When J. Alexandria Garcia was just 16 years old, she started experimenting with drugs.
“I had experienced a really traumatic event,” Garcia said, “ and after that traumatic event, I didn’t necessarily have the types of resources that I needed to get any type of trauma therapy or assistance for that. So I turned to the one thing that I found that would help with that, and that was heroin and cocaine.”
It took her more than a decade to get out of it, including several stints in Arizona’s Department of Corrections, several rounds of anonymous programs to get clean.
Those are some of the leading harm reduction organizations in the state, that work to help people stay safe and alive while using drugs.
“And it wasn’t really until I had become engaged with types of organizations like Sonoran Prevention Works and Shot in the Dark, and organizations like that played a really instrumental role in me finding my footing and understanding that this way that I had viewed substance use previously may not be the way that things really are,” Garcia said. “And by meeting them and learning more about harm reduction and getting access to the things that I needed in that time when I wasn’t necessarily ready to get clean yet, played a huge role in my ability to again find my footing when I was ready to get clean.”
Sonoran Prevention Works and Shot in the Dark are some of the leading harm reduction organizations in the state that work to help people stay safe and alive while using drugs. For Garcia, it all led her to the work she does now with Arizonans for Transparency and Accountability and Corrections, dream.org, and the University of Arizona’s Harm Reduction Lab.
She wrote an opinion piece recently in The Arizona Republic calling for the state to spend more on overdose prevention and less on incarceration, diverting people away from the criminal justice system and into treatment that addresses the root causes of substance use disorder.
It comes as there is some good news on this front: National public health data shows a dramatic drop in overdose deaths across the country. And, here in Arizona, there is more money coming to the Department of Corrections from a sweeping $1.14 million settlement with opioid manufacturers and pharmacies to tackle the fallout from the opioid epidemic. Though, it didn’t come without controversy: Attorney General Kris Mayes took Governor Katie Hobbs to court over diverting the funds to Corrections, arguing they weren’t meant to fill a hole in the state budget.
For Garcia, it points to an opportunity and a challenge. Garcia joined The Show to talk about how her own story led her here.
Full conversation
J. ALEXANDRIA GARCIA: Even after I got clean, it wasn’t a simple journey. I continued to lose people very close to me to the overdose crisis. And that’s really what led me into this work, was understanding that I had gotten very lucky by making it out. And I was very lucky with the types of resources and connections that I had and understanding that not everyone has that, but that everyone should.
I wanted to be somebody who could help bring that information to the public, start working on policy because I do have policy experience as well as experience in the drug world, in the incarceration world. I felt that I could do a really good job of trying to bridge that gap between people who use drugs, people who are impacted by incarceration and then government and lawmakers.
LAUREN GILGER: Right. So that’s the work you do today. I want to talk a little bit more just briefly about your time in prison. Because this also feeds into the work that you do now, but from a very different point of view. Talk a little bit about the challenges in that. Did you get treatment when you were in the Department of Corrections?
GARCIA: So I did not receive treatment while I was in the Department of Corrections, and I was even taken off of the medication for opioid use disorder that I had been on when I went into incarceration. So I was actually receiving less treatment when I went into the prison. And that’s a really common story that you hear.
It’s becoming less common. Director (Ryan) Thornell is doing a good job of beginning to expand the medication for opioid use disorder program. But it was a struggle. I would come home, and the reason I went back multiple times was because throughout those times that I was incarcerated, I wasn’t learning anything new. I was just having a dry break from substances and then coming home and doing the same.
And there was one time that I’d come home — I was still pretty young — and I actually ended up overdosing in the parking lot of the Department of Corrections and had to be rushed to the hospital by my husband, who thankfully saved my life.
But that is just a testament to the need for better treatment because people are coming home in similar mindsets. Nothing’s changed. They have no new tools in their toolkit.
GILGER: So that I want to ask you about some news on that front. Right. Because there’s been some controversy over this. But the state says it’s using a big chunk of the opioid settlement money over the opioid abuse crisis and overdose crisis we’ve been seeing over the last decade here. Some of that money will be going to state prisons.
How do you feel about that? Because like I said, it’s been controversial.
GARCIA: So it has definitely been controversial. And I have taken a lot of time to think about it. I think on one hand, it’s great the current administration is showing that combating the overdose crisis is somewhat of a priority. But on the other hand, I think that it’s going to be imperative that we’re ensuring that this money is really going to the right things.
