Treatment in Phoenix, Arizona
For many Americans, hearing the name “Arizona” triggers thoughts of cactuses for some who imagine this Western state. For others, they think of the numerous television commercials for online universities based in Arizona. The state indeed does have a breadth to it ranging from ballet and art museums in its major cities to historical retellings of the land and its people in geographical landmarks and places such as the museum of Native American history. There are desert ghost tours and canyons to photograph, botanical gardens and museums such as the museum of musical instruments.
As the capital of Arizona, Phoenix is host to a population of 6.9 million, making it the sixth largest city in the United States. Skyscrapers and desert lead to a contrasting topography in which the many attractions of the city are hidden. When it comes to the residents of the city, there is a large Latino contingency. Almost half of the residents are married, and the male to female ratio is well-balanced in line with national standards. The population is extremely dense within the city and largely Caucasian, although African-American, Asian, and the aforementioned Latino groups have a strong presence as well. The average age of residents is thirty-two years old for those within the city. The median salary is $46,881 and yet almost as many people are in the range of making $50,000-$100,000 as there are making under $26,000. The area is generally described in terms of large districts, or neighborhoods where people identify themselves as being from within the larger city. These include: Downtown Phoenix, South Mountain, Park Phoenix, Desert Ridge, Desert Valley, Willo, Tatum Ranch, Camelback East, Desert West, Lookout Mountain, Stetson Valley, Arcadia Lite, Thunderbird Villas, Central City, West Phoenix, Norterra, North Mountain, Moon Valley, as well as numerous others.
Not only is Phoenix the center for cultural activities for the state, but it is also a drug portal for the entire United States. It serves as a hub for illegal substances as a result of the Mexican cartels south of the border moving into Arizona and taking control. Sometimes called “Cartel City,” or the “kidnapping capital” as a result of this phenomenon, it is currently dominated by a group known as the Sinaloa Cartel, who along with other providers seem to have chosen Phoenix as a perfect distribution point for substances such as heroin, meth, and marijuana. These can be sold on the street locally and in wholesale for use across the nation. It is assumed that there are somewhere in the range of one hundred “bosses” who run the cartel on the streets of Phoenix and provide enforcement to be sure the group receives payment from dealers on time. When dealers fail to provide said payment, the Cartel provides the consequences, which is often a severe and very violent, or fateful, punishment.
The Sinaloa Cartel has gained power through its ingenuity, wide network, and vast resources. A partnership with two Chinese groups has allowed them to obtain the synthetic products they need for their substances. Unfortunately, authorities believe that they are also the source of a lot of the lethal fentanyl that is now in the United States. The transfer of the fentanyl and other such drugs is elaborate and has involved multiple tactics since the formation of the cartel in the mid-1960s. When the cartel first started its leaders began using aircraft as a novel way to smuggle drugs. After aircraft came a transition into underground tunnels that could be astounding lengths and lead from Mexico straight into Arizona by going under the city. Some of these tunnels are even rumored to exist under the Mexican airport in the state of Tijuana. More recently, the cartel has been smuggling drugs across the border, adding to the bloodiness of an already treacherous journey for those crossing in search of a better life. The infamous “El Chapo” was one of the leaders during this period when drug traffic was escalating and violence was as well. The two so often go hand in hand.
Despite the cartels power over the city, it is not the only group at work moving drugs. Many other small groups exist, such as the 15 man smuggling ring interviewed by the Phoenix New Times . Even with their small numbers, this group of men net around $500,000 a year through their drug business. None of them have the typical tattoos or rough appearance, but are all clean cut and work hard to stay low key and out of the spotlight. When they travel back and forth between Mexico and Arizona, they are able to sell their marijuana for an even higher profit based on how many miles they had to take it. The majority of marijuana in the United States, around 67% is believed to come directly from the Sinaloa Cartel, even if it is then sold to smaller groups like the aforementioned smuggling ring, who break it up among them and sell it again. At each stage, prices are changed so that maximum profit may be obtained. Because of risk factors, small, one-time deals are often avoided in favor of larger deals with an ongoing relationship and folks who can be held accountable if something goes wrong or someone is discovered.
