Open your medicine cabinet. Now count how many leftover prescription pain pills you have “hidden” behind the Q-tips, Tums, and deodorant. If you find hydrocodone (Vicodin®); oxycodone (OxyContin®, Percocet®); oxymorphone (Opana®); codeine or fentanyl, you are not alone. Six in ten U.S. households have a backstock of these dangerous, highly addictive pain relievers, the detritus of two decades of physicians’ and dentists’ over-enthusiastic prescriptions, according to Dr. Robert Valuck of the Skaggs School of Pharmacy and Pharmaceutical Sciences at CU Anschutz. Valuck, a Park Hill resident, spoke to parents and community members at McAuliffe International School on October 29 about the dangers of opioids.
Seven Opioid Myths
Valuck discussed the seven myths most people have about prescription pain relievers (see sidebar). As Director of the Colorado Consortium on Prescription Drug Abuse Prevention, his language was deliberate. Opioids are not “painkillers,” for no drugs can eliminate pain (Myth 1). More importantly, these medications are not even terribly effective; 40% of the pain relief people taking opioids report, is a result of the placebo effect. Valuck recommends that those seeking pain relief instead alternate ibuprofen (Advil® or Motrin®) and acetaminophen (Tylenol®) every 3 hours. Whereas opioids reduce the pain people experience by only 33%, rotating these common over-the-counter and non-addictive medications reduces pain by 55%.
Colorado’s Growing Opioid Problem
In Colorado, deaths from opioids are increasingly the result of combining opioids with other medications (e.g., benzodiazepines like Ativan, Halcion, or Klonipin). Over half of the 1,012 drug-associated deaths in Colorado in 2017 were opioid-related.
Parents Share Their Children’s Stories to Create Awareness
One of those deaths was that of Jonathan Winnefeld. Just three days after starting at the University of Denver, Jonathan died from a batch of fentanyl-laced heroin. Jonathan’s father, a retired Navy Admiral and former vice chairman of the Joint Chiefs of Staff (2011-2015), wrote about his son’s path to addiction in The Atlantic: “He began by sneaking a bit of alcohol at night in order to bring himself down from the Adderall a doctor had prescribed him, based on a misdiagnosis of attention deficit disorder. By the eighth grade, he was consuming alcohol in larger quantities and beginning to self-medicate with marijuana. Next came Xanax and, eventually, heroin.” The full story in The Atlantic merits a read, as Jonathan’s life was more than just his addiction; he was, in so many ways, like any number of kids growing up in our community.
Suzi Stolte’s adult daughter Heidi died on May 7, 2011 after combining medications. A vibrant woman who loved animals and cared deeply for people, Heidi became a caseworker so she could help others. Stolte recalls the night of her daughter’s death, before the phone call that upended her life. She was anticipating the next day, which was Mother’s Day. When Heidi’s boyfriend called at 10pm, he had already dialed 911. But in the seven minutes it took Stolte to drive to her daughter’s home, Heidi died. Her prescription medications (Vicodin for pain relief, Valium for anxiety, and Metaxalone, a muscle relaxant) combined with over-the-counter Benadryl, had killed her.
Heidi had been in a car accident about five years earlier that caused ongoing pain, which doctors consistently treated with opioids; she had just received new prescriptions a few days before her death. Stolte recalls expressing concern with her daughter’s continued need for medication, but Heidi dismissed her mother’s words, saying “Mom, you don’t understand.” Stolte acknowledges now that she did not in fact understand. “I didn’t understand the dangers of combining these drugs with alcohol, Adderall, benzodiazepine, and over the counter medications. I didn’t understand why she needed to take more pain relievers than the prescriptions called for.” Stolte shares Heidi’s story in hopes that other families will not experience this devastating loss.
