Arizona Drug & Alcohol Addiction: Facts & Stats

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Arizona Drug & Alcohol Addiction: Facts & Stats

Like any professional entity within the field of substance use, addiction and treatment, SpringBoard Recovery continually ensures it only uses the most accurate and respected sources of information in our work.

All the factual information, including statistics and other detailed analysis, that we use is monitored and updated as required. Only by doing this can we continue to operate and grow as one of the most respected drug and alcohol addiction treatment centers in the southwestern U.S.

Official research data, particularly from federal health resources, invariably takes time to come to fruition in terms of its qualification, peer review and final publication.

Therefore, in addition to these resources, SpringBoard Recovery uses recent analytical studies published through respected medical journals, like the Journal of the American Medical Association (JAMA) and The Lancet) to provide a more up-to-date picture of notable trends in the U.S. and, specifically, Arizona, in relation to substance use and mental health.

On this page, we will provide you with the very latest and most accurate information – our “Facts & Stats” – on drug and alcohol use, abuse and addiction in the state of Arizona.

We will look at how substance use affects the youth in our state, and how the decline in the mental health of Arizonians – as seen in all areas of the post-pandemic U.S. population – directly contributes to the use and abuse of drugs and alcohol.

We’ll also look at other areas of the subject which are specific to Arizona, such as our Native American population, and the serious issues and impact of bordering Mexico – the historical hotbed of the cartels’ illicit drug manufacturing and trafficking.

Contents:

1.

Drug & Alcohol Addiction in Arizona

1.1

Substance Use, Abuse & Addiction in the U.S.

1.2

Substance Use, Abuse & Addiction in Arizona

1.3

Substance Use Disorder Treatment in Arizona

1.4

Fatal Drug Overdose in Arizona

2.

Mental Health in Arizona

2.1

Mental Health Illness in the U.S.

2.2

Mental Health Illness in Arizona

2.3

Mental Health Illness Treatment in Arizona

3.

Arizona’s Top 6 Most Dangerous Drugs

3.1.

Fentanyl

3.2.

Heroin

3.3.

Methamphetamine (Meth)

3.4.

Alcohol

3.5.

Cocaine

3.6.

Benzodiazepines

4.

Arizona Youth: Drug & Alcohol Addiction & Mental Health

4.1.

Substance Use Among Arizona Youth

5.

Arizona: State-Specific Factors

5.1.

Arizona’s Proximity to U.S. / Mexico Border

5.2.

Arizona’s Native American Tribes

IMPORTANT: “Facts & Stats” & The Official Sources Used

Accurate statistics rely on official and published survey results, reports and data from federal and state governments and other accredited national and state organizations.

SpringBoard Recovery commonly uses official facts and statistics as derived from the national surveys conducted by the Substance Abuse & Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services.

Currently, as of May, 2022, the SAMHSA has yet to publish the respective statistics and tables, and their usual individual state reports, for the 2020 National Survey on Drug Use and Health (NSDUH).

However, in October, 2021, SAMHSA published the following national reports and tables, along with model-based state estimates:

Even though these results are only estimated, they have been released with “95% confidence intervals by age group” (or + or – error allowances), and this should be stated when using these figures and tables.

In addition, other approved informational sources regularly used by SpringBoard Recovery include:

SpringBoard Recovery: Approved Informational Sources

U.S. Federal Government:

Other Charitable / Private / Medical Organizations):

1.

U.S. Centers for Disease Control & Prevention (CDC)

1.

Journal of the American Medical Association (JAMA)

2.

Substance Abuse & Mental Health Services Administration (SAMHSA)

2.

British Medical Association (BMA) publication “The Lancet

3.

U.S. Drug Enforcement Agency (DEA)

3.

Partnership to End Addiction

4.

U.S. Food & Drug Administration (FDA)

4.

STAT News

5.

National Institute on Drug Abuse (NIDA)

5.

Mental Health America (MHA)

6.

National Institute on Alcohol Abuse & Alcoholism (NIAAA)

6.

Research Gate

7.

Rural Health Information Hub (RHIhub)

7.

KKF

8.

U.S. National Institute of Health Services: News in Health

8.

Pew Research Center

Arizona State Government:

1.

Arizona Department of Health Services (ADHS)

2.

ADHS: Opioid Prevention

3.

2020 Arizona Youth Survey (AYS)

Lastly, each section contains “Further Reading” (where appropriate), which includes internal resources and articles available on the SpringBoard Recovery website. Click on the title for access.

1. Drug & Alcohol Addiction in Arizona

Drug & Alcohol Addiction in Arizona

Overall levels of substance addiction – including new cases of opioid use disorder (OUD) – have generally leveled in recent years, thanks in part to the current restrictions placed on family physicians to stop them prescribing opioid painkillers like candy.

However, unfortunately, the numbers of fatal drug overdoses do continue to rise. The latest federal data reports the number of overdoses nationally standing at a massive 106,854 predicted deaths for the last 12-month period ending November, 2021 – at present, the highest figure on record.

Looking at Arizona, specifically, there were 2,735 predicted deaths for the same period. This is actually a small reduction in deaths from the 12-month period which ended 6 months prior, when there were 2,801 deaths (Arizona’s highest mortality rate for a 12-month period so far).

Addiction experts are now saying that it’s not a steady stream of new drug users that continue to drive the record numbers of fatal overdoses – it is a matter of current drug users encountering far stronger, more potent substances.

The majority of illicit drugs available either online or on U.S. streets have been laced (or contaminated) with the synthetic opioid fentanyl and a number of fentanyl analogs, by criminal drug manufacturers.

Historically, Arizona has always had more than its share of substance use disorders compared to the national average in the U.S.; the same description also applies to the prevalence of mental illness in the state.

However, in recent years, those rates have stabilized, as they have done nationally.

Unfortunately, though, Arizona still continues to be rated as one of the worst states to suffer with a serious behavioral issue, such as a substance use disorder (SUD) or a mental health disorder (MHD), because of its distinct lack of accessible treatment resources.

1.1 Substance Use, Abuse & Addiction in the U.S.

Here is a brief summary of the most prominent facts and stats from the 2020 National Survey on Drug Use and Health for the U.S. as a whole:

Drug & Alcohol Addiction in the U.S.: 2020

2020 NSDUH (Highlights)

Age

# (millions / m)

# (%)

Prevalence of Substance Use Disorder (SUD), including:

12 years +

40.3m

14.5%

  • with Alcohol Use Disorder (AUD)

12 years +

28.3m

  • with Illicit Drug Use Disorder

12 years +

18.4m

  • with AUD & Illicit Drug Use Disorder

12 years +

6.5m

Prevalence of Illicit Drug Use & Abuse

12 years +

59.3m

21.4%

  • Marijuana use

12 years +

49.6m

17.9%

  • Marijuana use by age:

12 – 17

10.1%

18 – 25 years

(highest)

34.5%

26 years +

16.3%

  • Opioid use

12 years +

9.5m

3.4%

  • Misused prescription pain relievers

12 years +

9.3m

  • Used heroin

12 years +

902,000

Prevalence of Alcohol Use

12 years +

138.5m

  • Alcohol Abuse: Binge Drinkers

12 years +

61.6m

44.4%

  • Binge drinking by age:

12 – 17

4.1%

18 – 25 years

(highest)

31.4%

26 years +

22.9%

  • Alcohol Abuse: Heavy Drinkers

12 years +

17.7m

IMPORTANT: The 2020 survey marked the first year in which substance use disorders (SUDs) were assessed using the criteria defined in the Diagnostic and Statistical Manual of Mental Disorders: 5th edition (known as DSM5), as opposed to previous years where the criteria from the Diagnostic and Statistical Manual of Mental Disorders: 4th edition (DSMIV) was used.