Phoenix fights back
Phoenix (and a few outlying areas of Maricopa County) had over eighteen thousand drug arrests in the year 2013. Paired with a violent crime rate of double that of New York Cities, even though New York has vastly more people, it becomes more clear why this is such a difficult issue to get under control. According to the DEA, every year in Phoenix over six tons of prescription pills are confiscated. In addition to the influx of folks from Mexico, there have also been a great deal of people from Middle Eastern countries such as Syria and Somalia. Of all the people who are running drugs on the ground those who are arrested are generally the folks who are not very high up in the organization, and as a result when they are incarcerated the organization continues to carry out its business and even thrives to an extent, leaving law enforcement with a tricky situation to figure out how to take back control. Some local citizens have tried to use their own resources to fight back. In one suburb of the city, a group of residents started filming a house down the street from them that they saw frightening incidents occuring at. They were fairly certain it was a meth house and they wanted to raise awareness so that it could be shut down and their street would be safer. So they began posting the videos on Youtube, and to their delight received over two hundred thousand views, to the point that law enforcement and news stations became involved. However, one retired police chief reminded the city that this was just one house of which there are hundreds throughout Phoenix.
Most Prevalent Drugs
The top drugs throughout the city include: cocaine, heroin, meth, marijuana, and club drugs. The cocaine is often moved throughout the state on tractor trailers and personal automobiles although when street dealers are selling it locally it is often crack cocaine. Heroin is present in the Mexican black tar form as well as in the brown powder form. It is often found in transit entering into the country through one of the entry ports or being carried on an individual’s body across the border. It is also easily transported in vehicles. Meth is also available in the Mexican brown powder or in the form known as glass, ice, or pure. Crystals are the most prevalent. Club drugs tend to be found more among those who are partaking in recreational drug use, such as college students or those at clubs or parties. Ecstasy is the most popular of the club drugs for the area. Marijuana is definitely the drug that is used the most on the whole throughout the state of Arizona, perhaps because Mexico is the largest producer of Marijuana and with the Sinaloa cartels influence in the city it is readily available. It is often moved by vehicle or by backpackers who carry it on their person from destination a to b.
Since the inception of Proposition 200 in 1996, individuals are able to receive a card that certifies them as having a credible, diagnosed need for marijuana to be used for medical purposes. This card verifies that marijuana is the appropriate treatment for their ailment and generally must be signed off on by two physicians. Interestingly, rather than say that the cardholder has been “prescribed” marijuana for use against a disabling medical condition, the card and paperwork state that the doctor “recommends” marijuana for use against such a condition. The language of “prescribing” is not seen as an acceptable definition of the proposition.
The other group of drugs is the prescription drugs that are greatly abused and often smuggled in from Mexico and other countries. In addition to being highly addictive themselves, drugs like oxycodone serve as gateways to drugs like heroin as they have the same effect on the same receptors within one’s brain.
One drug in particular has been appearing on the scene as the choice of young adults, especially those under the age of eighteen. Known as BHO, which stands for Butane Hash Oil, just like the Butane gas which is highly flammable and dangerous. Indeed, there have been several explosions when it was being made. BHO has high levels of THC, the substance found in marijuana that is also called tetrahydrocannabinol. While THC normally comprises less than fifty percent of the overall makeup of marijuana (most often being closer to around twenty percent) it can be over fifty percent (more like sixty-seven percent) of the makeup of BHO. Not only can the oil contain a lot of THC, but it can also have remains of actual Butane in it, which wreaks havoc on the brain.
