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Addressing Pain and Substance Use Disorders: Flagstaff, AZ Summer Opioid Summit 2023

The opioid crisis has taken a devastating toll on communities across the United States, and Arizona is no exception. With over one million lives lost since the crisis began and more than five people dying each day in Arizona alone, urgent action is needed to combat this epidemic. Recognizing the need to address pain and substance use disorders (SUD/OUD) in rural communities, the Flagstaff, AZ Summer Opioid Summit 2023 brought together experts and stakeholders for a one-day interactive training to explore evidence-based solutions and strategies.

Community Conversations

During the Summit, one of the notable sessions was the 'Community Stories' discussion facilitated by Mark Martz, the Executive Director of Axiom Community of Recovery. The panelists for this session were Cecilia Bogle, a family member who had been personally affected by addiction, and Stephanie Robinson, MSW, Integration of Healthcare & Public Relations Director with Intensive Treatment Systems. Together, they explored various aspects of pain and addiction from a patient's perspective and discussed the barriers that hinder individuals from fully engaging in life and their communities. Additionally, they shed light on how lived experiences can be applied to improve strategies in practice.

Identifying Pain and Addiction from a Patient's Perspective

During the 'Community Stories' discussion, Martz, Bogle, and Robinson emphasized the importance of understanding pain and addiction from the perspective of the patient. They acknowledged that addiction is a complex and multifaceted issue that goes beyond the surface level. By listening to the experiences of individuals grappling with addiction, healthcare professionals and communities can gain valuable insights into the challenges they face and the support they need.

By sharing her personal journey, Bogle shed light on the emotional turmoil and struggles that individuals with addiction and their families go through. Her perspective helped attendees at the summit develop empathy and a deeper understanding of the profound impact addiction can have on individuals and their loved ones.

Barriers to Engagement in Life and Community

The discussion also delved into the barriers that prevent individuals affected by addiction from fully engaging in their lives and communities. Martz, Bogle, and Robinson highlighted various factors that contribute to these barriers, such as stigma, lack of access to comprehensive treatment options, limited resources, public policy, and social isolation.

Stigma was identified as a significant obstacle that prevents individuals from seeking help and support. The panelists emphasized the need to create a compassionate and non-judgmental environment where people feel safe to disclose their struggles with addiction and seek the necessary assistance.

Lack of access to comprehensive treatment options, including mental health services and medication-assisted treatment, was identified as another major barrier, particularly within rural areas. It was emphasized that increasing access to evidence-based treatments and integrating addiction treatment into the broader healthcare system is crucial for supporting individuals on their journey to recovery.

Applying Lived Experience to Practice Improvement Strategies

The 'Community Stories' discussion also focused on the significance of incorporating lived experiences into practice improvement strategies. Bogle, drawing from her personal experience, highlighted the importance of including individuals in recovery and their families in the decision-making process. Their insights and perspectives can inform the development of more effective and patient-centered treatment approaches.

Robinson emphasized the need for healthcare professionals and policymakers to actively listen to the voices of those affected by addiction. By integrating their feedback and incorporating their suggestions, healthcare systems can better address the unique needs and challenges faced by individuals with addiction.

Martz, Bogle, and Robinson collectively conveyed the message that individuals with lived experience should be seen as experts in their own recovery journeys. Their input and stories can help shape policies, treatment protocols, and community support programs to ensure they are responsive, inclusive, and effective.

Disproportionate Impact on Rural Communities

The summit provided a comprehensive look at the opioid crisis in Arizona's rural communities, highlighting the factors contributing to addiction. Rural communities in Arizona have been disproportionately affected by the opioid crisis. Individuals residing in rural areas are 1.32 times more likely to die from an overdose than the national average. The counties with the highest overdose death rates were identified as Pima, Yavapai, Gila, and La Paz. The summit highlighted that the highest rates of non-fatal opioid overdoses and deaths occurred among individuals aged 25 to 34, with 72% of overdose deaths male and 49% white.

Legislative Changes and Progress & Public Health Strategies

To combat the opioid crisis, Arizona has implemented legislative changes. One notable change was the requirement for electronic prescription of opioids, which was enacted in January 2020. This measure aims to enhance monitoring and reduce the potential for abuse and diversion of prescription opioids.

The summit emphasized the importance of public health strategies in combating the opioid crisis, particularly in rural communities. Some methods discussed include telehealth and mobile-based interventions, peer providers, prescriber training, family interventions, school-based prevention programs, school-based health centers (SBHCs), and transportation services. Many organizations in Arizona are currently implementing these strategies to mitigate the impact of the opioid epidemic.

Initiatives and Collaborative Efforts

The summit highlighted Arizona's initiatives and collaborative efforts to address the opioid crisis. Training programs have been established for Community Health Workers, Community Health Representatives, Emergency Medical Technicians, Law Enforcement personnel, and Naloxone administration. Programs such as the AzMAT Mentors Program, Naloxone Delivery Program, Overdose Data to Action Program, Crisis Treatment and Support Services, and 24/7 hotlines like Arizona211, OARLine, Talk Now AZ and Naloxone AZ were introduced to enhance prevention and response efforts. The Phoenix Area Alcohol and Substance Abuse Program (PAIHS) is also crucial in providing support and treatment services.

Collaboration between local governments, response organizations, and various stakeholders is crucial to increasing access to prevention programs and treatment centers. By working together, communities can pool resources, share best practices, and develop comprehensive strategies to combat the opioid crisis effectively.


The Flagstaff, AZ Summer Opioid Summit 2023 served as an essential platform to address the pain and substance use disorders prevalent in Arizona's rural communities. By exploring innovative practices, prevention strategies, treatment options, and collaborative efforts, the summit offered a roadmap for combating the opioid crisis. Through such collective action, Arizona can make significant strides in reducing the devastating impact of opioid addiction and ensuring that rural communities have access to the care and support they need.

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