Highs, Lows as Arizona Takes on Drug, Alcohol Use
Its response has often been a strong one — boosting penalties for impaired driving and setting in motion prescription drug monitoring programs, for example. As a result, progress toward a healthier Arizona has been made, but much remains to be accomplished. Alcohol use and drunk driving deaths are down, but drugged driving is up. And disturbingly, mental health issues such as depression are increasing among its residents, and many appear reluctant or unable to reach out for the help they need. Here’s a snapshot of what the state has done and is doing to address such concerns and a look at where it might be heading.
Drawing Lines and Setting Goals
If you’re tempted to have one for the road in Arizona, you may want to think twice. The state has some of the nation’s toughest driving under the influence (DUI) penalties. In 2007, for example, officials passed a law requiring those convicted of DUI to use an ignition interlock on their car for a full year, even if it’s a first-time offense. (The interlock is a breathalyzer-type device that is wired into the ignition and that prevents the car from starting when the driver has been drinking.) The state also established DUI categories, with more severe levels of intoxication above the baseline 0.08 legal limit facing additional penalties. An “extreme DUI” — meaning a BAC of between 0.15 and 0.20 percent — is punishable by at least 30 days in prison. A “super extreme DUI” carries a sentence of at least 45 days in prison. MADD calls the legislation “one of the best in the country” and credits it for a 45 percent decline in drunk driving deaths in the state since 2007. Still, officials note there is still far to go; almost a third of all traffic fatalities in 2013 were alcohol-related.
DUI arrests soared over the same period, according to annual enforcement statistics from the Arizona Governor’s Office of Highway Safety, with 10,133 arrested in 2007 and 31,891 in 2013, an almost 215 percent increase. Even more dramatic has been the number of arrests for driving under the influence of drugs: from 538 in 2007 to 4,519 in 2013, an almost 740 percent increase. Drugged driving is also becoming a more common factor in crashes. In 2008, drugs played a part in 2.9 percent of fatal crashes; in 2012, the number was up to 3.75 percent.
Marijuana might be thought to be a culprit in those numbers, given the state’s relaxing attitudes toward pot use. (State voters approved medical marijuana use in 2010, and proponents of legalization hope to have an initiative on the ballot in 2016.) However, a Phoenix New Times investigation into the spike in drugged-driving cases found that marijuana played a factor in only a handful of instances. It noted that five times as many fatal and injury crashes involved people who had illegal drugs in their system, but no booze or marijuana. And those drugs were often prescription drugs such as pain pills and tranquilizers.
According to Cory Nelson, interim director of the Arizona Department of Health Services, the state ranks sixth in the nation for prescription drug misuse and drug overdose deaths. CDC statistics put Arizona’s overdose death rate at 17.5 per 100,000 population, well above the national rate of 12.4 per 100,000. The Arizona Criminal Justice Commission notes that in a 2010 survey, 13 percent of the state’s adults and 10.4 percent of its youth reported misusing prescription drugs in the previous month, and most of that was related to opioid painkillers. Along with that has come a dramatic increase in opioid-related emergency room visits.
In response, the state kicked off a Prescription Drug Reduction Initiative in 2012 that brought together leaders in law enforcement, the medical community and the drug prevention field. Their strategy is to increase public awareness of the dangers of prescription drug misuse, to promote responsible prescribing, dispensing, storage and disposal of the drugs, and to increase the use of the state’s Controlled Substances Prescription Monitoring Program, which helps detect diversion and misuse. In addition, the initiative aims to help identify those who are struggling with dependence on prescription drugs and assist them into addiction treatment.
A Behavioral Health Barometer
Arizona’s drug and alcohol problems, and the mental health issues that so often accompany them, form a complex picture. Helping make that picture a little clearer is the 2014 Arizona Behavioral Health Barometer. Compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA), the report brings together substance use and mental health survey data that has been tracked over time from 2009 to 2013. Among the findings:
Drug and Alcohol Use
- In the 2012-2013 figures, 7.2 percent of those 12 or older reported abusing alcohol or being dependent on it within the previous year. That’s above the national percentage of 6.7 percent, but it’s down from a five-year high of 8.2 percent in 2010-2011. Illicit drug use was also higher than the national average, although only slightly — 3 percent as compared to 2.7 percent. Heavy alcohol use, however, was slightly below national figures from 2009-2013 — 6.2 percent as compared to 6.8 percent. (Heavy alcohol use is defined as having five or more drinks at a time on five or more days in the past 30.)
- Binge drinking by those ages 12-20 has dipped over the past five years, falling from 16.4 percent in 2009-2010 to 14.5 percent in 2012-2013. That’s just slightly under the national figure of 14.7 percent. (Binge drinking is defined as having five or more drinks within a couple of hours of each other.)
- In the 2012-2013 statistics, 11 percent of adolescents ages 12-17 said they’d used illicit drugs in the previous month. That’s a number that hasn’t changed much since 2009, but it’s above the national figure of 9.2 percent.
- Across the five years of the study, 10.9 percent of those ages 12-17 said they’d started drinking alcohol within the year prior to being surveyed, 3.9 percent began marijuana use and 3.4 percent began nonmedical use of prescription drugs.
- The majority of youth ages 12-17 see no risk from having five or more drinks once or twice a week — 61.1 percent, a number that’s in line with national figures. Even more saw no risk from smoking marijuana once a month — 78.3 percent, which is above the national number of 74.7 percent. Both state and national numbers have been rising steadily since 2009-2010.
Substance Use Treatment
- A count of those in substance use treatment on a single day in 2013 found 31 percent were there for a drug problem, 21.3 percent for an alcohol problem and 47.6 for both an alcohol and drug problem. From 2009 to 2013, the number of those seeking help has fluctuated, from a single-day count of 27,599 in 2010, to a high of 37,920 in 2012.
- Of those 12 and older with alcohol use issues, 11.4 percent per year from 2009 to 2013 received treatment. Although low, the number is higher than the national percentage. Of those 12 and older with drug issues, 14.6 received treatment, which is similar to the national numbers.
- Methadone and buprenorphine can be used to help those struggling with an addiction to opioids such as prescription painkillers and heroin. In some cases, they are used long-term as part of maintenance therapy. Buprenorphine use has more than tripled since 2009. Methadone use has fluctuated across the years but has increased more than 12 percent since 2009. A single-day count in 2013 showed 1,040 using buprenorphine as part of their substance use treatment and 6,376 using methadone.
Mental Health Issues
- Arizona’s youth are increasingly depressed, but most aren’t being treated for the issue. The survey found 10.9 percent in 2012-2013 had at least one major depressive episode in the previous year, up from 8.4 percent in 2009-2010. Both numbers are slightly higher than the national figures. From 2009 to 2013, only 29 percent per year received help for their depression in the year prior to being surveyed, a number that is similar to the national percentage.
- 2 percent of adults had serious thoughts of suicide in the years 2009-2013, and 4.8 percent reported at least one serious mental illness. Only about 40.1 percent received any mental health counseling or treatment, however. The numbers parallel national percentages.