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Communities Use Opioid Settlement Funds to Gain Insights
Some Colorado Communities Are Using Opioid Settlement Funds to Gain Addiction and Mental Health Insights
In 2022, the United States reached a $50 billion settlement with the manufacturers, distributors, and pharmacies that were part of making and selling opioids. The funds are distributed to all U.S. states over 18 years and are intended to help counter the devastating impact of the nation’s ongoing opioid epidemic. According to the CDC, more than 806,000 Americans died as a result of the opioid epidemic, which started in the mid- to late-1990s as a result of aggressive sales of highly addictive opioid medications like OxyContin, oxycodone, and hydrocodone.
States began receiving opioid settlement funds in 2022. Colorado’s share of the funds is $880 million, 60 percent of which is allocated to “Regional Abatement Councils” (RACs) that determine the most effective use of the funding to address regional needs. While all funds are intended for opioid abatement, the RACs determine how to allocate the monies to meet the needs of residents in their respective regions. Some regional councils are increasing treatment capacity, bolstering harm reduction services, enhancing peer support services, and providing education on opioids and public safety messages.
Region Five (also known as the Opioid Abatement Council) comprises Eagle, Garfield, Lake, Pitkin, and Summit Counties. OAC Five leadership includes elected officials, people with lived recovery experience, judicial officials, law enforcement, substance use disorder treatment professionals, and other stakeholders. One of the ways the Region 5 council is using the funds is to gain new and important insights into the mental and behavioral health of the region’s residents. A dashboard created by Region Five provides statistics on Income, Housing Stability, Food Security, and Social Vulnerability — the so-called social determinants of health. It also reports key information about the region’s mental health, substance use, and access to care.
Among other significant findings, the dashboard indicates that residents in Region Five counties fare relatively well in terms of household income, employment, labor participation, and access to healthy foods. However, like many other rural areas, the region lags behind the rest of Colorado in access to mental healthcare. This region’s adults report significantly higher rates of “heavy drinking” and “binge drinking.”
Access to this kind of information is helpful to elected officials and other public health stakeholders. The ability to measure rates of mental health, substance use, and access to necessary resources is crucial to ensuring the success of steps taken to address the opioid epidemic and other behavioral healthcare problems.
Foundry Steamboat, an NRT Behavioral Health men’s residential treatment program located in Steamboat Springs, in Routt County, which borders Region Five. Foundry Steamboat clients come from across the state, but many are residents of Western Colorado rural communities, which experience similar lifestyles and challenges. Many of the men who come to Foundry Steamboat to treat addiction nd co-occurring mental health disorders live in communities and family systems that are permissive or encouraging of substance use. As in Region Five counties, many rural communities report significantly higher rates of alcohol and drug use than in the rest of the state.
Helping men and their family members learn how to create a recovery-supportive lifestyle and home environment is a central component of Foundry Steamboat programming. A robust family program that provides education and coaching to clients and family members helps clients understand the importance of seeking treatment for depression, anxiety, and other mental health disorders, as opposed to using substances to cope. Learning to mask the symptoms of untreated mental health problems is a leading trigger for the development of substance use disorders and addiction.
If you or a loved one needs help, please call an experienced Foundry Steamboat team member at (844) 955-1066.
NRT Celebrates the 2025 Recovery Month Theme
The 2025 Recovery Month theme is “Recovery isREAL (Restoring Every Aspect of Life).”
Recovery Month is a federal government initiative launched in 1989 and currently organized by the Substance Abuse and Mental Health Administration (SAMHSA).Recovery Month, observed in September, recognizes the recovery community, reduces stigma, promotes recovery, and supports treatment providers.
This year’s theme is “Restoring Every Aspect of Life,” which, according to SAMHSA, refers to health, home, community, and purpose. These themes closely align with the so-called Social Determinants of Health, which are critical factors contributing to addiction and recovery.
Researchers, recovery advocates, and treatment providers have long acknowledged the strong connection between the so-calledSocial Determinants of Health (SDOH) and the development and perpetuation of substance use and mental health disorders. The connection between social determinants and addictive disorders was initially recognized in the 1960s. The linkage was eventually solidified and codified when it was written into the2010 Patient Protection and Affordable Care Act. According to the US Department of Health and Human Services, the SocialDeterminants of Health include economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social community context.
Essentially, the social determinants are the factors that significantly influence health and well-being. Access to financial security, education, a safe place to live, quality healthcare, and being connected to others contribute to better health and wellness. When any of these pillars are lacking, however, people can experience severe stress, illness, mental health disorders, and trauma, all of which increase the potential for substance use disorders and addiction.
The social determinants are also closely related to recovery capital, another important measure. Recovery capital is a measure of the intrinsic and external resources that help people sustain recovery from substance use disorders, mental health conditions, and other health problems. Taken together, the social determinants of health are contributing factors that may put people at risk of developing behavioral health disorders, and recovery capital is a factor that helps people maintain health and wellness after recovering from these conditions.
