Opioid Data for Boulder County

Opioid Data for Boulder County

The opioid crisis is a complex issue, best understood through a variety of data sources covering health-related burden, in addition to both the social and legal ramifications of opioid misuse. The Opioid Advisory Group and Boulder County Public Health works with local and state partners to see trends across sectors, understand the current burden of the opioid epidemic in our community, and evaluate whether current strategies and programs are making a difference.

Data can tell us what is happening in our community, for example use of treatment services or drug possession events, as well as how outcomes are being impacted, such as hospitalizations and deaths connected with opioid use.

While in isolation, a single data point cannot tell a complete story, we hope by showing cross-sectoral data side-by-side, we tell a more complete story of the opioid epidemic in Boulder County and bring partners together to implement solutions.

Healthy Kids Colorado Survey

The goal of primary prevention is to stop risky behavior, such as drug use, before it starts.

When young people have a trusted adult in their life, they are less likely to engage in risky behavior. Parent Engagement Network, Healthy Futures Coalition, and other Opioid Advisory Group partners work with schools, youth and parents to ensure more young people have adults that they trust in their lives.

Syringe Access – The Works Program

graph showing increase in Works Program participants

Syringe Access – The Works Program

The WORKS program, administered by Boulder County Public Health, Boulder County AIDS project and Mental Health Partners, provides outreach, education, and syringe exchange services to reduce HIV and viral hepatitis transmission among people who inject drugs and their partners. Demand for WORKS services is high and continually growing: From 2010 to 2017 number of WORKS clients has increased by over 1,100%.

Hospital Data

Multiple Provider Episodes

multiple provider episodes rate

Patients Prescribed Long Acting/Extended Release Opioids Who Were Opioid Naive

graph showing patients who were prescribed long acting/extended release opioids who were opioid naive

Patient Prescription Days with Overlapping Opioid & Benzodiazepine Prescriptions

graph showing patient prescription days with overlapping opioid and benzodiazepineprescriptions
Prescription Drug Monitoring Programs (PDMPs) have been enacted by nearly all states across the nation (49/50 states). While PDMPS vary, they all provide data on prescribing and dispensing of opioids and other drugs, which are used by medical providers, public health professionals, law enforcement and others for prevention, enforcement, education and research.

Colorado’s PDMP is managed by the Department of Regulatory Agencies. Boulder County data is compiled by Colorado Department of Public Health and the Environment.

Learn more about prescribing in Boulder County.

Possession of Opioids

graph showing law enforcement charges of possession of opioids in Boulder County

Possession of Heroin

graph showing law enforcement charges of possession of heroin

The Boulder County District Attorney‘s office provided data of adults ages 18 and up who are charged with possession of controlled substances. The opioid category includes include OxyContin, Vicodin, morphine, codeine, tramadol, hydromorphone, heroin, fentanyl, and methadone.

According to law enforcement partners, rate of interactions with law enforcement may not be indicative of overall drug use in the community; as drugs affect the body differently, likelihood of interactions with law enforcement may vary by drug type. For example methamphetamine, a stimulant, produces increased activity in users, compared with opioids, which may induce lethargic states and semi-consciousness.

While two years of data is not enough to draw conclusions, it is possible the statewide prescription drug monitoring program (PDMP), has decreased the availability of prescription opioids, which could lead users to turn to heroin.

Learn more about the connection between prescription opioids and heroin.

Rates of drug possession are not uniformly reported on a state or national level.

  • Rate of heroin possessions
  • Rate of opioid prescription possession

Emergency Medical Services

graph of opioid-assisted resuscitative emergencies
When an ambulance is called to a scene, Emergency Medical Services (EMS) professionals follow guidelines for administering naloxone, which acts as an antagonist to reverse an opioid overdose. Since patients who are suffering from heart attacks and other conditions may have similar symptoms to those experiencing an opioid overdose, naloxone can be administered in cases where it is unclear whether a drug overdose has occurred.

