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Heat-related deaths in the Phoenix metropolitan area have been soaring for the past decade. A record-shattering 645 people died from heat exposure last year. The percentage of heat-related deaths that involve substance use is also skyrocketing. Last year, it was 2 out of every 3 cases. From member station KJZZ, Katherine Davis-Young reports.
KATHERINE DAVIS-YOUNG, BYLINE: On the center of the wall in Maria Montano's living room is a big display of photos of her brother, Brandon - a family trip to the beach, a few silly selfies and, in the middle, a big close-up of his face, his brown eyes gazing upward.
MARIA MONTANO: I just remember him always smiling and being happy.
DAVIS-YOUNG: Sounds like you guys were pretty close.
MONTANO: Yeah. We were.
DAVIS-YOUNG: Maria says, when they were kids, she loved to take care of Brandon. He was only five years younger, but she thought of him like her little son. When they grew up, Brandon struggled with addiction. But still, Maria always tried to look out for him.
MONTANO: I tried to get him to, like, go to rehab, tried to get him to go to therapy, talked to a lot of his probation officers about how we could get him help.
DAVIS-YOUNG: And Maria let Brandon stay with her sometimes since he didn't have stable housing. On July 20 last year, Brandon left Maria's place. It was one of the hottest days in Phoenix history, 119 degrees. Later that day, a passerby found Brandon unresponsive on the street. Paramedics took him to a hospital, where his body temperature was recorded as 106. He didn't survive.
It was days before Maria found out Brandon had died and months before she saw the medical examiner's report. It listed his cause of death as methamphetamine and fentanyl toxicity. But Maria was surprised to see another cause listed, too - heat exposure.
MONTANO: I always just thought, like, people hiking, like, out, like, exercising, 'cause they're not used to it...
DAVIS-YOUNG: She and Brandon grew up in Arizona. They were used to heat. But Maria had no idea extreme temperatures would make her brother's drug use more dangerous. She doesn't think Brandon knew that, either.
MONTANO: I don't really think he thought about it.
DAVIS-YOUNG: But these circumstances are increasingly common. Substance use was involved in the majority of heat-related deaths in Maricopa County last year, and the majority of the time, the substance was methamphetamine, one of the drugs Brandon used. Last year, 330 deaths were attributed to meth and heat, nearly triple the number reported just three years earlier.
JONATHAN GARCIA: I have personally seen an increase of meth use with the population that we serve.
DAVIS-YOUNG: Jonathan Garcia is clinical director with Community Bridges, a behavioral health organization that runs drug intervention programs for the city. He says meth may not garner as much attention as other drugs like fentanyl, but it's growing in popularity because it's relatively cheap, and, for the homeless populations he works with, it offers an appealing burst of energy.
GARCIA: They say they have to stay up to protect themselves. They have to watch their belongings.
DAVIS-YOUNG: Garcia says some clients stay awake on the powerful stimulant for days at a time. That itself is dangerous, but meth also raises the heart rate, increases body temperature and even reduces the unpleasant feeling of overheating. Combined with Arizona's triple-digit temperatures, that can be deadly. Arizonans die from meth use at one of the highest rates in the nation, according to the CDC. Nicole Witt, public health adviser for the city of Phoenix, thinks climate is part of the reason.
NICOLE WITT: I do think that we are on the front lines in Arizona in talking about this issue.
DAVIS-YOUNG: Witt says, when you look at data on all drug overdoses across the U.S., typically, numbers are pretty even month to month. Not so in Arizona.
WITT: It's a very unique curve for Arizona, this huge spike that we really see associated with those summer months and, in particular, in July.
DAVIS-YOUNG: This year, Phoenix officials wanted drugs to be a bigger focus of the city's heat response plan. But Witt says, she struggled to find peer-reviewed research to guide the city's approach to the problem.
WITT: In this case, there really is not a lot of examples of strategies for this particular topic and that combination of heat and substance use.
DAVIS-YOUNG: Witt and her colleagues created a new pamphlet they're distributing this summer. It recommends people who use meth or other stimulants stay hydrated and learn to recognize the symptoms of heat stroke. It also gives tips like limiting drug use to air-conditioned spaces and never using alone. But she says it will take time to increase awareness of the dangers of drugs and heat and for officials to figure out what the most effective interventions are to prevent these deaths.
WITT: You know, we really are creating something from nothing.
DAVIS-YOUNG: For now, Maria Montano worries about how many people in Arizona are struggling with substance use without understanding the full risk. Her brother was just 25 when he died. Maria knows he wanted a better future for himself.
MONTANO: He would tell me that, that he wanted to change but that he couldn't anymore. It was really, really hard.
DAVIS-YOUNG: She just wishes he'd gotten that chance. For NPR News, I'm Katherine Davis-Young in Phoenix. Transcript provided by NPR, Copyright NPR.
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