‘People actually die from this’ | AspenTimes.com

‘People actually die from this’

Janet Urquhart
Aspen Valley Hospital emergency room staff, from left, Dr. Scott Gallagher, paramedic Charlie Abramson, nurse Peg Vidakovich, paramedic Eric Guthmann and nurse Cre Donvan have seen their share of alcohol- and drug-related cases. Aspen Times photo/Paul Conrad.

For the next several days, The Aspen Times looks at a dark side of our community that is seldom talked about. Drug and alcohol abuse, according to the Aspen Community Forum, is the No. 1 health problem facing our town. This five-part series, “After the Party,” looks into different aspects of the problem in advance of the Aspen Valley Medical Foundation’s community conference on substance abuse on June 22. Aspen’s reputation for hard-core athleticism is well deserved. Tune into the Winter X Games, hike to the top of Highland Bowl or gaze up at the rock climbers on Independence Pass and see for yourself.The resort’s reputation as a party town is apparently well deserved, as well. Just ask a physician working the night shift in the emergency room at Aspen Valley Hospital on a busy weekend. It’s a sobering perspective.”A good night would be when you don’t get someone drunk at 2 a.m. who has fallen and split their head or had a car accident,” said Dr. Steve Ayers, an ER doctor and Pitkin County’s coroner. “I would guess more than half the nights, we have something come in.”When Elaine Crowley, house supervisor with the AVH nursing staff, arrived in Aspen from a much bigger city 12 years ago, she was taken aback by the number of such cases.”I was surprised that such a small town could have so many problems,” she said.Now, cognizant of the lifestyle in an international resort, Crowley isn’t surprised, but she and her colleagues aren’t blind to it, either.

“It’s significant enough that we’re very aware of it as a group of emergency health care workers,” she said.”We see a fair amount of abuse – where people aren’t addicted but just choose to use it,” Ayers said.The numbers indicate substance abuse cases, involving alcohol or other drugs, don’t constitute a staggering percentage of the care that AVH provides. They amounted to a little more than 1 percent of the hospital’s ER visits in 2003 (the 2004 percentage is not yet available), but a string of headlines this spring brought the issue front and center.Aspenites found themselves reading about a series of tragedies, including the cocaine-related deaths of two valley residents in one month, followed by the suicide-via-overdose of a longtime local musician who’d battled drug abuse.”I don’t know that it’s out of proportion here compared to anywhere else, but that doesn’t make it any more right,” said Ayers, who will join a panel of experts next week when substance abuse and suicide take center stage at a forum hosted by the Aspen Valley Medical Foundation.The community health conference, The Divided Self: Crisis in Paradise, will take place June 22 at the Hotel Jerome Ballroom.Ayers will participate on a panel addressing “Warning Signs – How, When and Where to Get Help.”

If nothing else, Ayers said he hopes the forum increases the community’s awareness of the issue and perhaps generates support for improved care locally for such cases.Aspen, Ayers pointed out, is served infrequently by a visiting psychiatrist.A psychologist can offer counseling but can’t prescribe medication. A physician can dispense an antidepressant, for example, but isn’t trained to offer the psychiatric follow-up. It’s a psychiatrist who does both, noted Crowley, who also works as a crisis counselor for the Aspen Counseling Center.”I think we’re fairly unique in this area in that we don’t have a lot of psychiatric resources because we are such a small community,” Crowley said.Aspen is also somewhat unique in the types of substance abuse it sees. By far, the hospital treats more alcohol-related cases than other types of drugs, but the drug of choice tends to be cocaine, according to Ayers. Users of Ecstasy, a hallucinogenic, show up at the hospital on occasion, as well.The cheaper street drugs of large urban areas – crack, heroin and meth – don’t appear prevalent here, he said.

Though whiffs of pot waft from the occasional chairlift and among outdoor concert crowds, and cocaine at a party isn’t likely to raise anyone’s eyebrows, substance abuse cases aren’t a huge part of the local hospital’s caseload.Cases in which the principal diagnosis – the reason the patient wound up at AVH – was related to alcohol or drugs have numbered about 80 annually for the past few years, hospital statistics show. The total was 82 in both 2004 and 2003. The vast majority of them were alcohol-related – 69 last year and 71 in 2003.The number of cases in which drug or alcohol use was the secondary diagnosis – the patient who was treated for a split skull for example, but suffered the injury in a drunken fall – are higher.In 2004, such cases numbered 187. There were 174 such cases in 2003 and 207 in 1999.Then there are the cases that Ayers sees, not in his role as a medical provider, but in his job as coroner.”I see the ones who don’t make it – the ones who die before they get here, so I get a different perspective,” he said. “We need to realize this is a real thing – people actually die from this.”Janet Urquhart’s e-mail address is janet@aspentimes.com