1.1.1. 2020-2021: U.S. Alcohol-Related Deaths Increased Beyond Projections

Alcohol remains the most favored “drug of choice” for the vast majority of Americans, and it also remains as one of the U.S.’s most prevalent killers, too. One of the clearest observations to appear out of the myriad of coronavirus pandemic data was the steep increase in alcohol use and consumption across the U.S. during 2021 and 2021.

According to a recent study published in JAMA Network Open on the subject of AUD–related mortality in the U.S., in the year 2021, deaths where AUD was listed among multiple causes were 22% higher than officially projected, and 28.8% higher in cases where AUD was listed as the underlying cause.

AUD-related deaths

Los Angeles researchers (from the Cedars-Sinai Medical Center) reported similar findings for 2020, with AUD-related deaths 24.8% higher than projected, and 30.7% higher in cases where AUD was listed as the underlying cause.

The greatest increases were seen in the adults aged 25 to 44 – 40.47% in 2020, and 33.95% in 2021.

1.1.2. CDC Revises U.S. Alcohol-Related Mortality for 2015-19

Additionally, according to the CDC’s new Alcohol-Related Disease Impact (ARDI) application, excessive alcohol use was responsible for more than 140,000 deaths in the U.S. each year during 2015–2019, which equates to more than 380 deaths every single day.

1.2 Substance Use, Abuse & Addiction in Arizona

As described above, the SAMHSA has provided state estimates from the 2020 NSDUH. However, please remember the previous proviso: they have been released with “95% confidence intervals by age group” (or + or – error allowances), and this should be stated when using these figures and tables.

Arizona: Substance Use & Abuse (2019-2020)

Based upon 2019-2020 NSDUH State Prevalence Estimates (in thousands)

Selected Measure of Substance Use

All totals are in thousands

Age Demographic (Years)

12 +

12 -17

18 – 26

26 +

18 +

1.

Illicit Drug Use (Past Month)

868

39

188

641

829

Illicit Drug Use includes the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine

2.

Marijuana Use (Past Month)

710

36

170

503

674

3.

Illicit Drug Use – other than marijuana (Past Month)

237

9

36

192

228

4.

Cocaine Use (Past Year)

110

2

41

67

108

5.

Heroin Use (Past Year)

1

43

44

6.

Meth Use (Past Year)

109

1

6

102

109

7.

Prescription Pain Reliever Misuse (Past Year)

240

13

43

185

228

8.

Alcohol Use (Past Month)

3,029

48

378

2,604

2,982

9.

Binge Alcohol Use

(Past Month)

1,338

25

240

1,123

1,363

Arizona: Substance Use Disorders (2019-2020)

Based upon 2019-2020 NSDUH State Prevalence Estimates (in thousands)

Selected Measure of Substance Use Disorders

Note: All numbers are in thousands

Age Demographic (Years)

12 +

12 -17

18 – 26

26 +

18 +

1.

Illicit Drug Use Disorder (Past Year)

468

27

123

318

441

2.

Prescription Pain Reliever Use Disorder (Past Year)

60

1

9

50

59

3.

Alcohol Use Disorder / AUD

(Past Year)

691

17

114

559

673

4.

Substance Use Disorder / SUD (Past Year)

958

35

183

740

923

1.3 Substance Use Disorder Treatment in Arizona

As stated earlier, Arizona continues to be rated as one of the worst states to suffer with a serious behavioral issue, such as a substance use disorder (SUD) or a mental health disorder (MHD), because of its distinct lack of accessible treatment resources.

Arizona: Substance Use Treatment (2019-2020)

Based upon 2019-2020 NSDUH State Prevalence Estimates (in thousands)

Selected Measure of Substance Use Treatment

Note: All numbers are in thousands

Age Demographic (Years)

12 +

12 -17

18 – 26

26 +

18 +

1.

Needing But Not Receiving Treatment at a Specialty Facility for Illicit Drug Use (Past Year)

483

33

124

327

450

2.

Needing But Not Receiving Treatment at a Specialty Facility for Alcohol Use

(Past Year)

653

14

105

534

639

3.

Needing But Not Receiving Treatment at a Specialty Facility for Substance Use

(Past Year)

913

34

184

695

879

Further Reading:

1.4 Fatal Drug Overdose in Arizona

One of Arizona’s most devastating aspects of its drug and alcohol abuse is the state’s alarming rise in opioid overdose deaths, with many caused by fentanyl, a synthetic (or man-made) opioid, along with the rest of the U.S.

Fentanyl, which is 50 to 100 times more potent than morphine, has greatly contributed to the number of opioid deaths in Arizona. Nogales Customs & Border Patrol (CBP) Port Director Michael Humphries said, “The size of a few grains of salt of fentanyl…can kill a person very quickly.”

Arizona saw 2,735 predicted deaths for the 12-month period ending in November, 2021, according to the CDC’s latest “Provisional Drug Overdose Death Counts.” This shows a small reduction in deaths from the 12-month period which ended 6 months prior, when there were 2,801 deaths (which has proven to be Arizona’s highest mortality rate for a 12-month period so far).

Further Reading:

1.4.1. Overdose Mortality Driven By Deliberate Fentanyl Contamination

Arizona’s geographical location, unfortunately, has made the trafficking of counterfeit pills containing fentanyl into the state fairly easy. Doug Coleman, Special Agent in Charge of the Phoenix Division of the Drug Enforcement Administration stated, “The proliferation of these pills trafficked into the U.S. by Mexican cartels and the sheer number of fentanyl pills seized in Arizona is alarming.”

Arizona is now witnessing a rise in the use of fentanyl, methamphetamine, and tranquilizer drugs such as Xanax, and the coronavirus pandemic appears to be the catalyst.

According to Todd Vanderah, head of the Department of Pharmacology at the University of Arizona College of Medicine, “Many people have been increasing their intake of alcohol, which is easier to track because of sales, but this leads me to believe that illicit drugs are also being consumed more due to the overall depression that COVID-19 has put upon the world.”

One particular county in Arizona – Pima County (home to the city of Tucson and situated right on the U.S. / Mexico national border) – has suffered extensively from fatal drug overdoses, especially in adolescents and young adults.

According to the Pima County Health Department (PCHD), their latest report – Pima County Monthly Surveillance Report 2021 Fatal Overdoses (covering January to June, 2021) – shows that a total of 245 overdose deaths have been confirmed to date.

The number of overdose deaths in 2021 is projected to exceed 500, based on the monthly average for January through May.

