“We were able to double our supplies," said Jane McCulloch, the prevention program manager with the Colorado Health Network.
The supplies she's referring to, includes the amount of naloxone, a life-saving medicine that reverses the effects of an opioid overdose.
The program, while mainly serving as an anonymous syringe access program, also provides fentanyl test strips and naloxone to anyone that asks for it, and no photo ID is required.
"So after we have done a syringe exchange that will be part of our standard offering to participants, and they will either be new to having Narcan and fentanyl test strips, in which case we will train them as to how to use them, or they will be here for replacement supplies," McCulloch said.
The overdose deaths of five people at an apartment in Commerce City last month has highlighted the methods to stop it from happening again. Police said the victims ingested cocaine laced with fentanyl.
Recently, the city and county of Denver started offering naloxone and fentanyl testing strips to Denver residents for free, but other organizations, like Colorado Health Network among others, have been combatting fentanyl-laced drugs in a similar way for a while now.
"It's vitally important, particularly in the climate that we have today. It helps save lives, and that's the simple answer," McCulloch said referring to distributing naloxone.
Longtime, consistent demand
McCulloch explained that they believe there has been an increase in fentanyl being used in products "across the board" for nearly all substances that are available on the street today.
According to the Colorado Department of Public Health and Environment (CDPHE)'s dashboard that tracks this data, there were 49 fentanyl-related overdose deaths in Colorado in 2016. In 2021, there were 803 related deaths, and that data is not final.
In addition, the Drug Enforcement Administration's (DEA) Denver division has seized about 800,000 fentanyl pills in the past five months alone, 10 times more than the 80,000 seized in 2019.
For use of the Access Point program in general, McCulloch said that the number of people utilizing the service has remained "pretty steady," but acknowledges that the few months of this year have seen more people coming in compared to the first few months of 2021.
In 2021, they helped around 5,000 people.
"I think what is altered is the demand for fentanyl test strips and Narcan, for carrying that," she said. "The demand has been on the increase for a long, long while. That demand has been on the increase as products have become adulterated with fentanyl, unfortunately, there were a lot of deaths which were bizarre to people."
Because of the pandemic, Access Point had only been operating three days a week. But, due to demand, along with the drop in COVID-19 cases, they expanded back to five days a week.
“I was desperate to get back to five days a week – desperate – the need was just growing and growing," she said, adding that fortunately, their funding has increased, resulting in a growth to their supply.
"Because what we're basically saying is, you know, you should test every time now because you don't know, you don't know what's in that product," she said.
They recently had larger shipments of Naloxone, which included double-doses of the medicine.
Part of the reason for larger shipments is that they're seeing in some cases, that more doses of naloxone is necessary to actually reverse a particular overdose.
"And therefore, we're trying to get to the situation where we are not limiting Narcan distribution, but giving out as many doses are required to handle those situations," said McCulloch.
She added that part of the increase in the amount of people they see is because they're now able to provide smoking kits, which she said is a safer alternative than injection drug use.
A progressing conversation around stigma
McCulloch acknowledged the stigma surrounding some prevention services, but used the example of alcohol abuse to help explain why their goal is harm reduction, not enabling.
"I think the realization is the biggest substance abuse that we have in this country, in fact, most countries is alcohol. So, I think anybody who is an alcohol user has to accept that substances are used. And that's the basic principle – substances are used, they will always be around, they have always been around. But, what we are after is harm reduction. We are trying to make it the safest it possibly can be. Acknowledging that that use will always be there," she said.
McCulloch meets with people through consultations before providing the program's kits, and said she can feel the conversation progressing.
"And I do know that if you are a good service provider that brings more people in, that raises the awareness of it, more people feel less stigma attached to coming to syringe exchange programs. And there are several inside of Denver that are available to them. Not only us," McCulloch said. "I think my message would be, please support them. Please understand that syringe exchange programs do not increase drug use. They are about harm reduction. They are about saving lives. They are about giving everybody the best possible chance at wellness."
The Harm Reduction Action Center in Denver provides similar services, and CDPHE has a program that allows schools to apply for free shipments of naloxone.
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