Opioid Education and Treatment Programs
Stolte is the Communications and Marketing Director for the JP Opioid Interaction Awareness Alliance, which works to educate people about the dangers of combining medications. For more information see: http://www.jpopioidalliance.org/
Michael Miller, Communications and Chapters Director for Young People in Recovery, shared his own story of addiction and recovery, and emphasized the need for more evidenced-based recovery programs in Colorado and nationally, especially in rural areas. Young People in Recovery is a national organization that works to “provide the training and networks all individuals, families, and communities need to recover and maximize their full potential.”
Reducing Opioids in Our Homes
The stories and experiences of Jonathan Winnefeld, Heidi Stolte, and Michael Miller underscore the power each of us has to reduce the availability of opioids. Go through those medicine cabinets and collect these dangerous drugs so they don’t fall into the wrong hands. Children’s Hospital, Denver Health in Lowry and Montbello, and numerous Walgreens have permanent collection boxes for disposing of unused medications. For more sites and more information on safe disposal, go to: http://takemedsseriously.org/
Seven Opioid Myths
1) I can get to a pain level of zero if I take enough pills.
A zero-pain level is neither attainable nor desirable. The best pharmacology reduces pain by about 50%; opioids are not that powerful, and only reduce pain by 1/3. After taking a recommended dose, a patient’s pain plateaus; taking more pills doesn’t reduce their pain further but increases side effects.
2) The U.S. is #1 in treating pain.
No. We are, however, #1 in dispensing opioids; the U.S. consumes 80% of the world’s opioids.
3) They must be the best at treating pain since they’re Schedule II drugs.
The DEA’s Schedule II criteria do not refer to a drug’s efficacy; they only speak to its dangers. Per the DEA’s website, these are “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous.”
4) But I had surgery. I need serious drugs.
Opioids are not required after surgery; opioid-sparing protocols exist for most major surgeries. Communicate with your doctor or dentist to request such a protocol.
5) You have to be pretty messed up to get hooked.
People of all ages, races, and walks of life succumb to addiction. Studies document a correlation between the number of pills dispensed and the likelihood of becoming dependent on opioids.
6) It’s ok to combine prescriptions. They’re from my doctors.
Combining drugs can be deadly. 51% of Colorado’s opioid deaths in 2017 were the result of combining common benzodiazepine drugs (Ativan, Halcion, Klonipin) with an opioid. Do not combine opioids with sedatives like Ambien either!
7) I might want to use those outdated medications stashed in my cabinet. What’s the harm?
Fully 87% of people who become hooked on opioids begin with using leftover medications—often from a family member, a neighbor, a friend who may not even notice the missing drugs.
The free and open to the public informational event was sponsored by the Cherry Creek Rotary Club. For more information on future speakers and events in the Innovation Zone speaker series, check updates and/or contact: www.ndiz.org.
Each of the 34,000 Rotary clubs in the world share certain characteristics while having rituals that make them unique. Most club meetings feature a meal, a speaker and a period of social interaction within the hour and a half weekly meeting. Many clubs have happy dollars which give members an opportunity to update their fellow club members on family milestones or personal successes. My previous club in Illinois, in addition to happy dollars, had a Rotary moment, in which a member was assigned to speak for a few minutes about Rotary projects around the world or in their local community. In my case, my Rotary moment has lasted a lifetime.
It began in 1986 with Jeff Maen asking me in the hall of our office complex if I wanted to help him start a new Rotary club. “What is Rotary," I asked, to which he said, "I guess we will find out together.“ That moment led to ten years with Cherry Creek Rotary, mostly as a Board member and finally as Club President and Assistant Governor, then to the life changing event of selling everything and moving to Chicago to work at Rotary world headquarters.
During the next twenty years, I shared with my club first-hand Rotary moments of our organizations activities that I witnessed as I traveled the world doing the good work of Rotary. When that incredible opportunity was over, nothing seemed more natural than to come home to Colorado and the club that made it all possible. And that is my Rotary Moment!
by Doris Sanders
Some of us are younger, and a stumble or fall on an irregular, bumpy sidewalk might cause a few scrapes and bruises – and a wounded ego – but chances are they’ll heal quickly. Some of us are mid-life, and the same fall can have more serious consequences, maybe even hospitalization and long term health issues. And let’s face it, all of us are going to be older someday; many of us already are. Tripping and falling for us can alter our lives forever; sometimes even be fatal.
