The Arizona Opioid Epidemic Act signed by Gov. Doug Ducey on Friday touches on several of the most important components of addressing opioid abuse and improving treatment in Arizona, said officials with one of the agencies that provides opiate treatment in Flagstaff.
“We're very excited. Very excited that there is attention to the challenge, attention to education and attention to alternative practices,” said Lauren Lauder, a senior vice president with Southwest Behavioral and Health Services. The behavioral health provider offers medication-assisted treatment, counseling and other mental health and pain management services as part of its opiate treatment program.
One important focus of the new legislation is on increasing access to and education about “opioid antagonists,” or drugs that rapidly reverse opioid overdoses, Lauder said. Right now there is still a lot of stigma and fear surrounding such drugs even though “the benefit of it outweighs any of the negatives,” Lauder said. There’s a need to get overdose reversal drugs into the hands of anyone that may have any contact with opioid users like firefighters and police officers as well as parents, roommates or grown children of people who may be at risk of overdosing, Lauder said.
The new Arizona law authorizes law enforcement and county health departments to administer opioid antagonists like Naloxone and calls for training law enforcement officials in its use. It also requires those drugs to be prescribed to patients who are prescribed more than a certain dose of painkillers per day.
Another part of the law is a $10 million appropriation for uninsured or underinsured people in need of treatment. It’s hard to say how far that money will stretch, but Lauder said she does think some of it will reach Coconino County and will significantly benefit neighboring Mohave County. A number of Southwest Behavior and Health Services’ clients in Flagstaff are uninsured or underinsured and not eligible for Medicaid, said Susan Nelson, the agency’s Flagstaff program director.
Nelson said concern about not being able to afford services is a barrier to some people seeking care.
Similar to national trends, the majority of people who end up seeking treatment for opiate dependence in the agency’s Flagstaff clinic started with prescription painkillers, she said.
What the new Arizona law doesn’t address however, is the need for stable housing and living environments for people who struggle with substance abuse and aren’t financially stable, Lauder said. That is one need she said has been brought up in many of the counties where her agency works.
Also absent from the legislation is any mention of or allowance for safe injection sites, which are spaces where drug users can shoot up under the supervision of medical staff who can treat an overdose if needed. Needle exchanges meant to stem the spread of bloodborne infectious diseases like HIV and Hepatitis C among drug users are another more controversial strategy to stem the negative effects of opioid abuse that wasn’t included in the legislation.
The topic of needle exchanges has come up in recent Coconino County stakeholder meetings about overdose prevention, Lauder said.
“If the community identifies a need, it’s a community decision,” she said in response to a question about whether Southwest Behavioral and Health Services would support such an option.
As for concerns that more regulation of prescription painkillers will turn more people to illegal drugs like heroin, time will tell if that plays out in Arizona, Lauder said.
“Unfortunately we have seen that pattern historically, when someone has a challenge getting prescription medication or a doctor is cutting them off, individuals resorted to using heroin. But with the complement of regulation and access to treatments, our hope is that doesn't have to be a choice for them,” she said.
Photographs of people around the city cover the lavender walls of the mayor’s office while colorful figurines sit on the edge of the desk. The window frames an unobstructed view of the snow-covered San Francisco Peaks.
“I remember the first time I walked into the mayor’s office, it was scary. I was determined, but it was scary,” Flagstaff Mayor Coral Evans said. “I want everyone who comes in here to see something they can connect with that makes them feel comfortable and welcome here.”
Evans calls her approach a “new dynamic” for the city.
“I think people feel valued and welcomed,” Evans said. “We have a highly engaged council. People need to feel their representatives care. Whether they agree with us or not, I would say people feel that they can voice their opinion.”
Evans, who is more than halfway through her two-year term, is quick to list accomplishments of the entire council in the past year.
“First of all, addressing the issue of the two minimum wage initiatives passing, and quite frankly the threat to our social service providers and our small businesses that we cherish,” Evans said when asked about the council’s victories this year.
The council’s choice to move forward with three parcels for the scattered site affordable housing project was another highlight. Evans ended up being the deciding vote to remove a three-acre parcel at Schultz Pass and Fort Valley roads from consideration for an affordable housing development after extensive public outcry. However, Evans said removing the parcel “sets a very bad precedent in our community.”
Regardless, the city-approved project and the council’s January decision to reduce engineering fees for a development that promises to bring 100 affordable housing units are concrete steps toward the council’s priority of affordable housing, Evans said.
“Affordable housing is something we have been talking about for a long time,” she said.
In December, the council approved the first round of changes to the city’s transect zoning code, which councilmembers said could stop another building like The Hub, which they called too large and out of scale with the existing neighborhood, to be built in the zone where The Hub is being constructed. Evans said the change, and subsequent amendments that are scheduled for discussion will help balance Flagstaff’s need for growth while respecting city character.