Importantly, during the last 4 years, the average age of overdose decedents has dropped significantly, in part due to increases in teens and young adults dying from fentanyl.

2. Mental Health in Arizona

Substance addiction and mental health and wellbeing are, and always have been, intrinsically linked – in other words, where you find one, the chances are you will find the other.

Mental Health in Arizona

Why? Oftentimes, those people with a SUD have developed the disorder through continued “self-medication” as they attempt to alleviate the symptoms of an existing, but as yet undiagnosed, MHD, such as depression, anxiety, bipolar or PTSD.

It is estimated that around half of those with a substance use disorder (SUD) have a co-occurring mental health disorder (MHD), and, likewise, around half of those with a MHD will also have a SUD.

2.1 Mental Health Illness in the U.S.

Open Source (Infographic): Mental Health America

Mental Health Illness in the U.S.
Mental Health Illness in the U.S.-2

Overall, mental health and wellbeing across the U.S. continues to worsen, even more so since the outbreak of the global coronavirus pandemic, and in response to the various socio-economic measures introduced by U.S. federal and individual state governments, such as “stay-at-home” orders.

In fact, many U.S. respected mental health experts believe the state of our nation’s mental wellbeing has worsened to the point of being a public health crisis, one which will continue to affect American youth for years to come.

It is also believed that many U.S. states – including Arizona – do not currently have the huge range of resources necessary to handle this crisis.

According to the Centers for Disease Control & Prevention (CDC):

  • Around 1 in 5 Americans will experience a mental illness in any given year
  • Around 1 in 5 children, either currently or at some point during their life, have or will have a seriously debilitating mental illness
  • Around 1 in 25 Americans has a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

According to the national highlights of 2020’s NSDUH (published in October, 2021), this is how mental health on a national basis looks:

Mental Health Illness in the U.S.: 2020

2020 NSDUH (Highlights)

Age

# (millions / m)

# (%)

Prevalence of Adult Mental Illness, including:

  • with Any Mental Illness (AMI)

18 years +

52.9m

21.0%

  • with Serious Mental Illness (SMI)

18 years +

14.2m

5.6%

  • with AMI & Substance Use Disorder (SUD)

18 years +

17.0m

6.7%

  • with SMI & SUD

18 years +

5.7m

2.2%

Prevalence of Adolescent Depression, including:

  • With a Major Depressive Episode (MDE)

12 – 17 years

4.1m

17%

  • With a Major Depressive Episode (MDE) & SUD

12 – 17 years

644,000

2.7%

Prevalence of Adult Suicidal Thoughts & Behavior, including:

  • Serious thoughts of suicide

18 years +

12.2m

4.9%

  • Made a suicide plan

18 years +

3.2m

1.3%

  • Attempted suicide,

including:

18 years +

1.2m

0.5%

  • Whites

18 years +

741,000

0.5%

  • Two or more races

18 years +

57,000

1.2%

  • Hispanics or Latinos

18 years +

243,000

0.6%

Prevalence of Adolescent Suicidal Thoughts & Behavior, including:

  • Serious thoughts of suicide

12 – 17 years

3.0m

12%

  • Made a suicide plan

12 – 17 years

1.2m

5.3%

  • Attempted suicide

12 – 17 years

629,000

2.5%

Further Reading:

2.2 Mental Health Illness in Arizona

Mental Health America (MHA) is the U.S.’s leading community-based nonprofit dedicated to addressing the needs of those living with mental illness, and promoting the overall mental health of all.

Their recently published report“2022 The State of Mental Health in America” – is derived from a collection of publicly available data across all 50 states and the District of Columbia, including the U.S. National Survey on Drug Use & Health (NSDUH), published by the Substance Abuse & Mental Health Services Administration (SAMHSA), and the CDC’s Behavioral Risk Factor Surveillance System (BRFSS).

Unfortunately, the latest NSDUH from the SAMHSA from 2020 has yet to be finalized in terms of findings, including the relevant data tables, for each specific U.S. state. Therefore, the MHA has no choice but to use the 2019 NSDUH data for their report’s results for Arizona and all the other U.S. states.

According to the MHA report, Arizona ranked 49/51 nationally, and is considered the 3rd worst U.S. state in the nation for the prevalence of mental health disorders and their related issues, and for ensuring the necessary treatment access and treatment resources are currently in place to treat every affected individual.

Previously – in last year’s 2021 report, Arizona had ranked higher – 40/51, and so was considered the 12th worst U.S. state in the MHA’s national rankings.

Lastly, according to the MHA report, the U.S. states enjoying the best mental health when compared to elsewhere in the nation are:

Massachusetts (1st.); New Jersey (2nd.); Pennsylvania (3rd.); Connecticut (4th.); Vermont (5th.); and New York (6th.) – notably, all states located in the Northeastern U.S.

The State of Mental Health in Arizona 2022

Mental Health America Report Findings

Ranking Position

( __ / 51)

Worst Ranking U.S. States

Arizona: Mental Health Ranking in the U.S.

49 / 51

3rd.

Adult Mental Health Ranking in the U.S.

35 / 51

17th.

Youth Mental Health Ranking in the U.S.

49 / 51

3rd.

Prevalence of Mental Illness

32 / 51

20th.

Access to Care

46 / 51

6th.

Arizona: Prevalence of Mental Health Illness

Ranking Position

( __ / 51)

Worst Ranking U.S. States

AZ

%

(+ or -)

National %

1.

Adults with Any Mental Illness / AMI

18 / 51

34th.

20.06

19.86

2.

Adults with AMI & Substance Use Disorder / SUD (Past Year)

9 / 51

43rd.

7.11

7.74

3.

Adults with Serious Thoughts of Suicide

36 / 51

16th.

5.01

4.58

4.

Adolescents with a Major Depressive Episode / (MDE) in the Past Year

43 / 51

9th.

17.41

15.08

5.

Adolescents with AMI & SUD (Past Year)

40 / 51

12th.

4.83

4.08

6.

Adolescents with Severe MDE

28 / 51

24th.

11.9

10.06

Table Note: Where the Arizona percentage (%) of those affected under the measure (within the adult or youth demographic) is higher than the U.S. national average, the percentage figure is colored RED; likewise, where it is lower, the percentage figure is highlighted in GREEN.

MHA Disclaimer: While the above 15 measures are not a complete picture of the mental health system, they do provide a strong foundation for understanding the prevalence of mental health concerns, as well as issues of access to insurance and treatment, particularly as that access varies among the states.

2.2.1. Analysis of Arizona’s Mental Health Results: Highlights

In general terms, the prevalence of mental health disorders in Arizona affects youth noticeably more than it affects adults; however, the rate of mental illness for both adults and youth is still significantly higher than the U.S. national average.

Unfortunately, the MHA’s report highlights the clear disparity between the prevalence of mental illness in Arizona, and the necessary access to and the number of treatment resources that are currently available. Arizona’s performance in this respect is easily one of the worst in the entire U.S.

At present, these treatment resources (and an individual’s access to them) are simply not sufficient to deal with its existing number of individual cases, let alone being in a position to effectively respond to the public mental health crisis.