Denver Cherry Creek Rotary Club members have seen these scenarios play out among their diverse membership. Thus, we are natural partners with WalkDenver, which had the foresight in 2011 to improve the walkability of Denver. By becoming a Gold Footprint Supporter, we “put our money where our mouth is” in support of WalkDenver’s vision.
WalkDenver’s vision: “In 2040, Denver will be the most walkable city in the United States. As a result, its residents will be the country’s healthiest and happiest, and its economy will be thriving.”
This vision statement hits all of the goals of Rotary International, the “parent organization” for the 35,000+ local clubs in 200 countries across the globe. Overall, RI’s priorities for projects are to 1) support sustainable projects, like WalkDenver’s commitment to make Denver the most walkable city in the US by 2040, 2) grow local economies, an important aspect of WalkDenver’s vision, and 3) conduct service projects, as WalkDenver is certainly doing!
It is implicit in WalkDenver’s vision that improving walkability will improve the health of all ages, as walking is the one thing that almost anyone can do from about one year of age until death. Not only can it help prevent obesity, the scourge circling the globe, but it involves no special equipment and costs nothing. That makes it infinitely “doable.”
Rotary International and its local clubs are immersed in a goal that shares a portion of WalkDenver’s vision statement: to promote health, happiness and thriving economies. In 1985, we started the “Polio Plus” Program to eradicate polio across the world. We were joined in 1988 by such notable organizations as the World Health Organization, the U.S. Centers for Disease Control and Prevention, UNICEF and the Bill & Melinda Gates Foundation.
In 1988, there were 350,000 annual cases of wild polio virus from 125 countries. In 2017, there were 22 wild poliovirus cases reported in only two countries – Pakistan and Afghanistan. Local Rotary clubs worldwide contributed funding and participated on immunization teams that blanketed countries with polio cases. While most countries welcomed these teams, they sometimes faced intimidation from citizens who did not understand their purpose, and in a few tragic cases were killed. This has not deterred Rotary from its goal of eradicating polio worldwide.
This is an example of the kind of long-term, global projects Rotary supports. Local clubs also have their own projects, depending on the interests of the membership. Right now, DCCR has several projects that support children. For over 20 years, our Dental Mission has traveled to a Latin American country for two weeks to provide dental services to children, most who have never seen a dentist.
We have also provided over 100 eReaders to disadvantaged schools, in some cases resulting in an increase of five levels in children’s reading abilities. We furnish books for school libraries, tutor in a variety of subjects, raise funds through a Book Fair in partnership with Barnes and Noble, and partner with Operation Warm to provide new warm coats to children who may otherwise have no coat at all.
An important project completed every year are Leadership Programs for both Junior High and High School students. This program, known as the Rotary Youth Leadership Awards, has propelled some students to leadership positions in their schools or to college when they probably would never have considered it before participating.
The most important thing we do, whether at the local or the international level, is support each other personally and professionally. For example, one member of our club, an older member, participates erratically due to brain injuries. We support her in every way possible, and include her in projects when she is capable. Another member was quite distraught over the death of a close friend. The club rallied around him to give moral support. Another member’s son needed a new heart. We worried with her and then celebrated with her after the successful transplant of a new heart for her son. Our premise, and that of Rotary International, is that if we are to accomplish projects, we must help each other first.
We always welcome new members, no invitation necessary. Just show up at one of our meetings, and be ready to be welcomed with open arms.
by Lindsey Hayes
Our family, family friends, and members of the Denver Cherry Creek Rotary Club
gathered in front of the Jungle School Kindergarten Classroom.
Even before touching ground, we saw the beauty of the sea. Colors sparkled from deep blue to translucent green, jungle-covered mountains rose behind the ocean and the sun shone (despite Hurricane Nate threatening the days before). Our trip had begun!