“RestoringEvery Aspect of Life” Resonates at NRT Behavioral Health Treatment Programs
NRTBehavioral Health addiction treatment programs, including Foundry Steamboat, Foundry Front Range, and Foundry Outpatient, pay careful attention to each patient’s social determinants and recovery capital.Effective addiction treatment programs focus on more than addressing the side effects of addictive disorders and teaching skills to reduce reliance on substance use. It also helps people improve their lifestyles and support systems so that they can stay in recovery after completing treatment.
In keeping with the Recovery Month theme,“Restoring Every Aspect of Life,” NRT programs acknowledge that many of their clients struggle with financial stress or joblessness, insecure housing, problematic home lives, social networks that normalize substance misuse, and more. Significant numbers of NRT Behavioral Health program clients face social determinants of health deficits that are shared by many Coloradans, especially those in rural communities. Our programs attempt to help clients access available resources and make connections to increase recovery capital after completing programming. NRT programs also use a specialized Recovery CapitalIndex measure to determine the overall recovery resources of its client base to improve care, identify appropriate resources and partners, and give clients more ways to sustain recovery.
Quitting Tobacco Associated With Recovery From Other Addictions
Adults who smoke cigarettes and are addicted to alcohol or other drugs were more likely to achieve sustained remission of their substance use disorder (SUD) symptoms if they also quit tobacco, according to scientists at the National Institutes of Health (NIH).
Based on their analysis of data from a large US study of smoking and health, the researchers believe the results clearly show the benefit of pairing smoking cessation with addiction recovery efforts.
“We now have strong evidence from a national sample that quitting cigarette smoking predicts improved recovery from other substance use disorders,” explained Nora Volkow, MD, director of NIH’s NationalInstitute on Drug Abuse (NIDA), which partly funds the study, known as the Population Assessment of Tobacco and Health (PATH) study. “It underscores the importance of addressing different addictions together, rather than in isolation.”
Scientists analyzed data from 2,652 people 18 and older who had a history of substance use disorder and who experienced a change in their recovery status over the next four years.
Participants in the PATH Study are asked annually about their smoking status and other substance use. In this analysis, a change in smoking status from “current” to “former” use of cigarettes was associated with 42 percent greater odds of the individual being in recovery from their non-tobacco substance use disorder.
People with addiction to alcohol or other substances have a higher likelihood of being addicted to nicotine as well. Previous research has suggested an association between smoking cessation and improved outcomes from other substance use disorders. However, the authors note that most prior studies used data from treatment centers focusing on addiction to a single substance or from smoking cessation trials, and those that used nationally representative samples could not adequately test for an association with recovery. Researchers believe the new finding is generalizable to the millions of adults with substance use disorder and accounts for numerous confounding factors, thus increasing confidence in the results.
“Although the health benefits of quitting smoking are well-known, smoking cessation has not been seen as a high priority in drug addiction treatment programs,” said Wilson Compton, MD, deputy director of NIDA and senior author of the study. “This finding bolsters support for including smoking cessation as part of addiction treatment.”
Although this was a longitudinal analysis that was strongly suggestive that quitting smoking plays a role in improved recovery outcomes from other substance use disorders, further research will be needed to establish a causal connection definitively. Also needed is more research on the best ways to support smoking cessation among people in treatment or recovery for substance use disorders.
The PATH study is an ongoing, nationally representative longitudinal cohort study of youth and adults who may or may not use tobacco products, funded by the NIH and the federal Food and DrugAdministration (FDA).
FOUNDRY STEAMBOAT HELPS CLIENTS QUIT TOBACCO
Foundry Steamboat is a tobacco-free treatment provider that encourages and helps clients stop using tobacco products while receiving treatment for other substance use disorders. As an evidence-based treatment provider with experienced clinicians, Foundry Steamboat knows that smoking cessation is an important opportunity for people receiving treatment for substance use and co-occurring mental health disorders. Foundry Steamboat provides education, support, and can occasionally prescribe medications that reduce craving associated with tobacco cessation.
17 Percent of Americans Have Substance Use Disorder
Every year, the National Survey on Drug Use and Health (NSDUH) provides the most recently available information on tobacco, alcohol, and other substance use, mental health, and other health-related issues in the United States.
The NSDUH began in 1971 and is conducted annually in all 50 states and the District of Columbia. Approximately 70,000 people were interviewed for this important study.
Information from the NSDUH is used to support prevention and treatment programs, monitor substance use trends, estimate the need for treatment, and inform public health policy.
17 PERCENT HAVE SUBSTANCE USE DISORDER
In 2024, nearly 50 million Americans, 16.8 percent of people 12 years or older, met the diagnostic criteria for a substance use disorder (SUD) in the past year. Of these individuals, 27.9 million had an alcohol use disorder, and 28.2 million had an SUD involving drugs.
About one in six people with a past year substance use disorder (16.0 percent or 7.7 million people) had both an alcohol use disorder and a “drug use disorder” in the past year. Cannabis (marijuana) use disorder (CUD) was the most common drug use disorder (20.6 million), followed by opioid use disorder (4.8 million), and a central nervous system stimulant use disorder (4.3 million).