In fact, the only measures where Arizona was shown to be actually better than the comparable national average were (1.) the percentage of adults with a SUD, and (2.) the percentage of academically-enrolled students with an emotional disturbance of some kind.

Suicide Alert

Throughout the report, Arizona consistently ranked as one of the worst states to live in for a young person with a mental illness.

2.2.2. Suicide Alert in Pima County, Arizona: March, 2022

In April, 2022, the Pima County Health Department (PCHD) published a Suicide Health Alert for March 2022,” which described how suicides had surpassed their alert threshold for the month of March 2022, which had 23 confirmed suicides.

According to the Suicide Alert, suicides by older adults (aged 60-79) were occurring in higher numbers through the first quarter of 2022. Adults in this age group are committing suicide at double the rate of the previous year – 2021.

Firearms continue to be the most common method used in suicides – 55% of suicides were caused by a firearm in 2022. Additionally, suicides caused by intentional overdose have accounted for 19% of suicides overall in 2022 (up from 7% in 2021).

2.3 Mental Health Illness Treatment in Arizona

Arizona: Mental Health Illness Treatment, 2022

Ranking Position

( __ / 51)

Worst Ranking U.S. States

AZ

%

(+ or -)

National %

1.

Adults with AMI Who Did Not Receive Treatment

37 / 51

15th.

57.0

55.9

2.

Adults with AMI Reporting Unmet Need

42 / 51

10th.

28.4

24.7

3.

Adults with AMI Who Are Uninsured

31 / 51

21st.

11.6

11.1

4.

Adults with Cognitive Disability Who Could Not See a Doctor Due to Costs

39 / 51

13th.

31.35

29.67

5.

Youth with MDE Who Did Not Receive Mental Health Services

48 / 51

4th.

70.1

60.3

6.

Youth with Severe MDE Who Received Some Consistent Treatment

47 / 51

5th.

16.1

27.2

7.

Children with Private Insurance That Did Not Cover Mental or Emotional Problems

42 / 51

10th.

10.2

8.1

8.

Students Identified with Emotional Disturbance for an Individualized Education Program

27 / 51

25th.

7.39

7.59

9.

Mental Health Workforce Availability

The ratio of individuals with a MHD to each available mental health provider

48 / 51

4th.

710:1

n/a

3. Arizona’s Top 6 Most Dangerous Drugs

Due to its own southern limits forming part of the U.S. border with Mexico, Arizona is one of the states most affected by the seemingly endless illicit drug manufacture and drug trafficking carried out by the powerful Mexican drug cartels.

In fact, Arizona suffers twice because of its southern location; it is an easy destination to get to for the trafficked illicit drugs, and it is also a major pathway and hub to traffic the drugs further into the U.S., primarily over to the states on the East Coast.

As a result, Arizona is home to the use of the most dangerous drugs out there, including synthetic opioids like fentanyl, as well as the potentially lethal counterfeit pills now flooding across the national border.

3.1 Fentanyl

Fentanyl

The majority of the record-breaking rise in drug overdose mortality across the U.S. in recent years can be attributed to one specific opioid – the synthetic (man-made) opioid fentanyl.

However, pure fentanyl is not the most common form of the illicit drug to find its way into illicit drug use in the nation as a whole, and in Arizona itself.

Because it is far cheaper to manufacture and far easier to traffick than say, for example, heroin, fentanyl is now commonly being found mixed with other substances, such as counterfeit pills, like “Mexican Percocet” and fake prescription benzodiazepines, and illicit stimulants, such as methamphetamine and cocaine.

Fentanyl is exceptionally potent – 50-100 times stronger than morphine. This makes the possibility of a drug overdose significantly higher than what it used to be, especially as many users may not know that their drug has been “laced” (or contaminated) in this way.

Those new to using drugs which contain fentanyl are some of the most at risk of overdose, as they have no tolerance to such a potent substance.

Additionally, for regular drug users, the continued abuse of fentanyl, fentanyl analogs (other synthetic similar to fentanyl), and drugs that contain fentanyl can lead to severe vital organ damage and worsening mental health issues.

Drug Facts: Fentanyl

Drug Name:

Fentanyl

Description: A potent synthetic opioid drug approved by the FDA for use as an analgesic (pain relief) and anesthetic – approximately 100 times more than morphine, and 50 times more potent than heroin.

Illicitly manufactured in bulk by Mexican drug cartels, and used to “lace” (contaminate) their other illicit products, such as heroin and methamphetamine, and is also used extensively in counterfeit pills.

Fentanyl: Lethal Dose (DEA)

Counterfeit Oxycodone Pills containing Fentanyl

Drug Class:

Opioid

DEA Schedule:

Schedule II narcotic

Prescription Names:

Actiq®, Duragesic®, and Sublimaze®

Prescription Products: Oral transmucosal lozenges (commonly known as fentanyl “lollipops”), effervescent buccal tablets, sublingual tablets, sublingual sprays, nasal sprays, transdermal patches, and injectable formulations

Illicit Fentanyl: Sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into counterfeit pills [as shown]

Street Names: Apache, China Girl, China Town, Dance Fever, Friend, Goodfellas, Great Bear, He-Man, Jackpot, King Ivory, Murder 8, and Tango & Cash

How is Fentanyl abused?: Fentanyl can be injected, snorted/sniffed, smoked, taken orally by pill or tablet, and spiked onto blotter paper.

Fentanyl in U.S. & Arizona: Latest Facts & Stats

Here are the latest statistics relating to fentanyl and its analogs, and drug and overdose mortality relating to both the U.S. and Arizona:

3.1.1. Centers for Disease Control & Prevention (CDC)

According to the CDC’s latest data, for the 12-month period ending in November, 2021, opioids in general accounted for 80,242 predicted drug overdose deaths, and the number of drug overdose deaths where a synthetic opioid, including fentanyl, was found specifically totaled 70,420.

3.1.2. Drug Enforcement Administration (DEA)

In April 6,202, Ann Milgrim, the Administrator of the Drug Enforcement Administration (DEA) Media Relations division released a letter to federal, state, and local law enforcement partners, entitled “Responding to Nationwide Increases in Fentanyl-Related Mass Overdose Events.”

According to Milgrim, “Fentanyl is killing Americans at an unprecedented rate. Already this year, numerous mass-overdose events have resulted in dozens of overdoses and deaths. Drug traffickers are driving addiction, and increasing their profits, by mixing fentanyl with other illicit drugs. Tragically, many overdose victims have no idea they are ingesting deadly fentanyl, until it’s too late.”

These mass-overdose events typically occur in one of the following recurring scenarios:

  • When drug dealers sell their product as “cocaine,” when it actually contains fentanyl; or
  • When drug dealers sell counterfeit pills designed to appear nearly identical to legitimate prescriptions, but are actually fake prescription pills containing fentanyl.

Last year, the U.S. experienced more fentanyl-related deaths than gun- and auto-related deaths combined.

3.1.3. Arizona’s Department of Health Services (ADHS)

According to Arizona’s Department of Health Services (ADHS), more than 5 people die every day from opioid overdoses in Arizona. In 2017, the ADHS issued a statewide public health emergency in an effort to reduce opioid deaths, and continues to collect opioid data on the ongoing opioid crisis in the state.

