State grapples for way to cope with deadly opiate epidemic

While Gila County has one of the highest drug overdose rates in the state, it has not joined in on lawsuits against drug manufacturers.

The plague continues to spread, with deaths rising and the public health system struggling to adapt.

No — not the COVID-19 pandemic.

We’re talking about the epidemic of drug overdoses, mostly driven now by synthetic opiates like fentanyl. While drug overdose deaths rose by just 1.2% last year nationally, Arizona saw a 16% increase — one of the fastest increases in the nation.

Gila County has one of the highest drug overdose rates — some 26 per 100,000 population. That’s roughly double the state and national average.

In 2017, Arizona ranked 28th nationally for opiate deaths, with a rate of 14 per 100,000. Half of Arizona deaths involved more than one drug, including prescription pain killers, benzodiazepine and illegal, synthetic opiates. Fentanyl played a role in 16% of overdoses, an increase of 130% between 2017 and 2018.

The federal Centers for Disease Control’s website shows that in 2019, Arizona had a predicted 1,970 drug overdose deaths — a 16% increase from 2018. The “predicted” rate was based on extrapolations for various surveillance systems. For comparison, the state has had 624 COVID-19 deaths in the past two months.

Only New Mexico, Alaska, Montana, Minnesota and Montana had higher rates of increase. Most East Coast states had declines.

Nationally, the U.S. had 70,000 drug overdose deaths in the 12-month period. That compares to 85,000 COVID-19 deaths in the past two months.

The state Department of Health Services reports that doctors write 137,000 opiate prescriptions each month in the state. About 9% of people with prior overdoses still are receiving prescriptions from 10 or more prescribers per year, according to the state’s website.

Police and paramedics administer about 6,000 doses of naloxone each year to reverse the effects of an overdose.

The report also tracked overdose deaths per 1,000 health care system encounters. Payson had 10-14 deaths per 1,000 encounters, based on the statewide 2016 Department of Health Services opiate report.

The national opiate epidemic started with a surge in prescriptions for painkillers, mostly among whites — especially in rural areas. Whites have more than twice the death rate for opiates as American Indians, Hispanics or African Americans.

A crackdown on prescribing practices and a nationwide campaign reduced deaths from prescription opiates, but the huge increase in people addicted to the painkillers led to a fresh surge first in heroin use and now in the much more lethal synthetic opiates like fentanyl.

The CDC reports that nationally the overdose death rate dropped by 4.6% in 2018, but then rose 1.2% in 2019.

However, the death rate from synthetic opioids rose 10%. Moreover, from 2012 to 2018, overdose deaths from cocaine tripled and deaths from methamphetamine increased fivefold.

The opiate epidemic has settled into a chronic, long-term health problem. Some 85% of people who overdose have a pre-existing medical condition — including a history of substance abuse, alcohol abuse, chronic pain, depression, anxiety and suicidal ideation. Men accounted for 60% of the overdoses, mostly aged 25-34. Among women, most overdoses occurred in the ages 35-54.

The state/federal grant will provide money for the county health department to keep track of cases, educate people about the dangers of the ongoing epidemic and host prevention programs.

The grant will also provide naloxone shots, which police and paramedics can use to reverse the effects of an opiate overdose. The money also pays for a fatality review team in the event of an overdose.

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