GRAND JUNCTION, Colo. — Two state transportation workers were replacing a sign on the shoulder of U.S. Highway 6 in western Colorado one morning when a Jeep Grand Cherokee swerved off the road and struck them.

The workers, Nathan Jones and Trent Umberger, died in the September 2024 crash, as did a passenger in the Jeep. Tests found that the driver, Patrick Sneddon, then 59, had oxycodone and six times Colorado’s presumed impairment threshold for THC — the psychoactive compound in cannabis — in his blood. He pleaded guilty and is serving on three counts of vehicular homicide and other charges.

“Our four children are completely crushed without their Dad,” wrote Kristine Umberger, the wife of Trent, in a victim impact statement for the local district attorney. “We have lost our ability to live life like we used to.”

Federal highway safety officials have long tracked the role of alcohol in fatal crashes, but they don’t track deaths that involve a driver under the influence of drugs or a combination of drugs and alcohol.

That discrepancy is partly due to the challenges of proving impairment, since some drugs remain detectable for weeks after use. Sneddon’s attorney, Jennifer Gregory, said a driver can be presumed impaired under Colorado law if their blood contains 5 nanograms of THC or higher per liter. But that “permissible inference” threshold is different from a legal limit — such as the 0.08% blood alcohol content limit — and the level set by Colorado is not supported by published scientific studies, Gregory said.

Such information could prove useful as the nation struggles with , the on marijuana, and more than 40 states have legalized or decriminalized some forms of cannabis and .

“Impaired driving is a top public safety issue that extends beyond alcohol,” said Sean Rushton, a spokesperson for the federal highway safety agency, which is tackling the issue collaboratively, with resources to ensure a “comprehensive and coordinated approach.”

But President Donald Trump’s cuts to the federal workforce since he returned to office in 2025, along with dwindling federal investments, mean that efforts to expand and improve the tracking of impaired-driving deaths nationwide have slowed.

The gap in data can be significant. In Mesa County, Colorado, where Jones and Umberger were killed, the coroner’s office tracks various forms of impaired-driving fatalities. From 2017 through 2024, a third of traffic deaths involved alcohol alone, according to data from the county coroner’s office.

When drugs are factored in, nearly half of Mesa County’s traffic deaths over the same period involved a driver intoxicated with alcohol, drugs, or a combination, according to the coroner’s reports.

“If you want to solve a problem, you need to understand the problem,” National Transportation Safety Board researcher Jana Price said. “If you only know that alcohol is present, then it limits your ability to fully understand what might have been impairing a person or a population of people. It trickles into the countermeasures that we use as a society to address the problem.”

Identifying a hidden issue

NTSB researchers that, across four geographical samples of roughly 26,000 drivers, about half of those arrested for impaired driving and more than a quarter of drivers killed in crashes tested positive for more than one substance, such as cocaine, sedatives, and antidepressants. The analysis also found that only four states and the District of Columbia drug-tested more than 60% of fatally injured drivers in 2020.

Those findings led the NTSB, an independent federal agency that investigates major incidents, to make a series of recommendations to the and states to establish a comprehensive, nationwide dataset on impaired driving.

But hurdles remain to creating such a system. Fatality and injury reports submitted to the NHTSA database often feature missing or erroneous data, according to a .

Varying state laws around testing arrestees and decedents for drugs make getting uniform data difficult, according to , a former employee of NHTSA’s impaired-driving division, as does a lack of proven metrics like blood alcohol content to measure drug impairment, not just the presence of a drug.

“It����ap a slow process, which is incredibly difficult when you know that each day that passes is risking a lack of safety for however many people facing the potential of a drug-impaired-driving crash,” Cash said. “But some progress is better than no progress.”

Acknowledging how long those efforts will take, the NTSB also recommended that NHTSA build an interim surveillance system that would use data from trauma centers to create a national sample of crash-involved impaired drivers.

The agency made some headway, reporting in 2023 that it was conducting its own study with the help of 11 trauma centers and medical examiner offices. It also helped California establish a 19-month statewide surveillance system, which NHTSA will use to evaluate the feasibility of a nationally representative system.

Such programs are useful for public awareness and for improving the ability of police to understand drugged driving patterns that can help them tailor enforcement, said , a University of California-Davis associate professor who researches toxicology and was involved in the California program. But some trauma centers, especially in rural areas, often lack the research infrastructure necessary for round-the-clock drug testing and participation.

Still, it����ap possible, and he said the benefit is apparent in the findings from California’s surveillance system.

“If you go out there and tell people that 44% of drivers who ended up in the ER from a car accident had at least one potentially impairing substance in their blood at the time of the accident, that gets people’s attention,” Chenoweth said.

Shrinking research teams

Since NHTSA’s update to the NTSB three years ago, however, the agency has yet to follow up on the recommendation. Staff cuts and departures at NHTSA last year paint a poor outlook for change.

From 2021 to 2024, the agency . At the end of Trump’s first year in office, NHTSA had dropped to about 550 people due to government-wide cuts and people leaving on their own.

Cash, who now works for the nonprofit Governors Highway Safety Association, was one of five employees who left NHTSA’s last year. That leaves just two staff members in the division, she said.

Ian O’Dowd, a former employee in NHTSA’s , said he was part of a team of 16 people who studied, in part, impaired driving. Only three or four team members are still with the agency, he said.

“At some point, it becomes unwieldy for a handful of people to be managing all of the research work going on,” O’Dowd said.

NHTSA communications director Sean Rushton said the agency has “both the financial and personnel resources necessary to support its programs with multiple offices carrying out this work collaboratively, ensuring a comprehensive and coordinated approach.”

The 2021 infrastructure law, passed under the Biden administration, increased funding for NHTSA’s state highway safety program from about $667 million in 2021 to nearly $953 million this year.

The law included $750 million to modernize crash-data programs, but as of January over $475 million was unused. The funds expired in September unless they were obligated through a signed agreement.

A report by the U.S. Government Accountability Office found that nearly a quarter of entities awarded grants in 2022 had not received a signed agreement when surveyed between December 2024 and March 2025. It also found that over 1 in 5 grantees reported that obtaining timely replies from Department of Transportation staff was moderately or very challenging.

With the Biden-era infrastructure law expiring later this year, Congress could extend the unused crash-data fund or implement a new approach to impaired driving.

In mid-April, House Transportation and Infrastructure Committee Chairman Sam Graves (R-Mo.) said proposed legislation — less than half of the current bill’s $1.2 trillion — with a more “traditional” focus on roads and bridges.

The bill has amid negotiations for more funding, leaving future support uncertain.

“Certainly, we are always hoping that there will be an increase in the amount of money available to do this work,” Cash said. “Whether or not that will happen this year, I don’t know.”

©2026 KFF Health News. Distributed by Tribune Content Agency, LLC.

Then March hit.

Within Denver, 63 people died of overdoses that month, followed by 58 in April and 63 again in May – an average of two people per day, every day, for three months straight. March and May , and while experts point to changes in the drug supply as a likely culprit, no one can definitively say what happened.

Most of the people who died had both fentanyl and methamphetamine in their systems, said Dr. Sterling McLaren, chief medical examiner for the city of Denver.

Fatal overdoses also are up for the state as a whole, rising from 1,603 in 2024 to 1,813 in 2025, according to preliminary data from the .

The increase came at a time when most of the country continued to see improvement. Preliminary data shows fatal overdoses went down 15% nationwide in 2025, with the most significant drops along the coasts, .

The biggest exceptions were New Mexico, where overdose deaths rose about 21%; Arizona, 17%; and Colorado, 13%. Other states with smaller increases included North Dakota, Minnesota, South Dakota and Montana.

A chaotic supply

A shift in the form of fentanyl people use could has caused some of the overdoses, said Ally Arnaiz, overdose prevention and education program coordinator for the Denver Department of Public Health and Environment. Since fentanyl showed up in Colorado, people generally took it by smoking counterfeit pills, colloquially known as “blues,” off a piece of foil. But powder, which is easier to inject, makes up an increasing share of the supply, she said.

Without regular testing and surveys, no one can be sure if the drug supply has become more potent, or if people are using it in riskier ways, Arnaiz said. While people do overdose from smoking fentanyl, the chance is higher when injecting.

“We’re dealing with an illicit drug supply, one that does not have oversight,” she said.

than in the rest of the country, so the region might simply not be as far along the curve of reducing deaths, said Thomas Stopka, a professor of epidemiology at Tufts University School of Medicine. Other factors could include regional differences in the availability of naloxone and medication for opioid use disorder, he said.

But data from seizures does show powder fentanyl making in-roads in the Southwest, Stopka said. Powders could be more potent, and are also easier to mix with other substances, such as meth, he said.

“The fake pills may have been more predictable, to a certain extent,” he said.

Dave Olesky, special agent in charge of the Rocky Mountain division for the U.S. Drug Enforcement Administration, said the DEA also observed a shift from counterfeit pills to powder, but he sees that as a positive, since people who aren’t experienced with drugs are more willing to take a pill than to smoke or inject something.

“If somebody doesn’t take a pill that doesn’t come from the doctor, we are going to make so much progress against the fentanyl epidemic,” he said.

While cases of teenagers taking what they thought were diverted pills do happen, Denver’s 2025 data showed only 36 of the 674 people who died of drug-related causes were younger than 25, including six who were under 18. Statewide data by age isn’t yet available.

The purity of seized pills has gone down over time, though it still can vary significantly, Olesky said. People who are accustomed to a certain amount of fentanyl may be using more pills to get the desired effect, with some dying if they get a stronger-than-expected dose in the mix, he said.

Lisa Raville, executive director of the Harm Reduction Action Center in Denver, isn’t sure a shift in form is to blame. Powder fentanyl has been available to some degree for years, but with an unregulated market, people have no way of knowing if a batch is dramatically more potent than usual or contains additives that have their own risks, she said.

The Pennsylvania-based reported finding 134 relatively new substances across drug samples it tested in 2025. The sheer range of potential substances means that, even if someone uses a fentanyl test strip, .