After passing customs in the San Pedro Sula airport, where we handed over hastily completed forms never quite understood, we loaded bags full of glue and glitter, deemed safe by the TSA, into a rented van and our three-hour journey began. We drove through a toll booth with an option to pay or not, past bikes and pedestrians, and through the town of El Progreso. Jesus (our driver and soon to be translator, tour guide, and friend) played "Take My Breath Away" by a cover band and maneuvered the road. After one instance of the two lanes accommodating four vehicles, we accepted that we were in his hands and acquiesced to the broken seat belts and missing head rests. "Welcome to Honduras!"
Three generations together in Honduras.
Our first meal was at a gas station/restaurant. Buffet-style, we ordered pollo y papas fritas, botelas de agua, y coke sin calorias. We were delightfully full and ready to get back on the road, past more small houses, beautiful vistas, locals wading in rivers, small towns with speed bumps, and sun shining on poverty. We drove through La Ceiba and up La Quanca to Hotel Rio where we were greeted by the employees who live onsite. After coordinating rooms using our muddled Spanish (as none of us but Dick spoke the language) we settled in. The apartment house had already become home to Cynthia and Kate, and as Evan plopped into the hammock to read his latest book, Pepe, the gracious owner of this beautiful hotel by the river, shared stories of Honduras and Colorado and adventure. We gathered for a homemade meal in the restaurant and enjoyed the local beer Salva Vida, fresh pineapple as sweet as candy, and conversation. The sun had long set and the jungle was coming alive, so we retreated to our rooms, with fans blowing and excitement for the next day upon us.
We entered the Jungle School with only basic knowledge of the school's history and purpose. The barbed wire and padlock at the entry gate were sobering reminders of the gangs and poverty-driven crime nearby. With our craft bags in tow, we toured the school from the (literal) bottom up. We stopped at Fourth Grade and Evan confirmed
Jungle life was part of the learning! the class would enjoy the art project so we rummaged through donated craft supplies to pass out patterned paper, scissors, glue and GLITTER! Evan, Marcia and Susan led the organized chaos as students transformed construction paper into symbolic paper dolls holding hands and sparkling crowns. Dick chatted with the teachers and was called upon to translate as needed. The group divided and Cindy and Rogene went to Kindergarten, where kids enthusiastically created pictures of their family under a blue sky. Marcia brought clouds of cotton balls, glue and blue paper to Second Grade for more sky creations and Evan and Dick demonstrated for Fifth Grade while Susan and Lindsey passed out more supplies to share among todos en su clase. Cynthia and Kate led the First Grade and next door, in a calm and respectful Third Grade, Evan, Dick and Joel passed out pigamente and more glitter. In between art projects, a nurse distributed vitamins and staff members measured students for gym uniform shorts which will be sewn by mothers whose time as a volunteer is the only required tuition to attend the Jungle School.
Our craft projects complete, we gathered as David, the founder of Helping Honduras Kids and the Jungle School, detailed the abject poverty and abuse suffered by the very children we had just entertained. The same kid we saw with a smile on their face, knack for engineering, or glitter artist may have walked two hours to be at school, may not eat all weekend, may have witnessed horrific crimes or murder, may have experienced abuse, and was undeniably one of 69% of Hondurans who live on less than $2.50 a day. He shared this as we sat by open flames where rotating volunteer mothers cook food for the hundreds of students. Near us, a solar heater ensured safe water and tin roof shielded students from rain. Chickens ran free and a loose dog did not faze the mothers or kids, responding to a casual "shoo!" Plans are in place to move the smoky kitchen away from the outdoor "cafeteria" and funding is needed to build a meeting area larger than the current one that doubles as a fútbol field - for a school on a hill does not allow for traditional space for kids to act like kids. And despite their hardships, the Jungle School kids are kids, and as we helped them with glue and scissors in small classrooms, surrounded by maps of Honduras, times tables, and history lessons, we were reminded of the commonality of kids all over the world.
