In the wake of the response to the coronavirus, communities across the United States are seeing a rise in substance misuse and addiction. Complicating the issue, rural areas in particular have limited access to addiction treatment services. This is an increasing problem in Colorado, where geography challenges treatment providers even as overdoses are on the rise.
A new program in Colorado, launched by the state’s Office of Behavioral Health, delivers mobile addiction treatment in renovated RVs to rural areas with limited behavioral health services. The agency used a $10 million federal grant to turn the RVs into mobile clinics and staff them with healthcare providers.
Mobile health clinics have operated for years, but usually deliver vision care or dental services, or collect blood donations. Mobile addiction treatment is less common, but is becoming increasingly valuable.
These transformed RVs offer a variety of substance use-related services:
In-person drug testing
Used needle disposal
Broadband access for telehealth visits with providers who can prescribe medication to treat addiction
These RVs currently serve six regions, with a seventh region serviced by a refitted SUV. When the federal grant ends in September 2022, the mobile unit operators will continue to use the RVs while billing Medicaid and private insurance.
Programs to address and mitigate substance misuse are becoming increasingly crucial as Colorado faces an increase in drug overdoses. According to the Colorado Department of Public Health and Environment (CDPHE), provisional 2020 data show 1,333 overdose deaths among Colorado residents. This is the highest rate of overdose deaths since 1975.
Substance misuse experts have pointed to a variety of factors that led to increased overdoses. These include increased anxiety, depression, and stress associated with the COVID-19 pandemic. The increasing prevalence of the synthetic opioid fentanyl is also linked to a rise in drug overdose fatalities. The Drug Enforcement Administration (DEA) has reported that, in testing fentanyl pills around the country, the DEA said 26 percent contain a lethal level dose.
The Denver medical examiner’s office reports that there were 119 deaths from fentanyl in that city alone in 2020, seven times the 17 fatalities in 2018. Fentanyl may be added to heroin to make it more potent, or used to create counterfeit Xanax or Percocet tablets.
Individuals facing addiction and overdose are often in serious need of a stable setting, according to Marc Condojani, the director of Adult Treatment and Recovery with the Colorado Office of Behavioral Health. Condojani points out that there are obstacles to providing services in residential and inpatient facilities.
Many traditional, brick-and-mortar addiction clinics no longer accept new patients or offer in-person services due to the COVID-19 pandemic. Some facilities have had to close temporarily due to COVID-19 outbreaks, while others have reduced bed capacity to enforce social distancing requirements. This loss of onsite, traditional addiction treatment services could be seriously harmful for individuals in underserved areas.
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