Providers and health departments on the East Coast generally identify new contaminants in the drug supply early on. Recent additives include , a veterinary drug that can cause severe flesh wounds when injected; , another animal drug which causes a withdrawal syndrome that includes a potentially life-threatening spike in blood pressure; and more-potent synthetic opioids such as , and .

Most of the new chemicals showing up on the East Coast don’t appear to be common in Denver at this point, Arnaiz said. Drug supplies are highly variable, so each local market needs data about potency and adulterants, she said.

“The drug supply in Denver is very different from what you see in Grand Junction,” she said.

While people died from heroin overdoses, long-term users generally had a fairly accurate picture of how much they could take, Arnaiz said. The arrival of fentanyl and other additives created a more chaotic supply, where dosing is a matter of guessing, but the fear of withdrawal pushes people to take the risk, she said.

“No one wants to be dependent on a substance under these conditions,” she said.

Drug seizures are up, for good or ill

Last year, seizures of both fentanyl and methamphetamine were up about 30% in Colorado compared to 2024, said Keith Weis, executive director of the , which offers training and coordination for law enforcement in Colorado, Wyoming, Utah and Montana. No one can know the amount of drugs available on the market, but generally, higher seizures point to greater demand, he said.

The DEA had a record year for seizing fentanyl in the region, most of which starts with cartels in Mexico and moves up Interstate 25, Olesky said. One particularly notable bust was a storage unit in Douglas County holding 1.7 million counterfeit pills, plus enough powder to make about 6 million more, he said. A person not involved in the drug trade had purchased the unit’s contents without seeing them after the previous owner got arrested and stopped paying rent.

Olesky described the seizures as a major success: each pill taken off the street is no longer available for someone to misuse. But recent studies in and found short-term increases in overdoses following police drug seizures.

When someone’s usual seller gets arrested or doesn’t have product available, they find another source, which may be more potent or mixed with other substances, Stopka said. Increased law enforcement activity in an area can also make people reluctant to seek treatment or harm reduction services, he said.

“When drug seizures happen, that leads to more uncertainty in the drug supply,” he said.

How to reduce deaths?

So far, overdose deaths don’t appear to be surging in 2026, though the data is incomplete because toxicology testing can take weeks or months.

Olesky said he doesn’t think Colorado will make real progress until it provides more drug education and sends a message that substance use isn’t acceptable. The state also needs penalties for drug trafficking that are severe enough to dissuade criminals, he said.

“When you see the same things happening, the criminals are not being deterred,” he said.

Colorado increased penalties for fentanyl possession in 2022 and created the category of fentanyl distribution causing death for people who sell someone a mixture containing fentanyl, resulting in a fatal overdose. Raville believes the law has made people using drugs together less likely to call for help if someone has an overdose.

“Most people who use drugs are low-level sellers” who could face a lengthy prison term if they call for help, she said.

The city has promised that it will start distributing drug-checking machines to harm-reduction groups later this year, Raville said. Unlike fentanyl test strips, which can only detect one substance, the machines will be able to give a more holistic, real-time view of the supply, she said.

“We need to be more nimble in understanding what’s in the drug supply today,” she said.

Under the checking program, people will share a small portion of the drugs they intend to consume, Arnaiz said. Even if people still decide to use them after concerning results, they’ll still contribute to keeping others safe, she said.

“People who use drugs, despite the perception of the general community, really care about their health and the health of the community,” she said.

Denver has invested in connecting people to health care and harm reduction efforts, such as offering clean needles and naloxone, Arnaiz said. Ideally, it would be able to use funds more creatively, such as offering small rewards to people who are trying to quit stimulants – a method known as contingency management.

People get scared when they see public drug use, and compassion is running short, Arnaiz said. But relationships, along with naloxone, are some of the best tools to prevent more deaths, she said.

Raville would like to see the city set up sites where people can use the drugs they’ve purchased under supervision, meaning someone would be there to intervene if they start to overdose. But ultimately, she thinks the only thing to really stem the deaths would be a safer supply, such as medical-grade fentanyl patches and prescription amphetamines as alternatives to illicit opioids and meth.

“Alcohol isn’t legal because it’s safer. It’s safer because it’s legal,” she said.

This is a question parents face today, as changing cultural attitudes have inspired marijuana legalization in some states, and other sweeping drug reforms. School-based drug education is slowly adapting to these new norms by equipping kids not only with science-based information about various substances and their impact on the adolescent brain, but also the life skills they need to make healthy choices.

Still, parents have a vital role to play when it comes to prevention and intervention, experts say.

“Parents, along with schools, are one of the primary socialization agents for drug use prevention,” said Devin McCauley, post-doctoral scholar at , which studies adolescent behavior and develops drug prevention curricula.

While advocating that kids simply avoid drugs and alcohol may seem instinctual, research shows that this strategy doesn’t typically lead to abstinence. Today, experts like McCauley recommend a more nuanced approach to discussing drugs as a family — one that starts with fostering open lines of communication and demystifying these conversations so they don’t feel taboo.

Building a foundation of trust is essential so that youth will take what their parents say seriously and also feel comfortable confiding in them when issues arise.

“We’re never going to live in a landscape where 0% of the kids try substances, right? When parents take a ‘just say no’ approach and someone maybe tries something at a party or feels pressured, uses a vape because they feel cornered by friends, they’ve already used it — and they’re like, now what do I do? Do I hide it? There’s nothing in place for people who have experimented and don’t know what to do next,” McCauley said.

“Understanding that kids are being targeted and having empathy, work with your kid — like hey, I know this can be a really tough issue, let����ap team up and be partners to make sure you’re safe,” he said.

Here are five practical tips to help parents navigate talking to their kids about drugs.

Start conversations early and return to them often

In today’s culture, experts say it is never too early to start talking to your kid about drugs and, in fact, it should be a topic revisited often.

Instead of working up to a single, all-encompassing conversation, consider discussing drugs in small, incremental ways, McCauley said. That will allow you to circle back without feeling like there’s pressure on the topic.

It is, however, important to make the conversations age-appropriate. For example, parents can start talking with preschoolers about cold or toothache medicines, what they do and how they should only be used when feeling unwell. As children reach middle school, parents can approach conversations with curiosity and open-mindedness in order to understand exactly what is happening in their kids’ social circles.

“I know this is common sense, but just building a strong relationship with the youth in your life — spending one-on-one time, listening without immediate judgement, knowing what children are interested in, what their activities are, who their friends are — that����ap foundational, so that when they experience stress or peer pressure, they’re more likely going to come to you,” said Alison Long, health promotion manager at the .

As they reach their teenage years, it is OK to be specific about the substances you think they will encounter. McCauley suggests generalizing or using the news to ask open-ended questions that take judgement out of the tone. For example, “I’ve seen a lot about nicotine vapes on the news. What do you think about that? What do you notice among your friends and peers?” Those set the stage for a different conversation than asking teens, “You’re not vaping, are you?”

To avoid putting pressure on these discussions, initiate them in places and at times where you naturally connect with your kid, McCauley added. That could be on drives to and from extracurricular activities, while watching television or walking, or anywhere else you usually spend quality time.

Practice active listening

Conversations about drugs should be just that — two-way exchanges. McCauley and Long advise parents to listen more than they talk to build trust and validate their child’s experiences.

“There’s data saying teens want to be able to open up and talk about this with their parents. A lot of them aren’t quite sure how. They fear being judged, they fear consequences. So if we respond in a way that is an invitation and shows that we trust them as well, I think that can acknowledge that need on part of teens and have this be an ongoing, evolving conversation,” McCauley said.

To that end, avoid lecturing and interrogating teens, which will almost assuredly turn them off to whatever message you are trying to get across. Be curious and ask questions. That includes asking for permission to share your personal perspective and understanding of drug risks.

All this works to show adolescents that they are valued, trusted and that, as a parent, you want to work with them. Health organizations across the state even host educational opportunities for teens and trusted adults to attend together, which can further strengthen relationships as well as offer essential knowledge to both parties.

“We try to stress that knowledge is power on both parts, on the adult and the youth,” said Lyndall Young, nurse and instructor at , which curates a variety of drug education programming for youth and adults. Whether it’s learning how to use naloxone, understanding the risks of opioids or getting tips on how to navigate hard conversations, “the more they know, they can go out and not only be safe for themselves, but be safe for their whole family,” Young said.

Don’t freak out if you hear something you don’t like

The whole point of building trust with your kids is to open the floor for honesty. So if your teen confides in you and you don’t like what you hear — such as they or their friends have been experimenting with drugs and alcohol — it is important to remain calm.

“If you hear something that����ap alarming to you, take a beat, take a breath,” McCauley said. It is fair for parents to express their concerns, he added, but do it in a way that avoids shaming. Stick to personal statements such as “I am a little concerned” or “I just want you to be safe.”

Asking questions and getting feedback here is also essential to understand a young person’s motivation and the context in which this happened. Long suggested leading with an affirmation — e.g. “Thank you for sharing that with me.” — and following up with curiosity: Do you want to talk about it? Why did you do that? How did it go? Can we talk about some of the risks?

“If it makes you upset and angry, recognize that. That����ap OK and understandable as a parent, but maybe that����ap not the time for you to give your side. Maybe just focus on listening,” Long said.

Lean on the facts

Removing emotion and judgement from drug discussions can be difficult, but leaning on the facts will assist parents.

Resources like the offer parent brochures that outline need-to-know facts about fentanyl and how to share those with your teen. Other health leaders like the and have guidance for parents to bolster their knowledge about marijuana and frame discussions.

One of the most compelling avenues, experts say, is harping on the fact that adolescent brains aren’t done developing until age 25, so using substances can have long-lasting impacts. Note that it is also illegal to use alcohol, marijuana and nicotine until age 21, and doing so could have legal implications for a teen’s future.

McCauley noted there is a fine line between informing kids about drugs and teaching them how to use. Approach these subjects in ways that empower teens to share the information with their friends and be a leader or in a position to help when issues or questions arise among their peers.

“There’s a difference between saying, ‘When you use, slow down, wait two hours,’ versus ‘adolescents have gotten really sick because they ate three or four (cannabis) gummies in a row. They didn’t know it can take up to an hour (to take effect),’” said McCauley. “It’s worthwhile to have that information and you can try to present it in a way that����ap not an instruction manual.”

