Steamboat Springs No segment of the community escapes the effects of drug and alcohol abuse.
That's why representatives from medical, mental health, social service and law enforcement agencies in Routt County are jointly pursuing a plan to treat people who struggle with abuse and dependence problems.
"It's a community problem," said J.D. Hays, public safety services director in Steamboat Springs. "Everybody is involved."
As Routt County has grown, so has the number of people who would benefit from a detoxification center.
Investing dollars in drug and alcohol treatment problems could save the county money that is otherwise spent on publicly funded programs that fight the effects of drugs and alcohol on society.
But detoxification centers in Northwest Colorado share a small amount of state funding. If Routt County pursued a detoxification center, it would need to dip into funds already earmarked for centers in Glenwood Springs, Grand Junction and Gunnison.
So Hays and other agency representatives are looking at alternatives to a center.
One neighboring community's solution caught their attention.
Moffat County's STEP program has saved taxpayers money and helped treat substance abuse.
The program, implemented in 1999 at the county's public safety center, eliminates unnecessary trips to the emergency room.
"What we have in place is a partnership with the hospital and law enforcement," Moffat County Sheriff Buddy Grinstead said.
Officers take anyone arrested and under the influence of drugs or alcohol to a STEP nurse at the public safety center. While the nurse examines the patient to determine if medical care is warranted, the officer books the patient into the jail.
If the STEP nurse is concerned about the patient's condition, the patient will go to The Memorial Hospital in Craig.
Beka Warren, a nurse and STEP team leader, said prior to the program many people who did not need medical care were sent to the emergency room. The arresting officer waited in the ER while the patient was examined.
"This tied up the officer who needed to be on the street," Warren said.
The STEP program saved Moffat County $29,000 in its first year.
"It's still a problem," Grinstead said. "But this is the most economical and best solution for everybody."
The Yampa Valley Medical Center incurred $158,000 last year in charges for emergency care for intoxicated patients.
The hospital was paid half that amount, said Karl Gills, chief executive officer of the Yampa Valley Medical Center.
Some of those patients were sick enough and admitted, but many others only tied up medical staff, he said.
"The struggle that we're having is how do we deal with those people when they don't have a medical problem : and who haven't broken any laws yet?" Gills said.
No easy solution exists, he said.
"At its root, it's a social problem which has implications for the medical community and law enforcement," Gills said.
And it's a dilemma for all communities, said Bob White, director of human services in Routt County.
Solutions to substance abuse become complex because the problem reaches into so many facets of a community, he said.
"It's one of the health and human service problems that cross over all traditional arenas of care," White said.
Communities cannot just hand over responsibility for alcohol and drug abuse to one agency because it's not just a medical or a law enforcement problem, he said.
People can die if substance abuse triggers a medical emergency, he said.
But when people abuse substances they sometimes break the law.
"A lot of those people have no medical necessity to be at the hospital," White said. "Jail doesn't make sense. The hospital doesn't make sense."
Moffat County's STEP program makes sense because it entails a screening process that determines the safest place for people, he said.
A critical component of the STEP program, Warren and White agree, is the counseling that follows once a patient is sober.
"If you don't have after care, it can be nothing more than a revolving drunk tank," White said.
Intervention is necessary to get people out of the cycle of dependence and abuse, Warren said.
"It's not perfect, but it's a program that can be duplicated and tweaked to meet a community's needs," she said.
White said Routt County's solution might involve arresting law enforcement agencies committing to share the program's operational costs based on their level of utilization.
"It's kind of a pay as you go," he said.
A location for drug and alcohol treatment is still being sought.
Moffat County built its public safety center with a detoxification area in mind.
The Routt County Jail has been suggested, but Sheriff John Warner is concerned about space constraints.
A recent remodel added two more holding cells, but those cells fill up quickly on the weekends.
Warner recognizes the county's present dilemma of where to place people under the influence of drugs or alcohol once they've been arrested.
"The first and primary concern is their health," he said.
The people involved in finding an alternative to a detoxification center stress any proposed plans are conceptual and subject to change.
But they are all optimistic about their ability to collectively find a viable solution.
"If we continue to work together, eventually we'll have something," Hays said.