Tucson City Council passed a motion declaring the town’s fentanyl epidemic a “public health crisis” on Oct. 17. 

As defined by the United States Drug Enforcement Administration, fentanyl is “a potent synthetic opioid drug approved by the Food and Drug Administration for use as an analgesic (pain relief) and anesthetic.” According to the Arizona Department of Health Services, more than five people in the state die each day from opioid overdoses. In Pima County, 286 of the 495 fatal overdoses from 2022 involved fentanyl. So far in 2023, 222 out of the total 374 fatal overdoses in the county have involved fentanyl.

Pima County recently received a foundational grant from the Centers for Disease Control and Prevention that provides $12.5 million over the course of five years for the county to reduce the incidence of overdose, according to a presentation by Pima County Public Health Director Dr. Theresa Cullen.

There are six areas of focus for this funding, as dictated by the CDC. These areas are prevention and education, linkage to retention in care, harm reduction, stigma reduction, implementation of clinician/health systems best practices and overdose surveillance infrastructure.

Cullen said while Tucson and Pima County as a whole have made great improvements in these areas, there is still plenty of work to be done, especially in the implementation of clinician and health systems best practices. In partnership with the University of Arizona Health Sciences Comprehensive Pain and Addiction Center, the county is working to educate health care providers on best practices when it comes to opioid prescription. 

According to Cullen’s presentation, some of the continuing efforts the county is participating in through this grant include educational campaigns, prevention strategies and enhanced harm reduction in community, public safety and healthcare systems, linkage to and retention in care and informing clinical and health systems best practices. 

To fund these objectives, Pima County is currently using money from the One Arizona opioid settlement.  According to Cullen, Pima County and its partner jurisdictions (Marana, Oro Valley and Sahuarita) will receive $48.5 million over the next 18 years as part of a legal settlement by pharmaceutical companies and distributors. 

The process of implementing these funds is the community offers input to the Substance Use Advisory Committee, which then brings these recommendations to the Board of Health and the Pima County Health Department. The department then presents the recommendations to the Pima County Administrator and Board of Supervisors. 

In her presentation to the mayor and council, Cullen broke down the recommended funding for 2024. The proposed allocations that have gone through the Board of Supervisors are: $200,000 towards planning/primary prevention, $200,000 towards mobile treatment and intervention, $100,000 towards services for pregnant women and $100,000 towards harm reduction.

Cullen emphasized the importance of a “community-based, holistic approach” to fighting this crisis. This involves students at the UA who are doing their part to contribute to this effort. 

Team Awareness Combatting Overdose UA is “a chapter of Team Awareness Combating Overdose Inc., a non-profit organization that provides non-judgemental, neutral, scientific data backed by neuroscience,” according to Madison Trotter, president of TACO UA. 

According to Dezi Rachels, a member of TACO UA, the group prioritizes education on college campuses because many college students are being exposed to a new environment and a variety of different substances they may not be familiar with. Run by and for students, TACO engages with the campus community in a way other outreach programs might not. 

“The cool thing about TACO is that it is run and formed by students so we’re able to connect in a really unique way from other drug education programs,” Rachels said. “It’s really cool to see how people are gaining awareness and actually using the fentanyl testing strips.” 

As Rachels mentioned, a significant aspect of the work done by TACO is the distribution of fentanyl testing strips to members of the campus community.

“We’ve distributed roughly around 700 test strips since our first distribution in October 2022 and I hope we can continue to increase this number and educate people that if you are taking anything that did not come from a pharmacy, it needs to be tested for fentanyl,” Trotter said. “My members and I have had multiple reports of people that go to big party events [that] tell us that they used our test strips or they saw people using them and that’s what makes me the happiest. I do not want to see anyone on our campus that uses drugs to become a victim to fentanyl.”

This student group is demonstrating, on a smaller scale, the type of community collaboration that Cullen emphasized to the mayor and council. TACO UA presents information about drug use and safety to Greek Life organizations across campus, according to Trotter. Additionally, the group will be distributing “Halloweekend Survival Kits” on the UA Mall Thursday in partnership with the Student Health Advocacy Committee. 

As TACO demonstrates, fighting the fentanyl crisis will require efforts from sources throughout the community. In the past, according to Tucson Mayor Regina Romero, the burden of handling this crisis fell on the shoulders of the Tucson Police Department. The mayor and council are hoping that this community-based approach alleviates some of this burden and gets other groups involved in finding solutions. 

Part of this initiative by the city also involves looking at the root causes of substance misuse and the underlying contributing factors that impact different communities. Tucson Chief of Police Chad Kasmar emphasized the urgency of the situation while also noting that finding solutions to these root causes will not be immediate. 

“In my 24 years of public safety service in this city, I have never seen a drug impact our country like fentanyl has […]. TPD has completed over 4000 arrests this year related to fentanyl, and that’s an 83% increase year to date. Our deflections are down, but nearly 200 deflections,” Kasmar said at the Oct. 17 council meeting. “I want to recognize that poverty is an underlying contributing factor to this conversation. In our investments in our educational systems, in our larger community, our root cause solutions, they’re not immediate, like we’d all like to feel, but they’re absolutely root cause solutions to reducing drug use in our larger metropolitan Tucson.”

According to Ward 1 City Council Member Lane Santa Cruz, another important step in fighting this crisis is combating the stigma associated with addiction. 

“It’s people of all ages, all income levels, it’s not just people who are experiencing homelessness or are unsheltered that are being impacted by this, and I think that the question we need to continue to ask ourselves is […] why is there so much pain and suffering within our community […]? People who have addiction issues or who are experiencing addiction are people who want to live. And so I think that’s always an important reminder; they’re self-medicating, because they want to live,” Santa Cruz said. “And our role as a society, as an institution, is to provide the support systems to get people who are dealing with alienation to feel like they’re part of a community.”

Overall, the goals of the O2A campaign and the city’s efforts to fight this crisis are creating healthy communities, preventing substance misuse, diagnosing/treating substance use disorder and preventing sequelae (the after effects of addiction or injury). The motion passed by the council declared fentanyl and opioid use a public health crisis in the Tucson community and directed the city manager to work with Pima County to create a road map to address the crisis.

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