NCAD Spotlight: Colorado Collaborative Delivers Solutions to Address Opioid Crisis

In the face of a mounting opioid crisis threatening their communities, stakeholders from various groups in Colorado joined forces to answer the call with a pair of ambitious programs. The Northern Colorado Opioid Prevention Workgroup is a collaboration between local health systems, jails and health districts. The workgroup, which formed in 2017, has been responsible for two key initiatives:

• Colorado Opioid Synergy Larimer and Weld (CO-SLAW) network, a program designed to increase access to medication-assisted treatment, on-site care coordination and community treatment in Larimer and Weld counties
• Jail Utilization of Substance Use Disorder Treatment – Northern Colorado (JUST-NOCO), a comprehensive jail-based MAT and naloxone distribution program at the Larimer County jail

Cyndi Dodds, LMFT, chief clinical officer at SummitStone Health Partners, Lt. Staci Shaffer, MCJ, of the Larimer County Sheriff’s Office Jail, and Heather Ihrig, RN, CO-SLAW project director, were among the collaborators who helped make the work of the Northern Colorado Opioid Prevention Workgroup a reality. Joined by additional workgroup participants, they will present on their experiences with the group at NCAD West, convening later this month in Denver.

Ahead of their session at NCAD, Dodds, Shaffer and Ihrig spoke with Behavioral Healthcare Executive.

[Editor’s note: This interview has been edited for length and clarity.]

How did this initiative come together, and what does it entail?

Dodds: A little over two years ago, we pulled together two communities in Colorado—Larimer County and Weld County—for a collaborative effort called the Northern Colorado Opioid Prevention Workgroup. We have quite a bit of patient flow back and forth between the two, so we really wanted to do a collective effort. We said, ‘We believe we have an opioid issue, and we believe we can be the solution. Anybody who wants to be part of that, join us.’ We started meeting on Fridays at 7 a.m. Through that work, we identified four priority areas we wanted to focus on. From that, we had the opportunity to apply for a SAMHSA grant. We were awarded the SAMHSA MAT-PDOA grant, and were able to use that. Our communities have a fair amount of medication-assisted treatment; we have eight providers. The grant allowed us to do care coordination and start planning on how we could expedite access in the jails and from the emergency departments. It was that community collective effort that got us to where we’re at today.

Ihrig: In regards to introducing MAT to emergency departments, we have two fairly large healthcare systems here, Banner Health and UCHealth, who we came to with this proposal to introduce MAT and have their staff and emergency physicians provide their initial dose of medication-assisted treatment there with the understanding that they would then have this partnership for the community to catch these members when they do release from the hospital. It’s a simple one call. They get their first dose in the emergency department, they call our 800 number, which is covered 24/7, and we get them into an appointment same day or within 24 hours. That is not common at all within emergency department facilities.

Have you encountered any surprises as you have pursued the workgroup’s projects?

Shaffer: What surprised me the most was the way the community partners came together to bring the JUST-NOCO program into the jail. Historically, these sorts of expedited access programs have not been well received in jails. There’s a stigma about what this medication will do. We were worried about medication being diverted and being sold within the facility. What we decided was, as a jail, we would create the platform for the communities to bring their programs into the facility, allow them to come in, and allow the providers to do the work they needed to do within our facility. The surprising piece was that it was really easy as a jail administrator to work with such good community providers. We worked through all the stages of panic and grief together and came out the other end. As of today, we’ve had 260 patients in the jail who have either continued on their medication from the community or have started on new medication. What was surprising was that it could be just that easy by opening the door and saying “what can we do?” instead of “no, we’re not going to.”

What advice would you give to your peers in other communities looking to launch similar initiatives?

Shaffer: From a jail’s perspective, you can only go as fast as your community is ready to go. Engage with the partnership and understand what’s available. The other component is don’t try to do it because you want to do a jail program for medication-assisted treatment for addiction. Don’t do it that way. You need to go with the flow in your community and allow them in. When you do that, you share the triumph and the disappointment, and you talk through the issues, the documents that need to get signed, wait times, anything that is happening, you work together as a partnership. I would say don’t try to start a MAT program on your own just because you think you need to have it now. Make sure the community is engaged. If that means you have to bring the community in, that’s fine. Don’t feel like you have to do it alone.

Dodds: At the larger community level, leverage everybody’s strengths and what they bring to the table. Everything we’ve done, it takes little bit of everybody’s effort to pull this off. Everybody’s welcome. Harness everybody’s contributions.

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