STEAMBOAT SPRINGS — Ashley McAuliffe grew up as the typical Steamboat Springs native, skiing every chance she could and suffering the inevitable injuries from the sport.
After a few broken ankles and wrists, plus a three-year regimen of opioids to handle the pain, she found herself in a scary place she never expected — addicted to the pills that were supposed to help her.
McAuliffe is one of about 1.7 million people in the U.S. who suffered from substance use disorders related to prescription opioid pain relievers in 2017, according to estimates from the National Institute on Drug Abuse. That same year, the Colorado Department of Human Services recorded 558 opioid overdose deaths across the state.
To combat this rapidly growing epidemic, Colorado lawmakers passed a two-year pilot program in 2017 to provide funding for medication-assisted treatment for addicts.
Routt County, whose rate of drug overdoses increased six-fold from 2014 to 2016, was one of two counties in the state that participated. The program, which provides medication to help addicts cope with cravings and withdrawals, has been so successful that lawmakers have proposed an expansion of the program.
SB19-001 would expand the medication-assisted treatment program from Routt and Pueblo counties to counties in the San Luis Valley, as well as two additional counties that have not yet been determined. It would also expand the program’s budget from $500,000 a year, appropriated from the marijuana tax cash fund, to $5 million annually.
Road to Recovery in Steamboat was the first treatment center in Routt County to receive a grant from the program to help addiction patients, according to its executive director Nancy Beste.
In the last year the center has been active, about 70 addiction patients have gone through the treatment program. While Beste said it is still in its early stages, she has seen about a 90 percent success rate in keeping patients involved in treatment.
“This program is working better than any program I’ve ever seen,” she said.
McAuliffe became one of Beste’s first patients last April. After three years on painkillers, she got hooked on heroin and saw her life spiraling downward.
She lost a job after showing up high and strained her relationship with her husband and two sons.
She desperately wanted to get clean. She went to rehab three times trying to do so, but the constant cravings and withdrawal symptoms made recovery impossible.
“It felt like the flu,” McAuliffe said of her withdrawals that wouldn’t go away. “I had stomachaches, shakes and cold sweats.”
Beste put McAuliffe on a regular regimen of Suboxone, a narcotic that has been shown to reduce withdrawal symptoms in addicts.
Within hours of her first dose of Suboxone, McAuliffe’s noticed her withdrawals had improved. She was able to go days, then weeks, without getting high.
She owes that recovery to Beste and the treatment program.
“It was impossible without getting some of the medicated aid,” she said.
How the medication works
Beste explained opioids, as well as amphetamines or alcohol, cover receptors in the brain that control the flow of dopamine, the neurotransmitter associated with feelings of well-being.
“People begin to chemically stimulate their own euphoria through controlling their dopamine,” Beste said.
The brain eventually becomes dependent on that stimulation. When someone stops taking their drug of choice, their brain cannot regulate its dopamine levels, which leads to depression and a general feeling of being unwell.
Addiction treatment medications like Suboxone work by covering those same receptors but without getting people high. That prevents patients from feeling the full brunt of withdrawals and helps to eliminate their cravings.
No treatment is perfect, and not everyone who goes through the medication treatment program sticks with it.
Beste said that out of the 70 people who have started the program in the last year, about 65 keep in touch about their recovery and come to Road to Recovery’s therapy programs.
“That’s a higher than normal outcome,” Beste said.
McAuliffe admitted to relapsing about a month ago due to stress over her marriage. She quickly told Beste about it, who started her on Naltrexone injections once a month.
Naltrexone has been shown to prevent relapses in people who abuse drugs and alcohol. It is similar to Suboxone, but it specializes in minimizing cravings.
McAuliffe said she noticed an immediate improvement with the injections.
“I have zero cravings now,” she said.
Beste explained withdrawal symptoms can persist for up to two years after people stop using opioids. That points to the importance of maintaining regular doses of addiction medications.
She emphasized medication is just one piece in a jigsaw of Road to Recovery’s addiction treatment.
“The medication doesn’t fix the problem,” she said. “The medication is simply a tool to help people overcome the withdrawals.”
The treatment center also offers therapy and regular meetings to form a community of recovering addicts who encourage each other to stay sober.
Treatment for other drugs
While the pilot program targets opioid users, Beste has seen success in treating addicts of other hard drugs with medications.
Longtime Steamboat resident Melinda McDowell made her first appointment with Beste about nine months ago.
At the time, McDowell was abusing methamphetamine, the latest drug in her decades-long struggle with substance abuse. After a trip to the hospital last April, she received a sobering ultimatum.
“The ER doctor told me that if I didn’t quit, I had a month to live,” she said.
A friend told McDowell about Road to Recovery’s medication-assisted treatment program, and she quickly reached out to Beste.
“She pretty much adopted me,” McDowell said.
Like McAuliffe, McDowell felt immediate relief from her withdrawal symptoms after just the initial dose of Naltrexone. Nine months later, she is the first of Beste’s patients to recover from methamphetamine addiction through medication.
“For the first time in 20 years, I am able to stay sober,” McDowell said.
Hers has been such a success story that Beste is including her in a case study on how meth addicts can benefit from medication-assisted treatment similar to opioid patients.
With eyes to the future, Beste hopes she can continue treating people with addictions and that more centers in Routt County can get state funding to do the same.
Colorado’s current pilot program expires in June, along with its funding.
Thus far, the bill to expand the pilot program has fared well among legislators. It unanimously passed the state Senate Health and Human Services Committee and is set to go before the Senate Appropriations Committee on March 8.
For someone like McAuliffe, the availability of medication-assisted treatment could mean the difference between addiction and sobriety. For someone like McDowell, it could mean the difference between life and death.