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Naloxone fund dries up even as money for opioids comes in | Western Colorado

Naloxone fund dries up even as money for opioids comes in | Western Colorado

DENVER — On a recent afternoon on a busy street corner near the Harm Reduction Action Center offices, staff from an education and advocacy nonprofit were handing out free naloxone kits to passersby.

Distributing opioid reversal medications is essential to the center’s work to reduce fatal overdoses in the community. But how long the group can continue to do so is questionable. The center depends on the Colorado Bulk Opioid Antagonist Fund, also known as the Naloxone Bulk Purchase Fund, which currently has no consistent source of money despite hundreds of millions of dollars in settlement money flowing into the state from national opioid lawsuits.

“We’re concerned that we won’t have access to naloxone, which means more people will die from preventable overdoses,” said Lisa Raville, the center’s executive director.

The grassroots fund was created in 2019 to provide free naloxone to organizations like the Harm Reduction Action Center. The fund’s annual budget has grown from just over $300,000 in fiscal year 2019 to more than $8.5 million in fiscal year 2022, according to legislative reports from the state’s Office of Overdose Prevention.

The fund has increased the availability of the drug throughout Colorado, where a law was passed in 2013 giving legal immunity to health care providers who prescribe the drug and anyone who prescribes it to someone suffering an overdose. The foundation currently provides more than $550,000 worth of naloxone kits to various organizations each month.

Despite the increased availability of naloxone, the number of fatal opioid overdoses continued to rise. In 2023, 1,292 people in Colorado died from opioid overdoses, according to the Colorado Department of Public Health and Environment. This is 132 people more than a year earlier.

And now one of the fund’s main sources of money, the American Rescue Plan passed by Congress in response to the Covid-19 pandemic, is set to expire next year. Colorado’s fund had $8.6 million remaining as of September, according to Vanessa Bernal, a spokeswoman for the state health department.

SIMULTANEOUS BOOST

The fund received a boost in September when the state Behavioral Health Administration awarded it $3 million in a one-time grant for substance use prevention, treatment and recovery services and nearly $850,000 in a state grant to combat opioids. Colorado Attorney General Phil Weiser said his office will “ensure that the necessary budget remains in place for next year.”

The amount of this funding and its source are yet to be determined, and long-term solutions are still being considered. One option to bolster the fund beyond next year would be to use Colorado’s share of the nation’s opioid lawsuit settlement funds, said Mary Sylla, former director of overdose prevention policy and strategy at the National Harm Reduction Coalition.

“It’s just ironic that something that aims to address the opioid overdose crisis is being underfunded at the same time that those relief funds are coming,” Sylla said. “There’s no better use for them.”

As of July, Colorado had received and distributed more than $110 million in opioid relief money to regions, local governments, government entities and infrastructure projects, with the total expected to reach more than $750 million by the end of the year, according to the Colorado Attorney General’s Office. US dollars. 2038.

However, more than half of the settlement money Colorado received has already been paid to 19 regional opioid councils, which have developed their own plans to distribute the money to programs such as drug treatment centers, public education campaigns and training. for emergency providers.

For example, the Denver council, which has received more than $18 million since 2022, has awarded money to organizations in two- and three-year contracts, most of which do not include the purchase of naloxone.

“We thought we could all continue to get (naloxone) from the state health department and the Naloxone Bulk Purchase Fund,” Raville said.

The Denver council is working on a plan for the coming years, expected to be released in mid-2025, and is considering reducing the fund’s core amount, said Marie Curran, program coordinator for the Denver Anti-Opioid Funds.

Lawrence Pacheco, a spokesman for the attorney general’s office, which administers 10% of the state’s opioid payment dollars, said the office is “working on options to ensure this life-saving drug can continue to be part of the state’s efforts to mitigate the opioid crisis.” ” These options have not yet been made public.

OPIOIDS HAVE DIFFERENT USES

California, where Sylla works, used settlement money for a distribution program similar to the one in Colorado. In Washington and Kentucky, states’ settlements with Teva Pharmaceuticals will make tens of thousands of free naloxone kits available to residents. Each state uses its opioid settlement funds differently, and while many provide naloxone to residents in some way, including through vending machines, there is no centralized tracking of naloxone distribution programs.

Over the past five years, the Colorado Foundation has distributed more than half a million doses of the opioid-reversing drug to hundreds of organizations and schools across the state. Last year, the Harm Reduction Action Center received 7,284 doses from the fund, which Ravil estimates helped save more than 4,500 lives.

Unless additional money is found, the main fund risks limiting distribution even further, leaving hundreds of organizations that rely on it with little or no access to free naloxone. Although the drug became available over-the-counter nationally last fall, the $45 price tag for a two-dose package means it may remain out of reach of those who need it most.

In May, the state announced a plan to prioritize groups receiving drugs from the drug pool, with four categories ranging from “essential” to “low need,” depending on how often the organization directly encounters people who are most at risk of developing or becoming witnessing an overdose. The Harm Reduction Action Center is classified as “essential.” School districts and colleges and universities are in the next largest category.

Another organization, The Naloxone Project, said it was misclassified because it was not given the highest priority. As a result, he said, the foundation received only 1,200 doses of naloxone this year instead of the 6,000 it requested.

“We argue that we fall into the ‘essential’ category because many of our programs are public-facing and consistently provide naloxone to people who use drugs and are at greatest risk of overdose,” said Rachel Duncan, deputy director of The Naloxone Project.

The group, which has offices in 12 states, provides nasal and injectable forms of naloxone to more than 90% of Colorado hospitals to give to patients before being discharged from the emergency room or maternity ward. More than half of the 12,000 naloxone kits the project distributed to Colorado health care providers came from the bulk fund.

Another organization, the UCHealth Center for Addiction, Addiction and Recovery, known as CeDAR, which offers inpatient, outpatient and telehealth treatment, is no longer eligible to receive free naloxone because its patients are typically insured or may pay out of pocket.

Carly Yarnell, CeDAR physician assistant, said even though someone can pay for a drug, that doesn’t mean they can go to the pharmacy and pick it up.

And Duncan is concerned about what losing doses would mean for organizations like The Naloxone Project and CeDAR.

“What I fear is that organizations competing for funding will have a deficit mindset,” Duncan said. “But I’m also concerned about places where it’s running out so quickly.”

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