STEAMBOAT SPRINGS, Colo. - Los centros comunitarios de salud de Colorado (Colorado Community Health Centers) están regresando el tiempo y rescatando terapias no farmacéuticas para ayudar a contrarrestar lo que ya se conoce como epidemia de opioides.

Ken Davis, médico asistente en la organización “Northwest Colorado Health,” en Steamboat Springs, dice que hace 15 años los proveedores de salud aplicaban un abordaje interdisciplinario para el manejo del dolor, que incluía terapia física, pero que eso cambió cuando las compañías de seguros – debido a los costos ascendentes – decidieron pagar sólo medicamentos.

Señala que los centros de salud tienen una posición única para ofrecer alternativas a los pacientes.

“Prefieren no usar opioides. Si se pudiera controlar su dolor usando otro método, realmente creo que la mayoría de la gente elegiría esa opción.”

En 2015, 33,000 vidas se perdieron en los Estados Unidos a causa de los opioides, los cuales provocan la muerte a unas 91 personas cada día.

Davis comenta que al principio las empresas farmacéuticas dijeron que los proveedores de opioides representaban un riesgo menor para los pacientes, pero agrega que la nuevas investigaciones muestran que el uso de opioides para tratar el dolor crónico tiene más riesgos que beneficios.

Davis comenta que además de la terapia física, los centros comunitarios de salud de todo el estado ofrecerán servicios como acupuntura, orientación y terapia de masaje. Dice que desde como los centros tienen tarifas accesibles, quienes normalmente no podrían pagarlo de su bolsillo tendrán acceso a otras opciones.

“Uno de los factores más determinantes de nuestros resultados en salud, es el ingreso. Los centros atienden sobre todo a la población marginal de bajos ingresos. Así que tienden a sufrir un poco más de enfermedades, males crónicos y dolor crónico.”

Davis agrega que el estigma sigue siendo una barrera importante para que la gente busque tratamientos para la dependencia de las drogas.

“Por mucho tiempo la adicción al uso de drogas ha sido culpada y despreciada. Es una condición crónica, de recaídas, que necesitamos tratar de cuantas maneras inocuas y efectivas sea posible.”

Colorado creó un consorcio para ayudar a capacitar a los proveedores y al público en cuanto a los peligros de los opioides, y cómo desechar sin riesgo las pastillas no usadas que pudieran caer en las manos equivocadas.

En el Congreso, una ley de egresos pide 150 millones de dólares para combatir la crisis y mejorar el acceso a tratamientos de salud mental.



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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.