The fight against fentanyl
As the deadly drug drives record overdoses, legislators, law enforcement and behavioral health experts push back.
This story appears in the RED magazine’s fall 2022 issue.
Eric Perez was a success story. He grew up in south Denver in an environment plagued by poverty, gang violence and incarceration, but he pursued higher education at Metropolitan State University of Denver to better his life and help others do the same.
Perez spent six years as a youth mentor in MSU Denver’s Journey Through Our Heritage program, which pairs its students with local high-schoolers from at-risk populations. Perez showed students with backgrounds similar to his that they could be successful too. At the University, he won student leadership awards and became president of Journey Through Our Heritage. In the community, he led a Bible study group and was active with Conservation Colorado, traveling to Washington, D.C., to testify on conservation legislation.
“He liked to teach others, to show them how you can make progress,” said Perez’s grandmother, Patricia Perez. “He was determined to get into college.”
In May 2021, Perez became the first person in his family to graduate from college, reaching that milestone achievement with a degree in Criminal Justice and Criminology and a bright future ahead of him. But less than a year later, he was gone. He died of a fentanyl overdose in April.
“This fentanyl epidemic is devastating the best and brightest people we have,” said Renee Fajardo, J.D., coordinator of the Journey Through Our Heritage program, who remembers the positive impact her standout student had on the program and classmates. “He was just so dedicated and motivated,” she said. “Even after graduating, he kept coming back to help us.”
But Perez became one of many lost to overdose. In Colorado, deaths involving fentanyl increased 1,200% over a five-year period, with more Coloradans dying of a fentanyl overdose in 2020 than the previous five years combined. The rise in deaths spurred the state legislature this year to pass a contentious law increasing the penalties for fentanyl possession and distribution. Meanwhile, behavioral health experts and educators, such as those at MSU Denver, have advocated for alternative solutions and are engaged in preparing the next generation of mental health professionals for work in an increasingly critical field.
Searching for solutions
Drug overdoses claimed the lives of 108,000 people in the United States in 2021, according to estimates from the Centers for Disease Control and Prevention (CDC). That’s one death every 4.9 minutes on average.
Overdose deaths in the U.S. have been trending up since the 1990s, starting with increased prescribing of opioids and soaring in recent years due to the proliferation of synthetic opioids such as fentanyl. The CDC says fentanyl is 50 times stronger than heroin, and widespread illicit manufacturing of the drug has made it affordable and accessible to virtually anyone, including many who unknowingly use fentanyl mixed into other substances by sellers looking to enhance the potency of different drugs.
In an attempt to address the drug crisis in Colorado, state legislators passed House Bill 22-1326, which made it a felony to possess more than 1 gram of a substance that contains any amount of fentanyl, reduced from 4 grams under previous law. Individuals who can prove in a trial that they did not knowingly possess fentanyl can have their charge reduced to a misdemeanor. The bill also established mandatory drug treatment for people convicted of fentanyl-related crimes and made investments in overdose-reversing medicine such as naloxone.
“This comprehensive plan cracks down on dealers peddling this poison in our communities and invests in proven public health strategies to prevent overdoses and death,” House Speaker Alec Garnett said in a statement after the bill was signed. “For months, we worked with law enforcement, public health experts, Democrats and Republicans to craft this law, and it’s a major step forward toward saving lives.”
The bill dominated legislator and media attention during the General Assembly’s 2022 session, as everyone agreed something had to be done about the fentanyl crisis but couldn’t agree on much beyond that. In total, 75 amendments to the bill were formally proposed, and one of the primary sponsors withdrew his support of the bill on the last day of the session. Proponents wrestled with pressure from all sides, as the governor, attorney general and law enforcement officials advocated for felonizing any amount of fentanyl possession while behavioral health experts pushed back against stiffer penalties.
For Sen. Brittany Pettersen, an MSU Denver alumna and one of the bill sponsors, the legislation was personal. Pettersen has spoken publicly many times about her mother’s decadeslong addiction struggles, which began with an overreliance on prescription painkillers after an injury. During a Senate floor discussion, Pettersen said Colorado has the second-worst access to opioid addiction treatment in the country, with more than 450 people in the state on waitlists for inpatient care.
“We are in the third wave of the opioid epidemic and in the worst overdose crisis in the history of this country,” Pettersen said in a statement. “Fentanyl is the drug of choice for the cartels because it’s potent, cheap and easy to traffic. We need to go after the dealers who are poisoning our communities and provide training and resources to better equip law enforcement to investigate fentanyl poisonings while increasing access to desperately needed treatment and lifesaving harm-reduction tools.”
Limitations of the law
Once a prosecutor in the Denver District Attorney’s Office, Lori Darnel, J.D., is the top legal expert in the Department of Social Work at MSU Denver. The assistant professor teaches master’s courses on legal issues, policy and leadership, and she organizes trips to the state Capitol so students are attuned to the macro-level discussions influencing their professional field.
“It’s always hard to legislate in a way that effectively impacts what you are trying to accomplish,” she said. “You could end up with a law being so broad that you’re sweeping up people that you don’t intend to or so narrow that you’re not making the impact that you want to make.”
