Pitkin County not immune to opioid crisis; officials to host Aspen forum

Pitkin County lags behind the state in such categories as opioid deaths, but one statistic has caught the attention of health officials — the rate of patients vulnerable to long-duration opioids.

At 38.1 percent in Pitkin County, it is a figure more than double that of the state’s 16 percent while the nation is in the grips of an opioid-addiction crisis.

Patients receiving prescription opioids — those include Percocet, Oxycodone, OxyContin, Norco, Vicodin and Dilaudid — might just take a few and leave the rest in their bathroom cabinet. It’s a practice the Pitkin County medical officer discourages.

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“Someone gets a sprained ankle and they get prescribed 40 Percocet, and they use three, and 37 are sitting in their medicine cabinet,” Dr. Kimberly Levin said. “And they let it sit there because it’s been overprescribed in the past.”

What happens next can either possibly start an addiction or fuel one — someone other than the patient discovers and takes the leftover drugs, or the patient takes them not for the ankle injury but for the high they produce.

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Levin will be one of the speakers at an upcoming forum aimed at bringing the opioid epidemic home to residents of Pitkin County, an area of active people who are prone to injuries, and an area with plenty of folks looking to get high (Aspen is home to six and soon to be seven cannabis dispensaries). Both types are candidates for addiction to opioids, which killed more than 42,000 people in 2016, according to the Centers for Disease Control and Prevention.

The Opioid Crisis Community Forum, scheduled June 20 at Aspen School District Theatre, will include talks from Levin and Dr. Robert Valuck, director of the Colorado Consortium of Prescription Drug Abuse. Also on tap is a 30-minute panel discussion with Levin, Valuck, Dr. Kelly Locke, Aspen Valley Hospital Pharmacy director Alyssa Franklin and Pitkin County Sheriff Joe DiSalvo.

While reducing the supply of opioids is one step to addressing the crisis, Levin also urges decreasing the access to the pharmaceuticals while increasing awareness and educating the public about them.

“It’s such a complex epidemic,” she said. “There are so many issues that feed it and create it, and it needs to be combatted by the community as a whole — the hospital, the department of public health, the county, the city of Aspen, the schools. It’s a problem that needs to be addressed by all parties in the community.”

Of the five classes of controlled substances — opioids, benzodiazepines, stimulants, sedatives and muscle relaxants — opioids accounted for 43 percent of the dispensed prescriptions from 2014 to 2016 in Pitkin County. That was the highest rate among the five classes, according to Colorado Prescription Drug Monitoring Program, which provided the data to the Colorado Department of Health & Environment as part of a study last updated in July.

In Colorado, opioid-related deaths tripled from 1.9 per 100,000 residents in 2000 to 5.8 per 100,000 in 2015, according to the Colorado Department of Public Health & Environment. Figures for the mortality rate in Pitkin County and 37 other Colorado counties were not available.

However, Region 12 — comprised of Eagle, Garfield, Grand, Pitkin and Summit counties — had a rate of between 1.8 and 4.8 deaths per 100,000 residents from 2013 to 2015, lower than the state average.

Against that backdrop is the data showing the percentage of Pitkin County residents being prescribed long-duration opioids is more than double the statewide average.

“What this statistic tells us is that we need to keep an eye on opioid use in our community, because we know the longer a patient uses opioids the greater their chance of addiction,” said Pitkin County Public Health director Karen Koenemann in a statement. “There could be individuals in our community who are struggling with opioid addiction, but are afraid to ask for help because of the stigma associated with substance use disorders.”

Levin agreed, adding that Naloxone, also called Narcan, can help block opioids’ effects. Any household inhabited by someone with an opioid problem should have Narcan in the event of an overdose, she said, noting the Aspen Police Department and Pitkin County Sheriff’s Office keep them in their patrol vehicles. Patients also need to express their concerns about opioids with their prescribing physicians, who, likewise, should seek alternative medications when possible, Levin said.

“Patients can initiate that conversation if a physician doesn’t,” she said. “What’s going to work besides opioids.”

Levin dropped the acronym ALTO, which stands for alternative to opioid medications, as one way to put a dent in the problem.

“From the hospital and medical community, we’re trying to increase the use of ALTO medications,” she said. “And the most important part of this discussion is with the patients. We really think it’s a responsibility on both sides — what can you do to combat this.”

rcarroll@aspentimes.com