When we returned the next day to the Jungle School with cash in hand, the presentation of our gift was not the priority of the office. Helping a mom and her two young kids and reviewing paperwork in la oficina de adminitracion took precedence. After our tour from the day before of an American-owned Honduran-operated business, we knew there were complexities to receiving support from abroad. Skepticism often greets offers of aid after past experiences when promises never materialized. Once David, the liaison between our two worlds, arrived, the transaction became simple. A Denver Cherry Creek Rotary grant to purchase fabric for Physical Education uniforms and supply a year’s worth of essential notebooks for every student. We made promises of connecting with other US groups to support the Jungle School’s larger future projects and hopefully our presence demonstrated accountability toward these goals. As we walked down the stairs created from repurposed tires, a faded sign the only indication of the hundreds of lives influenced on the hill above, we hoped our short-time left a positive impact in their world, as theirs had certainly impacted our world.
The number one source of income in Honduras is money sent back from the states. Local unemployment is high and skilled jobs are highly valued. We visited Oro Maya - the Honduras Chocolate Company, where locals are employed and capital investments from the United States sustain production. The chocolate factory was carved from a steep, jungle-covered hill near the Hotel Rio. Cacao trees flourish underneath the shady umbrella of the jungle. A seemingly simple cement building houses solar drying rooms, cacao grinders, and glass panels separating the jungle seed from the packaged good. Despite the remote setting, quality control and FDA compliance ensure food safety and quality. We put on hair nets and face masks, promised not to touch despite the temptation to dip a finger and lick, and toured as machines swirled, liquid formed, sugar joined and chocolate appeared. Two employees hand-wrapped Honduras Chocolate Company bars made only of sugar and 65%, 70%, 75% or 80% cacao while another vacuum sealed Oro Maya couverture, used by chocolatiers to produce specialized creations. After witnessing technical magic transform cacao pods into delicious, organic dark chocolate, we marveled at how this small facility in the middle of the jungle could produce the same product displayed in the San Pedro airport, local shops, and gas stations. As we enjoyed a dinner prepared by the lovely family of Hotel Rio (and relished chocolate for dessert), we reflected and marveled at the varied sights and experiences of our day and the beauty of the vast jungle and all it contained just a short, bumpy ride away.
During a relaxed morning, our last at Hotel Rio, we sipped our café, seemingly prepared straight from the bean with smooth flavor con o sin leche and savored the pineapple, in awe of its sweet taste as much on the last bite as the very first. We appreciated the desayuno typico of plantains, beans, scrambled eggs, crema and la sandia and prepared for a "tourist day." Shall we shop? Kayak? Hike? With the enthusiasm of Jesus' suggestion, we ventured to Canopy Tours. Some put on a harness, bounced around in a truck to the top of the mountain, and for eighteen platforms, zip-lined over the jungle below con a vista del mar. Below, others jumped in fresh spring water with areas of temperatures welcomingly cool in the humid air with pockets of soothing heat. Descending the steps sprinted down by locals and youth and personally assisted for those more cautious, we discovered a private warm pool with mud baths and massage treatments. Looking like warriors slathered in red mud, our bodies feasted on the pure minerals of Honduran earth.
Just as the jungle had become our familiar home – like a tropical Colorado – we parted and headed to the town of La Ceiba. Poverty that had been shielded from us by the vivid flowers and towering trees of the jungle was now seen as abject. In the first downpour after the anticipation of many, the lack of infrastructure floated to the surface. Whole families balanced on a bike, crowds of kids puddle-jumped after school, and groups of men piled in flatbeds venturing out into the flooded streets of La Ceiba. Small cars stalled as whatever drainage existed clogged the streets. Jesus skillfully maneuvered through deep water and snarled traffic in this urban third world. For a short while, only van walls distanced us from a typical day in the third largest Honduran city. When we stopped at the Buena Amiga souvenir shop and then checked into our beach hotels, we were once again separated from the realities of the city, but our guard was up in a new way. A beach view with patrolling policia and a brief electrical blackout from the evening use of air conditioners on an inferior power grid provided visual reminders of the country’s day-to-day reality. Settling into after-dinner drinks on a balcony overlooking the Caribbean, we heard waves crashing and street cats fighting, highlighting a country striving to draw tourists yet inherently challenged by its history, violence, and poverty.
