Arizona Profile 1997

Drug Strategies

Substance Abuse in Arizona

A diverse population, limited prevention resources and close proximity to Mexico create special challenges for those working to combat substance abuse in Arizona. Surveys reveal progress on tobacco use, but rates of alcohol and illicit drug use remain far above national averages. Substance abuse among young people is a crucial challenge to the state's future success.

Tobacco

Despite some progress against smoking, Arizona still must address several areas of concern. In 1996, the Arizona Department of Health Services' first biennial adult tobacco use survey found that 26 percent of men and 22 percent of women in Arizona are smokers. These rates are significantly lower than national figures. (Nationwide, 31 percent of men and 27 percent of women smoke.) Earlier figures from the annual Behavior Risk Factor Surveillance Survey indicate that regular cigarette smoking has been stable in Arizona since 1990 (between 19 and 24 percent of all adults).

Consistent with national trends, adults age 18-24 in Arizona are most likely to smoke (31 percent of men and 24 percent of women). Northern counties have smoking rates well above national averages, while metropolitan areas and Southern counties are generally below average. The figures point to vulnerable populations that would benefit from targeted prevention and intervention efforts.

Similarly, data suggest that tobacco use is a growing problem among elementary school children in Arizona. In 1995, the Arizona Criminal Justice Commission reported that by the sixth grade, one in three children in the state had tried cigarettes; in 1991, the proportion was slightly more than one in five. However, among high school students in Arizona, smoking rates have dropped 23 percent since 1989; in 1995, 27 percent of high school students smoked.

One way Arizonans can stem the rise in youth smoking is to counter pro-smoking messages in tobacco advertising with hard facts about tobacco's harmful consequences. In 1996, the Arizona Department of Health Services launched a statewide social marketing campaign to reduce tobacco use by kids. But these efforts must compete with private industry advertising. About $112 million is spent each year by private industry to promote and advertise tobacco and alcohol in Arizona. These figures do not include the increased presence of billboards and other tobacco ads in metropolitan areas since the state's tobacco excise tax went up in 1994.

Alcohol

Arizona has the sixth-highest per capita alcohol consumption rate in the nation-30 gallons per person in 1995. Binge drinking (at least 5 drinks at a time for men, 3 for women) is most common among young adults: in Arizona, one third of adults age 18-24 binge drink (47 percent of men and 18 percent of women). Overall, one in five Arizona adults are binge drinkers.

These behaviors start early, and prevention messages for young people must focus on the consequences of over indulgence. Nonetheless, throughout high school, drinking rates in Arizona remain at or below national averages. Arizona's eighth-grade drinking rates match national figures (in1995, more than half of eighth graders had tried drinking, and one in four drank monthly), and tenth and twelfth grade drinking is consistently below national rates.

These figures do not necessarily mean that drinking is below average among all groups of Arizona's young people. While state-specific rates are unavailable, Native American teens consistently use alcohol at higher rates than teens nationwide.

Evidence suggests that overall alcohol consumption is dropping in Arizona. Despite population growth between 1995 and 1996, excise tax revenues for wine dropped 29 percent and those for liquor dropped 41 percent, although revenues from beer sales increased 10 percent. Lower revenues indicate lowe rtotal consumption.

Far more than merely a consumption indicator, excise taxes can also serve as a key deterrent to consumption-if they are high enough. Arizona, however, has not raised alcohol taxes since 1984. Excise tax rates on liquor ($3 per gallon) and beer (16¢ per gallon) are below national averages ($3.59 and 24¢, respectively). Wine, which accounts for just 14 percent of Arizona alcohol sales, is taxed at 84¢ a gallon, 11¢ above averagetax rates.

Illicit Drugs

Overall, one out of nine workers in Arizona tests positive for illicit drugs. And Arizona teens use drugs at rates higher than national averages. But one word dominates Arizona's recent struggle against illicit drugs: methamphetamine. Between 1994 and 1995, workplace drug tests conducted by Sonora Laboratory Sciences showed slight decreases in marijuana and cocaine use, while methamphetamine use rose 35 percent. Another Arizona lab found that self-reports of methamphetamine as the drug of choice tripled during1995, and 95 percent of employees using employee assistance programs reported methamphetamine as their primary problem.

Glorified as a weight-loss tool, methamphetamine has also been used increasingly among Arizona teens. Use by twelfth graders increased 35 percent from 1993 to 1995; at 17 percent, it is four times the national rate. Among younger teens, national rates are so low that they cannot be measured reliably. But in Arizona, 16 percent of tenth graders and 11 percent of eighth graders have tried methamphetamine-double the 1991 rates. One particularly startling statistic is the following: sixth gradersin Arizona are more likely to try methamphetamine (7 percent) than high school seniors nationwide (4 percent).