“With the ready availability of illicitly made fentanyl and other potent synthetic opioids such as nitazenes, the emergence of substances like xylazine, medetomidine, and illicit benzodiazepines, and increasing polysubstance use, Americans face an illicit drug supply that is more toxic, unpredictable, and dangerous than ever,” wrote Art Kleinschmidt, Ph., MBA, Principal Deputy Assistant Secretary, Substance Abuse and Mental Health Services Administration in a press release. “In addition, the proliferation of social media and other technology that is inundating America’s young people, coupled with other social stressors in homes and communities across the Nation, has contributed to declining mental health and well-being and rising rates of suicide in the past two decades.”
MAJOR TRENDS
The 2024 NSDUH identifies “areas of progress” and “trends heading in the wrong direction.”
“Americans are binge drinking and smoking tobacco less but consuming marijuana significantly more,” summarized Lev Facher in the findings of the new federal survey on STAT News.
“On the progress front, we see from the NSDUH that the percentage of people 12 years or older reporting use of most substances either decreased or remained stable between 2021 and 2024, with decreases in past month use of tobacco, cigarettes, binge and heavy drinking as well as decreases in past year use of cocaine, misuse of prescription opioids, and past year alcohol use disorder,” reported Dr. Kleinschmidt.
Heading in the wrong direction, however, are trends that include past year illicit drug use, marijuana use, and hallucinogen use, and past year drug use disorder and cannabis use disorder. “Among adults, we also saw that the percentage of people 18 or older [who] reported making a suicide plan increased between 2021 and 2024.”
Dr. Kleinschmidt points out that “the increases in past-year illicit drug use and past-year drug use disorders are largely driven by increases in marijuana use and [cannabis] use disorder among adults 26 years or older. Although marijuana use and [CUD] trends remained stable among adolescents and young adults between 2021 and 2024, the increase in adult use is important to inform prevention and treatment activities given changing attitudes around marijuana use and the shifting state policy landscape which has increased risk for marijuana use and use disorder among young people, and enabled the ready availability of high-potency marijuana products linked to negative health impacts in communities across the country.”
MENTAL HEALTH AND SUBSTANCE MISUSE
The NSDUH highlights the “substantial overlap” between substance use and mental health. “Although mental health and substance use funding and treatment systems have historically often been separate, the NSDUH clearly demonstrates that in reality, people with substance use disorders and those with mental health challenges often have co-occurring conditions.”
For the first time in 2024, the NSDUH included the Generalized Anxiety Disorder (GAD-7) scale, a validated self-report measure to screen for and assess symptoms of GAD in the past two weeks.
Among adults 18 years or older in the US, 7.4 percent had moderate or severe symptoms of anxiety and 14.3 percent had mild symptoms. Moderate to severe symptoms were more common among 18 to 25-year-olds (14.5 percent) compared to 26 to 49-year-olds (9.0 percent) and adults 50 years or older (3.9 percent).
TREATMENT NEEDS NOT MET
According to the NSDUH, “approximately one in five people (19.3 percent) who needed substance use treatment actually received treatment in the past year. Treatment receipt was highest among adolescents aged 12 to 17 years (30.2 percent of those needing treatment reported receiving treatment in the past year), followed by those 26 years or older (20.5 percent) and those 18 to 25 years old (11.3 percent).”
Modern, evidence-based addiction treatment needs to be trauma-informed and dual diagnosis capable, addressing the needs of the patient as a whole person, including their life experiences, and going far beyond simply suppressing powerful cravings to use drugs and alcohol.
Every patient with addiction deserves the best medical care. When it comes to behavioral healthcare, the ability of your treatment provider to understand your needs, provide effective therapies, and identify the specific resources that will help you maintain health and recovery after treatment is vital to your success.
FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER
NRT Behavioral Health Managing Partner Ben Cort has written two books on the problems associated with today’s high-potency cannabis products and their effects. Growing evidence demonstrates that consuming highly concentrated cannabis poses significant health risks, from anxiety and depression to cardiac problems and suicidal ideation.
A minority of cannabis users will develop cannabis use disorder and its serious effects. However, those who are impacted, and their family members and loved ones, face significant challenges and the same risks associated with other forms of substance use disorder.
NRT Behavioral Health programs, including Foundry Steamboat, Foundry Front Range, and its intensive outpatient program, have specialized expertise in treating cannabis use disorder. With some of the most experienced clinicians, modern and well-equipped clinical facilities, and leading experts in addiction medicine, Foundry Steamboat and Foundry Front Range represent an appropriate treatment option for people experiencing cannabis use disorder.
If you or a loved one needs help or to learn more about our comprehensive addiction treatment program, visit www.foundryfrontrange.com or call (720) 807-7867.
The Damaging Impact of Polysubstance Use on the Heart
New research has revealed problematic cardiac changes in patients with both cocaine and alcohol use disorders. This raises concerns about the effects of cocaine and alcohol use on the heart, even after treatment and abstinence.
