Reduce incidence of substance abuse disorder

Why is this important to Colorado?

  • Drug abuse and deaths from drug overdose continue to be a serious problem in Colorado. In 2016, 912 people died of a drug overdose.
    • The prescription opioid death rate stopped increasing in 2016. The number of prescription opioid overdoses in 2016 decreased to 300 deaths from a high of 338 in 2014.
    • There were 228 heroin overdose deaths in 2016, an increase of 68 deaths in one year. The heroin death rate of 4.1 deaths per 100,000 persons in 2016 has doubled since 2012 (when 2.2 deaths per 100,000 persons occurred).
  • Since 2013 when the Colorado Consortium for Prescription Drug Abuse Prevention started, non-medical use of prescription opioids among those age 12 and older dropped from 5.1 percent in 2013 to 4.9 percent in 2014. Among 18-25 year olds, non-medical use dropped from 10.7 percent to 9.3 percent in 2014.
  • Marijuana use among Colorado's youth is in line with national averages (21.2% of CO youth compared to 21.7% of national youth); however, due to increased access to marijuana by all Coloradans after legalization, and decreased perceptions of the substance as risky for youth use, many in Colorado are concerned that legalization of marijuana may lead to higher youth use in the future.

 

How do we measure success?

  • Reduce self-reported, non-medical opioid (prescription drug) use from 5.10 percent in June 2013 to 3.50 percent in 2018.*
  • Prevent an increase in  the percent of high school students who used marijuana one or more times during the past 30 days from the 2013 level of 19.70 percent to 18.70 in 2017.**

*The National Survey on Drug Use and Health (NSDUH) changed the misuse question starting on the 2015 survey, making it impossible to compare the data on non-medical opioid use with previous surveys. The NSDUH did not release state-level data using the new question in 2015.  Colorado will be able to compare 2015 and 2016 data about non-medical prescription drug misuse using when the 2016 survey is released in early 2018.

**Given that as recently as the 1990s high school marijuana usages rates in Colorado have been much higher than current levels, the State's original goal for 2018 was to prevent a spike in the high school usage rate following recreational legalization.  Early data suggests we have avoided such a spike, and thus the Administration is now turning its efforts to decrease the high school usage rate from current levels. As of June 2017, CDPHE established a new goal for past 30 day Marijuana usage among youth of 18.70 percent.

Status Outcome Measure

Outcome Baseline

(June 2013)

Actual

(June 2016)

Actual

(June 2017)

Outcome Target Target Date
Work in Progress
Non-medical prescription drug use 5.10% 4.93% (2015) TBD- early 2018 3.50% 2018
Work in Progress
High school students using marijuana 19.70% 21.20% TBD- early 2018 18.70% 2018

Source: CDPHE, National Survey on Drug Use and Health, Health Kids Survey Colorado.

What actions are we taking?

  • Colorado’s Department of Public Health and Environment (CDPHE) and the Colorado Department of Regulatory Agencies (DORA) are partnering with other members of the Colorado Consortium for Prescription Drug Abuse Prevention to conduct a series of pilot projects to make the Prescription Drug Monitoring Program (PDMP) easier to use and access in an effort to increase PDMP utilization rates. CDPHE is also funding local health agencies to conduct provider and prescriber education to increase the use of the PDMP.
  • Colorado’s Department of Public Health and Environment is partnering with other members of the Colorado Consortium for Prescription Drug Abuse Prevention to expand the Colorado Household Medication Take-Back Program. Permanent collection locations are being established statewide at law enforcement agencies, pharmacies, hospitals, and clinics to provide all Colorado residents a safe and convenient way to rid their homes of unused medications, reducing the potential for misuse or abuse.
  • Colorado Department of Health Care Policy and Financing (HCPF) implemented the Chronic Pain Management Program.   This program uses interactive video technology to connect primary care providers with pain management specialists.  The second phase of the program began in May 2016, and offers providers the current Chronic Pain Telehealth Program and the new Buprenorphine Telehealth Program, to assist providers with treating clients with opioid addiction.
  • Colorado Department of Health Care Policy and Financing is working with the University of Colorado Skaggs School of Pharmacy on a number of initiatives designed to reduce inappropriate use of opioids. In 2017, letters documenting prescribing patterns of physicians compared to their peers will be evaluated for effectiveness in impacting prescribing behavior.
  • Colorado Department of Health Care Policy and Financing implemented a new policy on August 1, 2017 limiting opioid naive members to a 7-day supply of opioids.  The member can receive two additional prescriptions of 7 days and after that a prior authorization and possibly a pain consultation is required to continue to receive opioids. 
  • Colorado Department of Health Care Policy and Financing is reducing the Morphine Milligram Equivalent (MME) from 300 to 250 effective October 1, 2017.  The Department implemented the 300 MME February 2016 to require a prior authorization for anyone receiving more than 300 MME per day.  The Department’s goal is to ultimately reduce down to the current recommended dosing of 90-120 MME.  The Department is taking a slow approach to this to allow tapering and appropriate reduction in use to reduce the danger of people using other sources of opioids. 
  • Colorado Department of Health Care Policy and Financing continues to provide a pain resources webpage for providers to obtain information about opioids including pain assessment charts, information about tapering, patient education, overdose information, and substance use disorder assistance/prevention.
  • Colorado Department of Public Health and Environment launched the “Protect What’s Next” campaign in August 2015 in an effort to encourage youth to think about their goals and how marijuana can get in the way of achieving them and prevent youth from using marijuana before age 21. Colorado also launched a complimentary campaign in 2015 to encourage adults to have conversations with youth about marijuana. In fiscal year 2017, there were 125,000,000 media impressions between the two campaigns.
  • Colorado is enforcing retail marijuana age restriction laws, including identification spot checks and cracking down on enforcement actions.