Using this data, the ADHS publishes weekly opioid-related statistics (on the Thursday of every week). Their current 2022 statistics (so far) report:

  • 241 confirmed opioid deaths
  • 718 verified non-fatal opioid overdose events
  • 2,418 emergency and in-patient visits involving suspected opioid overdose, and
  • 80% of EMS / Law enforcement responses (2,291 out of 2,854 total responses) for non-fatal suspected opioid overdose involved the administration of naloxone

ADHS: Latest Reports & Presentations:

3.1.4. Pima County Health Department, Arizona (PCHD)

The Pima County Health Department released a “Drug Overdose Health Alert for December 2021” on January 26, 2022, which stated that there were a total of 498 deaths from drug overdose during the entirety of 2021, another significant year-on-year increase, and continuing its 11-year continuous upward trend.

Because of its southerly location in the state, and its lengthy border with Mexico, Pima County remains one of the worst affected counties for substance use and mortality in the state of Arizona. The county’s Health Department regularly publishes surveillance-type “health alert” reports for its residents.

3.1.5. Substance Abuse Coalition Leaders in Arizona (SACLAz)

Lastly, fentanyl is now the driving force of the ongoing opioid crisis and record drug overdose mortality across the U.S. and in Arizona. In response, a new organization was launched in Arizona: Substance Abuse Coalition Leaders in Arizona (SACLAz).

SACLAz was developed to strengthen and support the collective impact of substance abuse coalitions in Arizona, and its primary goal is to prevent youth use of drugs and alcohol.

Lastly, May 10, 2022, sees the inaugural National Fentanyl Awareness Day in the U.S. The proposed call to action for National Fentanyl Awareness Day is a simple one: to spread the word on social media.

The day was deliberately chosen to be during Mental Health Awareness Month to amplify the warning message about self-medication – especially at a time when counterfeit pills have flooded the online and street drug markets.

fentanyl
fentanyl

Source: Shareable graphics (Toolkit) from National Fentanyl Awareness Day

Further Reading:

3.2 Heroin

One of the most addictive substances known to man, heroin is another illicit opioid commonly being used in the state of Arizona. With the ever-present opioid crisis, more and more prescription opioid addicts are now turning to heroin when their prescriptions are no longer filled.

For those with opioid use disorder (OUD), heroin, which is actually more expensive to produce and harder to traffic than fentanyl, is still a far cheaper alternative to prescription painkillers.

With the widespread contamination of fentanyl in other illicit drugs, heroin users are again at high risk of opioid overdose, as their street-purchased drugs are complete unknowns when it comes to what ingredients they contain.

According to the DEA’s 2020 National Drug Threat Assessment (NDTA), in 2019, DEA Field Divisions seized the largest amounts of heroin in Arizona, along with Texas, California, and New York.

Arizona (as well as California and Texas) is considered a major entry point for heroin sourced from Mexico, and also serves as a trans-shipment point for the onward movement of heroin to U.S. domestic markets.

Drug Facts: Heroin

Drug Name:

Heroin

Description: Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of specific poppy plants grown in: Mexico, South America, Thailand, Laos, and Myanmar (Burma), Afghanistan and Pakistan.

Heroin comes in several forms, primarily white powder from Mexico and South America; and “black tar” and brown powder from Mexico.

Drug Class:

Opioid

DEA Schedule:

Schedule I narcotic

Heroin has been classified as Schedule I, meaning it has a high potential for abuse, no currently accepted medical use, and a lack of accepted safety for use under medical supervision.

Illicit Fentanyl: Sold illegally as a powder, dropped onto blotter paper, put in eye droppers and nasal sprays, or made into counterfeit pills [as shown]

Street Names: Big H, Black Tar, Chiva, Hell Dust, Horse, Negra, Smack, and Thunder

How is Heroin abused?:

Further Reading:

3.3 Methamphetamine (Meth)

Methamphetamine, commonly known as either “meth” or “crystal meth,” is a major issue in Arizona, as it is trafficked in-state, cheap and readily available, from Mexico.

Additionally, Arizona does also have its own independent meth suppliers, as the drug can be manufactured cheaply and efficiently in simple, home-made labs – known as “meth kitchens.”

The use of both methamphetamine and fentanyl increased significantly during 2020, according to a report by drug testing company Millennium Health. They found the positivity rate of urine drug screens was up 78% for fentanyl and 29% for methamphetamine during the first 9 months, compared with the same period in 2019.

The rise in meth use was seen most prominently in the states of Virginia and Nevada (which neighbors Arizona), which saw increases in positive meth screens of more than 300%.

The report’s researchers stated, “Methamphetamine use poses unique challenges because there is no antidote for methamphetamine overdose, and no FDA-approved medications indicated for the treatment of methamphetamine use disorder.”

Drug Facts: Methamphetamine (Meth)

Drug Name:

Methamphetamine

Description: Methamphetamine (meth) is a highly addictive stimulant drug, usually sold in crystalline form, known as “crystal meth.”

Street Names: Batu, Bikers Coffee, Black Beauties, Chalk, ChickenFeed, Crank, Crystal, Glass, Go-Fast, Hiropon, Ice,Meth, Methlies Quick, Poor Man’s Cocaine, Shabu,Shards, Speed, Stove Top, Tina, Trash, Tweak, Uppers,Ventana, Vidrio, Yaba, and Yellow Bam

Drug Class:

Stimulants

DEA Schedule:

Schedule II narcotic

Prescription Names:

Desoxyn®

(Methamphetamine hydrochloride)

Prescription Products: Tablets (5mg) used in the treatment of ADHD (Attention-Deficit Hyperactivity Disorder) for children 6+ years

Illicit Methamphetamine: Because the “high” from the drug both starts and fades quickly, people often take repeated doses in a “binge and crash” pattern. In some cases, people take methamphetamine in a form of binging known as a “run,” giving up food and sleep while continuing to take the drug every few hours for up to several days.

How is Methamphetamine abused?: People can use methamphetamine by smoking, swallowing (in pill form), snorting the powder form, or injecting the powder that has been first dissolved in water or alcohol.

Furthermore, the CDC’s latest provisional data reports that, during the 12-month period ending in November, 2021, there were 32,476 predicted fatal drug overdoses involving psychostimulants with abuse potential, including methamphetamine, in the U.S.

In Arizona, for the same period, there were 1,284 predicted fatal overdoses involving methamphetamine or other psychostimulants with abuse potential.

The persistent abuse of meth can result in severe psychological damage, such as paranoia and psychosis, behavioral issues such as aggression and confusion, and numerous mental health disorders.

Further Reading:

3.4 Alcohol

Alcohol remains the most favored “drug of choice” for the vast majority of Americans, and it also remains as one of U.S.’s most prevalent killers, too. In fact, excessive alcohol use was responsible for more than 140,000 deaths in the United States each year during 2015–2019, or more than 380 deaths every single day.

