The building that once housed the last drugstore in this town of fewer than 600 is now a barbecue restaurant, where pit boss Larry Holtman dishes out smoked brisket and pulled pork across the same counter where pharmacists dispensed vital medications more than 30 years ago.
It’s an hourlong drive over treacherous mountain passes to Laramie, Wyoming, or Granby or Steamboat Springs, Colorado — and the nearest pharmacies. The routes out of the valley in which Walden lies are regularly closed by heavy winter snows, keeping residents in and medications out.
Walden has suffered the fate of many small towns across the United States, as the economics of the pharmacy business have made it difficult for community drugstores to survive. With large pharmacy chains buying up independent drugstores and increasingly controlling the supply chain, towns such as Walden have too few residents to attract a chain drugstore and no great appeal for pharmacists willing to strike out on their own.
With no local access to prescription drugs, the town of mainly cattle ranchers and hay farmers has crowdsourced a delivery system, taking advantage of anyone’s trip to those bigger cities to pick up medications for the rest of the town.
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“Really, it’s a network of community and people reaching out and knowing that others have needs,” said Tina Maddux, who runs a nonprofit that provides food and other assistance in Walden. “We’re a community that pulls together for the wellness of everyone.”
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The system is just one of the creative ways that rural communities deal with a lack of health care. In Walden, the senior center runs a regular shuttle to the bigger locales so older residents don’t have to drive to pick up groceries, visit doctors or refill their meds. In October, a pharmacy in Steamboat Springs began delivering medications to Walden once a week. Mail-order pharmacies can help with medications for chronic conditions, but not for acute needs.
Yet these solutions can’t replace a bricks-and-mortar pharmacy, as pharmacists do much more than count pills. They can give flu or COVID shots and, in some states, such as Colorado, even prescribe contraceptives. Some run diabetes management or smoking cessation programs. Medications can be complicated, and without a live person to talk to, patients can struggle to take them correctly.
Walden, Colorado, has no hospital and no pharmacy, only a small clinic. The clinic stocks basic medications to handle routine acute needs, but residents also band together to help one another pick up prescriptions when they head out on the hourlong drive over mountain passes to Laramie, Wyoming, or Granby or Steamboat Springs, Colorado.
In Walden, locals are one snowstorm, one mishap, from being cut off from their meds.
That uncertainty leaves Whitney Milek with constant anxiety. Her younger son, 8-year-old Wade, relies on medications to control his seizures. She usually picks up his medicines in Laramie, where the family does its big grocery runs. But when she needs to refill in between trips, she turns to her neighbors for help.
The informal system runs primarily through a Facebook group created in 2013 as a sort of online garage sale. For years, people have been posting to ask if anybody is headed toward a pharmacy and can bring back a prescription. Neighbors deliver to neighbors, even during the pandemic, and no money is exchanged.
“There are times when nobody is going and you end up having to have them mailed, which is a whole other thing, especially with seizure meds,” Milek said. “Some are controlled substances and they can’t mail them.”