“Cocaine use is a well-established cardiovascular risk factor, further enhanced by concurrent alcohol use. However, cardiovascular risk is poorly managed in individuals with cocaine use disorder,” wrote Porras-Perales, Segovia-Reyes, et al. in their cross-sectional case-control study on cardiac troponin alterations in patients with cocaine and alcohol use disorders.
People with substance use disorder (SUD) frequently misuse more than one addictive drug, which is known as polysubstance use. This includes taking two or more together or within a short period, either intentionally or unintentionally.
“Whether intentional or not, mixing drugs is never safe because the effects from combining drugs may be stronger and more unpredictable than one drug alone, and even deadly,” explains a CDC webpage.
“While research indicates combined use of cocaine and alcohol poses [a] greater threat than either substance alone, there may be different mechanisms of injury,” explained Mark Gold, MD, in Psychology Today.
Researchers studied 84 participants with substance use. “Highly sensitive cardiac troponin T (cTnT) blood levels were measured. Cardiac troponin levels are markers for heart attack and other heart abnormalities. CTnT is a substance released into the bloodstream with damage to heart muscle. It includes troponin I (cTnI), a protein in heart muscle cells that regulates muscle contraction. The research showed distinct cardiac troponin blood alterations in cocaine addicts.”
When heart muscle is damaged during a myocardial infarction (heart attack), cTnI releases into the bloodstream. The major research finding was that cocaine use disorder patients showed significantly elevated cTnT levels relative to controls. In addition, patients with alcohol use disorder exhibited elevated cTnI levels relative to controls.
“This suggests possible subclinical myocardial injury caused by cocaine distinct from alcohol’s effects,” wrote Dr. Gold. “Sadly, even with abstinence and without overt cardiovascular disease, substance use disorders (especially cocaine) are associated with detectable and important heart and injury signals.”
The new study is a reminder that among drug combinations, cocaine (and methamphetamine) is a well-established cardiovascular risk factor. “The combined use of methamphetamine/cocaine plus alcohol may cause cardiovascular disease (CVD) problems so often that when addiction treatment begins in early abstinence, physicians should consider a cardiovascular risk assessment,” explained Dr. Gold.
“Chronic heavy alcohol use has a direct negative effect on the heart, referred to as myocardial toxicity. This causes cardiomyopathy, arrhythmias, and hypertension. In the Porras‑Perales et al. study described at the beginning of this post, researchers found that alcohol use was associated with elevated cTnI, suggesting subclinical injury.”
Chronic alcohol use contributes to dilated cardiomyopathy, atrial fibrillation, left ventricular dysfunction, and increased heart failure risk.
NRT Behavioral Health programs take a comprehensive approach to treating Substance Use Disorder.
Our programs provide modern, evidence-based addiction treatment and integrated addiction medicine to address the needs of the patient as a whole person. Many individuals suffering from prolonged substance use disorder and who use multiple substances have increased risks for complex medical problems, such as heart conditions.
Our experienced medical team members are experienced at identifying comorbid health conditions accompanying long-term substance misuse and can refer clients to appropriate specialized treatment. Treating comorbidities is crucial for maintaining lasting health and promoting recovery. Unless chronic conditions are treated, people may experience a range of debilitating symptoms that prevent them from feeling well and sustaining their recovery.
NRT Behavioral Health residential treatment programs, Foundry Front Range, and Foundry Steamboat provide the level of comprehensive assessment and treatment needed to successfully diagnose and create treatment plans to find and treat heart problems and other healthcare problems associated with substance use disorders.
If you or a loved one needs help, please get in touch with our informed admissions team at (720) 807-7867.
Cannabis Use Increases Depression and Suicidal Ideation
This article mentions suicide. If you or someone you know is in crisis, please call, text, or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.
“The frequent use of cannabis is associated with a plethora of negative health and social consequences,” wrote Langlois, Potvin, Khullar, and Tourjman in their 2021 study regarding depression and cannabis.
“There is a growing body of evidence pointing to the co-occurrence of cannabis use and depression,” confirmed Feingold and Weinstein in the same year. “There is also some evidence that the use of cannabis may lead to the onset of depression; however, strong evidence points to the inverse association, i.e., that depression may lead to the onset or increase in cannabis use frequency.”
New research has now raised more concerns about cannabis use, especially for young users.
“Cannabis use has become increasingly normalized in the United States, and at least half the states have 'medical marijuana' laws,” wrote Mark Gold, MD, in Psychology Today in July. “This reversed criminalization, but rather than following FDA-like testing and approval, cannabis was suddenly ‘a medicine.’ Access to cannabis or its intoxicant THC has never been greater. Adolescents may not legally purchase cannabis; however, their access has increased.”
Alarmingly, there appears to be a strong relationship between cannabis use and suicidal thinking that can only partly be explained by depression.
“Cannabis is largely unstudied or has failed rigorous medication trials, so its impact on mental health is mostly unknown,” warned Dr. Gold. “However, new findings indicate distressing results, causing experts to call for a reassessment of the risks and benefits of cannabis, as nearly 30 percent of users develop cannabis use disorder (CUD). For adolescent users, risks for addiction are twice that of adults, and after four years, one in five adolescents develop problematic use. Disturbingly, new studies suggest elevated cannabis risks for depression and suicidal thoughts and behaviors, especially in adolescents and young adults.”