Model the behavior you hope to see

Stressing again that parents are among the primary role models for kids as they age, Long emphasized exhibiting the behaviors you hope to see in your children. What you do is going to impact your kids more than what you say, she said. For example, if you are stressed, promote healthy coping mechanisms like taking a walk or calling a friend.

“If you’re going to have wine, maybe don’t say, ‘I’m so stressed, I’m going to have a glass of wine.’ Rather, if you are going to have a glass of wine, have it with dinner and show you can drink responsibly,” Long said.

She and McCauley also advised setting clear expectations for your kids, even brainstorming family values together to get teens to buy in. Additionally, make sure all the adults in the household are on the same page.

“One of the whole points of adolescence is to become your own person, develop your own autonomy and your own independence. If parents can respect that and empower it����ap going to go a long way,” McCauley said.

Rightfully so, since the mural was inspired by a similar drawing she had done for a sticker contest hosted by , a youth-focused drug prevention organization. It was one of the winning designs and earned her the opportunity to adapt the sticker into a piece of public art.

“I think it inspires kids to give out their creativity and use their voices to say what they’re proud of,” Sprouse said at the mural reveal. “Balloons rise up, and if you see someone out there doing drugs, help them, be a support system for them, show them that they’re able to rise up.”

Rise Above’s art projects aim to engage youth in community initiatives that foster personal relationships and give them a sense of belonging, two factors that studies show are linked to lower rates of substance use. The nonprofit promotes to debunk the myth that teen drug use is pervasive and help young people cultivate healthy behaviors,��said executive director Kent MacLennan.

In 2024, Rise Above Colorado kids ages 12 to 17 and found that youth who choose to abstain are the majority, not the minority.��“Our focus has really been (to) change the narrative, show the data from these surveys that are legitimate that show most youth aren’t using,” MacLennan said.

Nonprofits like Rise Above Colorado and Western Colorado Area Health Education Center offer activities and events that aim to engage teens outside of classrooms and help them develop a sense of purpose. From documentary screenings and naloxone trainings to youth-built drug information resources and even mural projects, organizations seek to equip young people with science-based facts and enable them to become experts among their peer groups. Recent state-level public health campaigns, too, have focused on the facts instead of fear, in hopes of illuminating new research on substances like marijuana.

This is the final story in The Denver Post����ap three-part series examining how drug education has evolved alongside the legalization and normalization of substances like cannabis and psychedelics. Previous stories focused on how the general public has begun warming to harm reduction ideals in light of the opioid crisis and how local schools are navigating drug education in the era of drug reform.

“We have always wanted to focus on some of the root causes and what are the things that youth are doing that make life worthwhile,” MacLennan said. “So, celebrating all of that, yet at the same time making sure that youth understand the risks, the consequences. That they understand adolescent brain development and the importance of all the years that you cannot use are formative for the brain and dramatically reduce your risk of addiction later on in life.”

Today, these organizations are also filling in for state agencies that often lack the resources to lead educational campaigns.

After becoming the first state to permit recreational marijuana sales in 2014, Colorado funded several campaigns to inform both residents and tourists about its new laws as well as the health effects of cannabis use.

However, neither the Colorado Department of Public Health and Environment nor the Department of Revenue currently has funding to do the same for psychedelics, which were legalized and decriminalized in 2022.

Representatives from both publicly funded agencies declined to be interviewed for this story.

One exception is the Colorado Department of Transportation, which recently to educate folks about the effects and legality of driving under the influence of psilocybin, including those who microdose.

New campaign relies on cannabis research

Some of Colorado’s early government-led cannabis campaigns targeted teens with varying levels of success.

In one notorious flop, the Colorado Department of Law and the Governor’s Office spent $2 million on an initiative called “Don’t Be A Lab Rat.” Launched in 2014, the campaign suggested that Colorado was a testing ground for the consequences of marijuana legalization — and that teens would be the test subjects if they chose to consume. (It’s worth noting that the messaging targeted adolescents under the legal age to purchase and consume cannabis, which is 21 years old.) In addition to TV and movie theater ads, campaign organizers installed human-sized rat cages around Denver, which were promptly mocked and vandalized.

The state health department — which was not involved in “Don’t Be a Lab Rat” — later developed several youth-targeted campaigns, such as Protect What����ap Next in 2015, which encouraged kids to set goals for their lives and then cautioned that marijuana use could get in the way of those; and Forward Together in 2020, aimed at inspiring teens to build more connected relationships. (While not specifically for teenagers, a 2015 campaign called Good To Know showed some effectiveness in educating pregnant women, parents and tourists about Colorado’s marijuana laws.)

The only state-led initiative that still exists today, however, is called . Rolled out in 2018, it is essentially a website that features guidance on how to consume and store cannabis responsibly, as well as information related to adolescent use and use during pregnancy.

In recent years, the state legislature has invested funds to support researching and educating the public about highly potent marijuana.

Lawmakers passed a bill in 2021 requiring the Colorado School of Public Health to perform a systematic review of the scientific research related to possible physical and mental health effects of high-potency cannabis concentrates, such as vape oils and dabs, and create a public health campaign based on the findings. The state allocated $5 million to the school — a partnership between the University of Colorado’s Anschutz Medical Campus, Colorado State University and the University of Northern Colorado — to support this initiative over several years.

The result, called launched in 2024 with the goal of raising awareness about the risks of consuming high-concentration cannabis through podcasts, documentary shorts and social media content, including influencer partnerships. The campaign specifically highlights the potential health risks associated with consumption during adolescence and pregnancy, which researchers identified as the most critical periods for harm in their review of more than 650 scientific studies. (Researchers broadened their definition of “higher concentration cannabis” beyond concentrates to include flower with more than 10% THC and edibles with more than 5 milligrams of THC.)

While previous campaigns focused on helping people understand laws after legalization and risks of impaired driving, Tea on THC is the first to synthesize existing research about the potential health impacts, Greg Tung, associate professor of health policy at the Colorado School of Public Health, said by email.

“The campaign focuses on what����ap changed versus repeating outdated messaging,” Tung said. “Our work draws attention to the fact that cannabis products of today are very different than those in years past, and we convey the distinction between these products and what they mean for people’s health.”

For example, messaging emphasizes that cannabis flower contains much more THC now than in decades past — often between 17% to 28% compared to around 3% in 1983, — while concentrates contain as much as 95% THC. The combination of higher-concentration marijuana and a high-concentration delivery method means users can access unprecedented levels of THC at unparalleled speed, the website states.

Still, the campaign’s objective is to discourage people from starting to use cannabis unless they have a valid medical reason, so the messaging leans heavily into potential risks, even though researchers found some evidence that concentrates can benefit individuals with preexisting mental health conditions. Acknowledging the risks is important since legalization has propelled the perception that marijuana is effectively harmless, which is not the case, Tung said.

talks about short-term effects like problems with memory and concentration, a risk of psychosis and acute vomiting, as well as the potential for long-term issues like cannabis use disorder, breathing problems and increased risk of mental health conditions like schizophrenia, depression, and anxiety.

The Tea on THC has likely been the most visible state-funded campaign with more than 56 million viewer impressions between social media, paid media, billboards, and other forms of advertising. The website now exceeds 40,000 monthly visits, the school said, and has reached 62 of Colorado’s 64 counties.

Power to the young people

Instead of relying on top-down drug prevention initiatives, some nonprofits and local health agencies are entrusting young people to lead the way.

The city of Broomfield’s , for example, takes part in an advisory coalition that helps shape health initiatives, such as drug prevention and mental health programming. The city pays middle and high schoolers for their time and expertise, and puts them at the helm of a podcast called which touches on a range of topics, including drugs.

Rise Above Colorado recruits students from across the state to be part of its Teen Action Council, which does peer drug education in a variety of ways. The council receives training on positive social norms so members can act as ambassadors within their communities and also leads digital projects that seek to disseminate critical drug information to others their age.

In 2023, for example, the council collaborated with Attorney General Phil Weiser’s office to develop a website called intended to spread awareness about opioids and reduce the risk of misuse. It details facts that teens can share with their friends, like the majority of fake pills out there are laced with fentanyl and that ingesting just 2 milligrams can be fatal. It also offers guidance on how to use naloxone and where to find resources such as free counseling. Connect Effect was produced using $750,000 from the state’s opioid settlement funds.

Additionally, in 2017, the Teen Action Council created that provides robust information about various substances, including psilocybin, fentanyl, meth, marijuana and more. Pages include a brief history of the drug, its common names, descriptions of the high, its long and short-term effects on the brain and body, and the legal consequences of possession. Each one includes links to the information sources, so that teens who find the page can use it as a resource if they are interested in learning more.

MacLennan isn’t concerned that the website contains information that could be considered positive or focused on harm reduction.

“Hopefully, youth can understand: what is the high like, why does that potentially make it addictive, and then what are the repercussions? So that ultimately they make informed decisions,” MacLennan said. “We would rather that than, ‘Oh well, I just have to say no’ — it����ap not that black and white. We need to trust them that we’re developing skills enough so they can make good choices.”

Beyond the content, the most important part about the website is that it’s written for youth, by youth. Olli Hocker, who served on Rise Above’s 2024-25 Teen Action Council, considers it the organization’s most impactful initiative because of the service it provides.

“I know that I was looking things like that up when I was actively using,” Hocker said in a 2025 interview, proudly three years sober from using nitrous oxide. “I think it����ap really important to have accurate and nonjudgmental information and it����ap something that is hard to find other places.”

Lyndall Young, nurse and instructor at , echoed that peer-led initiatives are often the most successful she sees in the field.

Her organization acts as a resource hub, working to bring drug prevention and intervention to 15 communities across the Western Slope through a variety of initiatives both inside and outside of schools. Programming ranges from stocking naloxone vending kiosks and training educators to use the opioid reversal medication to facilitating classroom lectures about opioids and curating youth events, like documentary screenings and expert panels about substance use and addiction.

In Delta County, Young works with high schoolers to develop drug lessons that they then present to younger grades. The impact goes both ways, she said. Youth leaders become advocates and their message resonates profoundly with peer audiences.

