As fentanyl overdoses continue to soar in Colorado, a new medication assisted treatment facility in Aurora is hoping to lower barriers to treatment for people struggling with opioid addiction.
Community Medical Services opened its intake facility in Aurora Oct. 28, and is the city’s first opioid outpatient center. It will offer medication assisted treatment and counseling, 15 hours a day, seven days a week to people seeking help for addiction.
Based in Arizona, CMS has over 50 facilities in 10 states. This is its first location in Colorado, but it hopes to open about half a dozen more over the next several years, program manager Christina Boudreaux told The Sentinel. The company was drawn to Colorado due to what she described as an overwhelming need for more addiction services.
“When we were looking at the overdose rates, Colorado is so incredibly underserved, and so when we saw the opportunity to make an impact we jumped on it,” she said.
According to data compiled by the clinic using 2020 numbers, Boudreaux said that in Colorado four people die every day from an opioid overdose death, a rate that she believes is an undercount from the current situation.
Similar to states across the country, Colorado has been grappling for years with a rise in overdose deaths. The Colorado Department of Public Health and Environment reported that 1,881 people died from a drug overdose in 2021, and the age-adjusted rate of fatal overdoses was 31.7 per 100,000 residents, up from 1,477 deaths and a rate of 24.9 the previous year.
Fentanyl, an ultra-powerful synthetic opioid, which is 50 to 100 times more potent than morphine, has been driving many of the deaths, according to state and federal health officials.
The federal government counted more accidental overdose deaths in 2021 alone than it did in the 20-year period from 1979 through 1998. Overdoses in recent years have been many times more frequent than they were during the black tar heroin epidemic that led President Richard Nixon to launch his War on Drugs, or during the cocaine crisis in the 1980s.
As fentanyl gains attention, mistaken beliefs persist about the drug, how it is trafficked and why so many people are dying.
Experts believe deaths surged not only because the drugs are so powerful, but also because fentanyl is laced into so many other illicit drugs, and not because of changes in how many people are using. In the late 2010s — the most recent period for which federal data is available — deaths were skyrocketing even as the number of people using opioids was dropping.
Advocates warn that some of the alarms being sounded by politicians and officials are wrong and potentially dangerous. Among those ideas: that tightening control of the U.S.-Mexico border would stop the flow of the drugs, though experts say the key to reining in the crisis is reducing drug demand; that fentanyl might turn up in kids’ trick-or-treat baskets this Halloween; and that merely touching the drug briefly can be fatal — something that researchers found untrue and that advocates worry can make first responders hesitate about giving lifesaving treatment.
All three ideas were brought up this month in an online video billed as a pre-Halloween public service announcement from a dozen Republican U.S. senators.
A report this year from a bipartisan federal commission found that fentanyl and similar drugs are being made mostly in labs in Mexico from chemicals shipped primarily from China.
With such a deadly drug flooding the streets, providers at CMS say their mission is more important than ever.
Medication assisted treatment, commonly abbreviated as MAT, involves treating people addicted to opioids with a substance that inhibits their ability to get high off of opioids and that decreases their craving for the drug. The clinic offers both methadone and suboxone, which must be taken every day in liquid form, as well as vivitrol, an injectable drug administered every 28 days.
Located at 14300 E. Exposition Ave., a short walk from the Aurora Metro Center Station and the Town Center of Aurora, the new facility is specifically designed to be as accessible as possible. It is open from 5 a.m. to 8 p.m. seven days a week, operates on a walk-in basis and has a goal of having wait times of no longer than five minutes.
That makes it unique for MAT facilities, which often are only open in the early morning until around noon and don’t process people for initial intake appointments every day, Boudreaux said. With a medicine that needs to be taken every day to be effective, that can make things difficult for patients, many of whom don’t have their own cars or work irregular hours.
“The thought is, the second someone’s ready for treatment, they can come in,” she said.
Unlike some other programs, the clinic is also unique in that it will not stop treating patients if they continue to test positive for drugs, and will only kick patients out if they are aggressive or violent. From a public health perspective, Boudreaux said it doesn’t make sense to cut off people’s access to treatment when they are struggling.
“There’s no treatment if they die,” she said.
The clinic currently has 13 staff members, and the methadone and suboxone, which are highly regulated, will be administered by licensed nurses at several window kiosks. Past the kiosks are a series of rooms that will be used for one-on-one counseling sessions for patients.
The rooms are brightly decorated, and the reception area has floor-to-ceiling windows. Michele Ryan, community programs and integrations manager for CMS, said the clinic was designed to look as much like a normal doctor’s office as possible. A big part of CMS’ mission is to reduce the stigma associated with receiving treatment for addiction.