Gold pointed to a new review and meta-analysis by Maviel, Somma, et al. that found “a clear relationship between cannabis use and suicidal behaviors.” After adjusting for depression, adolescent cannabis use was significantly associated with increased risks for thinking about suicide and more than double the risk for suicide attempts. Among adolescents, cannabis use was linked to a 1.85 times higher likelihood of attempting suicide.
“Depression may contribute to the relationship between cannabis use and suicidality, but doesn’t fully explain it, suggesting cannabis use poses independent risks for suicidal thoughts and behaviors,” explained Dr. Gold. “Cannabis may act as a catalyst, accelerating depressive processes.’
Recent high-quality studies have reinforced findings that cannabis use during adolescence can predict increases in depressive symptoms and suicidal ideation. Gobbi, Atkin, et al. reported in JAMA Psychiatry that “adolescent cannabis consumption was associated with increased risk of developing depression and suicidal behavior later in life, even in the absence of a premorbid condition.” Cannabis use in adolescence was associated with an increased risk for major depression and suicidal ideation (about 1.5 times greater), and adolescent cannabis use was associated with suicide attempts in young adulthood (3.4 times greater).
A major study in Proceedings of the National Academy of Sciences compared a large sample of hospitalized adolescents with cannabis use disorder (CUD) vs. those without CUD and controlled for depression. Adolescents with CUD had substantially increased odds of suicide attempts and self-harm; the presence of comorbid depression more than doubled risks.
The authors concluded that their study “provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk.”
A study in Frontiers in Public Health found cannabis use associated with higher risks of major depressive disorder, as well as suicidality. “Another study demonstrated that adolescents with cannabis use disorder (CUD) symptoms were more severely ill than adults, suggesting a developmental vulnerability,” Gold wrote. “Experts concluded youth cannabis use likely fuels depression and suicide in young people.”
FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER
NRT Behavioral Health Managing Partner Ben Cort has written two books on the problems associated with today’s high-potency THC products and their effects. Growing evidence demonstrates that consuming today’s highly concentrated cannabis poses significant health risks, from anxiety and depression to cardiac problems to suicidal ideation. A minority of cannabis users will develop cannabis use disorder and its serious effects. However, those who are impacted, and their family members and loved ones, face significant challenges and the same risks associated with other forms of substance use disorder.
NRT Behavioral Health programs, including Foundry Steamboat, Foundry Front Range, and its Intensive Outpatient Program, have specialized expertise in treating cannabis use disorder. Cannabis, which is stored in fat cells, can remain in the body and cause psychoactive effects long after a person stops consuming it. This can lead to residual effects of cannabis that must be stabilized before clients are ready to engage in treatment programming. Specialized medical attention may also be required to help people experiencing severe side effects of cannabis use disorder, like cannabis-induced hyperemesis or psychosis, feel stable and comfortable before entering treatment.
With some of the most experienced clinicians, modern and well-equipped clinical facilities, and leading experts in addiction medicine, Foundry Steamboat represents a good treatment option for people experiencing Cannabis Use Disorder (CUD). To learn more, call us at (844) 955-1066.
Colorado Fentanyl Deaths Down, But Economic Toll Remains
Fentanyl deaths in Colorado dropped last year, but still inflicted a severe economic toll, says a new report by the Common Sense Institute (CSI), a free-enterprise think tank.
Fentanyl-related deaths in Colorado “dropped from 1,184 in December 2023 to 801 in November 2024, a 32.4 percent reduction, but that’s still well above death rates before 2020,” reported Derek Draplin in the Kiowa County Press.
CSI estimates that “the total cost of fentanyl-related overdose deaths in Colorado is on par with 2022 at $13.1 billion in 2024 – approximately $2,220 per Coloradan.”
Though last year’s overdose rates and their associated economic impacts are trending downward, “they are still highly elevated compared to any point before 2020. This mirrors the development of Colorado’s crime rate generally, which has recently improved from 2022 but remains far above the norm set in the previous decade.”
OTHER KEY FINDINGS
Fentanyl-related overdose deaths have declined since the passage of HB22-1326, the Fentanyl Accountability and Prevention Act. The legislation was a response to rising fentanyl overdose deaths in the state.
Colorado’s Drug Overdose Competitive Index is still higher (30th) than it has been since 2015. This is due to increased drug overdose per capita in Colorado and improvements in other states.
CSI recommends that policymakers consider reverting to the effective drug laws that imposed stronger criminal penalties for the possession of any amount of drugs like methamphetamine, cocaine, and heroin. “While the state made some strides in strengthening fentanyl possession laws with the passage of HB22-1326, the law fails to address other hard drugs that often contribute to overdoses,” the report says. The authorities should be “proactive in anticipating whatever drug will eventually replace fentanyl,” and “adopt a robust public health strategy with rigorous tracking criteria aimed at reducing fentanyl-related overdoses.”
