It is a heavy topic. Honestly, most people don't even think about the specifics of the Colorado End of Life Options Act until they’re sitting in a sterile doctor’s office hearing news they never expected. Death is uncomfortable. But in Colorado, voters decided back in 2016 that having a choice in how those final days look was a fundamental right. Proposition 106 passed by a massive margin—nearly 65 percent—and since then, hundreds of Coloradans have used this law to maintain a sense of control when their bodies were failing them.
But here is the thing.
It isn't just a "get out of jail free" card for pain. There are hoops. There are waiting periods. There are doctors who will look you in the eye and say, "I’m sorry, I can’t help you with this." Understanding medical aid in dying Colorado requires moving past the political slogans and looking at the actual clinical reality.
The basics you’ve gotta know first
The law is very specific. To even start the conversation, a patient must be an adult, a resident of Colorado, and have a terminal diagnosis with six months or less to live. This isn't for chronic pain that isn't terminal. It isn't for dementia where you’ve lost the ability to make decisions. That last part is a huge sticking point for many families. You must have "decision-making capacity."
Basically, if a doctor thinks you don't understand the consequences of your choice, the door shuts.
The process involves two separate oral requests, at least 15 days apart, and one written request. You also need two different doctors to sign off. One is the attending physician who writes the prescription, and the other is a consulting physician who provides a second opinion. They both have to agree: yes, you’re terminal; yes, you’re mentally sound; and no, nobody is forcing you to do this.
Why some people find it harder than others
You might think that because it’s legal, every hospital in Denver or Colorado Springs offers it. They don't.
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Under the law, healthcare providers can "opt out." Many religious-affiliated hospital systems—which account for a massive chunk of the beds in this state—do not allow their doctors to participate. This creates a "pharmacy desert" or a "provider desert" for people in rural areas or those stuck in specific healthcare networks.
Imagine being 75, exhausted from chemo, and finding out your local doctor won't even discuss the law with you. It happens. You’d have to find a new doctor, transfer your records, and start the 15-day clock all over again. It’s exhausting. According to the Colorado Department of Public Health and Environment (CDPHE), the number of participating physicians is growing, but it’s still a relatively small community of doctors who are willing to navigate the paperwork and the emotional weight of these cases.
The residency hurdle
You have to prove you live here. You can't just fly into DIA, check into a hotel, and ask for the medication. Doctors usually look for a Colorado driver's license, voter registration, or evidence that you own or lease property here. While some states like Oregon have started to drop residency requirements due to legal challenges, Colorado’s law, as written and currently enforced, focuses on its own residents.
The cost and the "Meds"
Let’s talk about the actual medication because no one mentions how expensive it is.
Back in the day, Secobarbital was the go-to. Then the price skyrocketed to several thousand dollars for a single dose. Now, most doctors use a compounded mixture of drugs—often a combination of morphine, diazepam, digoxin, and propranolol. It’s a powder that gets mixed into a small amount of juice or water.
Insurance is a mixed bag.
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- Private Insurance: Some cover it, some don't. You have to call and ask.
- Medicare: Does not cover it. Period. Because it’s federal, and aid-in-dying is not legal at the federal level.
- Medicaid (Health First Colorado): They actually do cover it in many cases, as long as the providers are enrolled and the paperwork is perfect.
The cost for the compounds can range from $500 to $1,000 out of pocket if insurance says no. For a lot of families already drowning in medical debt, that’s a real hit.
What actually happens in the room?
This is where the "human" part kicks in. The law requires that the patient self-administer the medication. The doctor cannot give you an injection. A nurse cannot put it in your IV. You have to be able to swallow the liquid or, in some cases, trigger a feeding tube yourself.
Most people choose to do this at home.
It’s usually quiet. Families often describe it as peaceful, but it's also incredibly intense. Once you drink the mixture, you typically fall into a deep sleep within minutes. The heart usually stops within an hour or two, though every body is different. Some people have the prescription filled and never use it. They just want it in the drawer. They call it "insurance." Having the option to leave on their own terms gives them the strength to keep living for a few more weeks. In fact, CDPHE data consistently shows that a significant percentage of people who get the prescription never actually take it.
Common misconceptions about medical aid in dying Colorado
People get the terminology wrong all the time. This isn't "assisted suicide" in the eyes of the law. In Colorado, the death certificate lists the underlying terminal illness—like Stage IV lung cancer or ALS—as the cause of death. This is huge for life insurance. If it were legally "suicide," many life insurance policies wouldn't pay out. But because the law treats it as a medical intervention for a terminal disease, those protections stay in place.
Also, it isn't a "quick fix" for depression. If a doctor suspects that a patient's request is being driven by a treatable mental health issue rather than the terminal illness itself, they are required by law to refer the patient for a mental health evaluation. The goal isn't to help people die because they are sad; it's to provide an end to suffering for those who are already dying.
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The 2024 Legislative Update
It's worth noting that the law evolved recently. Governor Jared Polis signed SB24-068 into law, which made some pretty big changes to the original 2016 act.
First, they shortened the waiting period. Instead of 15 days, it’s now 7 days in most cases. If a doctor thinks you’re going to die before that week is up, they can waive the waiting period entirely. This was a response to heartbreaking stories of people starting the process but passing away in agony before the second request could be legally made.
Second, they expanded who can help. Now, advanced practice registered nurses (APRNs) with prescriptive authority can act as either the attending or consulting provider. This is a game-changer for people in rural Colorado where specialized MDs are few and far between.
Actionable steps if you are considering this
If you or a loved one are looking into this, do not wait until the final days. The bureaucracy takes time.
- Check your hospital system. Ask your doctor directly: "Do you participate in the Colorado End of Life Options Act?" If they say they are "opted out," ask if they will at least provide a referral.
- Contact an advocacy group. Organizations like Compassion & Choices or the Colorado End of Life Options coalition have lists of "friendly" providers who are willing to take on new patients for this specific purpose.
- Gather your documents. Have your Colorado ID and your medical records showing your diagnosis and "prognosis" (the six-month timeline) ready to go.
- Talk to your family. The legal side is one thing; the emotional side is another. Make sure the people who will be in the room understand what the process looks like so there is no panic when the time comes.
- Find a participating pharmacy. Not every CVS or Walgreens stocks these specific compounds. You will likely need a specialized compounding pharmacy. Your doctor should know which ones in the Denver metro or surrounding areas handle these prescriptions.
The reality of medical aid in dying in Colorado is that it is a complex, regulated, and deeply personal medical standard of care. It requires planning, multiple medical opinions, and a clear-headed determination to follow through with the legal requirements. While the 2024 updates have made the process more accessible, it remains a path that requires significant legwork during a time when energy is often in short supply.