Durango sits perched at the convergence of two biomes, one a desert parched for resources, the other a craggy set of verdant mountains offering abundance on their slopes.
Although the region is ripe with opportunity, the small, rural nature of its communities can also mean that resources are often sparse. But the austere landscape of services does not exempt the Southwest’s residents from the addiction crisis facing the nation.
Perhaps no one knows this better than the region’s community of people recovering from substance use disorders.
“There’s not a lot of sobriety in Durango,” says Kelly DiGiacomo, a longtime Durango resident who sought inpatient treatment for a sleeping pill addiction.
Six years ago, the mother of three was facing a failing marriage and mental health problems. And so she would intermittently turn to sleeping pills, eventually supplementing them with bottles of wine.
As her addiction spiraled, DiGiacomo made attempts to avail herself of the resources Durango had to offer.
But she could only get so far.
“I needed to have an opportunity to be out of my house and away from my family and friends to maintain sobriety,” she said.
Sunday: Why is it hard to leave the area to seek inpatient substance use treatment? Patients who did so say that leaving was an immense hardship, complicating their recovery journey.
Wednesday: What challenges do people face upon returning to Southwest Colorado after inpatient substance use treatment? Often, they struggle to find support. They say having an inpatient treatment facility could foster the growth of a larger sober community.
Friday: What does this region have and what does it need? Action is underway to determine if an inpatient facility is viable.
The region has no recovery homes, no medical detox and no inpatient substance use treatment facilities. While treatment resources do exist, those demanding inpatient care must usually travel to the Front Range.
DiGiacomo arrived home after a stint in jail and, at the insistence of her friends, began to pack. On March 11, 2018, she said goodbye to her children and boarded a plane to Denver.
Three months and $30,000 later, she returned to Durango and began to rebuild the foundation of her life. She went back to school to get her masters, she launched a new career and she surrounded herself with a new group of friends.
Today, she is a licensed professional counselor.
Some people, like DiGiacomo, need a total life disruption to treat their substance use. Many treatment facilities intentionally isolate patients from the communities that can facilitate an unhealthy relationship with substances.
But the 340 miles between Durango and Denver exacerbates the anxiety and hardship of entering inpatient treatment. The location is often unfamiliar, the lifestyle can be novel and the relationships built there can be ephemeral.
And coming back to an isolated town that hasn’t changed can be an abrupt and jarring juxtaposition to a life of newfound sobriety.
The conversation around substance use in the Southwest has expanded in recent years, and the services offered have grown as well.
In response to the opioid epidemic, the Region 9 Economic Development District formed the SouthWest Opioid Response District, which will administer the region’s allocation of funds from settlements with opioid manufacturers. DiGiacomo sits on the SWORD advisory board.
A 2021 needs assessment found that 9 million prescription opioids were distributed in La Plata County between 2006 and 2012 – enough for each resident to take 30 pain pills per year. The SWORD district, which includes the five southwestern counties in the state – San Juan, Dolores, Archuleta, Montezuma and La Plata – will receive a projected $4,237,407 over the next 18 years.
Although it remains unclear for the time being whether an inpatient treatment facility is feasible for the region, other resources are growing. San Juan Basin Public Health is ramping up a harm reduction program that will provide free doses of the opioid overdose reversal drug naloxone, as well as fentanyl test strips and a clean needle exchange.
Axis Health System offers varying levels of substance use treatment as well, including an intensive outpatient program which involves daily group and individual therapeutic interventions.
Despite the growing abundance of outpatient and community resources for those trying to combat a substance use disorder, some people require a more intensive approach. But the barrier to access can prove itself to be too high.
DiGiacomo’s reflection was unequivocal.
“If there would have been something comparable that was in my community, I do believe I would have ended up there sooner,” she said.