Fentanyl is a powerful synthetic opioid that is up to fifty times stronger than heroin and one hundred times stronger than morphine. Its misuse is a major contributor to fatal and nonfatal overdoses in the United States. As the CSI report explains, “fentanyl and other synthetic opioids are the most common drugs involved in overdose deaths. Even in small doses, it can be deadly. Over 150 people die every day [nationally] from overdoses related to synthetic opioids like fentanyl.”
According to the latest data from the Colorado Department of Public Health and Environment, there were 222 fentanyl-related deaths in 2019, 540 in 2020, 912 in 2021, 920 in 2022, and 1,097 in 2023. The total number of drug overdose deaths decreased 15.7 percent from 1,935 in November 2023 to 1,631 in November 2024.
OPIOID USE DISORDER
Opioids such as fentanyl and heroin can produce feelings of euphoria that make it more likely that people will continue to misuse opioids, despite severe negative consequences such as addiction and death. Opioid use disorder (OUD) is a serious condition requiring treatment.
NRT Behavioral Health treatment programs, including Foundry Front Range and Foundry Steamboat, strive to make addiction treatment as accessible as possible. Every person with addiction deserves effective medical care. When it comes to behavioral healthcare, the ability of your treatment provider to understand your needs, provide effective therapies, and identify the specific resources that will help you maintain health and recovery after treatment is vital to your success.
If you or a loved one needs help, please contact us at (720) 807-7867.
A Quarter of US Children Have a Parent With Substance Use Disorder, Study Finds
Nearly 19 million children in the United States have at least one parent with a substance use disorder (SUD), according to a new study published in JAMA Pediatrics on May 12. A significant number of those children have a parent whose SUD is moderate or severe as opposed to mild, the study finds.
Witnessing a parent misusing drugs and alcohol as a child is considered an "adverse childhood experience" (ACE) that can have long-term negative impacts on health and well-being. ACEs are common. About 64 percent of adults in the United States reported they had experienced at least one type of ACE before age 18. Nearly one in six adults reported they had experienced four or more types of ACEs.
"Children exposed to parental SUD are more likely to develop adverse health outcomes than their peers without parental SUD exposure, including early substance use initiation, substance-related problems, and mental health disorders," wrote study authors Sean Esteban McCabe, Vita McCabe, and Ty Schepis. "We aimed to estimate the number of US children living in the same household as at least one parent or primary caregiver with a DSM-5-defined SUD."
As Rhitu Chatterjee reported on NPR, "the new study used data from the 2023 National Survey on Drug Use and Health, a federal survey that estimated the prevalence of substance use and mental health disorders based on the most updated criteria in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). The national survey is managed by the Substance Abuse and Mental Health Services Administration, but the team in charge of the survey was let go as part of the recent reduction in force. It is unclear how the cuts will affect the future of the survey."
"If one-quarter of kids in the US have a parent with a substance use disorder, that tells us that every day in our clinics we are encountering many, if not dozens of families that are affected by substance use disorders," Dr. Scott Hadland, chief of adolescent medicine at Massachusetts General Hospital told NPR. "We need to be poised and ready to help support those families."
"The study's main finding is significantly higher than previous estimates (7 million in a study originally published in 2022), which had relied on diagnostic criteria from the DSM-IV," reported Chatterjee. "The new study also estimated how many children have a parent with a moderate or severe addiction as opposed to mild."
McCabe and his team found that 7.6 million US children have a parent with a moderate or severe SUD, and 3.4 million live with a parent dealing with multiple substance use disorders. The authors also found that more than 6 million children have a parent dealing with both a substance use disorder and a co-occurring mental health condition.
"These estimates are incredibly important to understand the scope of parental substance use disorder in the United States," Davida Schiff, a pediatrician and addiction physician at Massachusetts General Hospital, told NPR. Dr. Schiff pointed out that a majority of the parents (12 million) had alcohol use disorder. "While alcohol is more socially acceptable in our society, the study points to a need to pay greater attention to a rising number of children exposed to parental alcohol use disorder."
Adverse childhood experiences and other lifetime traumas are regularly encountered by addiction professionals. The strong correlation between addiction and trauma, especially childhood trauma, is well known.
Addiction is truly a family problem.
NRT Behavioral Health Chief Clinical Advisor Dr. Michael Barnes is a foremost expert in family system disorders and trauma. The Trauma-Integrated Care Model, developed by Dr. Barnes and used at NRT Behavioral Health treatment programs, emphasizes the importance of identifying trauma and substance use in family systems. Because parental substance use disorder exposes children to physical and psychological danger and increases their risk of developing SUD in later life, addressing the effects of these problems on all family members is key to stopping generational cycles of behavioral health disorders. Family programming is a central part of treatment at NRT Behavioral Health programs. It focuses on educating clients and family members and helps families create recovery-supportive lifestyles and home environments.
Recognizing how families experience, normalize, and perpetuate substance use is vital to reducing high rates of SUD in America's rural communities. Close-knit families that spend more time together and are more isolated from other community members can inadvertently create an internal culture that makes using substances to self-medicate mental health disorders more acceptable. Ensuring that rural community members can access high-quality treatment is one way to address this problem. Helping individuals address anxiety, depression, loneliness, and other psychological problems through therapy and psychiatric medications can reduce their perceived reliance on alcohol and substances to reduce their symptoms. Sometimes, when one family member gets help, other members become more willing to accept help and to change their relationship with substances.