If the case is a true overdose, patients will generally improve upon naloxone administration. If the case is not an opioid overdose, the naloxone will have no effect (negative or positive). EMS professionals estimate the number of opioid overdoses by counting the number of opioid administrations where patient condition improved after naloxone was provided (they call these opioid-associated resuscitative emergencies).

The number of saves by EMS in Boulder County may be decreasing due to an increase in bystanders carrying and administering naloxone prior to EMS arrival. In addition, naloxone may be administered by other first responders such as police. All Boulder County law enforcement staff were trained to carry naloxone in 2017. In Boulder County naloxone is also available for people who inject drugs, friends, and relatives through the WORKS program as well as pharmacies.

Learn more about accessing naloxone/narcan at BoulderCountyNarcan.org.

Local Hospital Data

Emergency Department Rate Due to Opioids

emergency department visits for opioid overdose

Emergency Department Rate Due to Heroin

age-adjusted emergency department visits due to heroin

Hospitalization Rate Due to Opioids

age-adjusted hospitalizations due to opioid overdose

Hospitalization Rate Due to Heroin

hospitalizations due to heroin overdose

To understand the health effects and burden to the healthcare system related to opioid overdose and misuse, we calculated the total number of patients seen in the emergency department and hospitalized for heroin or prescription opioids (natural, synthetic opioids and methadone, or ICD-10-CM Codes T40.2-T40.4).

We included cases where the primary hospital discharge diagnosis indicated a drug overdose or poisoning from one of the three mentioned substance categories. We did not include codes involving opioid withdrawal symptoms or adverse effects from prescribed medications, or cases where the drug code was not the first listed. There were 174 emergency department visits and 87 inpatient stays due to prescription opioids in 2016 and 2017 combined.

Estimates for 2016/2017 were calculated with Colorado Hospital Association (CHA) data using ICD-10-CM codes, data 2015 and prior was provided by Colorado Department of Public Health and the Environment and calculated using ICD-9-CM codes. Due to changes from ICD-9-CM to ICD-10, numbers pre- and post-2016 are not directly comparable.

Residents Seeking Treatment for Opioids

residents seeking treatment for opioids

Residents Seeking Treatment for Heroin

residents seeking treatment for heroin

Residents Seeking Substance Abuse Treatment

Office of Behavioral Health

The Office of Behavioral Health (OBH) requires licensed treatment facilities to report data on all clients seeking treatment. Cases are residents of Boulder County who sought treatment in a licensed OBH treatment facility. Treatment admissions may fluctuate based on availability of space at treatment centers, costs (including what treatments are covered by Medicaid), and other factors.

Opioid treatment providers (OTPS) increased from two to four in Boulder County between 2015 and 2017, and one of the initial providers expanded services and geographic scope. A list of treatment providers is available here. During this time period, heroin was the second most common substance for treatment admissions, behind alcohol.

Learn More

chart showing rate of overdose deaths in Boulder County

Data calculated with Vital Statistics death data. Prescription opioids include codeine and morphine and other prescription opioids (T40.2), methadone (T40.3), and synthetic narcotics (T40.4) as underlying cause of death.

Opioid Deaths 2010-2017

Type of Opioid2010-20112012-20132014-20152016-2017Totals
Prescription Opioids35442223124

Since 2010, a median of 7 Boulder County residents have died of heroin overdose and a median of 15 residents have died of prescription opioid overdose each year. Since 2010, a total of 191 Boulder County residents have died of an opioid overdose (124 for prescription opioid and 67 for heroin). This includes both unintentional and intentional deaths.

Prescription opioid deaths were highest in 2012-2013 and have decreased slightly over the last several years. Heroin overdose deaths have been on the rise since 2013, and continued to rise in 2017, the most recent year of data available. A rise in deaths is not necessarily indicative of increasing use or availability of heroin; it may also be related to the type and strength of substances used. One hypothesis is that with the stricter opioid prescribing guidance, some individuals may have switched to heroin.

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Substance Abuse Advisory Group

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