Battle against opioid crisis: Map is sorrowful guide to lost loved ones

Partnership addressing opioid crisis is tied to project born of grief

Posted 1/15/19

The online map is a living, breathing eulogy of people who have died from opioid use. Matt Lazarus, of Castle Rock, “was known for having a ‘heart of gold’” and “will be missed by many,” …

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Battle against opioid crisis: Map is sorrowful guide to lost loved ones

Partnership addressing opioid crisis is tied to project born of grief

A woman stands in front of the Prescribed to Death memorial exhibited through the Stop Everyday Killers campaign run by the National Safety Council. The exhibit features 22,000 opioid pills engraved with the faces of people who died from opioids. The campaign also promotes a map, the Celebrating Lost Loved Ones map, first created by Thornton man Jeremiah Lindemann to document the local impact of the opioid crisis.
A woman stands in front of the Prescribed to Death memorial exhibited through the Stop Everyday Killers campaign run by the National Safety Council. The exhibit features 22,000 opioid pills engraved with the faces of people who died from opioids. The campaign also promotes a map, the Celebrating Lost Loved Ones map, first created by Thornton man Jeremiah Lindemann to document the local impact of the opioid crisis.
Courtesy photo
Posted

The online map is a living, breathing eulogy of people who have died from opioid use.

Matt Lazarus, of Castle Rock, “was known for having a ‘heart of gold’” and “will be missed by many,” according to his profile, which does not specify when or how he died. “I am so proud to call him my son,” the profile reads. “Love and miss you forever Matthew.”

Alexander Leeds, of Golden, overdosed on heroin in 2013. His profile says it was the 22-year-old’s first time using the drug — he was attempting to stifle pain from a dry socket complication from the removal of his wisdom teeth. “As a mother it never gets easier, it just gets different. Prayers to every mother that’s gone/going through this same pain.”

J.T. Lindemann was a Wyoming man who died in 2007 at age 22 after battling a drug addiction that started with a prescription for oxycodone, including OxyContin. “He is greatly missed by family and friends and will be remembered by all as a free spirit, the spark that lit up a room with his smile and fun-loving ways,” his profile says.

The Celebrating Lost Loved Ones map — now housed on the National Safety Council website as a nationwide testament of grief and love — was first created in 2015 by J.T.’s older brother, Thornton resident Jeremiah Lindemann, to show the human impact of the opioid crisis. Armed with data from the Colorado Department of Public Health & Environment, Lindemann built a series of maps showing the steadily increasing numbers of opioid overdose deaths in Adams County and the state from 2000 to 2014.

Lindemann then scheduled a meeting with Adams County commissioners, which inspired them to connect with other organizations and elected officials battling opioid misuse.

Eventually, as a result of that outreach, Adams and Arapahoe counties teamed with Tri-County Health Department, a health agency serving Arapahoe, Adams and Douglas county residents, to form the Tri-County Overdose Prevention Partnership in 2016. Its mission: to prevent opioid overdoses in the three counties and better educate the community on their addictive power.

MORE: How the Tri-Counties battle opioid abuse

“This initially started with just a concerned citizen coming in,” Adams County Commissioner Steve O’Dorisio said of Lindemann. “He was so influential.”

Diving in

For Lindemann, the maps were a way to open up about his brother’s death after years of silence.

J.T. was transparent about his oxycodone use, Lindemann said. “He said, ‘Give me five minutes and I can go into any bar and come out with it.’ He knew how to get it. It was just everywhere.”

Lindemann, however, was confused by the drug. He’d rarely heard of oxycodone and didn’t know the medication could be addictive. At the time of J.T.’s death, in 2007, no one talked about opioids, namely prescription pain medication, as addictive substances, let alone an epidemic, Lindemann said.

In those days, Lindemann rarely spoke about his brother’s drug use. “It’s not easy talking about losing someone close to you to drugs, because of the stigma,” he said.