“We’ve really found (younger kids) love the science behind it and they love it when it comes from a peer. So we really feel that has made a huge impact in our outreach to have those student stars,” Young said.

What exactly constitutes drug education has expanded over the last several years, Young said. While many think of classroom lectures, the work has broadened to become multifaceted and include wraparound services, such as housing, food and counseling support, that seek to address issues that often predate substance use and abuse. Young is heartened by this shift, as it personalizes services and education.

“One thing is not going to work for all the students. You have to hit it (from) different directions,” she said.

Risks of psychedelic use aren’t widely known; Colorado campaign hopes to change that

Education needed for young adults, too

Having access to science-based drug education isn’t just important for teenagers. Young adults also need to understand the perceived benefits and risks of any given substance so they can make informed choices once they turn 21, said public health expert Kristin Nash.

Nash is co-founder of the nonprofit , which is dedicated to addressing the need for accurate, nuanced and science-based information in the burgeoning psychedelics space. Last year, the organization used Colorado to test a new digital campaign called , aimed at educating Gen Z about psychoactive substances and concepts like “set and setting” that can impact a trip.

As psilocybin mushrooms have become more normalized, use has risen. In 2023, about 1.7 million Americans ages 18 to 29 reported using the drug in the past year, marking a 44% increase from 2019, according to .

Before You Trip’s goal was to encourage young adults to “pause, learn and reflect” with a mix of social media ads, Instagram influencer content and a website with drug information and harm-reduction resources. While the campaign highlighted psychedelics’ potential risks and documented harms, its tone was intentionally nonjudgmental and content did not advocate for abstinence.

“We know that young people are already making the decision to use and engage with these substances. We also know that ‘Just Say No’ approaches turn young people off to the message, and to be fair, we also know a lot of people do get benefit from these,” Nash said. “We need to arm them with the best information we have around risk, contradictions and harm reduction strategies.”

Before You Trip’s pilot campaign ran for roughly six weeks and reached 860,518 unique individuals aged 18 to 30 in the Denver, Boulder and Aspen metro areas, Nash said. Instagram content clocked 5.1 million impressions among that demographic and the Before You Trip website received about 66,000 visits. Those who saw the campaign said it was informative, engaging and helpful.

For Nash, the feedback was reassuring. For years, she has advocated that state governments adopt comprehensive education plans as they seek to legalize and decriminalize psychedelics. But so far, that hasn’t happened. To fill the gaps, the coalition plans to expand Before You Trip into a sustained public health education program and develop toolkits that cities, states and college campuses can use to support safer decision making among young adults.

Nash’s mission is a personal one. In 2020, her son Will died while under the influence of psilocybin at 21 years old. The honors his memory by supporting harm reduction efforts on college campuses, raising awareness about psychedelic safety and advocating for reality-based substance use education across the country.

“We can wish our kids wouldn’t use these all we want… but to me, education is the front line safety net,” Nash said. “When we downplay the risk and we fail to have those important discussions, we put people at risk and we're failing at informed consent.”

This series was reported with support of the .

An expert from Denver Health led the group in discussing which specific drugs are considered opioids and how to identify the telltale signs of an overdose, like clammy or cold skin, a limp body, and lips and fingernails that look purple or blue. The teens also learned how to administer the nasal spray, commonly known by the brand name Narcan, and then put their newfound knowledge to use practicing how exactly they would do it in the event of an emergency.

It’s scary stuff, but for many teens, it’s necessary knowledge in today’s world.

Suyash Shrestha, then a senior at Stargate School in Thornton, attended the event, but it wasn’t his first training. Shrestha spent much of his high school years trying to spread awareness about the concept of harm reduction to people his age. Harm reduction provides teenagers with honest information about drugs, along with advice for those who already use them about strategies for doing so more safely.

“Harm reduction is something that not a lot of teens or youth even think about or even know exists,” Shrestha said in an interview. “It ultimately creates that safer environment for the people who do need that information or do need those resources to come forward and get them… That����ap why we should continue pushing for that type of curriculum or education.”

Drug education, once ubiquitous in schools through the D.A.R.E. program, has struggled to find its footing in recent decades, even as changing cultural attitudes prompted marijuana legalization in many states across the country. In Colorado, a lack of consensus about approach and the logistical challenges of implementing curriculum have led to a patchwork of strategies where local control — which leaves it up to individual districts to decide the specifics of their health curricula — is the only standard.

The Denver Post is publishing a three-part series exploring why drug education has been slow to keep pace with the legalization of drugs like cannabis and psilocybin, and the ubiquity of deadlier substances like opioids. In the wake of the “Just Say No” movement of the 1980s and ’90s and a subsequent opioid epidemic, many local educators and organizations are embracing new philosophies about how to equip kids with the tools and information they need to lead successful lives.

Experts say drug education needs to be a more holistic endeavor — one that sees educators, community leaders, parents and youth working together to address the underlying causes of drug use and support healthier outcomes. For a generation of kids who have the world’s information at their fingertips, effective education must ditch fear tactics and instead rely on factual information presented honestly and transparently, they say, so that youth can make their own informed decisions.

As a member of the Rise Above Colorado’s Teen Action Council and Northglenn’s Youth Commission, Shrestha’s passion stems from hearing personal stories of Coloradans overdosing on synthetic opioids and from wanting to help anyone who might find themselves in a similar situation. After he first learned there was a medication that could literally save lives, Shrestha thought everyone deserved to know about it, including teens and other students.

Carrying naloxone was one way Shrestha saw he could potentially make a difference, and by teaching others to do so, he hoped to inspire his peers to be part of something meaningful — so that ultimately they make fewer harmful personal choices.

From ‘Just Say No’ to ‘just say nothing’

Putting trust into the hands of school students is a stark departure from historical norms. Traditionally, Americans have relied on school-based curricula and fear-based educational campaigns that aim to scare kids straight.

Stigmatizing drug and alcohol use as a black-and-white moral issue has a long legacy in the U.S., said Steve Sussman, professor of population and public health sciences at the University of Southern California. In the late 1800s and early 1900s, books such as and advocated bettering oneself and society by embracing purity, resisting temptation and finding a suitable partner.

The books, which were influential at the time, depicted two life paths for young men and women: They either grow up to be honest, decent citizens or, conversely, end up becoming degenerates depending on their life choices. For example, if , they would grow up to be honorable and venerable. However, if they choose to smoke cigarettes and drink alcohol, they would become moral and physical wrecks.

“There was nothing in between,” Sussman said. “, you’d either go the route of becoming a good mom, or you could end up going on the road to coquetry.”

Moral judgments like these became part of the school curriculum in the late 19th century, as the temperance movement gained momentum toward its goal of total abstinence. By 1901, the Woman’s Christian Temperance Union had successfully lobbied every state in the union to mandate its Scientific Temperance Instruction in schools. The curriculum — which it����ap worth noting was criticized by scientists at the time — asserted alcohol was “a dangerous and seductive poison” and promoted total abstinence as the only solution for mental, moral and physical well-being.

Scientific Temperance Instruction waned after Prohibition ended in 1933, but fear tactics remained a hallmark of campaigns to combat drug use and abuse.

In 1936, the film “” warned parents about the dangers of marijuana, a “frightful assassin of our youth” more threatening than opium, morphine and heroin. Three decades later, in 1963, that narrative persisted when a presidential commission to warn teenagers that “although the use of a drug may be a temporary means of escape from the world about him, in the long run these drugs will destroy him and all that he aspires to.”

The most famous effort, though, is , or Drug Abuse Resistance Education. Started in 1983 as a partnership between the Los Angeles Police Department and the Los Angeles Unified School District, it leveraged uniformed officers lecturing classrooms about various substances they saw on the job.

The goal was to teach kids to “Just Say No” to drugs, gangs, violence and peer pressure, echoing the country’s first lady at the time, Nancy Reagan. And it caught on quickly with the adults in power.

By 1994, D.A.R.E. was the most widely used school-based prevention program, reaching an estimated 5.5 million fifth graders in more than 60% of the nation’s school districts that year alone, The program continued to grow, and by 2009, it appeared in .

Despite its popularity, though, studies showed that D.A.R.E. wasn’t effective and that program participants were just as likely to use drugs as non-participants. In some cases, it had the opposite of its intended effect.

After developing a new curriculum in the early aughts, called Take Charge of Your Life, researchers at the University of Akron in Ohio found that seventh graders and ninth graders who went through the program from 2001 to 2006 experienced by 11th grade compared to a control group, and there was no reported change in active marijuana use. One positive effect was that seventh graders who used marijuana at the time they went through the program were less likely to continue doing so by 11th grade, the study found. In response to criticism, D.A.R.E. America retooled its curriculum for elementary and middle school students, starting in 2009.

D.A.R.E. still exists today, though curricula focus more on social-emotional learning and “helping kids learn to make healthy and safe decisions for a better life,” said regional director Dennis Osborn. Core lessons no longer include information about specific drugs, he added, though there are specialized units dedicated to vaping, fentanyl/opioids and marijuana.

About 2,000 law enforcement agencies currently participate in the program compared to around 7,500 at its height, according to Frank Pegueros, CEO of D.A.R.E America.

However controversial the content, D.A.R.E. provided the infrastructure, training and standardization necessary for drug education to proliferate widely. When that structure began to be dismantled in the 2010s, though, school-based drug education faltered, effectively leaving the generation of kids that followed to navigate the waters on their own.

“We went from ‘Just Say No’ to ‘just say nothing,’” said Rhana Hashemi, a social psychology researcher at Stanford University and founder of , which helps schools implement harm reduction education programs.

At the same time, a lethal substance was gaining traction. From 1999 to 2023, approximately 806,000 people died from an opioid overdose, with a significant increase in the number of deaths attributable to illegally made fentanyl and fentanyl analogs saturating the illicit drug supply over the course of the last decade, . Overdose fatalities involving synthetic opioids (excluding methadone) increased from 3,105 in 2013 to 72,776 in 2023, accounting for 91.7% of all opioid-related deaths that year, .

The widespread tragedy galvanized parents and politicians, who realized the pervasive “just say nothing” culture wasn’t cutting it.