“I think we’ve seen a lot of firsts this year,” Evans said, listing the council’s visit to the Havasupai Nation, A collective state lobbying trip and A joint work session with Northern Arizona University President Rita Cheng. Evans said she plans to have similar work sessions with leaders from the Navajo, Hopi and Havasupai nations in the upcoming year.
“We’ve never had this level of engagement, collaboration and understanding,” she said.
Flagstaff serves as a hub for activities for much of northern Arizona, which brings the responsibility to have strong relationships with neighboring communities, she said.
“We are really looking at Flagstaff from a regional perspective,” Evans said. “All roads lead to Flagstaff in northern Arizona, for employment, economic development and education. We need to understand Flagstaff’s role in a regional sense.”
Evans has plans to meet with Mark Mitchell and Jonathan Rothschild, the mayors of Tempe and Tucson, respectively, to discuss how the three cities that host the state’s public universities handle the challenges other cities without universities do not encounter.
“I will meet with them next month to create an agenda for a meeting with the Arizona Board of Regents to discuss community and university relationships and challenges,” Evans said. “This would be the first time ever that type of meeting has been held.”
The Community Policy Trust, a brainchild of Evans, has met four times in the past year to discuss broad topics affecting the region, including affordable housing, race, culture and identity and cost of living and minimum wage. The group is made up of former and current elected officials, as well as people who specialize in the area of discussion.
“We’ve taken community leaders and we’ve studied issues,” she said. “We’ve looked at what was tried in the past and didn’t work or what was suggested in the past and wasn’t done, maybe because the political will wasn’t there. We look at solutions.”
Evans is just as excited about what is going on behind the scenes as the decisions the council makes in the public sphere.
She has been working with a group, including Flagstaff Medical Center, North Country Healthcare, NAU and other stakeholders, to identify ways to gain access to neurologists, especially those who specialize in movement disorders, which she said is a need in northern Arizona.
“Some medical professionals we need, but don’t have,” she said.
She and one of her interns created a business resource directory for locally owned businesses that includes information about networking opportunities, access to micro loans and funding opportunities and mentors.
“I’m really passionate about small businesses,” she said. “I own a small business and I manage a small business incubator.”
So far, the brochures have been distributed to businesses on the east side of the city and she plans to distribute them on the west side soon.
She is also working with a group of developers, builders and realtors to look at barriers to affordable housing in the city, including possibilities like impact fees and their effects on development and the city’s incentive policy for affordable housing.
“One developer told me the city offers high density as an incentive, but said every time high density is proposed the community doesn’t like it,” she said.
The group has suggested the city could stagger the fee schedule for development, so the cost is not all incurred at one time for development.
As far as major policy decisions made by the council in the past year, former Mayor Jerry Nabours said he would have done exactly the opposite.
Nabours speculated that the council acted against the advice of the city attorney when it amended the city’s minimum wage ordinance.
“My guess is the city attorney told them it would be illegal to counteract the Flagstaff voters’ initiative,” Nabours said. “I don’t know that for sure, but as an attorney, that’s what I would have said.”
Instead, Nabours said he would have opted to hold the special election the council chose not to hold.
“I would have put the other initiative on the ballot right away,” he said. “If the voters wanted to rescind the Flagstaff minimum wage, they could have, but it was not up to the council to rescind it.”
Nabours, who was part of the group that sold the Schultz Pass parcel to the city originally, said the parcel has always been designated for affordable housing, and that was the city’s purpose when buying it.
“That parcel was purchased to be low-cost housing, and that has always been the plan,” he said. “We had a plan for the Lone Tree parcel they put in the proposal instead, we would have sold that to the (OneAZ) credit union and would have used the money to buy affordable housing.”
The city is also opening itself up to liability by amending the transect zoning code, he said.
“My concern is the city could have a lot of liability for taking away zoning rights,” he said. “When people realize what has happened to their property, they will be filing claims for diminished value.”
But the most obvious difference between Nabours and Evans as mayor has been the number of resolutions passed on national or statewide issues, Nabours said.
“I made it a point that I was not going to be voting on any resolution that did not directly relate to city business,” Nabours said. “Now we have a majority that does want those political resolutions, and it’s a shame because they do the city no good, but they do harm by alienating legislators we need on our side.”
Evans said the city’s charter outlines resolutions as one way the council can speak on issues.
“We are not an isolated, sleepy town,” Evans said. “We are part of a global community.”
And, Evans contends, each resolution passed has had an effect on Flagstaff.
