By Jon Huang
The origins of the opioid epidemic traces back to the early 1990s. Prior to this, opioids were used primarily for acute and cancer-related pain. However, with the marketing of newer longer-acting opioid formulations along with a national campaign to use pain to assess the quality of patient care, the use of prescription opioids skyrocketed across the country.
Between 2022 and 2038, the office of the Colorado attorney general reported that El Paso and Teller counties will receive an estimated $66 million from nationwide settlements with drug and pharmaceutical companies for their role in fueling the national opioid epidemic. Of these funds, 80% will be distributed through the Region 16 Opioid Abatement Council, whose voting body is comprised primarily of city and county representatives from the local government and first responder community.
In April 2024, the council released its first round of funded projects. Of those awarded, one group is aiming to address the ways the opioid epidemic has impacted the first responder and medical community.
Status Code 4, a Colorado Springs-based nonprofit that provides mental health support to first responders, in collaboration with Insight Services PLLC, the University of Colorado, Colorado Springs, Lyda Hill Institute for Human Resilience and Chance Multimedia, was awarded a grant to develop a course to address the opioid-related challenges experienced by the first responders and medical practitioners in the community.
The course will include a one-hour live class, an online module and the creation of a documentary that will include first person testimonies of the struggles with first responders’ experience with OUD (Opioid Use Disorder) and its impact on themselves and their adult loved ones.
According to the CDC, OUD is a problematic pattern of opioid use that causes significant impairment. A diagnosis of OUD is based on specific criteria such as unsuccessful efforts to cut down or control use or use resulting in a failure to fulfill obligations at work, school or home, among other criteria. It can even lead to overdose and death. In a report published by the Substance Abuse and Mental Health Services Administration in 2022, an estimated 6.1 million people in the U.S. had an OUD.
Among the goals of the project is to reduce the overall stigma associated with OUD and encourage help-seeking behaviors, provide resource information and resiliency skills to mitigate OUD, recognize signs and symptoms of those with OUD, PTSD, depression and or suicidal ideations, and provide OUD treatment options information.
Ann Rush, co-founder of Status Code 4 and project lead, explained that given the physically grueling nature of their work, many first responder and health care professionals can encounter opioids as part of treatment for a work-related physical injury.
“If they are struggling with a mental crisis, they can use that as a way to self-medicate and that’s really why we (want) to bring this awareness piece to it,” she said. “We want people to be aware that this potentially exists and overdose is very much a possibility. Most first responders and medical practitioners know that, but often times they don’t care what they do to themselves; they only care what they do to others.”
Joanie Lewis is the clinical director for Insight Services, a Colorado Springs-based licensed substance abuse facility that provides mental health counseling services. Insight also serves as a primary mental health provider for the local first responder community for trauma work. Lewis is a licensed professional mental health and addiction counselor. She is also the subject matter expert on this project.
Lewis said one of the considerations for this project is the inherently stressful environments that first responders work in and the effects this can have on their mental health.
“They’re on the front lines; they’re dealing with those who are overdosing; they’re dealing with those folks that are experiencing the consequences of addiction, whether that’s some of the homeless population … (or) some of the crime in the community” she added.
Further complicating this is the expectation to project a certain image.
“Part of it is that they’re expected to be professionals, to not have emotional responses … to get in, do the job and get out,” Lewis said. At the same time, however, this can lead to the public perception of them being cold or uncaring, creating a no-win situation.
One of the goals for the course is to create a “trauma-informed” curriculum, which involves understanding addiction not only in terms of a compulsive disorder but also as a complex neurophysiological process in which, due to repetitive traumatic experiences, an individual’s ability to regulate one’s emotions can be severely dysregulated. A curriculum that is “trauma-informed” takes into consideration these dynamics to not only avoid exacerbating the issue, but to also provide a supportive environment to aid an individual’s path to recovery.
The course will provide education on both pharmacological and non-pharmacological alternatives to opioid treatments, Lewis said. It will also involve educating on a concept of pain management that isn’t just about pain elimination.
“Our body has a need to experience a certain level of pain that’s manageable in order to not over injure ourselves and create worse problems,” she said. While no one wants to see family members or themselves in distress when it comes to pain, Lewis acknowledged that in some cases, parts of that are necessary to get to the healing stage.
In her own clinical experience, Lewis has witnessed how people use the pharmacological effects of opioids to manage their emotional pain. Because opioids act on the brain as a depressant, they often help patients feel calmer in the process. Part of this project will also help those on the front lines increase self-awareness of those symptoms and point them to resources that will help them find other ways to deal with emotional pain.
The course will be initially rolled out to local members of the first responder and health care profession community for additional feedback before the curriculum is finalized. The project is currently seeking volunteers from the first responder and health care communities who might be interested in sharing their own experiences and participating in various phases of the project.
If interested in learning more and potential ways to get involved, contact Ann Rush at volunteer@sc4i.org.
Pull quote: According to the CDC, OUD is a problematic pattern of opioid use that causes significant impairment. A diagnosis of OUD is based on specific criteria such as unsuccessful efforts to cut down or control use or use resulting in a failure to fulfill obligations at work, school or home, among other criteria. It can even lead to overdose and death. In a report published by the Substance Abuse and Mental Health Services Administration in 2022, an estimated 6.1 million people in the U.S. had an OUD.