If you or a loved one is experiencing problematic drinking or drug use, we may be able to help. Please call us for a free and confidential conversation at (720) 807-7867.
Marijuana is Bad for Your Heart
Marijuana causes heart problems — A new study led by UC San Francisco researchers has found that chronic cannabis use, whether smoked or consumed in edible form, is associated with significant cardiovascular risks.
The report, published in JAMA Cardiology, found that people who regularly used marijuana in either form had reduced blood vessel function comparable to tobacco smokers. Vascular function in those who used cannabis by either means was reduced roughly by half compared to those who did not use it.
Decreased vascular function is associated with a greater risk of heart attack, hypertension, and other cardiovascular conditions.
"There is a popular belief that marijuana smoke is harmless," wrote Mohammadi, Navabzadeh, Jiménez-Téllez, et al. in their study. "However, marijuana smoke contains many of the thousands of chemicals contained in tobacco smoke, along with fine particles that contribute to cardiovascular morbidity and mortality. As cannabis legalization increases, it is crucial to understand the public health and clinical implications of marijuana use."
The researchers recruited 55 people between October 2021 and August 2024 who were outwardly healthy and either regularly smoked marijuana or consumed edibles containing tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis.
Along with decreased vascular function, marijuana smokers had changes in their blood serum that were harmful to endothelial cells, which form the inner lining of all blood and lymphatic vessels. Those who took edibles containing THC, however, did not display these changes in blood serum. It's unclear how THC damages blood vessels.
"This study enhances the understanding of the potential risks to vascular health linked to cannabis use and provides more evidence that cannabis use is not benign," the researchers concluded.
THE RISE OF HIGH-POTENCY THC
Cardiovascular issues are not the only risks associated with cannabis use, of course. Many well-meaning Americans have internalized the propaganda of the well-organized cannabis industry, suggesting that cannabis products can cause no harm and may even mitigate specific health problems such as glaucoma or anxiety disorders, despite a distinct lack of scientific evidence for such claims. In an astonishing turnaround, cannabis went from a dangerous gateway drug to a wellness product in a matter of decades.
Foundry Front Range Managing Partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "Concentrates are everywhere and are not just being used by the fringe; they are mainstream, and they are what many people picture when they talk about marijuana," he wrote in Weed, Inc. In other words, cannabis products have been weaponized. Cort's 2024 follow-up book, "Weed Inked," contains further evidence that high-potency THC products are harmful to personal and public health.
Chronic cannabis use is associated with an increased risk of developing a substance use disorder (SUD) and can induce psychosis.
Cannabis Use Disorder (CUD) is a growing problem nationwide. Studies indicate increasing rates of cannabis use disorder following the legalization and commercialization of cannabis in recent years. Cannabis use disorder poses specific health challenges, including hyperemesis, psychosis, paranoia, and—as the UCSF study confirms—heart health risks.
FOUNDRY FRONT RANGE TREATS CANNABIS USE DISORDER
Foundry Front Range has specialized expertise in treating cannabis use disorder. Cannabis, which is stored in fat cells, can remain in the body and cause psychoactive effects long after a person stops consuming it. This can lead to residual effects of cannabis that must be stabilized before clients are ready to engage in treatment programming. Specialized medical attention may also be required to help people experiencing severe CUD side effects, like nausea or psychosis, feel stable and comfortable.
Because 58-plus percent of people with SUD have more than one substance use disorder, treating the effects of cannabis use disorder can be even more complex. Patients with cannabis use and at least one other substance use disorder are more likely to need more clinical attention and medical resources. They may also have home environments or relationships that make substance use seem permissible or supported, requiring family programming and education about how to build recovery-supportive environments.
Continuing care planning, which ensures that individuals have a specific ongoing care plan after completing treatment, is crucial for allowing them to navigate the fragile period of early recovery safely. As this article suggests, cannabis use disorder and other substance use disorders increase the potential for chronic health problems. With growing evidence that cannabis can affect the heart and blood flow, cardiological assessment may be advisable during and after substance use disorder treatment.
With some of the most experienced clinicians, a modern and well-equipped clinical facility, and leading experts in addiction medicine, Foundry Front Range represents a good treatment option for people experiencing Cannabis Use Disorder. To learn more, visit www.foundryfrontrange.com or call (720) 807-7867.
The Weaponization of Cannabis Products
“A strange thing has happened on the path to marijuana legalization. Users across all ages and experience levels are noticing that a drug they once turned to for fun and relaxation now triggers existential dread and paranoia,” wrote Malcolm Ferguson, an assistant editor at The Atlantic, in August. Like other journalists, Ferguson is beginning to realize what many addiction professionals have known for many years. Cannabis products in the United States have been weaponized on an industrial scale.