“I’ve had breast cancer twice, my mother died of breast cancer, she was a downwinder,” she said, when talking about the city’s resolution against uranium hauling. “I understand what our Native American partners are experiencing. Plus, the largest medical facility in northern Arizona is in Flagstaff.”
The city’s and state’s relationship with Mexico benefits from resolutions, like those in support of the Deferred Action for Childhood Arrivals program and against the border wall.
“Bottom line, a good relationship with Mexico means economic prosperity for our city.”
Vice Mayor Jamie Whelan said Evans’ time as mayor has created a culture of respect and transparency on the council.
“She gets as much from listening to someone who is like-minded as someone who is not,” she said. “She meets with everyone.”
The energy Evans brings to the council is unmatched, Whelan said.
“She really keeps us moving,” she said. “I don’t know how she does it. She had a girl reach out to her and say she wanted to be president, so Coral invited her to shadow her for the day, and so here’s this 9-year-old following Coral around. The love she does have for people really does shine through.”
Whelan, who is serving her first term on the council, said Evans and the other members with the most experience, Scott Overton and Celia Barotz, have been strong role models in a year full of difficult decisions.
“It’s just been an intense year, and I don’t see it easing up,” she said. “What I’m so grateful for is to have a council that talks about things and collaborates.”
Whelan said Evans has “done a wonderful job as a facilitator for the council.”
“I love it, I’ll be her vice mayor any day,” she said.
“I really feel like I’m living the American Dream,” Evans said. “I grew up in Siler Homes, in the projects, and I grew up to be mayor.”
Evans said the experience has been “everything I thought it would be, and so much more.”
“I’m honored to represent the city that I love so much,” she said.
Evans is seeking reelection in November. However, there is still much to be done before her first term expires.
“We still have to address minimum wage, Airbnb and Uber,” she said, adding she looks forward to seeing the city’s federal and legislative priorities move ahead.
She wants to establish a restaurant incubator and a way to attract qualified doctors to the city, in addition to reviving some of the timber industry that used to be the backbone of Flagstaff.
“I really feel the mayor’s role is to be the steward of monetary, natural and cultural resources,” she said. “Democracy works best when everyone is involved.”
NOGALES — Seven humanitarian aid workers with the advocacy group No More Deaths are facing multiple federal misdemeanor charges, while another volunteer has been charged with harboring undocumented immigrants, a felony. That eighth volunteer is Scott Daniel Warren, who also teaches environmental studies classes online at Arizona State University. The complaint against Warren states he “has been preliminarily charged with a felony involving alien smuggling.”
Lee Sandusky, a volunteer with No More Deaths’ documentation team and a desert aid worker, stressed that Warren’s arrest and that of the other seven individuals are “completely separate instances.”
When asked to comment, Warren responded Wednesday via e-mail, writing, “At the time being, I am directing all media inquiries to the No More Deaths media team.”
In a statement, an Arizona State spokesperson said Warren “was not acting in his capacity as an ASU employee at the time of the alleged incident, and we have no reason to believe it will impact his ability to fulfill his current duty with the university.”
The complaint says that on Jan. 17, the Border Patrol had been conducting surveillance on a building near Ajo known as “the Barn” when they encountered Warren along with Kristian Perez-Villanueva and Jose Arnaldo Sacaria-Goday, two migrants who had crossed undocumented into Arizona.
Warren provided aid, such as food and water, to Perez-Villanueva along with Sacaria-Goday, the complaint said.
Representatives with No More Deaths have called the timing of Warren’s arrest “highly suspicious” but recognize it’s only speculation to connect Warren’s arrest and the recent release by No More Deaths of evidence allegedly implicating Tucson Border Patrol agents in the destruction of humanitarian aid left in the desert for border-crossers.
“Right now, we are just trying to wrap our heads around what the actual legal case is and how best to support Scott,” a No More Deaths representative said.
Perez-Villanueva and Sacaria-Goday remain in custody. Authorities released Warren, but his court date has yet to be determined.
The other seven volunteers with No More Deaths are being charged with different federal misdemeanors, including “driving on a wilderness area,” “abandonment of property” and “entering a wildlife refuge without a permit” in the Cabeza Prieta National Wildlife Refuge.
“The interesting thing about that is that many other people are able to receive permits to drive on those roads,” Sandusky said. “Hunters and recreational hikers are able to receive permits. (Wildlife refuge groups) have blocked humanitarian aid providers from receiving these permits. In addition to this, Border Patrol drives with impunity wherever they please on the wildlife refuge.”
The Tucson Border Patrol deferred comments regarding the arrests to the U.S. Department of Justice, which declined to respond because the matter is ongoing.
Stephanie Dixon, an agent and spokeswoman with Tucson Border Patrol, said the agency also does what it can to help save lives.