Because of the potency of BHO, users only take a small amount at a time in an act that they refer to as “dabbing” or taking a “dab” of. The substance has many nicknames and is sometimes referred to as wax, ear wax, honey oil, amber, or shatter. BHO is something that can derived from many household items, making it all the more accessible for youth, and all the more addicting. In an effort to combat this, an organization known as “Not My Kid” is working to educate parents and students on the negative effects of the drug and hopefully prevent them from ever trying the highly addictive substance. Not My Kid takes several creative approaches to the issue, such as using peer educators for children to learn without feeling targeted. For parents, they offer a corporate lunch box series where parents can “lunch and learn,” participating in workshops ranging on everything from bullying, eating disorders, internet safety to actual substance. By identifying the factors and reaching parents and youth where they are at, Not My Kid maximizes their potential for a positive impact with lasting results. Founders Steve and Debbie Moak have been involved with the issues their organization works to combat on all levels. After seeing family members endure substance abuse, they took action for themselves, starting with the purchase of a drug testing company and leading up to Steve being appointed to the White Houses’ Drug Free Commission under President Bush. Working closely with the Moaks as a dual founder, Dr. Mark Rohde brings his expertise in the field of psychology to the program, ensuring its structure best meets the needs of all those who come to the figurative table.
Local Cases and Overdoses
Between May 2015 and February 2017 there were over thirty overdoses in which residents of Maricopa county died. In each of these cases, the individual took prescription pills that had been produced synthetically, laced with fentanyl, and then sold on the black market. These pills were most likely from one of the Mexican smuggling rings that move drugs into Mexico. Later that year, between June and October 2017, there were 400 cases of opioid overdose that were reported as leading to death, and three thousand two hundred overdoses in total. While these numbers were for the entire state they show the epidemic levels to which the drugs have reached. This report also noted that most of those who overdosed did so at home, often had chronic pain and had been prescribed a painkiller at some point. In addition, the statistics show that many of those who overdosed were men between the ages of twenty-five and twenty-nine.
As a result of the sheer number of overdoses and the ways in which the problem continues to grow exponentially, lawmakers in Arizona have developed new ways of addressing the problem. One of these safety measures took effect on October 16, 2017 and required several different groups to participate in reporting data and monitoring reported data. For example, licensed physicians are mandated to check the Controlled Substances Prescription Monitoring Program, which helps determine whether the patient has been given said drug before and if so the last date and location. When used properly, the system can be quite effective and monitors each patient in twelve month increments. However, not all physicians have followed through on their responsibility to check the system before writing a new prescription for a client. Not only are physicians asked to use this system, but emergency medical services employees and employees of correctional facilities are asked to use it as well. There is another form of monitoring that was set up in Phoenix when the epidemic of substance abuse exploded in the Phoenix area. Known as the Phoenix Metro Intelligence Strategic and Tactical Investigative Center, this agency allows local police, federal agents, drug experts, border patrol experts, and many other qualified individuals to work in partnership in their battle against drugs within Phoenix. The team has a specific focus on gathering intelligence and determining who the Mexican drug trade organizations are, and then pursuing investigations against them.
For someone living in Phoenix, Arizona there are signs of hope in the recovery process. Many folks receiving care choose to do so within Maricopa County or the actual city limits of Phoenix itself. In the state of Arizona on the whole, drug possession is taken very seriously. Although legally an individual who is in possession of marijuana can be charged with a misdemeanor, it is becoming more common that people found with marijuana that they are using for personal use are charged with a felony. The felony charge for marijuana in Arizona comes with a two year prison sentence. If someone is in possession of a narcotic drug (which is everything from Percocet to Oxycodone) they will also receive a felony charge punishable by a little over three years in prison. This is the same sentence prescribed for a “dangerous drug” such as meth or PCP. Furthermore, drug paraphernalia generally brings about a two year prison sentence when it is found in someone’s possession. People facing a charge that is drug related within the state of Arizona can benefit greatly from contacting a lawyer who specializes in drug law. It has been seen that when an individual is facing their first charge for possession the judge will sometimes consider not sending you to prison. However, this depends on other personal factors for the individual charged as well as the judge and jurors opinion. Because of the complexity of options, it can be helpful to have a drug lawyer who is able to help navigate these more smoothly.
