Colorado has continued to see an increase in overdose deaths related to opioid abuse and even an increase in the prescription of opioids, though slightly down in 2018.
Colorado has recently passed several bills to address opioid abuse within the state.
SB 19-008: Addiction Treatment in the Criminal Justice System
SB 19-008, Substance Use Disorder Treatment in the Criminal Justice System, is designed to provide alternatives to criminal charges for people in need of substance abuse treatment.
The bill specifies that the Colorado Commission on Criminal & Juvenile Justice must:
- Institute an easier process for record sealing and harm reduction practices when appropriate.
- Offer alternatives to criminal charges for individuals who have been arrested for drug-related offenses (low-level offenses).
- Determine the best practices to investigate the unlawful distribution of opioids in Colorado.
In addition, the bill outlines that:
- Jails that get funding for behavioral health services must have a policy in place regarding medication-assisted treatment (MAT) before January 1, 2020.
- The Department of Corrections must provide MAT to people who were receiving that treatment in jail or prior to being transferred to the Department of Corrections.
- The monetary appropriations used in the implementation of the bill are set.
This bill sets the tone of many of the other bills that follow. It attempts to address the overall approach to dealing with people who have substance use disorders, especially opioid use disorders.
HB 19-1009: Support for Addiction Recovery
HB 19-1009, the Substance Use Disorders Recovery, defines supports for people recovering from substance use disorders and expands programs for these individuals.
- Expands the standards of recovery residences so facilities that advertise themselves as sober homes, sober living facilities, or recovery residences must meet specific standards.
- Expands the housing voucher program that currently exists for individuals with substance use disorders.
- Establishes a certification and grant program for recovery residences.
- Establishes an opioid crisis recovery funds advisory committee to oversee the uses of any state funds.
- Defines the financial appropriations to be used to implement the bill.
The bill is primarily concerned with giving support to people recovering from substance use disorders instead of penalizing them.
SB 19-227: Overdose Prevention and Harm Reduction
SB19-227, Harm Reduction Substance Use Disorders, aims to identify individuals with substance use disorders and take steps to help them. The act:
- Allows nonpublic schools and public school districts to develop policies to obtain opioid antagonist medications and train employees to administer them.
- Allows for the distribution of opioid antagonists to specified public persons, law enforcement agents, and schools.
- Removes the definition of drug paraphernalia from products that are designed to test or analyze for presence of a controlled substance.
- Allows for licensed hospitals to be designated as clean syringe exchange sites.
- Expands medication take-back programs.
- Allows for the purchase of opioid antagonist medications in bulk.
- Specifies how the Department of Health must verify the identity of people in treatment for substance use disorders.
- Defines the appropriations associated with the bill.
The bill reflects the understanding that there must be more availability for opioid antagonists like naloxone to address the ongoing problem of opioid overdose. It also aims to reduce the overall harm associated with substance use disorders.
SB 19-228: Opioid Regulation and Prescriber Accountability
The passage of SB 19-228, Substance Use Disorders Prevention Measures,
was contingent on HB 18-1172 (getting finances from the Marijuana Tax Cash Fund) being law; HB 18-1172 passed in March 2018.
- Enhances dispensing fees for pharmacies that provide counseling regarding the risk of opioid use to individuals who are prescribed opioids.
- Prohibits prescribers from accepting any benefits for prescribing a medication. This includes payments or other perks from manufacturers of opioids.
- Requires warning labels for opioid prescriptions to outpatients.
- Allows medical examiners to access information in the drug monitoring program in certain instances.
- Allows the Colorado Department of Human Services to investigate cases of prenatal exposure to substance abuse.
- Creates the Charlie Hughes and Nathan Gauna pilot opioid prevention program to address opioid abuse in young people.
- Creates programs to develop and increase public awareness regarding opioid abuse and treatment.
- Requires certain types of health care professionals to receive training regarding the prescription of opioids and allows for a review of their practices.
- Establishes reporting requirements and financial appropriations.
The bill is primarily concerned with regulating the prescription of opioids and making prescribers of opioids more accountable.
SB 19-219: Continued Licensing of Control Substances
SB 19-219, Sunset Continue Licensing of Controlled Substances, is a continuation of a previous bill concerning the licensing of controlled substances. It attempts to implement recommendations regarding controlled substance licensing. The bill:
- Continues the Controlled Substance Licensing Act for an additional seven years and subjects it to review when the appeal comes up in September 2026.
- Makes sure that the Colorado Department of Human Services puts together an accurate, simplified, and objective system to categorize and track complaints against a licensed prescriber and to document disciplinary actions taken against that person.
- Develops secure central online registry that allows licensed opioid treatment centers to provide information to governmental authorities.
- Repeals references to research as regulated activities under the Controlled Substance Licensing Act.
The bulk of the new legislation in Colorado aimed at addressing opioid use disorders is designed to specify and deliver treatment services and other interventions to individuals in need.
The bills above do not increase penalties or incarceration for offenders. Instead, they are designed to get people the help they need.
The movement away from stressing penalties and incarceration toward addressing prescribing practices, providing supports and treatment for individuals with substance use disorders, and implementing the use of opioid antagonists like naloxone highlights the viewpoint that substance abuse is not a crime. Instead, it represents a form of mental illness that is best addressed with treatment and understanding.