Then actor Philip Seymour Hoffman died in 2014 from a combination of drugs, including heroin. A Colorado senator’s son was arrested and charged with heroin possession that same year. A story related to opioids was seemingly on the news each night, Lindemann said. The issue suddenly seemed to be everywhere.

In 2015, he decided J.T.’s story also needed to be told. And that he needed to do something to help.

A self-described tech geek who works in GIS mapping and knows how to mold piles of data into animated, storytelling maps, he did just that by creating a presentation comprising about seven maps detailing the rising number of opioid-related deaths in Adams County. In May of that year, he showed them to the Adams County commissioners and coroner.

The maps were haunting, O’Dorisio remembers.

The first one painted counties across Colorado in shades of red based on their number of opioid deaths since 2000. Adams County, along with Denver, Jefferson and El Paso, had the darkest crimson hue.

The others showed activity on social media from people sharing about lost loved ones, locations of medication drop-off sites, deaths broken down by age or drug type, and more.

“It really struck each of us, how scary it was, how serious the situation was,” O’Dorisio said. “It made me want to dive in.”

Roughly three months after the meeting, Adams County created the Adams County Opioid Prevention Group to explore how opioid overdoses and misuse could be prevented in Adams County. Its membership included county commissioners, the county coroner, the Tri-County Health Department and more.

Just the beginning

In Arapahoe County, Bill Holen was grappling with his own connection to the epidemic — a 21-year-old nephew from California who grew addicted to oxycodone following a car accident.

In 2012, the Arapahoe County commissioner was appointed to his first term in office when he began noticing signs of the opioid problem beyond his own family. Holen started networking with other county and state officials to address the issue. In the spring of 2013, Arapahoe County formed the Arapahoe County Opioid Task Force to closely examine the problem and try to develop a plan to begin to address it. It initially included the coroner, sheriff and Holen, but later expanded to include Kaiser Permanente, Holen said.

In 2013, Holen’s nephew died of a drug overdose the day after checking into a halfway house. He was attempting to transition back home after successfully completing a 30-day detox and a six-month outpatient program. He’d asked to come home, Holen said, but his parents feared he wasn’t ready and hoped the halfway house could be a stepping-stone out of treatment.

“He was a beautiful young man,” Holen said.

In 2013 and 2015, the years the Arapahoe and Adams county initiatives, respectively, began, rates of overdose deaths painted a troubling picture.

Colorado providers wrote approximately 3.7 million opioid prescriptions in 2013 and about 3.5 million in 2015, according to the National Institute on Drug Abuse.

The rate of prescription opioid overdose deaths in Arapahoe County in 2013 was 1.6 per 100,000 people. In 2010, the rate was 1.95 and last year it was 6.2 per 100,000 people. For heroin, the rate was 2 overdose deaths per 100,000 people in 2013. In 2010, it was 0.64 and in 2017 nearly 2.5 per 100,000 people.

In 2015, when the Adams County initiative began, the county’s prescription opioid overdose death rate was 7.6 per 100,000 people. In 2010 it was 5.1 and in 2017 it was 12.6 per 100,000 people. The rate of heroin overdose deaths was 2.8 per 100,000 people in 2015 compared to 0.84 in 2010 and 4.6 in 2017.

O’Dorisio had begun researching how neighboring communities were addressing opioids when he learned Holen had already started work in Arapahoe County.

Leadership from both counties’ opioid initiatives met in early 2016 to discuss shared goals and decided to join forces.

The Tri-County Health Department came in to facilitate a new group comprising members from Adams, Arapahoe and Douglas counties. With that, the Tri-County Overdose Prevention Partnership, referred to by its members as TCOPP, was born. It met for the first time in May 2016.

The partnership quickly identified people in the community who wanted to fight the epidemic, including law enforcement agencies, members of the criminal justice system and community leaders, O’Dorisio said. The partnership, managed by Tri-County Health Department, today comprises more than 30 organizations and private citizens.