Making their own decisions

The reason D.A.R.E. didn’t work, Hashemi said, is because of a cognitive dissonance between the messaging and what kids saw in real life. Warnings about the negative outcomes like overdoses, “brain rot” and addiction simply didn’t resonate. That paradox persists in prevention-focused social media campaigns today, .

“It����ap a similar thing that����ap happening now online, where our PSAs are still stuck in an abstinence-only mindset emphasizing these very serious consequences. But those messages are coming up alongside kids having fun and glamorizing their use,” Hashemi said.

That����ap why Hashemi and other experts advocate providing teenagers with honest information about drugs and safer use strategies, known as harm reduction. “I would define it as both a set of strategies and knowledge, but also a philosophical attitude in how we should address things,” she said. “Our goal is not net sum prevention of use, it����ap prevention of harms.”

For example, it����ap helpful to know that a single serving of alcohol varies depending on whether you’re drinking beer, wine or liquor. That way, if young people choose to drink, they have a better understanding of how much they’re consuming.

“Young people are going to make their own decisions,” said Marsha Rosenbaum, a sociologist and harm reduction expert. “So we need to acknowledge that even if we don’t like the decisions they’re making.”

Rosenbaum helped introduce parents to the idea of harm reduction through a series of booklets entitled “Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education,” the first of which was released in 1999. Harm reduction was something of a taboo topic in the ‘90s, she said. And in many ways, it still is today.

Luke Niforatos, executive vice president of advocacy organization , believes that harm reduction has gone too far in normalizing substance use and abuse, and that it often sends the wrong message to America’s youth. While he supports making naloxone more accessible, other safer use initiatives, like supervised needle injection sites, do little to help drug users get treatment or work toward recovery, he said.

Conversations about beverages’ specific alcohol content, marijuana edible standard dosing and onset times, and the potentially therapeutic benefit of things like cannabidiol should be the responsibility of parents — not schools — Niforatos added.

“I understand there has to be some level of teaching in the schools, but you have to be really careful about that line because, at the end of the day, it quickly traverses over the line into teaching someone how to use instead of educating them,” he said. “I think the message needs to start with ‘do not use’ and then support that message with evidence.”

Rosenbaum and other advocates dispute that characterization. Abstinence is part of harm reduction — in fact, it����ap the safest strategy of them all, she said. But presenting critical information about drugs in a nonjudgmental tone opens the door for trust building with kids and ultimately empowers them to make more informed choices, supporters say.

In a sign that public attitudes are changing, Rosenbaum turned “Safety First” into a comprehensive drug education and intervention school curriculum in 2017. It was subsequently acquired and revised by Stanford University’s REACH Lab in 2023, and ��for free. With lessons about cannabis, hallucinogens, e-cigarettes, opioids and more, public health experts hope Safety First can help set a new standard for evidence-based classroom instruction. The second lesson in the curriculum provides an introduction to harm reduction.

More than 629 schools across at least 46 states have used the curriculum, including schools within 15 Colorado districts, said Bonnie Halpern-Felsher, director of the REACH Lab. She estimates Safety First has reached more than 50,000 students, though it may be more than that since the curriculum is available for free online.

In broader efforts to prevent opioid deaths, naloxone has become widely available nationwide at hospitals, schools and even vending machines without a prescription. In Colorado, social media campaigns encourage young adults to by carrying the overdose reversal medication and testing their drugs for fentanyl.

Hashemi is encouraged by this shift, but she believes harm reduction needs to expand both beyond opioids and beyond the classroom. She hopes momentum continues and drug education addresses other prominent issues teens are dealing with, such as nicotine addiction and bad trips from psychedelics. She also wants to see social media campaigns, public service announcements and other digital campaigns reach kids online, where they already spend a lot of time. (A 2024 study suggests to explore.)

“When you expose the kids themselves to harm reduction education, they run with it,” Hashemi added. “But if we do not use fentanyl as a Trojan horse to do harm reduction around all drugs, this moment is going to sort of pass us, and we’re not going to be giving kids the comprehensive education that they’ve always deserved.”

This series was reported with support of the .

As these drugs have become more culturally acceptable and legally accessible, schools have had to rethink how they approach talking about them. After all, how do you educate youth about substance use and abuse when you can’t tell them to ‘just say no’?

Colorado’s “local control” approach means there’s no standardization for drug and health education, and lessons vary widely throughout the state — from Denver where there are many types of prevention education and interventions to rural districts like Gunnison, which hired its first full-time staff member to oversee health programming in 2024.

In a three-part series, The Denver Post is exploring what youth drug education looks like in Colorado’s era of drug reform. We spoke with educators, public health experts, nonprofit leaders and local teenagers about how conversations about marijuana, opioids and other substances have shifted from being confined to abstinence-only messaging to include science-based information and, in some cases, harm reduction strategies like overdose prevention. We also observed classes and projects that help youth hone leadership skills, develop peer groups where they experience a sense of belonging and cultivate healthy habits as means to prevent substance use.

Here’s what we learned.

From ‘Just Say No’ to Narcan: How drug education is changing in a modern world

Americans have long relied on school-based curricula and fear-based educational campaigns to discourage youth use. But as the opioid epidemic unfolded over the last decade-plus, harm reduction emerged as a new philosophy to keep kids safe from fatal overdoses. Read more ►

Colorado schools don’t have any standardized drug education, relying on patchwork programs

Because Colorado is a “local control” state when it comes to education, drug and health programming varies by district. However, the educators we spoke with agree that prevention starts with addressing students’ mental and emotional wellbeing. When talking to students about drugs, they also said transparency and trust are key to making an impact, especially for a generation with the world’s information at its fingertips. Read more ►

How teens are teaching each other about drugs

Schools are not the only places that teens learn about drugs today. In fact, many nonprofits in Colorado provide essential drug information and training to local youth, effectively entrusting them to act as positive influences among their peers. Read more ►

5 tips for how to talk to kids about drugs

Parents have a vital role to play when it comes to drug use prevention and intervention. We spoke to public health experts who offered practical tips for effectively building trust and communicating with teens about fentanyl, marijuana and more, so that they feel comfortable confiding in the adults in their lives. Read more ►

This series was reported with support of the .

Billed as , 5280 Recovery serves about 100 teenagers who deal with substance abuse and addiction. The school uses strategies such as coaching and group meetings to help kids get sober — and stay sober — one day at a time, said Keith Hayes, who served as the school’s director of recovery from 2020 to 2026. Many of the staff are also recovering addicts with their own past troubles and life lessons to share.

On one “Winning Wednesday” last May, Hayes stood in front of bleachers full of students and handed out chips to those marking monthly milestones of continuous sobriety. It was the last Wednesday of the 2024-25 academic year and one well worth celebrating. That year, the student body boasted an average of 440 days sober from drugs and alcohol, the highest average since the high school’s opening in 2018.

“There is no chaser with anything that we do here at 5280. It is raw, it is uncut and it is real,” Hayes said in an interview. “The ability to be vulnerable with each other without judgment, without shame, is a beautiful thing. And I think the only way that real recovery works is that we can have difficult conversations about difficult things.”

After the presentation, recovery coach Brittany Kitchens then led a group discussion to talk about the challenges of staying sober during the summer without the structure and accountability of school weeks. She asked the teenagers in the room how they would fill their free time and who they would surround themselves with in the absence of their classmates.

Educators say it����ap critical to build trusting relationships between students and adults, and to entrust student leaders to help shape the culture in their communities. For some, this also means working closely with students who get into trouble as well, and instituting deeper forms of development than simple discipline or punishment.

But approaches remain a patchwork across Colorado since the state’s “local control” form of governance leaves it up to individual school districts to determine curriculum content. When it comes to drugs, state law only requires that some type of prevention education must be taught, though it lacks specifics about what that should look like.

That means the breadth and depth of information covered varies “dramatically” between districts, said James Hurley, comprehensive health and physical education content specialist at the Colorado Department of Education.

This is the second story in The Denver Post����ap three-part series examining how drug education has evolved alongside changing cultural attitudes towards substances like cannabis and psychedelics, both of which are now legal in Colorado.

The Post spoke with five districts, both urban and rural, about their approaches; we also attended classes, virtually and in-person, at two. Prevention and intervention efforts within these districts are fairly new. Denver Public Schools, the state’s largest district, developed its programming in 2015 in response to marijuana legalization. Comparatively, the small Gunnison Watershed School District in southwestern Colorado hired its first student wellness coordinator in 2024 to oversee health programming and partnerships.

Normalizing sobriety

Educators said nicotine, cannabis and alcohol are the most common intoxicants they see and hear about among school-age kids, though awareness about opioids and psychedelics is growing.

In 2023, 20.5% of high school students reported they currently drink alcohol, according to the latest data available from the , issued every two years by the Colorado Department of Public Health and Environment. The survey found 12.8% of high schoolers use marijuana, 8.7% vape nicotine and 3.1% smoke cigarettes.

Additionally, 3.5% of respondents said they take prescription pain medicine not prescribed to them or differently than prescribed. (The 2025 Healthy Kids Colorado survey results are expected to be published in June.)

Some of those statistics mark a notable decrease from the prior survey issued in 2021, when 23.6% of high school-aged kids reported drinking alcohol, and 16.1% reported vaping. The percentage of students who reported abusing pain medication also dropped, from 5.9% in 2021. Marijuana and cigarette use remained flat.

Despite concerns that underage marijuana use would skyrocket after legalization in 2014, rates largely remained stable before decreasing significantly in recent years. In 2019, the use rate among high schoolers was 20.6%,compared to 21.2% in 2015, according to the survey.

The 2023 survey added a new question asking high school-aged kids if they had ever used psychedelics, and 3.8% reported that they had.

The data underscores that most local teenagers are not using drugs and alcohol — even though they often overestimate the number of their peers who are. For example, 42.8% said they thought a majority of their peers binge drank — defined as four or more alcoholic drinks in one night — compared to just 12.1% who reported having done so in the previous 30 days, according to the 2023 survey.

“We need to normalize sobriety,” Hayes said. “We need to normalize that it����ap OK to be comfortable in my own skin, I don’t need a social lubricant.”

