Phoenix’s Deadliest Month Isn’t Just Heat — It’s Heat and Meth, Together

Last year, 236 people in Maricopa County died from heat and drugs or alcohol combined, and in nearly all of those deaths, the substance involved was a stimulant. Not an opioid — a stimulant, most often methamphetamine. Opioids showed up in under 47% of those combined deaths; stimulants were in nearly all of them.

July is already the county’s historically deadliest month for overdoses, and this is the reason why that’s not a coincidence.

A heat death and an overdose death are, often, the same event with two different labels on the paperwork.

Here’s the mechanism, in plain terms. Methamphetamine and other stimulants make your blood vessels constrict instead of open up, which is exactly backward from what a body needs to do in 115-degree heat — dilated vessels near the skin are how you dump heat. At the same time, stimulants rev up your metabolism, which generates more internal heat, and they blunt the signals that would normally tell you to sweat, drink water, or get out of the sun. So a person on stimulants outdoors in a Phoenix July is fighting a body that’s producing more heat, releasing less of it, and not warning them until it’s already critical. Phoenix Fire Captain Mike Johnson put it simply: substances “can really kind of mask symptoms” of heat illness — people don’t notice they’ve stopped sweating, or that they’re dangerously thirsty, until they’re already in trouble. And once that trouble starts, he’s clear it moves fast: “heat stroke is definitely a life-threatening emergency.”

Maricopa County’s own health data confirms the county is on pace for another severe year, with heat deaths already ahead of last year’s count before peak summer even arrives. Layer July’s overdose spike on top of that, and Phoenix is looking at two crises that are actually one.

If you use stimulants, or you’re with someone who does, this week’s heat isn’t background noise — it’s an active threat multiplier. A few things matter more than usual right now: don’t use alone, especially outdoors or in a car. Know that confusion, hot dry skin, and stopping sweating can mean heat stroke as much as overdose — either way, call 911 and start cooling the person down while you wait. Keep water on hand and actually drink it before you’re thirsty, since thirst signals are exactly what stimulants dull. Check on people who use alone, particularly if they’re unsheltered. And know where the nearest cooling center or shaded, air-conditioned space is before you need it, not after.

Arizona doesn’t get to treat its heat season and its overdose crisis as two separate emergency lines on two separate spreadsheets. They’re one line, and it’s rising.