We currently have the massive lawsuit that’s been going on with the Department of Corrections for many, many years, and there are a lot of concerns that some of that money is going to be used to kind of backfill some of those things, rather than actually going towards what it’s intended to do, which is to help with the opioid crisis.
So I would say I am cautiously optimistic. At Arizonans for Transparency and Accountability in Corrections, a huge portion of what we do is trying to ensure that there is accountability within the department. So we will be watching very, very closely to see where those funds are being allocated, how they’re being used, and we’ll definitely be coming forward if we find that they aren’t being used in a way that aligns with our vision for the goals.
GILGER: But it really sounds like you think that there is an opportunity, at least in corrections, to use those funds really well and give people the kind of treatment you did not get.
GARCIA: I do, I absolutely think that there is an opportunity for the funds to be used well. But again, historically, we have seen that the department doesn’t spend money in ways that are beneficial to the people who are incarcerated. So we’ll see.
GILGER: I want to talk to you about some good news on this front, which is rare. There’s been a lot of reporting of late that the deaths resulting from overdose have really seemed to have plummeted in much of the country. What do you make of that? Like, is that true in your experience, do you have any feelings as to why that would be happening? Because a lot of researchers seem to be relatively puzzled as to how this could have happened and how we keep it going.
GARCIA: So I think it’s incredible. I think that any time we are lowering the numbers of preventable deaths is always an incredible thing. I think harm reduction organizations that are popping up all across the country, led by people who use drugs, led by people who have experience in this area, are playing a huge role. Access to syringe service programs, access to education through a lot of those harm reduction organizations.
I think a lot of it is just based on that education piece. And from what I’m seeing, there are areas that we are seeing significant drops. But what we’re hearing is that there are still a lot of areas where people are severely disadvantaged, a lot of minority communities or poverty ridden communities. Their numbers are still raising.
So we’re seeing numbers drop as a total, but there are still areas that need to be addressed. Specifically in Arizona, our Indigenous community is very, very heavily hit by the overdose crisis. So I’m hoping that we can move into those areas so that we can start to see those drops that are happening in some areas happen everywhere.
GILGER: So let me ask you a little bit about what you’d like to see change still. You talked about the things that worked for you, right? Some of those have been put into place pretty broadly in our state. Not all of them. What policies do you think should be adopted at this point to keep these good trends going and maybe to get into some of those communities you’re more concerned about, like you mentioned?
GARCIA: Yeah, absolutely. I think there are a lot of things that we can do. But if I’m looking at things that could be implemented in the immediate that could have a very quick impact, that first thing would be supervised consumption sites that would allow people to use in a safe area, not in the public, where they’re under the care of a medical doctor or nurse.
And then they would have the opportunity to be connected with resources, services or treatment. And then also earlier this year, we saw some changes to the federal regulations surrounding methadone. And these were done off of studies that showed that by giving people more privileges and less really, really intense hurdles to go over, that people were having higher success rates.
And this was studied during COVID. So these regulations have changed, but each individual state and then the medical clinics within each state have the opportunity to decide whether or not they want to implement those. And it’s going to be imperative that here in Arizona we implement those changes. So that we can be at the forefront of ending the overdose crisis here.
GILGER: One of the things that I always think is interesting in these kind of conversations is the sort of tension between allowing people to use drugs in a supervised setting when it’s an illegal thing. How do you convince people that’s a good idea, that it’s not just enabling them to do it?
GARCIA: So I think that a lot of people base their morality in legality. And obviously we don’t want a lot of people out committing crimes. But at its core, people are going to do drugs regardless. We should be ensuring that, just from an empathy perspective, people are using safely and we’re keeping them healthy until they get to a point that they maybe decide to go to treatment or maybe decide that there’s an area of recovery that works better for them.
And I think also there are tons of studies out there that have shown that people who go to supervised consumption sites — there was one that was done, I believe, based on the two sites that had opened in New York — and there was like 30% of the people who went to the clinic ended up seeking additional treatment.
GILGER: They were connected in that way.
GARCIA: Yeah. So by going to these sites, people are connected to resources that they wouldn’t have if they were just using in an alleyway. It’s giving people a safe place where they can find resources. They can use safely. They’re not catching hepatitis C or HIV, and then eventually they can go back home to their families.
