose statewide, including 143 in Adams County and 147 in Arapahoe County — almost a 50% increase from 2019.

The types of substances are changing, however. What was a crisis initially fueled by prescription pills and heroin has ballooned into encompassing meth and fentanyl, a super-powerful synthetic opioid that can be deadly in even minute quantities. In 2020, the last year for which complete data is available, more than a third of all overdose deaths in Colorado involved fentanyl.

Experts say what makes fentanyl so dangerous is that much of the time drug users don’t even know they’re taking it. As in the case of the Commerce City family, people take other drugs that dealers have laced with fentanyl to increase the potency — which also increases the risk of death.

Fentanyl and fentanyl analogs are being mixed into counterfeit opioid pills, heroin, cocaine, and methamphetamine,” the Centers for Disease Control and Prevention said in a report. “Illicitly manufactured fentanyl, which is illegal, non-pharmaceutical fentanyl, is likely contributing to deaths involving these other substances.”

In 2016, the CDC reported that synthetic opioids, primarily illegally manufactured fentanyl, were involved in 23.7% of deaths involving prescription opioids, 37.4% involving heroin, and 40.3% involving cocaine in 2016.

“It’s here in Colorado. It’s getting mixed in with drugs that it never has been mixed in with and because of its potency it really can take somebody by surprise,” said Dr. Lauren Mitchell, nurse manager of the Tri-County’s harm reduction and HIV prevention program.

“Everyone should just assume, whatever drug they’re taking, if it’s a street drug, it probably has been tainted with fentanyl,” she said. “So people need to be aware of that and act accordingly.”

In response to the crisis, the city of Denver last month launched a program allowing all residents to order Narcan, the drug that reverses opioid overdoses, and fentanyl testing strips to be shipped to them for free.

The program is unique to Denver, but the push to increase access to naloxone (the generic name for Narcan) isn’t.

“Our goal for this year is to try to normalize carrying naloxone,” Mitchell said.

Tri-County’s harm reduction program is responsible for fighting the spread of infectious diseases and preventing opioid overdoses. It provides testing for sexually transmitted diseases (STIs), distributes naloxone and runs a syringe exchange and disposal program.

The syringe exchange program helps insure that people who are injection drug users are using clean needles, which reduces their risk of infection and helps keep used needles off the street. Program staff spends a lot of time doing street outreach to drug users, many of whom are homeless, in encampments and on Colfax, Mitchell said. It also has a physical location on Lima Street in Aurora, where it shares space with nonprofit It Takes A Village.

During warm months, staff say they help as many as 30 people per week.

Along with exchanging needles, they also distribute naloxone to people and help connect them to drug treatment services if that’s something they are ready to consider.

“It’s about us trying to meet folks where they are,” Mitchell said.

The program also provides training about how to use naloxone to any community group or business that requests it, and has a stockpile of naloxone it distributes on request.

“Anybody who wants naloxone, we want them to have it,” Mitchell said.

Over the past year it provided a number of trainings at local motels, which have seen an increase in guests overdosing. After training motel staff members how to administer naloxone, Mitchell said that there have been four opioid overdose reversals that she knows of.

The demand for services appears to be increasing. The program distributed more naloxone in 2021 — 560 kits — than in any other year, she said. Staff say they’ve already distributed 77 kits this year.

In partnership with the City of Aurora the program also opened up a syringe disposal kiosk in front of the MLK Library along the Colfax corridor. The kiosk is a secure place where people can deposit syringes, which are then disposed of by a medical waste company.

In April, the program will launch two new initiatives. It will start using a mobile RV that will go into hard-to-reach communities to provide HIV tests, Hepatitis C tests, STI testing and syringe access services. And it will be opening a second brick-and-mortar location for syringe access services in Commerce City.

As Adams and Arapahoe counties prepare to stand up their own health departments next year, the future of the program remains uncertain. All of its services are fully funded by outside grants, Mitchell said, and she hopes that both counties will recognize the value of the work they do and want them to continue. 

“We just want to provide the best services for our people and our communities,” she said.

Tri-County’s syringe access services can be reached at 303-363-3077, and on Mondays, Wednesdays & Fridays from 1pm to 4pm at 1475 Lima Street, Aurora, 80010.

For a list of pharmacies where naloxone can be purchased over the counter, go to stoptheclockcolorado.org/map.

— Photojournalist Philip Poston contributed to this story