Darnel is skeptical that increased penalties for drug possession will solve the fentanyl epidemic. Instead, she advocates for public health intervention for those in crisis and using drugs, such as the highly successful Support Team Assisted Response Program in Denver. The program dispatches mental health clinicians and paramedics or EMTs to certain 911 calls in lieu of law enforcement.
“When we were first concerned about all the deaths from opioids, we really looked at it as a public health situation instead of criminal justice because the communities that were so highly impacted were a lot of white communities and not the communities of color that we stereotypically think of as impacted by drugs,” she said.
According to the CDC, prescription drug abuse started the first wave of opioid overdose deaths in 1999. A second wave began with a rise in heroin overdoses in 2010. At the end of the second wave, before fentanyl was as pervasive, white men had the highest age-adjusted overdose death rate of any race and gender combination. The death rate was 26.2 per 100,000 people, a figure that includes overdoses from any type of drug.
It wasn’t until 2016 that overdose deaths from synthetic opioids such as fentanyl surpassed other opioid overdose deaths. In this third wave, overdose death rates for every demographic group have grown drastically, but Black men now have the highest age-adjusted death rate from all overdoses at 54.1 per 100,000 people.
Darnel lauds the harm-reduction components of HB 22-1326 but warns that the felony penalties for possession could make it much harder for people to stay clean long-term when their criminal history becomes a barrier to getting a job, finding housing or accessing public benefits.
“The criminal justice system is overrepresentative of many marginalized communities,” she said. “So how do we stop using the system as the last resort for people who really need other kinds of help?”
Shawn Brndiar is one of the lucky ones — someone who went down the path of addiction as a young adult and managed to find his way out. Brndiar began experimenting with drugs in his 20s as he coped with childhood trauma, struggled with his sexuality and felt pressure to find a lucrative profession. He became addicted to methamphetamine and used it progressively more for seven years, until a life-threatening event prompted him to take a different direction.
Brndiar was shot by a Lakewood police officer in 2008 in an altercation that landed him in jail for five months. After he was released, he completed a drug treatment program and has been sober ever since.
At age 32, Brndiar was newly clean and unsure of what to do with his life. He had attempted prelaw, premed and business programs at three colleges by then, so he enrolled in a variety of summer courses at MSU Denver, where a Human Services professor helped him “fall in love with the idea of being a helper,” he said.
Within five years, Brndiar earned a bachelor’s degree in Human Services and a Master of Social Work from the University. Today, he is a licensed clinical social worker and licensed addictions counselor with his own counseling practice, Salient Counseling, in Centennial. He’s also back at MSU Denver teaching courses as an affiliate faculty member.
Informed by his experience and daily work with substance abusers, Brndiar doesn’t believe that law enforcement intervention is the ideal answer for helping addicts.
“I get that this is a highly emotional issue, and absolutely, something needs to be done,” he said. “But we’re going backward when we’re talking about increasing penalties because we always know Black and brown people are going to be affected at a level that far surpasses those who have any means of privilege.
“We need people to have access to quality treatment, and not just for 30 days but for a continuum of care over a year. For every dollar we spend doing that, we save so much more in incarceration.”
Help on the way
At MSU Denver, faculty members are preparing students to understand issues such as the drug epidemic from many angles. Brndiar said he got a great clinical education from his Human Services degree and a systems-level education from his Master of Social Work, which he calls “the MBA for mental health care” because of its versatility. He has also heard great things about the University’s recently launched Addictions Counseling graduate program.
All of the MSW courses Darnel oversees are taught by lawyers, giving students experience interacting with professionals in the field of law. Students learn the nuances of the language used by attorneys, a valuable tool as more professional social workers are called on to work with the legal system.
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Assistant Professor Tanya Greathouse, Ph.D., said the Department of Social Work provides micro, mezzo and macro initiatives to engage students on the fentanyl crisis and other societal issues. On the micro level, students participate in field courses infused with addictions curriculum and get hands-on experience through internships at Denver Health and other community partners.
The mezzo perspective includes psychoeducation for community members, such as a March panel featuring state Rep. Leslie Herod and faculty members and alumni working in behavioral health. For the macro viewpoint, students learn more about policy and legal issues. Greathouse said it’s critical that people see the big picture of fentanyl use and know it’s not limited to a single demographic.
“The most important thing is for people to really understand there is no face to fentanyl,” Greathouse said. “One of the most dangerous myths that individuals can believe is, ‘This couldn’t be my kid,’ or, ‘This couldn’t be my mother or father.’ It’s everywhere.”
Perez’s story is evidence of that.
MSU Denver’s Fajardo, the Journey Through Our Heritage coordinator, called her former student’s death a wakeup call for those who judge people struggling with substance use.
Fajardo said Perez was a prime example of what a person can do when someone believes in them. She recalled how he often worked nights and weekends for her program and even continued volunteering during a semester when he withdrew from classes to better support his family. He took on one of Journey Through Our Heritage’s most challenging assignments, mentoring students at an alternative school for teenagers who were court-ordered to attend. Students naturally gravitated toward him because he could relate to them.
“You can’t assume that because someone is using fentanyl that they don’t count,” Fajardo said. “You have people dying, like Eric, who had a burning desire to give back.
“If he had lived long enough, he would have made a huge difference in so many people’s lives.”