A focus on trust and transparency

When talking to students about drugs, Colorado educators said transparency and trust are key to making an impact, especially for a generation with the world’s information at its fingertips.

During his tenure at 5280 Recovery High School, Hayes sought to create a judgment-free zone so kids felt comfortable being honest with their recovery coaches.

“Let’s stop telling people drugs and alcohol are bad because that’s not true. Because if they were so bad, would anybody be out here doing them?” Hayes said. “So we tell kids, ‘We love drugs, we know they’re phenomenal. We love alcohol. But if I truly work in an active program of recovery, that can be even more phenomenal.’ And that����ap the messaging. Kids dig that.”

In more traditional high school settings, the tone is typically more tempered. But educators still aim to create an environment where trust and honesty are reciprocal with their students. Having trusted adults to confide in is one critical factor that ultimately supports youth emotional and physical well-being, experts said, and well-being is inextricably linked to substance use and abuse.

At Ridgway Secondary School, where enrollment in grades six through 12 totals just 150 pupils, Shawnn Row has a unique opportunity to build a rapport with students and their families. In addition to being a health teacher, Row serves as the athletic director, an English teacher and outdoor education coordinator, so he sees the same kids in numerous capacities for many years.

As the ninth graders filed into health class on a chilly February morning last year, it was clear they were immediately engaged. For one, Row was speaking their language. The first slide on the day’s presentation about marijuana featured a meme with a picture of a young boy smiling, his head flanked by text. “4/20? Puff puff pass? I’d rather pass today’s math quiz, thanks.”

As the kids repeated the punchline and giggled, Row stood at the front of the room with a welcoming smile. “Today we’re gonna talk about weed,” he said.

Health is a year-round class here, though the subject matter varies with the semester. Students receive sex education in the fall and drug education in the spring. Row began creating all the lessons himself several years ago after finding that out-of-the-box curricula didn’t resonate. His presentations combine scientific information about the adolescent brain, the known benefits and risks of various substances, and personal anecdotes from his own life.

Row appreciates that his school leaders believe drug education should be a continuous conversation, instead of something that����ap relegated to a specific timeframe or initiative. That also gives him the flexibility to address what specifically interests students.

“Usually at the beginning of eighth grade (and) ninth grade health, I say, ‘Hey, write down topics you’re curious about or you’ve seen somewhere or you’ve heard about,’ and I’ll try to integrate them into the lessons I have planned already,” Row said.

Row’s lecture about cannabis didn’t sugarcoat the fact that it is widely available in Ridgway, a town of about 1,200 residents and three recreational dispensaries near downtown. The students were well aware of that, of course. You can smell it “walking around on any given Tuesday,” one said during class.

Row broke down the differences between cannabidiol and tetrahydrocannabinol, explaining the psychoactive effects and how those distinguish the CBD products in grocery stores from the THC products in pot shops. He also shared a study tracking youth use and later life outcomes, and a story about how Kansas police once pulled him over and searched his car because of his Colorado license plate.

After class, then-freshman Izzy Katz said she learned a lot from the presentation, but still wasn’t sure if she considered marijuana good or bad. Some drugs, like fentanyl and heroin, have very clear harms, she said. Cannabis didn’t seem similarly dangerous, but it also didn’t seem benign like Vitamin C.

“I feel like marijuana is kind of put in that grey area where people don’t know how to categorize it,” Katz said. Her sentiment exemplifies the challenge of discussing once-demonized drugs that are now being reframed in light of legalization.

“I really hammer away on (the fact that) the teenage brain is not fully developed, and no matter what substance it is you put in your body, it����ap going to have a bigger effect on you than it will on a 25-, 30- or 35-year-old,” Row said in an interview. “That is kind of the challenge with the legalization of weed and now psychedelics is, if adults don’t see it as harmful, the kids are less likely going to, as well.”��

Row navigated this again when he tackled psychedelics during an April health class. While substances like psilocybin and LSD aren’t as popular as vaping, cannabis or alcohol, Row believes kids have been exposed to them enough through movies, social media and the news to warrant a discussion. And he’s probably right.

The freshmen were noticeably excited the morning they arrived and saw a presentation titled “psychedelics/hallucinogens.” After discussing the role of the brain’s thalamus and how psychedelics suppress its ability to filter all the sensory experiences of the world, one student suggested that this may be a good thing in moderation. After all, The Beatles “took LSD all the time and they had fire music during that timeframe,” she said. Another said she has read that microdosing ‘shrooms can help with anxiety.

Yes, psychedelics could boost creativity in some cases, and yes, research has shown they can be beneficial in therapy, Row responded. But the effects are not all just fractals and rainbows.

“If our thalamus wasn’t working, we would be in sensory overload all the time, and when people do acid, do mushrooms, usually once they wear off, they are completely depleted,” Row told the class. It can take a day or more to recover from a single 8- to 12-hour trip, he added.

Youth leaders cultivate culture

Three hundred miles away, substance prevention specialist Leah Raffa is tasked with disseminating drug education to the 89,000-plus Denver Public Schools students. There’s no one-size-fits-all solution here. Instead, Raffa and her colleagues in the Exceptional Student Services sector, which addresses mental health and student well-being, curate a menu of prevention resources and give each school autonomy over the best ways to serve their unique student populations.

Offerings include curricula that focus specifically on vaping, cannabis, prescription drugs and opioids, as well as programming designed to help students cope with stress and create meaningful connections with peers and adults at their schools. Where intervention is needed, DPS will deploy school social workers and psychologists to work directly with individual kids.

Perhaps one of the more interesting ways the district seeks to address whole child well-being is through a program called . The program, which resurfaces throughout elementary, middle and high school, teaches kids to identify and draw upon their personal strengths as a means for creating healthy habits and lifestyles.

At the high school level, Sources of Strength is an extracurricular activity intended to cultivate a group of peer leaders who effectively act as positive influences in their schools. At Denver South High School, the group includes about 10 students, freshmen through seniors, who work with onsite social workers on initiatives that amplify inspiring stories and build community within the student body.

While this program doesn’t directly educate kids about drugs, it works as a prevention mechanism by empowering students to shape their school’s culture and build a peer support network for those who might be struggling, Raffa said.

Rose Negler, who graduated from Denver South last spring, spent several years participating in Sources of Strength and said the most impactful projects were often some of the smallest. For one initiative, students wrote down the name of a positive friend on a slip of paper and then collectively linked them into paper chains that decorated the hallways. The skills she learned also benefited her theater class once when a student went missing. Negler was able to talk to other students who were stressed and help diffuse the situation.

“A lot of my Sources skills came in handy there because I knew what to do in that kind of crisis and I was able to handle it,” she said.

At 5280 Recovery High School, the students even sponsor one another. “We can talk to the kids ‘til we’re blue in the face about what we did to get sober, but it hits different when it’s a 16-year-old who has your same experiences and got their way out of that hole,” Hayes said.

Whole child solutions

In some districts, the most significant evolution has come in how educators react and intervene when students are caught using. In the Montrose County School District on Colorado’s Western Slope, strategies revolve around identifying environmental or circumstantial factors, such as food insecurity, that may be causing students’ drug use and connecting them with community organizations to help remedy those, said Megan Farley, the district����ap manager of student health and safety.

“What we find is (a student) might be using nicotine or something, but that����ap the tip of what����ap actually happening,” Farley said. “We go in with a whole person, whole family approach. Like if it����ap food that you need from the food bank, we hook you up with deliveries from the food bank.”

The district began shifting its approach in 2018, in the wake of the Parkland, Florida, mass shooting that killed 17 people at Marjory Stoneman Douglas High School and injured 17 others. A decade ago, Montrose had no school social workers in a district serving roughly 6,000 students. Today, Farley manages a team of up to 20 nurses, therapists, social workers, behavior coaches and school resource officers to support students’ needs.

The district also maintains partnerships with local organizations, like Hilltop Community Resources, so that young people can be connected to specific groups or specialists they may need for support. All someone within the district has to do is express concern about an individual kid and Farley’s team will jump into action.

This ethos applies if a student gets in trouble for something other than drugs, too, said district spokesperson Matt Jenkins.��“A child who is in crisis is not going to go away. We’re not going to expel our way out of that problem. We have to find an intervention and find the solutions in concert with that family to turn the corner.”

Most of the educators who spoke to The Post said they were reevaluating discipline methods in hopes of finding long-lasting solutions. Instead of pushing kids away with punishments like suspension, these educators want to bring the students closer.

Here, again, is where trust comes into play, said Hayes. Given that students at 5280 Recovery High School are in recovery, relapse is a real possibility. When that happens — as it sometimes does — the staff works to comfort and support the individual, connect them with groups and assure them they are not a moral failure.

“A lot of us come into recovery with so much guilt and shame for the things that we’ve done. These kids need love — lots of love and lots of grace and lots of understanding,” Hayes said. “Being able to be there for them and supporting them and encouraging them to keep going is very important.”

This series was reported with support of the .

NEWARK, N.J. (AP) — OxyContin maker Purdue Pharma is set to be dissolved and replaced by a company focused on the public good by the week’s end, as a massive legal settlement resolving thousands of lawsuits takes effect.

A federal judge on Tuesday delivered a criminal sentence to the company to resolve a U.S. Department of Justice probe — a last necessary step to clear the way for the settlement.

U.S. District Judge Madeline Cox Arleo made her decision after listening to hours of impact statements from people who lost loved ones or struggled with addiction themselves and requested she reject the negotiated sentence. While she didn’t go that far, she said she sympathized with people who bore the brunt of an����in the U.S. since 1999.

“It was a purposeful, intentional and sophisticated crime scheme,” she said.

The sentence calls for money, but no individual punishment

Purdue reached a deal with the Justice Department in 2020 to����the company was facing.

The Stamford, Connecticut-based company admitted it did not have an effective program to keep its powerful prescription painkillers from being diverted to the black market, even though it told the U.S. Drug Enforcement Administration that it did.

It also admitted it paid doctors through a speakers program to prescribe the drugs and paid an electronic medical records company to send doctors information on patients that encouraged more opioid prescriptions.

