Inside a nondescript building on Mastick Way in Nogales, a dedicated staff of 12 works on the front lines of combating the growing effects of drug addiction and associated behavioral health issues in Santa Cruz County. This facility is part of HOPE (Helping Ourselves Pursue Enrichment), a statewide nonprofit program that provides peer support services to individuals who are living with mental illness and/or substance abuse disorders.
“We work with mental health and addiction through group counseling, family support, life skills training, information referral services, and the eight dimensions of wellness,” said Luis Gaxiola, a counselor at HOPE’s Nogales center.
Gaxiola is one of the center’s 12 staffers who are either recovering addicts or have struggled with addiction of a family member. “The beauty of HOPE is that we have lived the experience,” he said. “We have been in their shoes, and we have come out of it, so we know what it takes, and we do it with open arms.”
HOPE’s Nogales center is busy. The Santa Cruz County Sheriff’s Office, Recovery Court, medical centers and fire districts direct clients to HOPE, but Gaxiola said most of their patients – called “members” – contact HOPE directly, based on HOPE’s word of mouth reputation. HOPE accepts members ages 18 and up. (Families with younger children are referred to Community Health Associates, Pinal Hispanic Council, and MIKID.)
As of mid-December, HOPE had 120 enrolled members, but the numbers fluctuate, said Gaxiola. They also usually have about ten people per month who are not enrolled and of those, three or so will eventually become enrolled.
98% of HOPE’s addiction members are being treated for opiate addiction, mostly street-bought fentanyl. Addiction to opiates can occur after only a few uses especially since opiates often have higher potency than heroin. In addition to opiates or “downers” that produce a sedative effect, HOPE is experiencing an uptick in stimulant abuse or “uppers.” Uppers include cocaine, methamphetamine, crack, Adderall, and ecstasy, which increase energy, alertness, and mood, and can also heighten feelings of self-confidence or sexual prowess.
HOPE members are empowered by the program to choose their route to recovery. If a HOPE member is facing an addiction-related health issue, a HOPE outreach team will visit them at the hospital, or visit them at home, to “place all the resources on the table,” said Gaxiola, including enrollment in medically assisted treatment, residential programs, and outpatient programs.
“The biggest challenge facing our area is the lack of treatment centers for detoxing and the lack of residential intensive outpatient homes or sober living rehabilitation houses,” said Gaxiola. “HOPE breaks the barriers because we have a lot of support from Tucson with rehab centers, but it is unfortunate because it takes people a bit far away from their homes.”
If the member chooses no treatment for their drug addiction, the HOPE team will coach them on harm reduction and safety, even offering free transportation from across the county to the Nogales Center so that members can participate in the Center’s day programs.
“It can be overwhelming for somebody coming from addiction straight into recovery,” said Gaxiola. “We know we have a small window of time where we do something for users seeking help, but if it passes, either they are going to get more drugs or postpone treatment. I am a recovering addict and the reason I kept using, honestly, was to not feel withdrawals – the withdrawals felt that bad. I wasn’t thinking of anything else, I just wanted to stop the pain.”
HOPE’s day program features peer counseling teams focusing on behavioral health, such as anxiety, depression, schizophrenia, bipolar and other diagnoses. Another team focuses solely on substance use disorder. “Both teams are strong, and the rooms are packed,” Gaxiola said. He added that HOPE also provides anger management training as emotions can be a trigger for substance abuse. In addition, the Nogales center dispenses the anti-overdose treatment Narcan to anyone who requests it.
The primary insurance for services provided by HOPE is Arizona’s Medicaid agency, Arizona Health Care Cost Containment System (AHCCCS). The enrollment process is completely automated so the staff provides computer access and will sit with people seeking treatment to help navigate the system. If members do not qualify, the staff assists in enrolling members for a substance abuse block grant.
HOPE also provides assistance to the local homeless population, which they estimate has grown to 2,000 people. “They just come in to get a free lunch everyday at noon and we’ll go sit with them,” said Gaxiola. “Many of the homeless are struggling with some sort of mental health issue like depression, and we do see a lot of substance abuse. Sometimes they just want to be here to talk and feel human.”
HOPE works to help homeless people find temporary or permanent homes using state and federal grants and housing vouchers. HOPE stocks hygiene materials, clothing, non-perishable foods and other items for the many transients and members in need. (HOPE accepts donations from the public; they are in particular need of coats, shoes, boots, and blankets during the winter months.)
Gaxiola said the holiday season is a challenging period for people in recovery. “Addicts in recovery are isolating but want to celebrate and they only know one way to celebrate and that’s getting high,” said Gaxiola. Drug use becomes a security blanket for recovering addicts coping with emotions. The upcoming tax season is another period of danger for recovering addicts, as income from tax returns often generates an increase in both using and selling drugs.
Gaxiola encourages people struggling with drug addiction – or affected members of the addict’s family – to contact the HOPE office in Nogales for help.
“I am grateful that the fentanyl crisis is starting to bring awareness to the community,” he said. “There are a lot of people recovering from addiction and I want people to know they are not alone. Others have lived through addictions, and recovery is definitely possible. There can be a new way of life, and it starts off with seeking treatment.”
The Nogales HOPE center is located at 1891 N. Mastick Way. Call (520) 287-9612 or visit hopearizona.org for more information. Also, the three-digit number 988 is the national suicide and crisis lifeline for anyone who needs someone to talk to. It operates 24 hours a day.
For further information on SCC programs and the current opiate crisis, see the PRT November 2022 article, “Combating Fentanyl in Santa Cruz County.”