When beginning to investigate rehab, a variety of words will appear in the literature about options and in personal conversations with representatives. Assessment is often the starting place after having self-identified or being identified as potentially needing rehab. While assessment varies based on the facility and their approach, as a general rule several individuals with unique focus areas (i.e. social worker, psychologist, nurse, etc.) will work together to understand each potential clients’ circumstances. The client will provide information via questionnaires and conversation, as well as often being asked for a urine and hair sample. This process serves to help the treatment center better understand whether the client is dealing with an actual addiction to said substance, and if so what the depth of their addiction may be. Furthermore, it allows specialists the opportunity to see if their are co-occurring conditions, be they psychological or environmental, at the time of admission. Whatever conditions are discovered provide better insight into the addiction itself and are also often able to be simultaneously treated.
During this phase of interaction with the potential treatment center, the service provider works with the client to map out what a treatment plan would look like, and seeks to name the ways in which life will change for that individual once they enter into rehab. In doing so, they are able to identify potential barriers to the treatment process, as well as struggles that may be specific to that individual. Since the life of an addict is often surrounded by a web of uncertainty, it can be invaluable to have the stability provided in a plan of treatment. However, even in its positive form, it is still a tough transition, and working with the facility to find the best program and fit is vital.
While a client may learn some about a facility during the pre-intake, it remains very important for the client to find the rehab facility that best fits their needs and liking. Not only does the initial impression need to be positive, but the ongoing climate of the facility needs to be good enough to ensure retention and a level of change occurring in the patient so that they do not simply leave the program. Since rehabilitation as an overall process differs from detox in its focus on lifestyle and thought pattern change and overall transformation, the intake process is more of a partnership with the rehab facility, whether it is self-initiated or proposed by a family member or close friend. Paperwork, urine samples, and breathalyzer all generally occur during this stage.
Detox can be a step in a rehabilitation center, and it can be a separate process completely, depending on the approach of the providers. In its most basic form however, detox is the withdrawal and cleansing of the body from the drug. It can be a very difficult process as the body craves the drug and has repeated visceral reactions to not having said drug that often resemble the symptoms of having the flu. However, this experience is made much more pleasant by the trained stuff able to assist the patient during the process. Centers are able to help monitor the physical process and do their best to aid in the transition for the client.
The Treatment Process
One of the main benefits of inpatient treatment, or treatment within a facility that offers around the clock care and trained staff to assist with all aspects of the transition, is that the friend groups, stress points, and triggers to use are temporarily removed as one is isolated from the outside world. RTC tends to be focused on individuals who have been struggling with addiction for an extended period of time or who may have been battling another co-occurring issue. PHP (partial hospitalization) allows for the freedom of not needing to stay the night, and yet having more intensive care during the daytime hours than at normal outpatient treatment. The third option, IOP, focuses more on illnesses such as eating disorders and depression, while also treating addiction in a subtle way so that the client is able to go about their work or family life in as normal a routine as possible.
When an addict has a community supporting them and the means to start replenishing the life they diminished during their drug use, outpatient treatment is often a good option. This format often requires meeting with a therapist during the week who specializes in addiction counseling, and following their advice along with the advice of a medical provider.
Whatever route an individual decides to follow when seeking help, it is vital that an aftercare plan is in place for the time period when the initial treatment has ended. Even after returning to society or passing benchmarks for sobriety, triggers such as lifestyle changes may still lead to a relapse. Having an aftercare plan in place helps ensure the recovery will truly be long lasting. Aftercare plans in which individuals “check in” and receive remedial work/information are very common. However, for individuals needing more than occasional realignment, options such as sober living communities exist, where people trying to stay clean live and work together and follow a set of house standards and rules.
Regardless of the route, recovery is worth the effort.