“In 2022, the federal government reported that, in samples seized by the Drug Enforcement Administration, average levels of tetrahydrocannabinol, or THC—the psychoactive compound in weed that makes you feel high—had more than tripled compared with 25 years earlier, from 5 to 16 percent. That may understate how strong weed has gotten. Walk into any dispensary in the country, legal or not, and you’ll be hard-pressed to find a single product advertising such a low THC level. Most strains claim to be at least 20 to 30 percent THC by weight; concentrated weed products designed for vaping can be labeled as up to 90 percent.”
NRT Behavioral Health™ managing partner Ben Cort has been raising awareness of the commercialization of cannabis products for years. In his 2017 book Weed, Inc., he explained how the potent products the marijuana industry is selling in the 21st century are a far cry from the weed people smoked in the 1970s. "The average cannabis product sold in Colorado in 2020 had a THC content of 69 percent," says Cort. "Concentrates are everywhere and are not just being used by the fringe; they are mainstream, and they are what many people picture when they talk about marijuana," he wrote in Weed, Inc. "You are going to think some of this must be talking about hardcore users on the edge, but it's not; concentrates are everywhere and have become synonymous with weed for this generation of users." “Weed Inked,” Cort’s recently published “Weed, Inc.” follow-up, discusses how many of the predictions about the harmful effects of high-potency THC product commercialization and industrialization have come to pass.
The consequences of making this largely unregulated psychoactive product available through legalization and commercialization have been devastating.
“In the past few years, reports have swelled of people, especially teens, experiencing short- and long-term ‘marijuana-induced psychosis,’ with consequences including hospitalizations for chronic vomiting and auditory hallucinations of talking birds,” reported Ferguson. “Multiple studies have drawn a link between heavy use of high-potency marijuana, in particular, and the development of psychological disorders, including schizophrenia, although a causal connection hasn’t been proved.”
The wider public remains largely unaware of these significant risks. In May, the number of Americans who use cannabis daily was reported to have surpassed the number who drink alcohol that frequently for the first time in the history of the United States. As the Associated Press reported, it is “a shift some 40 years in the making as recreational cannabis use became more mainstream and legal in nearly half of US states.”
In 2022, an estimated 17.7 million people reported using marijuana daily or near-daily compared to 14.7 million daily or near-daily drinkers, according to an analysis of national survey data. In 1992, when daily cannabis use hit a low point, fewer than one million people said they used marijuana nearly every day.
“Cannabis is in and alcohol is out”—a preference change likely driven by Gen Z, Nikki Battiste reported for CBS News in May. The cannabis industry has mostly succeeded in convincing large numbers of Americans—particularly young people—that their potent products are harmless if not beneficial for their well-being. As a consequence, millennials and Gen Z tend to think of alcohol as harmful and marijuana as healthy.
After years of promoting cannabis as "medication" (although the evidence for its efficacy is mostly anecdotal) and downplaying the risks of marijuana use, the cannabis industry is close to achieving another goal. In May, the federal Justice Department proposed reclassifying the drug, saying the change would recognize marijuana’s “medical” uses and suggesting it had less potential for abuse than other illicit drugs.
For now, however, the federal government continues to classify cannabis as a Schedule I controlled substance with “no currently accepted medical use and a high potential for abuse.” Any reclassification is not expected before the November election.
Meanwhile, the National Institute on Drug Abuse (NIDA)—one of 27 institutes and centers comprising the National Institutes of Health, which is part of the US Department of Health and Human Services—informs the public on its website that “marijuana use can lead to the development of a substance use disorder, a medical illness in which the person is unable to stop using even though it's causing health and social problems in their life.” A severe cannabis use disorder (CUD) is considered an addiction. “Research suggests that between 9 and 30 percent of those who use marijuana may develop some degree of marijuana use disorder. People who begin using marijuana before age 18 are four to seven times more likely than adults to develop a marijuana use disorder.”
Cannabis products—especially those with dangerously high THC concentrations—also affect brain development. When people begin using these weaponized THC products as teenagers, the drug may impair thinking, memory, and learning functions and affect how the brain builds connections between the areas necessary for these functions.
A 2022 review study found that higher THC concentrations are now causing more people to become addicted to cannabis. “One of the highest quality studies included in our publication found that use of high potency cannabis, compared to low potency cannabis, was linked to a four-fold increased risk of addiction,” study coauthor Tom Freeman told CNN.
Foundry Treatment Center Steamboat, part of NRT Behavioral Health, developed a specific treatment track for people affected by cannabis use disorder because the condition poses particular challenges. In 2000, Cort co-authored the first published best practices on treating CUD alongside Dr. LaTisha Bader in a medical text and reference book entitled Cannabis In Medicine and Evidence-Based Approach. He has spent the years since working to educate clinicians and medical professionals in our field on these practices. Many people experiencing cannabis use disorder suffer from extended periods of cannabis-induced psychosis and must be safely housed and medically supervised until their symptoms subside enough for them to engage in treatment programming successfully. Cannabis use disorder treatment is also an area of specialty offered by Foundry Front Range, a comprehensive residential addiction treatment program opened by NRT in August.

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