By David Heitz / NewsBreak Denver
(Denver, Colo.) Although fentanyl and meth grab the most headlines when it comes to vices in Denver, alcohol emerges as the most commonly abused substance.
That’s according to members of a three-doctor panel who shared their expertise Wednesday with the Denver City Council’s Safety, Education, Housing and Homelessness Committee.
Robin Kniech, chair of the committee, said substance abuse remains one of the biggest challenges facing Denver. The committee invited physicians who are experts in substance use disorder to discuss the problem with the council.
Kniech said the committee “wanted to take a step back from looking at it as a business and policy problem.” She said it’s important the committee understand substance use disorder as a clinical problem as well. “Let’s ground our conversation as a community with these facts.”
Treatment for substance abuse is all too common at Denver Health, Dr. Christian Thurstone said. Thurstone is director of behavioral health services at Denver Health and a professor of psychiatry at the University of Colorado, Denver. He pulled patient numbers from Denver Health for 2021.
Thurstone said 7,790 people were treated for substance abuse disorder through a primary care doctor. The emergency room, meanwhile, saw more than 23,000 substance abuse visits. Substance abuse disorder was diagnosed during more than 1,500 visits at school health centers. More than 8,000 people attended inpatient rehabilitation at Denver Health.
Denver Cares saw 11,000 admissions. Denver Cares is a non-medical site where people can sober up from acute intoxication. A roving ambulance picks up inebriated people on Denver’s streets and takes them to Denver Cares.
Dr. Kimberly Nordstrom, medical director of Signal Behavioral Health, noted that most people at Denver Cares are there to sober up from alcohol. Kniech noted a doctor who was unable to attend the panel, Dr. Hermione Hurley, told her meth also is commonly seen as an abused substance.
Hope needed
Several of the panelists discussed the importance of instilling hope in people battling substance use disorder. Kniech said there is a sense of hopelessness in the community.
Dr. Byron Adinoff, a professor at University of Colorado Anschutz Medical Campus, said the first goal in treating addiction is making sure the person doesn’t die. “If someone’s not alive, we can’t get them better.” He said it’s important to distribute naloxone, the opioid antidote, to people who use opioids.
Clinicians try to get a patient to buy into their recovery and go into treatment. Medications are available to lessen the sting of getting off opioids and alcohol. Unfortunately, medications don’t exist for people abusing stimulants like cocaine or methamphetamine.
Who is prone to addiction?
Councilmember Stacie Gilmore said “nervous system regulation, deep breathing, getting outdoors, all of those toolkit sort of items that we need to be diligent for our entire lives” don’t get discussed enough. “I guess it’s just the severity you have of the Jonesing if you don’t get that fix.”
Gilmore said people begin to believe they have a moral failing because they can’t stop using. “If you can look up before you start the swirl and use some of those tools, that will help everybody.”
How do you know if you have a problem? The experts said if a substance gets in the way of your daily life, as evidenced by things such as poor finances and relationships, you have a problem.
Councilmember Kevin Flynn asked the panel if two people in treatment were equally challenged by substance use disorder and one had an illness such as bipolar or borderline personality disorder, would the person with the co-occurring condition struggle more in recovery? The answer was yes, they would. Heredity also plays a role in substance abuse, the doctors said.
Kniech said there is a disconnect when it comes to substance abuse and getting sober. A diabetic is considered to be making progress if they take steps to reduce sugar intake, but with addiction only total stoppage is considered a measure of success.
Treatment works, but access ‘lousy’
Treatment works,” Thurston said. “Access to treatment is lousy.” He said that in Colorado, only 20 to 30 percent of people who need substance abuse treatment access it. He said part of the problem is a severe shortage of healthcare workers.
He said he has a vision for Denver called 90/90/90. This vision assumes a Denver where 90 % of people would know they have a substance problem, he said, and know it’s OK to have a substance problem; 90 % of people would go into treatment; and 90 % would find success in treatment. He said that public health approach could help tackle Denver’s drug and alcohol problem.
Kniech asked how people experiencing homelessness attend outpatient treatment when they don't have a home. Nordstrom said people living in shelters do attend treatment. She said people who are newly homeless and overwhelmed are most likely to miss appointments, however.
Councilmember Amanda Sawyer said she has three teenagers. She has learned substance abuse begins as early as sixth grade, she said, adding that interventions at the high school level are too late.
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