Alcohol

These estimates are from the CDC’s Alcohol-Related Disease Impact (ARDI) application, using a new methodology. The ARDI application shows estimates of alcohol-attributable deaths and years of potential life lost from 58 conditions by age, sex, and state.

Furthermore, it came as no surprise to many addiction experts that when the coronavirus pandemic hit, the level of national alcohol consumption increased considerably. Within months, alcohol wholesalers and online alcohol stores were reporting record sales, particularly online.

Depression, anxiety, stress, job losses, business closures, stay-at-home orders, social distancing, and other extreme socio-economic knock-on effects of the pandemic resulted in many existing drinkers drinking far more than usual.

The result of all this additional alcohol consumption is, sadly, of little surprise, too. For a second year in a row, deaths from AUD exceeded medical expert projections, with younger adults (those aged 25 to 44 years) seeing the steepest increases.

According to a recent study published in JAMA Network Open on the subject of AUD–related mortality in the U.S., based upon 343,384 AUD-related deaths from 2012 to 2021, in the year 2021, deaths where AUD was listed among multiple causes were 22% higher than projected, and 28.8% higher in cases where AUD was listed as the underlying cause.

The researchers (from Cedars-Sinai Medical Center in Los Angeles) reported similar findings for 2020, with AUD-related deaths 24.8% higher than projected, and 30.7% higher in cases where AUD was listed as the underlying cause.

The adult age group (aged 25 to 44) experienced the greatest increases – 40.47% in 2020, and 33.95% in 2021.

As the study’s researchers wrote, “Physicians and frontline providers should recognize the uprising trend of alcohol use, withdrawal, and mortality. During the pandemic, healthcare delivery for individuals with AUD was substantially shattered. A big wave of AUD-related complications (liver diseases, mental health issues, etc.) are surging now due to the loss to follow-up, progressive disease, or misdiagnosis during the pandemic, and we are not well prepared.”

In Arizona, too, alcohol remains one of the leading causes of premature death in the entire state.

Even despite severe legal punishments for drinking and driving (Arizona has some of the harshest jail terms / fines / other penalties in the whole of the U.S.), the number of yearly fatal DUI accidents in the state constantly remains at a high level.

According to another new study, by University of Arizona Health Sciences researchers, hazardous alcohol use and likely dependence increased every month for those under lockdowns compared to those not under restrictions.

Further Reading:

3.5. Cocaine

Powerful stimulant drugs are highly addictive, and just like methamphetamine, cocaine is one of the most addictive. Cocaine (again, just like meth) has also now become yet another illicit drug being sold after being laced with fentanyl.

In fact, half of all cocaine overdoses during 2020 were found to involve opioids, such as the synthetic opioid itself or a fentanyl analog.

Cocaine has been directly linked to a lack of social control and abnormal, risky behavior, which can result in serious medical conditions, such as HIV, hepatitis C and sexually-transmitted diseases. Additionally, those who are long-term cocaine addicts are at high risk of life-threatening health events, namely seizures, heart failure, and stroke.

Drug Facts: Cocaine

Drug Name:

Cocaine

Description: Cocaine is an intense, euphoria-producing stimulant drug, with a strong addictive potential.

It is derived from coca leaves grown in Bolivia, Peru, and Colombia. The majority of the illicit cocaine product entering the U.S. comes through Mexico.

Drug Class:

Antidote

DEA Schedule:

Schedule II narcotic

Prescription Names:

Cocaine

Prescription Products: Cocaine hydrochloride topical solution (4% and 10%) – used medically as a topical local anesthetic for the upper respiratory tract.

It is also used to reduce bleeding of the mucous membranes in the mouth, throat, and nasal cavities. However, its use is dwindling, as more effective, safer medications are now available.

Illicit Cocaine: Sold illegally as a white, crystalline powder, either increasingly online or in the street.

Alternatively, it is sold in rock form, as crack cocaine. When cocaine powder is mixed with baking soda, and boiled, it results in a solid forming.

Once it’s cooled, it’s broken into smaller pieces, and then sold as crack – described as “the most addictive form” of cocaine.

Street Names: Blow, Coca, Coke, Crack, Flake, Snow, and Soda Cot

How is Cocaine abused?: Cocaine is normally snorted in powder form through the nose, or rubbed into the user’s gums. Other users dissolve the powder, and inject it into the bloodstream. Some people even inject a combination of cocaine and heroin, a highly dangerous drug use activity known as “Speedballing.”

Cocaine can also be used by smoking the rock crystal form of the drug – also called “freebase cocaine.” The crystal is heated to produce vapors that are inhaled into the lungs. This form of cocaine is called “Crack,” which refers to the crackling sound of the rock as it’s heated. Some people also smoke crack cocaine by sprinkling it onto marijuana or tobacco, and smoking it like a cigarette.

In Arizona, cocaine is constantly being trafficked across the U.S.-Mexico border. Mexican transnational criminal organizations (TCOs) control cocaine trafficking and wholesale distribution in the U.S, while Colombian TCOs continue to maintain control over its production and supply.

Even though Mexican TCOs dominate cocaine transportation throughout the nation, they rely on local criminal groups for retail-level distribution. Furthermore, the production and distribution of crack cocaine is also predominantly handled by the same local U.S. criminal groups and street gangs.

3.6. Benzodiazepines

Benzodiazepines (often called “BZDs” or “Benzos”) are a group of prescription sedative medications prescribed to treat anxiety and stress, as well as insomnia.

This class of drugs provide some of the most commonly prescribed medications in the U.S. In actual fact, between 1996-2013, benzodiazepine prescriptions increased by 67% across the nation.

However, they are also misused and abused by recreational drug users.

Well-known approved brands of benzodiazepines include Valium, Xanax, Ativan, Klonopin, and Rohypnol (also commonly known by the slang term “the date-rape drug”).

On August 26, 2021, the CDC released their Morbidity and Mortality Weekly Report (MMWR), which revealed a dramatic increase of 42.9% in recent drug overdose deaths involving benzodiazepines.

Even more alarmingly, the increase was driven by overdoses which involved illegally manufactured designer benzos (or DBZDs), such as etizolam and flubromazolam.

Kim Aldy, American College of Medical Toxicology, Phoenix, AZ. stated at the time, “The growing use of illicit benzodiazepines requires a better understanding of the synergistic toxicity when these drugs are used along with opioids. Raising awareness among clinical, public safety, and community partners about dangers associated with the use of illicit benzodiazepines, including co-use with opioids, is critical.”

Drug Facts: Benzodiazepines (Benzos)

Drug Name:

Benzodiazepines,

including Xanax, Valium, and Ativan

Description: Benzodiazepines are rarely the sole drug of abuse, and abusers usually combine benzodiazepines with other drugs to increase the effect. For example, benzodiazepines are usually combined with certain opioids to enhance the euphoric effects.

Among abusers, diazepam (Valium) and alprazolam (Xanax) are most popular due to their rapid onset.