“All of us have the same idea that we don’t want anybody to die or get hurt in the desert. We understand the extreme elements that are out there,” she said. “These agents are out hiking on a daily basis and we succumb to the elements all the time, so we know the necessity for water,”
Warren’s arrest occurred only hours after No More Deaths released evidence in their “Disappeared” report of Tucson Border Patrol allegedly vandalizing humanitarian aid left along the desert from 2012 to 2015.
No More Deaths released evidence Tucson Border Patrol vandalizing humanitarian aid
Stretching for what seems like forever, the U.S.-Mexico border can be both beautiful and deadly.
“Most people out here aren’t being shot or breaking a leg and not being able to walk,” Sandusky said referring to undocumented migrants attempting to enter Arizona. “They run out of water and they can’t continue.”
No More Deaths recently released a three year report with photo, video and interview evidence showing several Tucson Border Patrol agents destroying water jugs left along desert routes for crossing migrants.
The report details incidents that reportedly occurred between 2012 and 2015. During that time, No More Deaths said they distributed more than 31,558 1-gallon jugs of water across the mountainous terrain of southern Arizona.
During those three years, the report said, 86 percent of their plastic jugs were used for the purposes for which they were intended; however, the rest can’t be accounted for because the jugs were vandalized and slashed 415 times. This totaled 3,586 gallons lost.
“It is not our claim that the U.S. Border Patrol is exclusively responsible for the vandalism of water supplies,” members of No More Deaths said. “We conclude that Border Patrol is responsible for the majority of the destroyed gallons we documented.”
Christopher Sullivan, a Border Patrol agent and spokesman for the agency’s Tucson sector, said authorities do not tolerate this type of behavior.
“Tucson’s sector does not condone or encourage the destruction or tampering with any water or food,” he said. “If it does happen, we want to be made aware of it so therefore we can take the corrective actions against the agents that conduct those activities,” he said.
Sullivan stressed that it would be easier for Border Patrol to punish agents vandalizing humanitarian aid if this information had been brought to them sooner.
“We don’t want a few agents to tarnish what you know most agents do,” Sullivan said. “The few agents that destroy or tamper with water like the aid, that is something that we don’t support and we want to make that clear.”
Wilderness hunters, drug and human traffickers as possible vandals
Before the report came out, Art Del Cueto, president of the Tucson sector for the National Border Patrol Union, said drug smugglers, their scouts and similar groups watch aid workers place supplies in the desert and then retrieve it.
No More Deaths reported an increase in destruction of water jugs during hunting season, but vandalization is consistent when hunting is not permitted.
Group volunteer Lee Sandusky has not seen a Border Patrol agent slash a water jug but has come across “horrible notes left on them” as well as jugs that have been shot.
“I am not sure why the guides or the coyotes would also destroy water they might need,” Sandusky said.
Standing under a bent tree surrounded by boulders and thorn bushes that now protect five water jugs and four cans of SunVista pinto beans, Kate Morgan, abuse document coordinator for No More Deaths, recounted interactions she has had with crossing migrants.
“I have met people who have found our water drop sights and told us, ‘We found it, but it was slashed, it was destroyed. We really needed it, we were really sad to see that,’ ” Morgan said.
“I have also met people who have said, ‘I found your water drop sight. It has been days since I had food and water and it really made a difference to me.’ ”
No More Deaths alleges that certain laws, agencies and presidential administrations have turned this land into a “graveyard for the missing.”
Its report says at least 6,915 bodies have been recovered in the U.S. borderlands from 1998 to 2016. Sandusky also said that within the three years documented in the No More Deaths report, the Pima County Office of the Medical Examiner received the remains of at least 593 border crossers. A majority of these individuals died from extreme weather conditions and dehydration.
No More Deaths said the high death toll is not coincidental but due to “Prevention Through Deterrence,” a large scale border enforcement policy that began in 1994. “Prevention Through Deterrence” increased all aspects of surveillance, including the border wall, more armed agents, checkpoints and heightened surveillance technology.
The group alleges the program has put the lives of migrant crossers at risk and pushes them into regions where natural water sources are sparse.
Sullivan, the Border Patrol spokesman, said the agency’s intention is not to harm anyone, but agents do have to uphold the law.
“The Border Patrol shares a common goal to preserve human life.” Sullivan said. “We don’t want anyone to die coming across the border. Every agent of the Tucson Border Patrol is trained to become first responders.”
Regardless, groups like No More Deaths say the will continue their humanitarian work as long as people keep trying to cross.
“Like so many border crossers whose lives are lost in this no man’s land between nation states, we know very little of these persons,” Morgan said. “The details of their life, journey and death are not ours to tell. But still we hope to gather in their honor and demand and end that in no small part led to their deaths in this rugged and remote terrain.”