Aspen's rural resort economy presents challenges in responding to opioid crisis
Lorenzo Semple—or Lo, to his friends—is a well-known character in Aspen. You may know him from his column in the Aspen Daily News or his ski gear rental business, Suit Yourself. This time of year, you can find him outside, mowing lawns and doing landscaping.
Like many other locals, Semple lives in Aspen for the outdoor recreation — skiing, namely.
He can recount very clearly a morning about 20 years ago, when he went out for a few turns with a friend on Aspen Mountain.
“The first run I decided to show off by doing a helicopter on the run ‘1 & 2 Leaf,’” he recalled.
Semple said he was in the middle of his jump when he rotated into the hillside.
“And when I landed, I heard a click and a pop sound, and that was the sound of my knee blowing out.”
It was two days before Christmas. Not long after, he found out he would need surgery for his injury.
“So my knee surgery went not very well. It got infected.”
Semple was prescribed hydrocodone, an opioid, in order to manage the pain from his injury and subsequent surgery. Also known by its brand name, Vicodin, it can be a pretty addictive medication. And Semple, who had struggled with other addictions in the past, found himself back in the habit, frequenting his local pharmacy.
“I remember one day I came in with my 10th, 12th prescrip for refill,” he recounted. “And [the pharmacist] looked at me and he said, ‘What are you still doing on this stuff?’ And, you know, that's a pretty sobering question, when the guy giving out the drugs at the drug place says, ‘Wow, you're taking a lot of these things.’”
Another longtime local of the Roaring Fork Valley and someone who’s dealt with addiction in her own life is Maggie Seldeen.
She’s the founder of the Carbondale-based group High Rockies Harm Reduction.
The nonprofit’s goal is to prevent overdoses and infectious diseases and direct people to health services, including treatment for substance use disorders and mental health.
Seldeen said Semple’s story is one she’s heard plenty of times before.
“People come here to recreate, to ski, to raft, to climb, to hurt themselves, to fall off their bicycles, and then go to the hospital with a broken leg,” she said. “So we have higher than average opioid prescribing rates, higher than average prescribing rates to people who are opioid-naive or who have never taken an opioid before.”
In Pitkin County, nearly 42% of long-duration opioid prescriptions in 2018 were given to people who had not taken an opioid in the past 30 days, but were prescribed them after an acute event, like surgery. In neighboring Eagle County, that number was nearly 53%. Those numbers are much higher than the statewide average of just 12%.
Many locals take part in risky outdoor activities that can often get patients an opioid prescription. Like Lo Semple, they live here to ski, to bike, to hike, to raft, and they get injured too, even if they might be more experienced than the average visitor.
“You start with a painkiller from your doctor, and then you build tolerance to that,” Seldeen said. “You become dependent. You can't get that painkiller from your doctor anymore. Now you're using heroin on the streets. Now you can't get heroin anymore, it's only fentanyl.”
And substance use disorder isn’t just a problem for the recently injured.
The people who make Aspen’s resort economy run sometimes rely on substances to be able to keep up with the demanding pace of their jobs.
Seldeen said this is especially common in the restaurant industry, where she worked for years.
“Drugs and alcohol are a big part of that,” she said. “Doing cocaine to stay up on a 12-hour shift on your feet waitressing and getting spit on and grabbed and talked down to and all these things, right? It's a really hard line of work.”
It’s that complex mix, combined with Aspen’s hard-partying culture, that pushes Seldeen to do her work with harm reduction, and she wants to reach that community of resort workers.
She provides people with clean needles, Narcan, referrals to recovery services, or anything else they may need.
This April, she even hosted a pre-aprés party to connect people with resources for addiction.
It was a lot of what you would expect from a party at the Sterling in downtown Aspen: colorful lights flashing in a dimly lit basement, a DJ blasting music with a thrumming bassline, elaborate cocktails on offer at the bar, but there were certain aspects that set it apart from your average Aspen bash.
For instance, most of those don’t usually include a demonstration for how to use Narcan, a drug used to reverse the symptoms of an opioid overdose.
“And all you’ve got to do is take this nasal spray, tilt someone's head back to open the airways, insert, and plunge,” Seldeen explained on a small stage at the Sterling. “It's one and done, easy nasal spray can save a life when administered in time.”
The goal of the party was to get Narcan and fentanyl test strips into the hands of as many people as possible, especially people with plans to celebrate closing day on one of the four Aspen Snowmass mountains.
And as attendees can attest, there’s plenty of reasons to want to party with some safety measures.
Seldeen’s group is getting an influx of cash to provide harm reduction services to the five-county region of Pitkin, Eagle, Garfield, Summit, and Lake counties.
High Rockies Harm Reduction will get $121,000 every year for three years from the state’s Harm Reduction Grant Program, and another $100,000 a year for the next 2 to 18 years in opioid settlement money.
Seldeen’s goal isn’t to get every single person who comes to her for clean needles or Narcan into rehab. She says that addiction is a disease of isolation, and connection is the opposite of addiction.
“When somebody comes in to receive syringes or pipes from me, right, I give them whatever they need,” she said. “‘Awesome. Do you need Narcan too? Do you need whatever, I have—chapstick, condoms? Okay, great. How are you?’”
When Seldeen meets a client for the first time, she tries to get to know them, and their situation in the valley. She asks them about what they do for work, whether they have family or friends here, and what their housing situation is.
“And for me, it's not about, ‘What does the drug or substance use look like?’” she said. “It's, ‘What is your whole life look like that's causing you to have problematic substance use that you're not happy about, that's become out of your control,’ right?”
Mental health and isolation are big problems in the valley.
In a 2021 Pitkin County mental health survey, people attributed short-lived relationships to a transient population, whether due to seasonal work or the sky-high cost of living.
They also said they didn’t feel like they belonged in the community. And addiction can worsen feelings of isolation, even for longtime locals like Lo Semple.
“I remember I was out to dinner one time in town with my wife and some friends, you know, scratching my arms,” he said. “And someone was looking at me and they said, ‘Hey, why are you scratching your arm?’ And I lied to him. I said, ‘Oh, yeah, I got a spider bite,’ knowing damn well that I was basically like a low-level junkie at the hands of the pharmaceutical industry.”
These days, Semple is doing pretty well.
During the spring and summer months, he spends a lot of time mountain biking and in his garden — which he said is his zen space. But this spring, his knee injury started acting up again.
“What I wouldn't do to get my hands on some painkillers right now, just to be able to come home and lay on the couch, after working outside, doing landscaping, pushing a lawn mower around,” he said. “But I know where that ends.”
Now, Semple turns to ice, aspirin and the outdoors instead of hydrocodone.
For Semple, the recreation aspect plays a role in recovery just as much as it did in kick-starting an addiction.
“The topography, the mountains, the rivers, the community is very conducive to recovery and sobriety on one level,” he said. “I think a big part of recovery is aerobic exercise, replacing opioids with endorphins.”