Illicit Counterfeit / Fake “Xanax” Tablet

Drug Class:

Benzodiazepines (Tranquilizers / Sedatives)

DEA Schedule:

Schedule IV narcotic

Prescription Names:

Xanax (alprazolam), Valium (diazepam), Librium

(chlordiazepoxide), and Ativan (lorazepam)

Prescription Products: Xanax, Librium, Valium, Ativan and Klonopin (clonazepam) all come in tablet and capsule form, and are primarily used for treating anxiety and anxiety disorders, but can be used for other conditions, such as depression, seizures, insomnia, and alcohol detox.

Street Names: Bars, Blues, Chill Pills, Downers, Nerve Pills, Planks, Tranks, and Zannies.

Illicit Benzodiazepines: Benzodiazepines (also known as “benzos”) are sold online or on the street. They can be authentic prescription medicines that have been stolen, or they can be counterfeit versions, such as the illicitly manufactured, fentanyl-laced fake pills that look like Xanax tablets that are now flooding the U.S. from Mexico.

Further Reading:

4. Arizona Youth: Drug & Alcohol Addiction & Mental Health

Arizona Youth

4.1. Substance Use Among Arizona Youth

It is now considered a medical fact that substance use and the risk of developing an SUD is significantly increased the earlier an individual begins using addictive drugs and alcohol.

Therefore, substance use prevention has to begin with the youngest members of society – our children and teenagers.

One way in which to monitor and predict how at risk specific youth demographics are to ongoing substance use and potential future use disorders is to survey a range of issues affecting them, such as actual use, gang involvement, delinquency and their exposure to violence, to name but a few.

Arizona, through the work of the Arizona Criminal Justice Commission (ACJC), systematically surveys the state’s children and teenagers (at the ages of 8th, 10th and 12th Grades, respectively) every 2 years; this is known as the “Arizona Youth Survey.”

The 2020 survey was administered between February and May (2020), and, because of the coronavirus pandemic and subsequent school closures, a second period of survey administration was administered between September and November (2020).

This resulted in the participation of a total of 30,052 students from 152 schools in 13 of Arizona’s 15 counties.

According to the report, it is possible that the results for reported substance use could be lower in 2020 simply due to restrictions placed on high school students with the coronavirus pandemic. This would severely limit the “peer social interactions where deviant behaviors commonly take place.”

The findings of the 2020 Arizona Youth Survey report can be found below:

Arizona Youth Survey 2020: Substance Use

Percentage of Students Who Used Substances on One or More Occasions During Their Lifetime

Substance Used

Grade 8

Grade 10

Grade 12

Total

2016

2018

2020

2016

2018

2020

2016

2018

2020

2016

2018

2020

Alcohol

28.3

30.6

24.9

44.6

47.2

41.4

59.5

59.4

53.6

42.1

44.9

39.6

Marijuana

13.2

15.7

14.0

27.2

31.8

29.6

40.3

44.1

41.3

25.1

29.7

28.0

Cocaine

1.2

1.2

1.4

2.4

2.7

2.2

5.5

5.5

4.4

2.8

3.0

2.6

Hallucinogens (LSD, shrooms, peyote, salvia)

1.5

2.1

2.0

3.9

4.7

5.7

6.7

7.5

8.9

3.7

4.6

5.5

Inhalants (nitrous, paint, gas)

6.9

6.4

8.8

5.1

4.1

6.1

3.9

3.4

4.5

5.5

4.7

6.5

Methamphetamines

0.5

0.6

0.7

0.7

0.8

0.7

1.1

1.0

0.9

0.7

0.8

0.8

Heroin

0.5

0.5

0.7

0.6

0.5

0.7

0.9

0.6

0.6

0.6

0.5

0.7

Ecstasy

1.3

1.4

1.3

2.6

2.4

2.3

4.2

3.5

3.3

2.5

2.4

2.3

Prescription Pain Relievers (codeine, Oxycontin, Vicodin, Percocet, fentanyl)

5.6.

7.8

4.8

8.4

9.2

6.2

10.5

10.1

6.7

7.9

9.0

5.9

Prescription Stimulants

(Adderall, Ritalin, Concerta, Vyvanse, Dexedrine)

1.7

2.9

2.7

4.3

4.7

4.2

6.5

6.7

5.2

3.8

4.6

4.0

Prescription Sedatives (Valium, Xanax, Klonopin, Ambien, Lunesta)

3.3

3.2

2.0

5.1

5.0

4.2

6.9

6.4

5.0

4.9

4.8

3.7

Synthetic Drugs (Bath Salts, K2, Spice, Gold)

2.0

2.0

1.0

2.1

1.4

0.9

2.9

1.8

1.0

2.3

1.7

1.0

Over-The Counter [OTC] Drugs (cough syrup, cold medicine, diet pills)

5.0

5.2

4.0

6.8

6.4

6.4

7.4

6.5

6.6

6.2

6.0

5.7

Poly Drug Use (multiple drugs at the same time)

n/a

6.3

5.0

n/a

11.9

1.2

n/a

18.1

17.4

n/a

11.7

11.4

Alcohol / Pain Relievers (used together)

n/a

2.1

2.0

n/a

3.1

3.0

n/a

4.0

3.3

n/a

3.0

2.8

Note:

  • Lifetime Substance Use is a measure of the % of youth who tried a particular substance at least once in their lifetime
  • 30-Day Substance Use is a measure of the % of youth who tried a particular substance at least once in the past 30 days
  • Binge Drinking is a measure of the % of youth who had 5 or more drinks in a row at least once during the two weeks prior to the survey

4.1.1. Teenage Deaths by Fentanyl-Related Drug Overdose

The district of Pima County, home to both the city of Tucson and the University of Arizona, is one of the worst affected areas in the entire state for both drug use and abuse, and for drug and alcohol-related deaths.

Specifically, the number of fatalities from opioids (including fentanyl and other synthetic substances) has continued to rise dramatically, and it’s not just adults that are overdosing in higher numbers than ever before.

In October, 2021, Arizona Governor Doug Ducey announced that more teenagers in Pima County were now dying from a fentanyl overdose than from car crashes, suicide, or the coronavirus – the first time ever this had been the case.

Gov. Ducey stated, “This is our reality. Fentanyl overdoses have replaced car accidents as the leading cause of death for people 19 and younger in Pima County. Pima County deputy sheriffs are responding to a call involving fentanyl every 40 hours.”

State health experts believe that this rise in teenage overdose mortality is being driven by the counterfeit pills now flooding across the national border with Mexico.

Further Reading:

4.2 Mental Health Among Arizona Youth

At the very beginning of the coronavirus pandemic, following social restrictions such as stay-at-home orders and school closures, many health experts became highly concerned about the mental health of children and teenagers.

Their concern was justified. In 2021, the American Academy of Pediatrics (AAP) declared a national state of emergency regarding child and adolescent mental health.

According to the AAP: “More than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted.”

“We are caring for young people with soaring rates of depression, anxiety, trauma, loneliness, and suicidality that will have lasting impacts on them, their families, and their communities.”

In April, 2022, an analytical study entitled Evaluation of Suicides Among US Adolescents During the COVID-19 Pandemic and conducted by the Massachusetts Institute of Technology in Cambridge found that suicides by adolescents aged 10-19 years of age significantly increased during the pandemic.

