{"id":7908,"date":"2026-07-15T04:28:38","date_gmt":"2026-07-15T11:28:38","guid":{"rendered":"https:\/\/wrwofficial.com\/index.php\/2026\/07\/15\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\/"},"modified":"2026-07-15T04:28:41","modified_gmt":"2026-07-15T11:28:41","slug":"the-epicenter-of-drug-deaths-in-america-is-shifting-west","status":"publish","type":"post","link":"https:\/\/wrwofficial.com\/index.php\/2026\/07\/15\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\/","title":{"rendered":"The Epicenter of Drug Deaths in America Is Shifting West"},"content":{"rendered":"

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By<\/span> Josh Katz<\/a><\/span> <\/p>\n

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Josh Katz has covered drug deaths and addiction in America for almost a decade. He reported from Phoenix.<\/p>\n

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For years, the opioid supply in Arizona was dominated by little blue pills pressed and stamped to look like 30 milligram oxycodone tablets, often called \u201cblues.\u201d But two years ago, that began to change. Now the market is mostly powdered fentanyl, and drug deaths are rising. In Phoenix, this shift in the illicit drug supply has combined with heat, meth and homelessness to create an emerging crisis of overdose deaths in America\u2019s fifth-largest city.<\/p>\n

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Marck Martinez grew up outside Phoenix, and when he first encountered fentanyl, it was those blue pills. But when he relapsed this past February, he had trouble finding them. \u201cI tried to look for blues again, and there were no blues at all,\u201d he said. In their place, he found fentanyl powder, which was stronger and less predictable.<\/p>\n

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With the switch to powder, he began to overdose much more frequently, most recently in April in a public park next to his 5-year-old son. He survived only because his mother found him and called paramedics, who were able to revive him with naloxone. After being driven to a hospital, Mr. Martinez, 26, fled to a gas station bathroom to smoke fentanyl again.<\/p>\n

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Marck Martinez started smoking meth at 15. Within a couple of years, he\u2019d moved on to fentanyl.<\/span> Caitlin O’Hara for The New York Times<\/span><\/p>\n

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Harm reduction workers, local researchers and people who use drugs all echoed the same idea: Blues with significant quantities of active ingredients have been disappearing. Blues didn\u2019t vanish all at once, they said. Rather, over the past year or two, it became increasingly difficult to find pills with enough fentanyl in them to have any effect at all. For the most part, the pills remaining on Phoenix streets today are \u201cfake,\u201d Mr. Martinez said, no longer containing enough fentanyl to prevent withdrawal. For drug users in Phoenix, it\u2019s mostly powdered fentanyl that remains.<\/p>\n

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Brian Clark, associate chief of operations for the Drug Enforcement Administration\u2019s Pacific and Southwest region, said the suppliers of fentanyl haven\u2019t changed, with the Sinaloa and Jalisco New Generation cartels remaining the primary movers of fentanyl across the southern border. But he couldn\u2019t say why these cartels shifted from counterfeit pills to powder in Arizona.<\/p>\n

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Neighboring New Mexico is seeing the same transition from pills to powder, according to Dave Daniels, harm reduction manager for the New Mexico Department of Health. These two Southwestern states had the largest increases in the drug death rate in 2025, all while drug deaths in West Virginia, once the center of the opioid epidemic, have plummeted. According to a New York Times analysis of provisional mortality data<\/a> from the Centers for Disease Control and Prevention, the drug death rate in Arizona last year overtook West Virginia\u2019s for the first time since the proliferation of prescription painkillers in the late 1990s. Arizona and New Mexico now have the highest rate of drug deaths in the contiguous United States.<\/p>\n

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The rising drug deaths in the Southwest are in sharp contrast to the large-scale decline that has returned the U.S. drug death rate to its pre-Covid level. The reasons for this decline are still<\/a> a matter of debate<\/a>. \u201cEpidemic curves can only go up for so long,\u201d said Caleb Banta-Green, a research professor at the University of Washington. And the shift to powdered fentanyl in the Southwest already happened in much of the country years ago.<\/p>\n

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The surge of powder in Arizona, however, has spread through a population that is not accustomed to using it. \u201cPeople adapt to market changes,\u201d said Raminta Daniulaityte, a professor at Arizona State University who researches illicit drug use. \u201cBut initially when things change, it can have devastating consequences because people haven\u2019t developed strategies to adapt.\u201d<\/p>\n

