Crested Butte could have bought nine doses of the overdose reversal drug naloxone with the amount of money the town has received so far from Colorado’s opioid settlement funds — but that might not have been enough to cover the sales tax, too.
The Gunnison County mountain town, which has received $351 since November 2022, didn’t get the state’s smallest share of the settlements. That distinction belongs to Empire, which received $121, followed by Naturita, at $230, and Yampa, at $310.
Still, it made the most sense for Crested Butte and other small communities to pool their funds with their counties rather than to try to address the opioid crisis on their own with less than $1,000, said Kari Commerford, juvenile services director for Gunnison County. The communities will receive additional money over the next 17 years, but the amounts aren’t likely to increase.
Colorado is set to receive $787.7 million over a total of 18 years to compensate the state for the costs of the opioid crisis, and already has received more than $110 million.
The largest recipient, Adams County, has been paid more than $8.4 million so far, with Denver not far behind at $7.9 million in combined funding. All of the multi-county regions in the state have received at least $300,000, and most have more than $1 million available to spend so far.
But a number of counties and towns have had to significantly limit their aspirations to stay in line with their share of the settlement. Seven small Colorado communities have gotten less than $1,000 so far, even after receiving two or more pieces of the settlements, while some of the state’s less-populous counties received just over $10,000.
Colorado has received shares of nearly a dozen multi-state settlements with pharmaceutical companies that allegedly mismarketed their painkillers as not addictive, and with drug distributors and some large retailers accused of looking the other way when unusually large orders suggested the pills they sold were going to the illicit market.
Most of the settlement funds will go to 19 regional groupings of counties, with 20% going directly to local governments, 10% to the state and 10% to a fund to build treatment infrastructure in areas that lack it.
The share that local governments are eligible for depends on their populations and how much damage the crisis caused locally. Just over three-quarters of 334 eligible towns, cities and counties told the state to reallocate their shares to their region, rather than sending them a small amount to spend locally.
Those that opted to keep small amounts of money have the task of figuring out what they can do with the funds. Colorado requires that all of the settlement funds go for uses related to opioid misuse and addiction — no building baseball fields or remodeling the town hall — and that it can’t replace existing funding for addiction programs.
Poncha Springs town administrator Lance Hostetter said the town opted to put its first payment of the $1,189 total it received so far toward “conversation chairs” along a popular trail. The chairs have guidance for productive discussions on the arms, and while town officials can’t know what people talk about when they sit down, the goal was to facilitate conversations about mental health and substance use, he said.
“We have to think about what can we do that’s meaningful and impactful with only a few hundred dollars,” he said.
The town only has eight employees and relies on Chaffee County for law enforcement and social services to its 1,600 people, so Hostetter said he doesn’t have a clear picture of how much of a problem drugs are for residents. He thinks Poncha Springs has been “fortunate” so far in the opioid epidemic, because he hasn’t heard about large numbers of deaths.
Hostetter said the town government hasn’t decided what to do with future allocations, because no one is sure how much they’ll get in subsequent years. The amounts will vary from year to year, though they will gradually decrease over time. If the county and other towns are combining funds for a bigger project that would benefit them all, Poncha Springs might chip in its allocation, he said.
In Gunnison County, towns pooled their small allocations with the county’s $48,092. Three of the Colorado municipalities that received less than $1,000 are in Gunnison County: Crested Butte, $351; Mount Crested Butte, $382; and Gunnison, $886.
They haven’t used the money yet, because the county still has some funding from two separate $1 million federal grants, with each spread over three years, said Commerford, the juvenile services director.
The county is using the grants to pay for people to receive treatment, to distribute naloxone, to embed social workers in schools and to diversify the behavioral health workforce, Commerford said. The opioid settlement funding won’t allow it to pursue all of those directions, but it should at least pay for treatment for some people who can’t afford it, she said.
“We’re trying to build up that funding” for when the grants end, she said.
Some counties also received relatively modest allocations.
Lake County has gotten $18,896 so far, which it plans to use to help people with opioid use disorder pay for housing, county deputy manager Lauren Snyder said. It hasn’t paid out any of the money yet, and county leadership is considering whether it might be better to direct it to youth education or harm reduction, she said.
Keeping the money local, rather than sending it to the region, allows for that kind of flexibility, Snyder said.
“We knew our county needs the best,” she said.
Custer County received even less, taking in $10,351 in the first year and a half of the settlement.
Patrick Fiore, substance abuse coordinator for Custer County Public Health, said about one-third of it went to buying and distributing 220 pill bottles that require a combination to unlock them. Weld County also spent some of its allocation on similar bottles.
“It doesn’t sound like much, but for 5,000 people (living in the county), not that bad,” he said.
While someone who has an established addiction could just smash the bottle, the hope is that making it harder to get pills will reduce “pilfering” by youth that could set them up for more serious misuse in the future, Fiore said.
They’ve also allocated about $2,000 for “response kits” to place in public places like the library and stores that are willing to have one, Fiore said. The kits, which range in price from $140 to $275, contain instructions on recognizing an overdose and performing CPR, as well as some protective equipment for the person responding. The county has to buy naloxone, the drug that can reverse an opioid overdose, separately.
“The ideal plan is to have an (automatic external defibrillator), an opioid response kit and a ‘stop the bleed’ kit,” in public places, he said. “It also, indirectly, can help with stigma and normalize seeing those things.”
Custer County is still working on a plan for its next allocation, which might include more publicly available naloxone, Fiore said. The county has to work both within financial constraints and within the bounds of what the community will accept — a syringe exchange program wouldn’t fly there, even if they had the money for it, he said.
The money is “enough to do something, but not to hire someone,” Fiore said.
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