The Adelante Foundation has been a part of my life since my only visit to Honduras in 2005. Then, it was grassroots and groundbreaking. After seventeen years of successfully providing borrowers, mostly women, with the opportunity to start businesses and support their families, the Adelante Foundation is now sophisticated, efficient, and respected. The General Manager and Honduran staff shared with pride a tracking application created in-house to efficiently locate clients, tell stories of entrepreneurs and better manage the staff supporting them. Company-owned cars transported us to an assembly, where women borrowers meet every month to make their loan payments, review business skills, and provide support to each other. Together, their collateral is more powerful than any one tangible asset. Their collateral is unidad, disciplina, trabajo y valor as the group of borrowers enthusiastically shouted at the assembly's beginning and end, “unity, discipline, hardwork and courage - this is our way of life!"
Four women shared their success stories with us and proudly displayed their products and services. A one-woman beauty shop servicing five to twelve word-of-mouth clients per day grew from an original small loan for a hairdryer. Thanks to a client’s latest loan, the Honduran crafts she sells from her porch come from the capital city Tegus via a newly purchased family-owned car, rather than the unreliable bus. We purchased a calculator and book of Honduran songs at a successful store owned by an Adelante client. The owner’s high school son was studying on the computer while she shared stories of her visa process for an anticipated future visit to the United States. (Not unlike a day in my home a few weeks ago when we anticipated this very visit abroad.) Our final stop was to a store in a home designed by the family, with graceful archways, a television and full kitchen. Still a work-in-process, using incrementally larger loans as the pulperia grew more successful, the home that was once cinder blocks and a tin roof was now approaching middle class. Her son helped in the store before turning back on the TV and her daughter changed out of her uniform first thing after school. (Something that occurs in my house every day.) Unfazed by the pools of rainwater in the street or tropical window panes lacking glass, Evan passed no judgment, only relief that the store had familiar non-spicy chips and Fruit Punch Gatorade.
We piled back in the van and left the Olympia neighborhood. As the rush-hour traffic kept us on the road longer than planned, we took the opportunity to process our impressions after witnessing first-hand the results of mixing limited education with a determination to succeed and the opportunity to thrive. At the Adelante offices, we thanked the staff for an inspiring day, waited as the Development Director and our liaison between the US and Ceiba, coordinated one last adventure, and left the experience excited that we had recently provided a Denver Cherry Creek Rotary grant to an organization with proven results, through both tangible data and success stories out in the field.
Our last day was bookended by stark reminders that despite his maturity and appreciation for our adventures, Evan is a nine-year old. The understandable first-world disappointment of a promised hotel water slide which never opened led to a morning of PBS television in Spanish, extra “tech time,” and promises of future stateside amusements. The day ended in tears, not of disappointment, but fear. That evening, we shared pizza with the children at the Helping Honduras Kids orphanage. Evan enjoyed distributing pizza and paper plates before joining the kids to eat. After the dinner, he decided to decompress and wait in the van with Jesus, our very trusted driver. Parked in the dark outskirts of La Ceiba, with skinny dogs wandering past the open padlocks on the orphanage gate, the scene became intimidating. Looking for us, he entered the dark building alone and could not find our group or speak the language to ask. The comforting similarities found earlier sharing a meal with kids like those at any other "pizza party" were abruptly replaced after twenty minutes away from the familiar. Kids may all be kids but all childhoods are not the same.
That reminder is my significant take-away from observing life in Honduras and America. As I watched Evan prepare a school presentation about what is surprisingly the same and vastly different, I appreciated the reinforced point that whether joy from a kid’s coaxing smile, fear of an unfamiliar situation, or pride glowing from a successful business, feelings are – undoubtedly – universal.