The substance use and overdose crisis continues in Colorado. According to the most recent available data from the Department of Public Health and Environment, almost 2,000 Coloradans died from overdoses in 2021, double the rate of overdose deaths in 2018.
State lawmakers want to address the problem, but they don't all agree about what the solution should be. Some bills being considered by the legislature focus on overdose prevention while others increase penalties for possessing and distributing controlled substances.
One bill sponsored by Democrats, House Bill 1202, would legalize overdose prevention centers, also called safe use sites, which provide a designated place for people to use illicit drugs under supervision to prevent deadly overdoses. The Boston-based Institute for Clinical and Economic Review found that the establishment of safe use sites lead to fewer ambulance calls for overdoses.
The facilities would be staffed by health care professionals who could also offer substance use resources. Sterile paraphernalia for using drugs and overdose prevention medications like naloxone would also be readily available. The safe use sites would not give out illicit drugs.
“Drug use is happening in our parks,” bill sponsor Rep. Jenny Willford said. “It's happening in our bathrooms and our libraries. It is happening already, so let's make sure that people are able to live and get well.”
The bill would not compel the creation of safe use sites or require cities to use them. Instead, the bill would allow municipalities to establish safe use sites at their own discretion.
“This is about local control,” Willford, also a former Northglenn city councilmember, said. “I was hearing from residents for many years while I was on council that they were finding needles on the playgrounds where our kids were playing, that they were finding needles in our open spaces where they're walking their dogs. They were seeing people using drugs in all areas of the city, and unfortunately, as a local elected official I felt like I didn't have the tools.”
In 2018, the Denver City Council voted to launch a pilot program that intended to establish one safe use site. The program ended up failing and the site was never created, however, due to a lack of support from state lawmakers. In other U.S. cities like New York City and Boston, overdose prevention centers are already in use. After opening in December of 2021, New York City's two safe use sites stopped almost sixty overdoses in the first three weeks.
House Bill 1202 was approved by the Public & Behavioral Health & Human Services Committee and will get a preliminary vote in the House next. Gov. Jared Polis, however, said he’s skeptical about safe use sites. It is unclear if Polis would sign House Bill 1202 if it makes it to his desk.
Opponents are concerned the bill would encourage substance use and illicit drug distribution. California's Democratic Gov. Gavin Newsom vetoed a bill last year that would have allowed a pilot program of safe use sites in the state.
Another Democrat-sponsored bill, House Bill 1167, expands existing protections against criminal charges for people who report overdoses to emergency responders under what are often referred to as Good Samaritan laws.
Current state law gives some immunity from arrest and prosecution for people who report an overdose to emergency responders. The new bill would expand that to include immunity for possession of four grams or less of a controlled substance like fentanyl if an overdose is reported. It would also apply to some distribution offenses, such as sharing a small amount of a controlled substance between friends that results in an overdose.
All but two U.S. states have Good Samaritan laws in place, and according to the nonpartisan U.S.Government Accountability Office, people are more likely to call 911 to report an overdose in states that have Good Samaritan laws in place.
House Bill 1167 was approved in a final House vote last week and is now being considered by the Senate.
Two other bills take a different approach to the proliferation of opioids, especially fentanyl, and the overdoses they cause. Sponsors say these bills would conflict with the protections included in House Bill 1167.
Senate Bill 109 would increase the penalty to a level one felony for the distribution of any amount of a controlled substance if it leads to an overdose. It’s unlikely to get approval from the Democratic majority even though one of its sponsors is Democratic Sen. Kyle Mullica. The other sponsor is Republican Sen. Byron Pelton.
House Bill 1164 builds on legislation from last year that increased the mandatory punishment for possession of the powerful opioid fentanyl. That legislation made it a felony to possess one gram or more of the substance but included a provision allowing a lesser sentence when someone is unaware they are in possession of fentanyl. The new bill would remove that provision and would call for felony charges regardless of knowledge of possession.
“It really makes it a hard line at one gram. Anything over one gram and now you're a felon,” House Minority Leader Mike Lynch, a sponsor of House Bill 1164, said. “I believe that that reduces harm, right? Because now we got people that are encouraged to not do that activity.”
The bill also includes funding for distributing more overdose reversal medications like naloxone to schools and includes a requirement that law enforcement compile reports each time they administer overdose reversal drugs.
“These things that I'm involved in are life and death,” Lynch said. “It's my goal to change the narrative of fentanyl being some sort of a drug. I look at it strictly as a poison.”
A 2018 study from the Pew Charitable Trusts found no evidence that increasing drug incarceration rates decreases overdose deaths or personal drug use. Overdose prevention advocates like Lisa Raville of the Harm Reduction Action Center push back on House Bill 1164 and Senate Bill 109, saying they will make the problem worse if passed.
“Those bills seem to be doubling down on the worst ideas of the drug war, which are incarceration and criminalization,” Raville, the executive director of the Harm Reduction Action Center, said. “All that's done is bring us to the worst overdose crisis we've ever been in, with the most unpredictable drug supply. Let's talk about gold-standard, evidence-based interventions that promote a healthier and safer community and increase public safety.”
Raville supports the bills that protect overdose reporting and allow for safe use sites. She said the bills that increase punishments would likely increase overdose deaths because they would prevent people from calling first responders when an overdose happens out of fear of penalty.
“The overdose crisis first and foremost affects people who use drugs. It's also a larger community trauma issue,” Raville said. “When you talk about increasing public safety, it means that people aren't using publicly, overdosing publicly, and dying of public overdoses.”
Overdoses are the leading cause of death for people suffering from homelessness in Denver, according to the Colorado Coalition for the Homeless. Raville added she would also like to see more available housing for people with substance use issues to address the overdose crisis.