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Margarita Mac\u00edas, Marck\u2019s mother, remembers coming home one day to find him lying limp in the driveway, soon after he\u2019d returned from four months in rehab, after powdered fentanyl had taken over. Foam was coming out of his mouth. She screamed for her husband. \u201cI felt so helpless,\u201d she said in Spanish, \u201cseeing things spiraling out of control and being unable to do a thing.\u201d<\/p>\n

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Margarita Mac\u00edas, Marck\u2019s mother, has witnessed her son overdose many times. \u201cI kept telling him all the time: \u2018If you want help, I can help you, son. All I want is for you to turn your life around,\u2019\u201d she said.<\/span> Adriana Zehbrauskas for The New York Times<\/span><\/p>\n

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Powdered fentanyl sold on the streets is particularly dangerous because of its higher variability. One recent study<\/a> of the fentanyl supply in Los Angeles, for example, found that one gram of what was sold as \u201cfentanyl\u201d contained anywhere from less than one milligram of fentanyl to almost 650 milligrams. The variability combined with the potential for extreme potency makes it difficult to dose properly. \u201cWith the powder, you would overdose instantly if you weren\u2019t careful,\u201d said Francisco Cabrera, who has used fentanyl for over a decade.<\/p>\n

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Among the people interviewed for this article who use opioids, most expressed a preference for blues over powdered fentanyl, all else being equal. But ultimately they would use whatever product was available to stave off withdrawal, which causes debilitating pain, vomiting and mental anguish. \u201cIt\u2019s like your blood is itching,\u201d said Mr. Martinez, who would scratch himself so severely that his mother would often find him bleeding through his shirt.<\/p>\n

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\u2018It is like a blast furnace\u2019<\/h2>\n<\/p>\n

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Phoenix, the largest city in Maricopa County and the center of the broader metro area, sits low in the Salt River Valley, under a blanket of warm air at the northeastern edge of the Sonoran Desert. The relentless heat of the city has only compounded the dangers of the fentanyl supply shift. Drug deaths in Phoenix typically peak during the summer months, when temperatures routinely exceed 110 degrees, often remaining above 90 degrees even at night.<\/p>\n

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America\u2019s fifth-largest city is one of its hottest.<\/span> Adriana Zehbrauskas for The New York Times<\/span><\/p>\n

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The hot nights make it harder for vulnerable populations to recover from hot days spent in a city with wide boulevards and relatively sparse tree cover. \u201cThere\u2019s nowhere to hide,\u201d said Scott Greenwood, C.E.O. of Sonoran Prevention Works, a local harm reduction agency. \u201cIt is like a blast furnace. It\u2019s like taking a hair dryer and pointing it at your face. That\u2019s what it feels like when there\u2019s a breeze here in July.\u201d<\/p>\n

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According to a Times analysis of data from the Maricopa County medical examiner\u2019s office from 2024 through March 2026, when the daily high in Phoenix crossed 110 degrees, drug deaths in the county increased by 40 percent. On days when the temperature reached 115 degrees, drug deaths nearly doubled.<\/p>\n

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In Maricopa County, drug deaths rise along with the temperature<\/h3>\n

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Drug deaths begin to rise once temperatures in Phoenix cross 110 degrees. Above 115 degrees, they nearly double.<\/p>\n

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Source: New York Times analysis of preliminary data from the Maricopa County medical examiner\u2019s office from January 2024 through March 2026. Daily high temperatures recorded at Phoenix Sky Harbor International Airport, from the National Oceanic and Atmospheric Association.<\/span> <\/p>\n

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As part of the street medicine team for Circle the City, a nonprofit organization that provides medical care to homeless people in Maricopa County, Dr. Matt Evans has witnessed these dangers firsthand, describing patients who had passed out from fentanyl and suffered third degree burns from pavement superheated by the desert sun. \u201cSubstance use and extreme heat do not mix,\u201d he said.<\/p>\n

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These dangers are aggravated by the widespread use of methamphetamine. According to Ms. Daniulaityte, 80 to 90 percent of fentanyl users in the region also use meth. The depressive effects of fentanyl are so strong that many drug users said they use meth just to function, smoking fentanyl to bring themselves down and then meth to bring themselves back up again. Several described using methamphetamine to ease the pain of withdrawal.<\/p>\n

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Dr. Matt Evans, director of addiction medicine for the nonprofit Circle the City, described how addiction can reshape a person. \u201cMeth and fentanyl mess with your sense of priority \u2014 your motivations are dictated by not being sick,\u201d he said.<\/span> Adriana Zehbrauskas for The New York Times<\/span><\/p>\n