Of course, methamphetamine is not the only drug of concern in Arizona. Inhalant use is also increasing, particularly among the state's rural youth. In 1995, 23 percent of rural eighth graders had tried inhalants, up from 16 percent in 1991.

Similarly, marijuana use is on the rise. In 1995, 5 percent of adults in Arizona reported recent marijuana use, compared to 3 percent in 1993. Despite the increase, this rate is slightly below the national average of 8 percent.

Teenage marijuana use, which has been rising nationally since 1992, is even more prevalent in Arizona. In 1995, half of all high school seniors in Arizona had tried marijuana, as had 45 percent of tenth graders and 26 percent of eighth graders.

These rates are three to four times higher than in 1991. Nationally, half of the teens who try marijuana become regular users.

Notably, after a sharp increase in 1993, marijuana use by eighth graders did not continue growing in 1995 (contrary to national trends). Perhaps prevention efforts in middle schools are working, or perhaps eighth-grade marijuana use-now at 26 percent-is reaching peak levels, since three-quarters of eighth graders disapprove of marijuana.

Specific population groups bear special concern. For example, although rates are unavailable for Arizona's Native American population, nationally, these adolescents use marijuana at five times the rate for teens overall, and 20 percent use drugs heavily. Similarly, anecdotal reports warn that misuse and abuse of prescription drugs is a huge problem among Arizona's growing population of retirees, although no confirming data are available.

Availability, Attitudes and Perceptions

Attitudes about drugs predict drug use; when teens perceive less danger in drug use or tolerate it more among their peers, they are more likely to use drugs themselves. Between 1989 and 1995, the percentage of Arizona high school students who either "approved" or "didn't care" about marijuana use rose from 31 to 55 percent. Their attitudes also grew more tolerant toward cocaine, alcohol and drunk driving. Meanwhile, Arizona teens say methamphetamine and marijuana are widely available and easy to obtain.

Two implications are clear: First, drug use among Arizona teens will likely continue to rise. Second, the state needs to strengthen teens' resistance skills and reinforce social stigmas against drug use.

The state's long border with Mexico offers a key area of intervention. The border is seen not only as a floodgate for drug smugglers, but as an easy entry point for youth who want to obtain alcohol and drugs in Mexico. Border area residents surveyed by the Arizona-Mexico Border Health Foundation say that there is too much alcohol and tobacco advertising in their communities. However, while adults in these areas uniformly disapprove of illicit drugs, just 10 percent participate in neighborhood prevention activities.

Still there is reason for optimism. Arizona voters favor more spending for children's programs by a two-to-one margin, even if it means a tax increase, according to a 1995 survey by Lake Research and Deardourff & Associates. Half of the public also supports a tax increase to fight drugs.

Prevention

Funding for Arizona substance abuse prevention programs increased by $1.9 million from 1994 to 1995, a period in which prevention dollars were slashed from federal and state programs nationwide. Some prevention programs rely heavily on state and local funds, which pay for 63 percent of prevention initiatives in the Arizona Department of Health Services, 87 percent of prevention activities in the Arizona Criminal Justice Commission, and all of the state's anti-racketeering efforts related to gangs and drugs.

Nonetheless, in 1995 two-thirds of Arizona's $25.6 million for substance abuse prevention came from federal funding streams. This included 79 percent of prevention spending by the Arizona National Guard, 90 percent of Department of Education prevention activities and 99 percent of the Governor's policy initiatives. Dependence on federal funds renders these state programs vulnerable to unpredictable changes in the national political landscape.

Arizona devotes more than two-thirds of its prevention funds to youth services and raised those funds by 17 percent between 1994 and 1995. In FY 1994-95, Arizona spent more than $4 million for K-12 school prevention services and an additional $725,790 to put DARE into 71 percent of Arizona school districts. The good news is that 93 percent of Arizona school districts have adopted health/prevention education curricula. The bad news is that a third of schools have no clearly defined scope and sequence of instruction for the curricula, and two-thirds do not require completion of the curricula.

But children are only half of the story. If Arizona hopes to build community-based initiatives, the state must boost parents' awareness of their own children's substance abuse problems. Adults in Arizona are worried about substance abuse, but do not know their own kids are in danger. Just 6 percent of Arizona parents think their children smoke cigarettes or drink alcohol, and only 4 percent think their children use illegal drugs. The disparity between these figures and the actual rates of use calls for parent education.

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