In 2017, the partnership drafted goals and a multipronged attack plan by creating workgroups to focus on six key areas: youth prevention, public awareness, provider education, safe disposal, harm reduction and treatment.

TCOPP is among several organizations in Colorado leading the way to curb the opioid epidemic, said J. Scott Bainbridge, founder of Denver Back Pain Specialists and board member of the Colorado Pain Society. Holding workshops, like ones that TCOPP offers to educate providers on best prescribing practices, is important in the mission.

Holen believes the partnership has had a positive impact in the decrease of prescription-opioid overdose deaths and improved awareness of opioids’ addictiveness.

The number of prescription opioid-related deaths in Adams, Arapahoe and Douglas counties from 2012 through 2013 was 150. From 2014 through 2015 it was 206. From 2016 through 2017, the number dropped to 183.

Still, “the enormity of the problem is getting worse, not better,” Holen said, as some people move to street drugs, such as heroin, when they can no longer afford prescriptions.

“Now we’re seeing increases in heroin deaths and, with the introduction of fentanyl into the mix, we’re seeing increased uses of that,” he said.

Fentanyl is a synthetic, or man-made, opioid medication that’s classified by the Drug Enforcement Administration as having a high potential for abuse. It is 50 to 100 times more potent than morphine, according to the National Institute on Drug Abuse. The Centers for Disease Control and Prevention reports the most recent cases of overdoses or deaths related to fentanyl involved illegally made versions of the drug.

Pharmaceutical fentanyl is typically used to control severe pain among people like cancer patients. The illicit version is often mixed with other substances like heroin or cocaine.

From 2012 through 2013, the three counties reported 44 heroin deaths. Over the next two years that increased by 39 percent, and from 2016 to 2017 it increased again by 54 percent from 2014-2015 for a total of 94 heroin deaths in the two-year period.

Approximately 70 percent of Colorado’s heroin users say their drug use began with a prescription, according to the Colorado Office of Behavioral Health.

The partnership is collecting data so that it can accurately measure the effects of its efforts, O’Dorisio said. He hopes it continues to make relationships with organizations relevant to the crisis and further promote accountability for opioid use and the prescribing of opioids.

Holen is hoping for the same.

“Thousands and thousands of people’s lives have been altered — families are grieving every place in America,” Holen said. “The only way it’s going to get resolved is through a collaborative effort.”

‘It just gets different’

The maps Lindemann showed his commissioners three years ago are now filled with outdated data and links that don’t work — except for Celebrating Lost Loved Ones, which gained widespread attention when the National Safety Council began running it on its website in 2018.

Katherine van den Bogert, a program manager for survivor advocates, volunteers at the nonprofit National Safety Council, which works to reduce preventable deaths. She learned of the map through a former colleague and believed it would fit well with the organization’s campaigns about opioid education.

“We just thought it was a really nice way to raise awareness of the broad impact of the opioid epidemic,” she said. “It was just such a personal story, that (Lindemann) took as a personal mission.”

The map is now promoted in the organization’s Stop Everyday Killers campaign, which travels the country exhibiting a memorial comprising 22,000 white opioid pills engraved with the faces of someone who died in the epidemic during 2015. Anyone who views the memorial is also informed about Celebrating Lost Loved Ones.

And anyone can add a loved one, his or her photo and a brief biography to the map.

In Highlands Ranch, there’s Lindsey Jo, who grew addicted to pain medication after being prescribed pills for back problems, her profile says. She died in 2016 after several attempts at treatment and an eight-month stint of sobriety.

“I cannot describe the pain that my entire family is going through,” one of Lindsey’s parents wrote. “We will never be the same and I am so angry that she did not get the help she needed.”

Devon Miller, an avid snowboard and wakeboard rider whose experiences with prescription opioids began with a torn meniscus in his knee, lived in Morrison. He attempted rehab three times, his profile states.

He died in 2016 at age 30.

Colorado opioid, Douglas County, Arapahoe County, Adams County, opioid crisis, Jessica Gibbs

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