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The combination of heat and meth can be deadly. Whereas a fentanyl overdose causes the brain to stop reminding the body to breathe, methamphetamine kills by pushing the body past its limits, effects that are heightened by heat exposure, lack of sleep and dehydration. \u201cIt raises your body temperature, it makes you tachycardic,\u201d Dr. Evans said. \u201cIt puts you at risk for heat exhaustion, heat illness, heat stroke in a way that is very dangerous.\u201d The body can quite simply overheat.<\/p>\n

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In 2025, over half of heat-related deaths<\/a> in Maricopa County involved drugs. At least 19 people in Maricopa County have died from heat exposure already in 2026, with drug use implicated in 11 of those deaths. In all but one of those drug-related cases, methamphetamine intoxication was listed among the causes.<\/p>\n

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The interplay between heat and meth is one of the reasons the Maricopa County Department of Public Health broadened its internal definition of drug deaths<\/a> in 2024 to include any death where drug toxicity was a contributing factor. \u201cThere really isn’t a bright line\u201d between a heat death and a meth death, said Dr. Jeffrey Johnston, the chief medical examiner for Maricopa County.<\/p>\n

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Phoenix has built a network of cooling centers and relief stations throughout the city.<\/span> Adriana Zehbrauskas for The New York Times<\/span><\/p>\n

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The twin pressures of heat and meth are felt by the large homeless population in the area, who have few options to escape the heat and often use meth as a tool of survival, to stay vigilant. Annual surveys estimate that on any given night there are about 10,000 homeless people<\/a> in Maricopa County; roughly half are unsheltered, living on the streets, in parks and river beds. Sustained meth use can easily trigger meth-induced psychosis, in which a person begins hearing voices. One man described starting using fentanyl merely to quiet the voices in his head so he could sleep.<\/p>\n

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According to Arlene Mahoney, the executive director of the Southwest Recovery Alliance, displacement from homeless encampments \u2014 like the 2023 dismantling<\/a> of \u201cthe Zone,\u201d the city\u2019s largest encampment \u2014 has further heightened the risk. When people can no longer find the drug supply they\u2019re used to, they\u2019re forced to choose between the agony of withdrawal or new, untested sources. \u201cIt\u2019s about destabilization,\u201d Ms. Mahoney said. \u201cPeople are losing the places and people they rely on.\u201d<\/p>\n

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Advocates for the homeless are especially concerned about a new city parks ordinance<\/a> that restricts the provision of medical care and food in city parks. City officials have defended the measure as a way to improve safety and sanitation. Outreach workers and medical providers say it will make it harder to reach people who already have little access to health care, at a time when city parks, with shade and grass, can provide a rare respite from the heat. \u201cI think what\u2019s coming here is terrifying,\u201d Ms. Mahoney said. \u201cThat\u2019s not public health, that\u2019s not public safety.\u201d<\/p>\n

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A \u2018wake-up call\u2019<\/h2>\n<\/p>\n

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After Mr. Martinez overdosed in the park, he returned to living on the streets. Shortly after, a close friend who\u2019d just left rehab, unable to find the blues he was used to, turned to fentanyl powder. The friend died. A few days later, Mr. Martinez checked into the HOPESS Residential Recovery Center.<\/p>\n

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\u201cIt was kind of like my wake-up call,\u201d Mr. Martinez said. He guesses he\u2019s entered inpatient treatment around a dozen times, but he\u2019s determined to make this visit his last. \u201cEvery time I come across fentanyl now,\u201d he overdoses, he said. \u201cI\u2019m not gonna make it, you know? It just gets worse and worse.\u201d<\/p>\n

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The nights remain hot in Phoenix even after the sun sets.<\/span> The New York Times<\/span><\/p>\n

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The initial data from 2026 appears promising. Reports of <\/a>nonfatal overdoses in Phoenix<\/a> through June are 17 percent lower this year than last. Data pulled from the Maricopa County medical examiner\u2019s office shows drug deaths through March tracking lower than last year. It\u2019s possible the crisis has begun to ebb. But it takes months to classify many drug deaths; a complete picture won\u2019t emerge until well after summer is over.<\/p>\n

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Mr. Martinez has entered a sober living house and has started taking classes at the local community college, where he hopes to pursue welding. Ms. Mac\u00edas follows his progress closely, eager to see the return of the son she knew from before he started using. \u201cPeople would say to me, \u2018Listen, why do you keep chasing after him?\u2019 But I\u2019d say: I have to help him. If I don\u2019t, who will?\u201d<\/p>\n