“Our clients are so judged in the rest of the world, when they come here we want that to be a respite from that,” she said.
The counselors will also provide case management services for patients, and will try to connect them with other services they need to try and deal with their addiction.
“We always try to have an answer to any barrier someone has,” said Patrick Sullivan, CMS’ outreach lead for the new clinic.
Sullivan is no stranger to the efficacy of MAT. In college in the late 1990s he started using heroin and illicit prescription opioids and ultimately became an everyday user dependent on the drug to function and not become sick.
“My normal was I had to have the drugs in my system,” he said.
He ultimately decided that he needed help, but was living in a rural part of Illinois where resources were scarce. He ended up moving to Tucson and started receiving treatment at a CMS clinic. It took about two months on methadone before he stopped using opioids, he said, but he ultimately quit completely and has been clean ever since.
Being on treatment that took away his craving for the drug and allowed him to focus on changing other conditions of his life instead of being trapped in a cycle of constantly trying to make enough money to get high so he didn’t become dopesick.
He was on methadone for a total of three years. After about two years he decided he wanted to start planning to quit, and worked with a doctor to taper off the medication over the course of 10 months.
“I wouldn’t have the life I have without it,” he said of the treatment.
Sullivan has now worked with CMS for five and a half years, and said his personal experience with addiction and recovery has been a benefit when working with patients and potential community partners. The company does a lot of outreach to local jails and hospital systems to try to streamline access to treatment for addicts, and he said being able to address people’s questions or concerns about MAT with firsthand knowledge is reassuring.
Over time he said he’s seen an increase in the acceptance of MAT, which was initially met with trepidation from some corners due. He worked for a number of years with patients who were in the criminal justice system, and said that the willingness of sheriffs and judges to allow people to receive MAT has increased over time.
“I would talk to police officers who started telling me, ‘we can’t arrest our way out of this problem,’ and they’re out there on the front lines arresting people,” he said.
That sentiment was repeated at a community event organized by Aurora Public Schools over the weekend, where local law enforcement and public health officials raised the red flag about the dangers of fentanyl.
Prosecutors in the 17th and 18th Judicial Districts, which encompass Adams and Arapahoe counties, said that fentanyl has completely infected the local drug supply. Fentanyl is easier to manufacture than other drugs and is highly addictive, which incentivizes drug dealers to add it to their supply.
“No drug is safe right now,” said 17th Judicial District Attorney Brian Mason. “Do not take any pill unless you know where it’s from and it came from a pharmacy.”
The department has found fentanyl in everything from meth and heroin to cocaine, he said. Darcy Kofol, who prosecutes drug crimes in the 18th Judicial District, said that fentanyl has completely replaced the supply of illicit oxycodone that used to be on the streets.
The U.S. Drug Enforcement Agency has warned that fentanyl is being sold in multicolored pills and powders — sometimes referred to as “rainbow fentanyl” — marketed on social media to teens and young adults. However, experts say fears of fentanyl being marketed to young children are unfounded.
Joel Best, an emeritus sociology professor at the University of Delaware, said that idea falls in with a long line of Halloween-related scares. He has examined cases since 1958 and has not found a single instance of a child dying because of something foreign put into Halloween candy — and few instances of that being done at all.
“If you give a dose of fentanyl to kids in elementary school, you have an excellent chance of killing them,” he said. “If you do addict them, what are you going to do, try to take their lunch money? No one is trying to addict little kids to fentanyl.”
Many times, people overdose because they take a pill that they think is an opioid or another prescription drug but is actually fentanyl, Kofol said. Without people knowing exactly what substances they’re ingesting, it’s incredibly easy to take a fatal dose by accident.
“Each of these pills are essentially Russian roulette with an overdose,” she said.
Kofol referenced a 2020 case where a 16-year-old girl died of an overdose after being given fentanyl by an adult man at a party. Kofol said the girl thought she was taking an oxycodone pill. The man was sentenced to 64 years in prison this summer.
“Teens are allowed to make mistakes,” she said. “The problem with fentanyl is it doesn’t care.”
At the Aurora Public Schools event, employees from the Tri-County Health Department handed out narcan, a drug that can be used to safely reverse opioid overdoses, as well as fentanyl testing strips that can be used to determine whether fentanyl is present in another substance.
The best thing people can do to help prevent overdose deaths is to be aware of the dangers of fentanyl and to talk to their children and friends about it, Mason said. He feels better when people who sell deadly drugs are put behind bars, but said that by itself incarceration won’t be enough to solve the problem — and it can’t bring someone back to life who has already died of an overdose.
“Prevention is better than prosecution,” he said.
— The Associated Press contributed to this report