Steve Miller, who became chairman of Purdue’s board to guide the company through the bankruptcy process and will cease to have that position when the company is dissolved, addressed the hearing: “I deeply apologize on behalf of the company for everything they did,” he said.

Only the company was charged — not individual employees or owners.

The guilty plea and civil settlement with the federal government included $8.3 billion in forfeitures, fines and penalties. But the federal government agreed in a negotiated settlement to collect just $225 million in exchange for Purdue reaching a separate settlement of the thousands of lawsuits it faced from state, local and Native American tribal governments, along with other groups. Purdue’s guilty plea did not include restitution to victims.

After����— and $1 billion and counting in legal and professional fees for the parties — the broader sentence was����by a bankruptcy judge in November.

‘We still deserve justice’

Arleo on Tuesday heard in person and by teleconference from people impacted by opioids in several ways: mothers who lost sons to overdose, a teenager born into withdrawal and whose mother later died, and people who were prescribed OxyContin after accidents and spent years dealing with addiction treatment and financial and emotional turmoil.

Many asked Arleo, who at times appeared to be on the verge of tears, to reject the negotiated sentence.

Alexis Pluis, an upstate New York mother who lost a son to opioids in 2014, said she doesn’t expect to receive anything from the settlement because she can’t locate 23-year-old medical records showing her son was prescribed OxyContin.

“We still deserve justice,” she said. “And this isn’t it.”

After listening to victims for about five hours Tuesday, the judge told them that she would keep photos of loved ones they lost to opioids in her chambers as long as she serves as a judge. She had harsh words for the federal government for approving OxyContin and not catching warning signs that it was being abused, and for prosecutors for not bringing charges.

She noted that she has sentenced convicted drug dealers to prison for selling OxyContin — and in those cases, federal prosecutors routinely bring up that it was part of an epidemic.

“It is not lost on me that those who started the epidemic will not serve a sentence,” she said.

Sackler family members to pay up to $7 billion

The settlement, which Purdue says could take effect as soon as Friday, calls for����who own the company to contribute up to $7 billion over 15 years. Most of the money is to go to government entities to use to fight the opioid crisis.

Early in Tuesday’s hearing, Arleo asked lawyers why Sackler family members were being allowed to pay over 15 years. She was told it was because they had to sell other businesses to secure the cash.

The judge offered a different reason. “They’d rather pay it from future money than pay it now,” she said.

A Purdue lawyer said most of the lawsuits against the company over opioids did not include specific financial claims. But the ones in those that did totaled over $40 trillion in damages.

The settlement is among the largest in a series of settlements by drugmakers, wholesalers and pharmacies in recent years — and the only major one that includes payments for some individual victims or their survivors.

Payments to individual victims are expected to range from about $8,000 to about $16,000. Some people said Tuesday that they could be rejected for payments because they can’t locate decades-old prescriptions to the pills. Arleo told Purdue bankruptcy lawyers to ensure there are additional ways to prove they were harmed.

Overall, the settlements are worth more than $50 billion, and most of the money is to be used to��.

Under the Purdue deal, members of the Sackler family will be shielded from lawsuits over opioids from those who agree to the payments. Family members received payments from the company totaling about $10.7 billion from 2008 through 2018, but said nearly half that amount was used to pay taxes on behalf of the business.

As part of the settlement, Purdue itself will cease to exist and be replaced by a new company, Knoa Pharma, with a board appointed by the states and an aim of combating the opioid crisis. Millions of internal Purdue documents are to be made public.

Members of the Sackler family also have agreed not to object if their names are����and other institutions they’ve supported.

Associated Press video journalist Emily Wang contributed to this article.

Dr. Richard Dart joined the in 1992, after working at a poison center in Tucson, Arizona. Since then, the Denver-based Rocky Mountain Poison and Drug Safety, which includes the poison center and related research, grew from about 30 employees to 150, added a surveillance system to monitor prescription drug misuse, and led a clinical trial that changed how hospitals treat venomous snake bites.

The center’s staff, who are employed by Denver Health, answer calls from Colorado, Montana, Nevada and Hawaii.

Dart and the Rocky Mountain Poison Center have been leaders in expanding how centers contributed to health care and public safety, and quite a few younger toxicologists and poison center directors were trained there, said Dr. Alan Woolf, a professor of pediatrics at Harvard Medical School who has worked with poison centers since the 1980s.

Dart’s tenure coincided with technological advances that allowed poison centers to respond more quickly and to better use their call data, Woolf said. Before personal computers, they had to rely on microfiche records of the thousands of products people could ingest and kept call records on paper, limiting the ability to do research, he said.

“I think Rick can be very proud of the role he played over the last 30 years,” he said.

While most people know poison centers as resources to call if their child swallows something potentially dangerous, they also train toxicologists and produce research on what substances Americans are ingesting, intentionally or not.

One of the Rocky Mountain Poison Center’s biggest accomplishments during Dart’s tenure was helping to pull off a clinical trial for a new rattlesnake antivenom, which became the preferred option in the early 2000s, he said.

Studying antivenoms is difficult because any given hospital will only see a few rattlesnake bites each year, which the poison center overcame by involving 15 medical centers and ensuring those hospitals’ emergency room doctors knew to randomize whether patients received only the old antivenom, or the new one in addition. They quickly realized patients getting the new one had better outcomes.

“You have to make sure that when that patient comes, you’re ready,” Dart said. “Luck favors those who are prepared.”

Dart also oversaw Denver Health’s acquisition of the or RADARS, which tracks misuse of prescription drugs with data from poison centers, reports from about 200 law enforcement agencies and surveys of the general public and people entering addiction treatment.

The U.S. Food and Drug Administration requires drugmakers to conduct studies about misuse of their products, and most contract with RADARS to do that work, Dart said.

Purdue Pharma, the now-bankrupt maker of OxyContin, created RADARS in 2001, then sold it to Denver Health for $100 cash and $10 million worth of reports.

with advocacy groups including Public Citizen and Physicians for Responsible Opioid Prescribing, as well as some individuals who lost family members to overdoses, urging the FDA not to work with RADARS.

Advocacy groups, including Public Citizen and Physicians for Responsible Opioid Prescribing, have alleged that RADARS is too close to drug companies and provides scientific cover for their products. But Dart maintains that the system is entirely independent.

RADARS offered an early warning about misuse and addiction from prescription opioids, especially generic forms of oxycodone, Dart said. Purdue became one of the main villains of the opioid epidemic in the public mind because of their unethical sales techniques, but most people misused cheaper generic versions, he said.

“While Purdue did some very inappropriate things and are getting their just deserts, I think, OxyContin wasn’t the problem,” he said. “OxyContin never had more than a few percent of the market.”

In general, the data RADARS collected from people seeking treatment showed price, availability and purity matter most to those who use illicit drugs, which foreshadowed the shift from prescription opioids to heroin and fentanyl following a government crackdown on pill mills, Dart said.

They haven’t yet been able to answer how many people would have preferred to keep using prescription pills, if not for the crackdown, and how many switched to heroin or fentanyl because they offered a stronger effect for the same price or less, he said.

“There was this demand, and people are going to fill it,” Dart said.

It also tracked the rise of polydrug use. About half of people who reported using one recreational drug also said they used others when Denver Health purchased RADARS in 2006, but now 80% to 90% take two or more drugs, Dart said.

That suggests people aren’t especially particular about seeking one experience, he said — they just want to feel something different than they would without drugs.

“State government, federal government, they focus on one drug at a time,” he said. People who use drugs “just go to something else.”

Like many providers around the country, UCHealth sent Houk to , an Englewood-based medical device company that manufactures and sells instruments used for pain management and rehabilitation.

When insurance didn’t cover the , Zynex promised Houk that she could make 10 payments of $25 to cover the cost. What the Westminster patient didn’t know was that this would kick off a year of fighting with a company determined to bill Houk and her insurance providers as often as possible.

The company billed her old insurance. It billed her new insurance. And it sent her bills for more than $2,000 for the $250 device, when she was already paying it off in installments.

“The billing was relentless and terrifying,” Houk said in an interview.

Houk was one of numerous Coloradans caught up in what federal investigators say was a years-long scheme by Zynex to oversupply medical devices and overbill patients seeking opioid-free pain relief. A federal grand jury indicted two former top executives in January, accusing them of orchestrating the fraudulent practices that netted Zynex nearly $1 billion. The company last month avoided further prosecution by admitting to participating in a conspiracy to commit health care fraud, securities fraud, mail fraud and other violations.

Former Zynex employees, in interviews with The Denver Post, said they felt uncomfortable following directives that were unethical or outright illegal. The company routinely fell behind on paying vendors, even as leadership touted rapid growth and record revenue. Staff said they were instructed to continue sending devices and supplies to patients, even when they didn’t request them. Executives told workers not to tell Medicare and Medicaid patients that they would be on the hook for the devices if their insurance didn’t cover them.

“It felt like that was poor business practice to essentially lie to your patients and scam them and create a bad reputation for the company,” said Cori Latousek, a former Zynex employee.

More than a dozen patients told The Post they received supplies that they didn’t order and didn’t need. The scheme has prompted a host of lawsuits from insurance companies and shareholders who say they were duped by Zynex.

At the top of the pyramid stood a chief executive officer who marketed the company’s work as the antidote to the opioid epidemic. Thomas Sandgaard started a to help fund alternatives to painkillers and on the opioid crisis. He was also known for driving expensive sports cars, playing guitar around the office and promoting himself at every turn, former employees say.

Zynex served as a Colorado startup success story — a one-man operation turned public company with hundreds of millions of dollars in revenue. This is the story about how it all fell apart.

Sandgaard, a Castle Rock resident, remained in federal custody as of late February, according to the U.S. Marshall’s Office. His attorney, when contacted by The Post, said he was no longer working on the case.��Anna Lucsok, Zynex’s former chief operating officer, who was also indicted, is free on bond. Her attorney, Bill Leone, said, “the allegations in this indictment are just that — allegations. We look forward to vindicating our client at trial.”

Zynex, in a statement, said the company, in its deal with the Justice Department, “took responsibility for past business practices implemented by former company executives.”