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Methodology<\/p>\n

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The chart of drug death rates is a Times analysis of mortality data from the Centers for Disease Control and Prevention. Deaths before 1999 reflect the underlying cause of death, using ICD-9 codes E850-E858, E950.0-E950.5, E962.0 and E980.0-E980.5. Deaths from 1999 onward include all deaths in which acute drug toxicity was listed among the contributing causes, using ICD-10 codes X40-X44, X60-X64, X85 and Y10-Y14.<\/p>\n

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Drug death numbers for Arizona in 2008 are omitted due to a known data issue<\/a>. Death numbers for 2025 are preliminary, with rates calculated using the Vintage 2025 state population estimates from the Census Bureau.<\/p>\n

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The chart of Maricopa County drug deaths classifies a death as drug-related if either the primary or contributory cause of death contains any of these words: acetaminophen, alprazolam, amphetamine, amlodipine, buprenorphine, buproprion, bupropion, caffeine, chlordiazepoxide, citalopram, cocaine, codeine, cyclobenzaprine, diphenhydramine, doxepin, fentanyl, fluoxetine, gabapentin, heroin, hydrocodone, ketamine, kratom, kratum, lorazepam, methadone, methamphetamine, mitragynine, morphine, oxycodone, phenobarbital, polydrug, polysubstance, sertraline, tramadol, venlafaxine or zolpidem; or the phrases acute drug, drug intoxication or drug toxicity. It excludes homicides, in which causes of death are redacted. Drug deaths classified as homicides are rare. Some case data is preliminary and subject to change.<\/p>\n

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<\/p><\/div>\n","protected":false},"excerpt":{"rendered":"

By Josh Katz Josh Katz has covered drug deaths and addiction in America for almost a decade. He reported from Phoenix. July 15, 2026 For years, the opioid supply in Arizona was dominated by little blue pills pressed and stamped to look like 30 milligram oxycodone tablets, often called \u201cblues.\u201d But two years ago, that […]<\/p>\n","protected":false},"author":1,"featured_media":7909,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[327],"tags":[1800,2040,364,2755,2756,1738],"class_list":{"0":"post-7908","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-america","9":"tag-deaths","10":"tag-drug","11":"tag-epicenter","12":"tag-shifting","13":"tag-west"},"yoast_head":"\nThe Epicenter of Drug Deaths in America Is Shifting West - Well Rooted Wellness<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/wrwofficial.com\/index.php\/2026\/07\/15\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The Epicenter of Drug Deaths in America Is Shifting West\" \/>\n<meta property=\"og:description\" content=\"By Josh Katz Josh Katz has covered drug deaths and addiction in America for almost a decade. He reported from Phoenix. July 15, 2026 For years, the opioid supply in Arizona was dominated by little blue pills pressed and stamped to look like 30 milligram oxycodone tablets, often called \u201cblues.\u201d But two years ago, that […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/wrwofficial.com\/index.php\/2026\/07\/15\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\/\" \/>\n<meta property=\"og:site_name\" content=\"Well Rooted Wellness\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/groups\/948985443013245\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-15T11:28:38+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-07-15T11:28:41+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/wrwofficial.com\/wp-content\/uploads\/2026\/07\/2026-04-23-drug-deaths-index-facebookJumbo-v3.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1050\" \/>\n\t<meta property=\"og:image:height\" content=\"549\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"wrwofficial.com\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"wrwofficial.com\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/\"},\"author\":{\"name\":\"wrwofficial.com\",\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/#\\\/schema\\\/person\\\/636ab349f3b686d9a710f47cc20a9f8b\"},\"headline\":\"The Epicenter of Drug Deaths in America Is Shifting West\",\"datePublished\":\"2026-07-15T11:28:38+00:00\",\"dateModified\":\"2026-07-15T11:28:41+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/\"},\"wordCount\":2349,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/wrwofficial.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/2026-04-23-drug-deaths-index-facebookJumbo-v3.png\",\"keywords\":[\"America\",\"deaths\",\"Drug\",\"Epicenter\",\"Shifting\",\"West\"],\"articleSection\":[\"Health\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/\",\"url\":\"https:\\\/\\\/wrwofficial.com\\\/index.php\\\/2026\\\/07\\\/15\\\/the-epicenter-of-drug-deaths-in-america-is-shifting-west\\\/\",\"name\":\"The Epicenter of Drug Deaths in America Is Shifting West - 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He reported from Phoenix. 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