Fighting Fire with Power

“Taken together, these clinical situations suggest that certain subpopulations of the LGBTQ community are at increased risk of developing opioid use disorder and signal the need for special care in prescribing opioids in these and other LGBTQ populations.”

National LGBT Center for Health Education

A large survey of transgender Americans found that 35 percent of those who experienced school-related harassment or assault reported using substances to deal with the mistreatment.”

“I have been very much focused on this, really since the beginning of my taking office, and that’s why we created this position of opioid response.” Attorney General Phil Weiser announced in January of 2020 that Thornton’s ex-mayor Heidi Williams would become the chief of opioid response for Colorado.

“We have a range of tools that we are looking at. The first three are education and prevention, treatment efforts, and then ongoing recovery.” He and Williams, along with other stakeholders and state agencies in Colorado, are very much trying to work toward a broader behavioral health agenda.

According to the CDC, more than 130 Americans die from opioid overdose each day, and those who belong to a sexual minority are more than twice as likely to abuse drugs compared to their heterosexual peers. LGBTQ+ individuals disproportionately face a number of challenges compared to their heterosexual peers. These challenges include: emotional abuse, bullying, hate crimes, rejection from family, and self-hatred.

Transgender youth need the most help. They often have to deal with compounding stigmas when searching for treatment as well as feeling safe. Weiser said, “The stigma issues are important, and we need everyone to be a part of this solution. It’s OK to admit you are struggling. Transgender youth are at risk; they have high rates of suicide and high rates of substance abuse, so if we can get support, we can get people on a path that supports recovery.”

The money to help fund transgender youth programs may come from a lawsuit—Weiser added Colorado onto the Purdue Pharma Lawsuit and added an amendment.

“I looked at this issue when I was first running for office and saw these lawsuits, and I was really concerned about the behavior of these companies.” In September of 2018, Colorado sued Perdue Pharma as a company. A year ago, Wieser added the Sackler family, the people behind the company, individually.

“This is a privately held company; they are the worst of the worst.” Weiser explained that the Sackler family pushed to get these drugs out there, encouraged doctors who were sanctioned for their practices and pushed them even harder. “We are now suing in bankruptcy court against the Sacklers; they are presently trying to work out a deal where they are not having to pay their fair share, and we want to get a fair share paid.” Weiser added that this settlement will help get funding for education prevention and treatment and recovery. Distributors named in the lawsuit are Cardinal Health, McKesson, Amerisource, and Johnson and Johnson.

So, what will be done in Colorado to keep these companies from distributing?

“We are talking about a settlement that would include very restrictive terms and conditions, one that would not allow loopholes and not allow distribution.” He described the horror stories that come from southern Colorado when it comes to high Oxycontin prescription rates. He is looking to make sure any settlement will have the right restrictive terms. “They recognize they are liable, and we are going to push for injunctive relief as well as monetary damages.”

Queering Mental Health- Envision:You 2020

In came the czar of Colorado’s opioid response, Heidi Williams. “She is positioned to build those relationships at the local and regional level and also helps to build an understanding of what these practices are,” Weiser said. Williams makes it a point to visit communities in these rural and frontier areas in Colorado towns and realizes that the LGBTQ+ population is a distinct community to manage.

She also said that telehealth is something they are looking at given the current climate. There has been a reduction in services, and there is a relaxation on methadone, with people unable to go to their clinics as often. “This is where telehealth is going to become a very robust method.”

Williams is passionate about her work, and it hits home on a personal level, too—she shared that her daughter came out two years ago. “We need to reduce the stigma so that we don’t have one in four of our LGBTQ+ community with substance use disorder. That is staggering.”

“We know that at least 80 to 85 percent who end up using heroin started with prescription opioids. For folks starting out because they had gender affirmation surgery or older HIV patients, they are at a higher risk of prescription drug abuse.” Williams knows the stats.

In 2015, one in 10 adults over the age of 18 who misused prescription opioids (such as hydrocodone or oxycodone) identified as LGBTQ+, and they were three times more likely to develop an addiction than heterosexual adults.

Substance use disorders affect approximately 25 percent of the LGBTQ+ population compared to 8.4 percent of the general population, according to the Substance Abuse and Mental Health Services Administration.

As part of the pharmaceutical industry’s commitment to addressing these concerns, the Rx Abuse Leadership Initiative (RALI) has worked closely with Envision:You.

“RALI appreciates the work Attorney General Phil Weiser and his staff have done on supporting mental health services, especially in Colorado’s LGBTQ+ community,” said Jennifer Churchfield, Rx Abuse Leadership Initiative (RALI). We’re all facing enormous stress due to the COVID-19 pandemic, but it’s an especially difficult time for those with economic or personal challenges. Thanks to Attorney General Weiser and Heidi Williams for the real dedication and passion they bring to caring for the mental health of our state. “

“Best practice from here on out is that we learn from one another. There is a statewide response to the distribution of Narcan. All first responders have Narcan. We want treatment and recovery available across the state; we want regional coordination lawsuits.” Williams knows the numbers of drug use and deaths are so hard to find within the transgender community, mostly because the stigma in place prevents these LGBTQ+ folks from asking for extra help and because of misgendering after death.

“Stigma issue is a big part of this. We need everyone to be a part of this solution. It’s OK to admit you are struggling. Younger-aged trans youth are really at risk; they have a higher risk of suicide and substance abuse, and if people can get behind this, with effort, we can provide peer support and counselor; we can get people on a path.”

To find support in Colorado, please visit cowellnessrecovery.org

Photo provided by Phil Weiser