“Our new management team is committed to the highest standards of integrity and compliance in everything we do, so we can better serve patients who can truly benefit from our prescription medical devices,” the company said. “We have completely broken from the past and look forward to closing this chapter and making an important contribution to the health care needs of Americans living with chronic pain.”

Rapid growth fueled by ‘moral conundrums’

Sandgaard, a dual citizen of the U.S. and Denmark, founded Zynex in 1996��after a career in the semiconductor, telecommunications and medical equipment industries. He positioned the company’s products as a safe alternative to opioids through the development of electrotherapy technology that alleviates chronic pain.

In February 2019, the company went public. Sandgaard that would help expand the Zynex team.

Rapid growth followed — and industry watchers started taking note.

The company ranked 13th in revenue growth among all medical device companies in the U.S. and Canada on Deloitte’s 2020 Technology Fast 500.��Jim Cramer, the popular host of “Mad Money” on CNBC, in 2021 .

Zynex, in the first quarter of 2023, reported 36% year-over-year revenue growth. Orders increased 61%. The following quarter, revenue jumped 22%.

At the end of 2024, Sandgaard said his company hit , and he expected to see 10% to 15% growth in 2025.

“The company is built by our employees,” the founder said in a .

Privately, though, many of those same employees grew concerned over how Zynex was making its money.

Latousek served as a territory manager in Seattle, targeting physical therapy, pain clinics and surgery centers for business. The sales pitch: non-opioid pain management.

She recalled leadership instructing her not to tell patients who received the devices that they automatically get enrolled for supplies, such as batteries and electrodes. Many patients, as a result, she said, received charges that they didn’t authorize.

“That felt really sketchy,” Latousek said. “I would always tell my patients to make sure they opted out.”

Most of the time, Medicare wouldn’t cover the stimulation device or the electrodes. When Zynex dealt with these patients, staff said they told them it cost $250 out of pocket.

But in the spring of 2021, leadership changed the directive. Going forward, the policy was to not tell Medicare patients the cost if their insurance didn’t cover it, former employees said.

“We’re pretty much locking in older vulnerable people on Social Security or fixed incomes who don’t have much money,” said one former Zynex worker, who spoke to The Post on the condition of anonymity because they feared career consequences for being associated with the company.

This led to constant “moral conundrums,” the former employee said. They recalled phone calls with elderly patients who said they couldn’t afford the device. Yet Zynex still found a way to send them the units, charging them $250.

When this employee brought up concerns from staff that they were taking advantage of people, they said they were let go.

“I never felt good,” the individual said. “Me getting fired was definitely a blessing.”

Former Zynex staffers said this occurrence was common: Workers who expressed concerns about the company’s practices would be fired or reassigned to different roles. As a result, few employees stayed for long, outside of top executives.

Meanwhile, Zynex was often late paying vendors, employees said. The company offered to pay half if it could receive some of the inventory — an arrangement that left workers feeling uncomfortable.

People in the buying department quickly grew alarmed that their supply orders for batteries and electrodes were so steady. Normally, in this business, there should be fluctuating inventory levels based on customer demand, employees said.��But at Zynex, the numbers remained constant.

That was because they were shipping batteries and electrodes over and over to the same patients, these workers said they realized. Many people would return the packages to the warehouse with notes telling Zynex to stop sending them supplies.

Unwanted supplies, unexplained bills

More than a dozen patients told The Post that they received supplies from Zynex that they never ordered and didn’t need.

Josh Kahn, 39, underwent a spinal fusion in 2023, and his surgeon recommended an electrical nerve stimulation machine. The Denver resident got a prescription for the Zynex device.

The implement worked well, Kahn said, but every month he received batteries and electrodes that were unnecessary given his usage of the machine. He stuffed a drawer with all the supplies.

In January 2025, Kahn asked Zynex to discontinue the recurring orders. The company acknowledged his request.

But Kahn continued to get charged $45 a month for the device and supplies, according to the bills he provided to The Post.

“This is becoming a nuisance,” he told the company in an email.

Chris Basser, 49, used a Zynex machine for a back injury he sustained in 2021 after getting hit by a drunk driver. Medicaid covered everything, the Colorado Springs resident said, but he still received packs of six or nine batteries every three weeks.

He said he tried calling the company to cancel the orders, but nobody ever responded. He eventually gave up.

“I thought it was maybe a miscommunication,” Basser said. “I didn’t think of fraud.”

It didn’t seem to matter whether patients paid their bills. Zynex continued to demand payment.

For nearly four years, Zynex has been seeking $250 from Michael Raizen, despite the Denver resident negotiating a deal with the company to pay for his device.

“It’s like a bad rash,” Raizen’s wife, Gail DeVore, said. “No matter what you do, you can’t get rid of it.”

Sports cars, electric guitars and giant banners

Sandgaard served as the face of Zynex — and he wasn’t shy about letting everyone know.

The CEO showed up to the Englewood office in a sports car, and liked to walk around the office with his electric guitar, blasting music, ex-employees said. One former staffer recalled carrying around his amp and handing out T-shirts “like a little groupie.”

Sandgaard hung a large banner on the fourth floor, a spoof of a in which the Zynex founder is holding a machine gun in one hand, a bald eagle perched on his other arm. He’s standing on a fiery hill with a white Zynex flag behind him. Dollar bills flutter around his feet.

“He came off as a man incredibly full of himself,” the former staffer who felt like a groupie said, speaking on the condition of anonymity due to fears about future career consequences. “It felt very toxic male CEO.”

Complicating matters was the fusion of Sandgaard’s professional and personal lives.

He was in the midst of a divorce when he enlisted the services of a local psychologist, Dr. Raelynn Maloney. In 2014, the two started dating.

Despite the Zynex founder boasting about the company’s success, Maloney learned that Sandgaard and his firm had accrued significant debt and had exhausted lines of credit, she alleged in a 2025 lawsuit against him and the company.

Desperate, Sandgaard asked Maloney to help save Zynex, she said. The psychologist started attending high-level meetings as an unpaid consultant.

Without the ability to obtain financing, Sandgaard regularly asked Maloney for loans for himself and the company, she alleged. Maloney put up more than $1.1 million in personal assets as cash or collateral throughout 2023 so Sandgaard and Zynex could avoid bankruptcy, the complaint alleges.

Sandgaard eventually bought a house for Maloney and her daughters. She quit her private practice to join Zynex full-time, serving as the head of customer service, billing and parts of human resources, Maloney alleged.

In 2020, Sandgaard , and asked Maloney to help turn that organization around as well, she said.

Eventually, Sandgaard started to pull away from Maloney, she said in the lawsuit. He began seeking sexual experiences with their mutual friends, colleagues and former Zynex employees, she alleged. He sexually harassed his staff, Maloney said, and even put her in charge of handling several sexual harassment complaints made by employees.

“I guess you’re not going to have your fairytale ending,” Maloney said Sandgaard told her.

Maloney did not respond to messages seeking comment. Her lawsuit remains open.

Sandgaard, in court filings, called the complaint a “vengeful recounting of events regarding her romantic breakup.” The lawsuit, his lawyers wrote, “is nothing but a punitive attempt to punish her ex-partner and seek financial relief for the benefits she can no longer reap from their relationship.”

Zynex begins to crumble

The facade eventually started to crumble when insurance providers began to catch on to the scheme.

In December 2024, , the health insurer for service members, suspended payments to Zynex “based upon credible allegations of fraud and its audit of Zynex’s billing,” according to Sandgaard and Lucsok’s indictment. That move represented a huge blow to the company’s business, as TRICARE accounted for a quarter of its revenue.

Other payors also stopped reimbursing Zynex.

, in September 2025, said it had paid out more than $3 million in bodily injury claims to Zynex based on “false and fraudulent records,” the insurer alleged in a federal lawsuit filed in New York.

Zynex, the insurer said, “abused Allstate’s claimants’ insurance coverage by billing for (durable medical equipment) that” Zynex “had no legal right to collect.”

Sandgaard and Lucsok concealed TRICARE’s suspension until March 2025, federal prosecutors said. After the news came out, Zynex’s stock dropped by 51% in one day, dipping to $3.41 per share from $7.

Two days after the disclosure, Sandgaard sold $4.8 million of his stock, even though the company could not afford to buy it back, the indictment states.

Records show Sandgaard and the company as a whole suffered from serious financial woes.

Between 2015 and 2025, the Zynex founder personally racked up more than $321,000 in unpaid taxes��to the , court records show.

In December, Zynex filed for Chapter 11 bankruptcy protection, listing assets of more than $45 million and debts exceeding $86 million. Among the creditors: U.S. Bank (owed $61.75 million), TRICARE (owed $2.77 million) and the Polsinelli law firm (owed $1.14 million). Maloney is also listed with an “undetermined” claim.

On Jan. 14, a federal grand jury in Rhode Island on charges of conspiracy to commit mail, health care and securities fraud, among other counts.

Federal prosecutors alleged what patients, Zynex employees and insurance providers had been saying for years: The company was billing for and sending people devices and supplies that they didn’t request and didn’t need.

The company collected more than $873 million for its products, including more than $600 million for supplies, “the vast majority of which were the result of fraud,” the government alleged.

Between them, Sandgaard and Lucsok used their sizable earnings to pay for a private jet, a Lamborghini, the McLaren sports car, cosmetic procedures, real estate and the British soccer club, investigators said.

“This case represents a troubling abuse of patients seeking care, as well as the federal health care benefit system,” U.S. Attorney Charles C. Calenda said in a statement announcing the charges.

On Feb. 17, the Justice Department announced Zynex to avoid prosecution, admitting to the long-running scheme. Zynex also agreed to pay up to $12.5 million in fines and forfeit all unpaid claims.

Sandgaard and Zynex also face numerous lawsuits from insurers, patients and shareholders, who say they were duped by the Colorado company.

For patients who used Zynex devices and employees who worked for the Englewood company, the indictment represented an unsurprising turn of events, while also serving as validation that their suspicions��were not wrong after all.

“What they were doing was shoveling as much money into their own coffers as possible,” said Houk, the patient who kept getting billed. “It was utterly relentless. A lot of people got hurt by this.”