The aim of the study was to assess any changes in suicide prevalence from prepandemic rates (2015 to 2019) and pandemic (2020) rates for that age group. The analysis included 85,102 decedents with suicide as the cause of death from 14 state public health departments (Arizona was not included in the study).

The official results state, “When data were aggregated across all 14 states, the proportion of overall suicides among adolescents increased during the pandemic.”

Adolescent suicide in Arizona has yet to be fully investigated for the period April, 2020, to April, 2022.

5. Arizona: State-Specific Factors

Arizona State Specific Factors

As highlighted previously, Arizona’s geographical location on the nation’s southern border is a significant factor in the levels of substance use, abuse and addiction, and the mental health of its residents. This factor is not unique to Arizona, as the southern border with Mexico is shared by a number of other U.S. states – namely California, New Mexico, and Texas.

However, because of the large expanses of rural Arizona with low population numbers, and the large areas uniquely covered by American Native reservations, it is an easier target for Mexican drug traffickers than the other states.

In addition to its southerly location, Arizona has the largest Native American population in the entire U.S. – totalling 332,273 residents. However, this population only accounts for 4.6% of the entire number of Arizona residents.

Native Americans are affected by substance use far more than other races or ethnicities, having significantly higher rates of abuse and addiction due to many mitigating factors, which are discussed in more detail below.

5.1 Arizona’s Proximity to U.S. / Mexico Border

Arizona’s part of the national border with Mexico is the primary reason for the state’s issues with substance use, making it a prime target for Mexican transnational criminal organizations (TCOs).

Mexican TCOs continue to control the highly lucrative drug trafficking and wholesale drug distribution in the U.S. The two largest organizations, the Sinaloa Cartel and the Jalisco New Generation Cartel (CJNG), are actually showing signs of expansion in Mexico, demonstrating their continued influence – even compared to other Mexican TCOs.

However, it is the powerful and infamous Sinaloa Cartel that continues to be the primary drug organization exerting its nigh-on complete dominance across the state of Arizona.

In response, in May, 2022, the Arizona Attorney General’s Office (AGO) reported a massive spike in drug busts, with the seizures of illicit drugs, including counterfeit pills, from January to March surpassing the entire total for drug seizures in 2021.

According to Theresa Rassas, the Section Chief Counsel for the Drug and Racketeering Section of the AGO, “Looking at the first quarter of 2022 – January, February, and March – we saw higher numbers of fentanyl pill and fentanyl powder and methamphetamine seizure than we had seen last year combined.”

Law enforcement has seized 845 pounds of methamphetamine and 780,000 fentanyl pills during one major investigation in 2022 alone.

During fiscal year 2021, the DRG had 686 open cases and resolved 265 of them, charging 220 defendants with felony offenses. AGO officials reveal total drug seizures included more than 2,000 pounds of methamphetamine and more than 2.2 million fentanyl pills.

Avenues and methods of drug trafficking are changing constantly, too. For example, Arizona’s Border Patrol recently reported a new trend where criminals are making use of car-sharing platforms like Turo.

People post their own cars on the platform thinking they’ll make extra money by allowing someone to rent their car for a few days, known as a peer-to-peer rental – only for their car to be actively used in drug trafficking.

For more information on how illicit drug production and trafficking affects Arizona, SpringBoard Recovery has the following article: “One Pill Can Kill: DEA’s Fentanyl-Laced Counterfeit Drugs Alert.”

5.2 Arizona’s Native American Tribes

More than 5.6 million Native Americans live in the U.S. as members of 574 federally recognized and 63 state-recognized tribes, and the number is projected to rise to 10 million by 2060.

About half of Native Americans live on reservations, of which there are about 326, comprising roughly 56.2 million acres. The 16 million-acre Navajo Nation Reservation (which spans parts of Arizona, New Mexico, and Utah) is, by far, the largest of these.

As stated previously, Arizona has the largest Native American population in the entire U.S. – totalling 332,273 residents. However, this population only accounts for 4.6% of the entire number of Arizona residents.

Native American population

Source: Map derived from open source map detail

Compared with other U.S. races, Native Americans have a 5-year shorter life expectancy, and Native American youth are 2.5 times more likely to commit suicide than youth in the rest of the country.

Furthermore, Native Americans are 2.5 times more likely to experience violent crimes than the national average, and more than 4 out of 5 Native American women will experience violence in their lifetimes.

Issues such as these are symptoms of several larger issues, eg. access to social services, educational opportunities, nutritional food, and health care.

5.2.1. Arizona Native Americans: Substance Use

One statistic which clearly highlights the sheer extent of substance use within the Native American community is this: nearly 1 in 5 Native American young adults (aged between 18 and 25 years of age) has a substance use disorder (SUD) – that’s a massive 20%, and incomparable to any other demographic (age, race or otherwise) in the U.S.

The Drug Enforcement Agency’s 2020 National Drug Threat Assessment (NDTA), published in December of last year, highlights how illicit drugs affect the Native American reservations. Unsurprisingly, Mexican traffickers are the principal wholesale suppliers and producers of the vast majority of the illicit drugs available on reservations throughout Arizona and the southwestern U.S.

In Native American communities, the most widely used illicit substance is methamphetamine, with alcohol and now marijuana the most widely used legal drugs. However, the use of prescription drugs and heroin has increased significantly in recent years.

Additionally, other easily available substances on the reservations include powder and crack cocaine, fentanyl, fentanyl-laced counterfeit pills (as either fake prescription opioids or fake benzodiazepines, like Xanax), and MDMA tablets (ecstasy).

Significant numbers of recent fatal drug overdoses in the Native American community were caused by fentanyl-laced meth.

The SAMHSA’s 2019 National Survey of Drug Use & Health includes a specific report on the

U.S. American Indian / Native American and Alaska Native (AI/AN) communities.

SpringBoard Recovery has published an article detailing substance use and other issues affected Native Americans in Arizona: Native Addictions: Substance Use in the U.S. Indigenous Community.”

Specific substances that affect Native American communities at a much greater rate than other demographics include:

  • Methamphetamine: Meth use in Native American communities continues to increase, as a greater number of Native Americans report that this is their primary drug of choice, and is used at higher rates than heroin, marijuana, cocaine, and other drugs. Approximately 15% of Native Americans reported lifetime use of stimulants such as cocaine and meth.
  • Alcohol: In 2019, the alcohol-involved death rate among Native Americans was 5 (yes, five) times higher than that in the general population.

Further Reading:

5.2.2. Arizona Native Americans: Mental Health

Native Americans Mental Health

Many diverse factors influence the health outcomes of Native Americans in Arizona, including historical trauma and social, policy, and economic conditions such as poverty, lower educational attainment, under-employment, lack of access to health care, housing problems, and violence.

These disparities can have severe, even fatal consequences. For example, suicide is the second leading cause of death among Native American youth aged 8 to 24.

With regard to behavioral healthcare and treatment in Arizona, Native communities continue to face service delivery issues, complicated by personnel shortages, limited health care resources, and distances to obtain services.

There also are other issues that inhibit access to appropriate behavioral health services such as referrals from school, detention, court, housing, primary care, and child welfare.

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