“Big ol cactus by their front door.”
“Is her phone turned off?”
“Do you have Facebook Messenger? Get a hold of her there.”
The conversation at each of Cochise Harm Reduction’s stops sounds like a long-standing game of telephone, a check-in with your neighbors at the grocery store, an audible map of a small town.
In reality, it’s none of those, and all of those, at once.
The core of the group’s work is to offer sterile syringes, drug testing kits and medicine to reverse an opioid overdose through a harm reduction framework that seeks to support people who use drugs without stigma or an abstinence-only approach.
“We believe that drug use is part of our world. It has been a part of human society for thousands of years. We don’t condone or promote it,” the group’s founder and executive director Lu Funk says. “We see it as a neutral thing that can bring people joy but it can also bring people harm.”
Funk saw some of the painful aspects of drug use as a person who formerly used heroin and had to revive their partner from an overdose. When a drug charge required them to do community restitution, they moved into harm reduction work in the Bisbee area. And when COVID-19 hit, and brought with it relief dollars, they used it to start Cochise Harm Reduction.
They do that by running a hotline that helps them figure out who needs delivery service of kits as well as food and clothing to people living in encampments, remote desert areas and mobile homes throughout Cochise County. The group also has an in-person program to help with job searches and public benefits in Bisbee every week.
But in a long afternoon on the road following the group’s unassuming white van, it’s clear that Cochise Harm Reduction is also filling broader holes, both for material needs and in accessing them, of the frayed social safety net thinly laid over Arizona’s rural communities.
“A lot of the people we see live far out, or they don’t have transportation, so then it’s almost like a communication hub where we can give updates because we see everyone,” says Funk.
Funk, who rides shotgun in the van on the March 17 rounds, has been serving the community of Benson for over five years and in that time has come to know a lot of people, and build an assessment of the best ways to engage with folks.
“The main misconception that I’m hearing, even from providers, is that if people don’t come to resources they don’t need resources,” Funk says. “What we’ve found is when we bring the services to people, and make them low barrier, people actually engage in them.”
St. David, the first community they visit, has a population of 1,098 and a radius of 6 square miles. Its residents have an average per capita income of $24,761.
The Cochise Harm Reduction van visits Benson and St. David on the first and third Tuesdays of the month. It also visits Douglas, Sierra Vista, Bisbee and Willcox, serving some of Southern Arizona’s rural areas, where amid the stark and beautiful views of the Rincon mountains, many people are far from services and grocery stores.
The group now gets about half its money from state and county level funds connected to the marijuana restitution fund, a pot of money created by state law to acknowledge the harms of laws against marijuana and funded by sales tax on legal weed. The rest comes from other grants and local donations, including local churches.
“I just love that — because marijuana is harm reduction,” Funk says.
“Hey do you need us to stop by today?”
Many of the group’s stops start with a shout and a knock on the door of an aging mobile home, or under the shade of a small patio in a little apartment block: “Hey, it’s Harm Reduction!”
From there, the person they’re visiting that day comes out, often excited to see them with genuine warmth: a smile, an excited exclamation. They check in on mutual friends, and offer what they have in the van all equally neutrally: a hot meal of hot dogs, sterile syringes, t-shirts in size XL.
Jaden Paul T. is bristling with excited energy as he greets Funk and outreach coordinator Ashley Iannacone. They talk about how weird it is to age, and how his mother is coming to visit. Arizona Luminaria is not using the full names of some people interviewed for this story because they shared information that could put them at legal or personal risk.
Originally from Utah, he became homeless when his rent went up from $900 to $1200. Since then, he moved to Benson, where he now lives with a housemate in a small two-bedroom.
The Cochise Harm Reduction folks have been a lifeline as Jaden Paul T. has struggled with drug use and a series of adjacent health issues. “I’ve never heard of this concept being a thing in like actual reality,” he says of harm reduction. “I love everything that they do.”
That includes, very clearly and casually, explaining how people who use drugs can protect themselves.
One of the drugs the group has test strips for is xylazine, a tranquilizer now found in an increasing number of drugs that can cause skin wounds. It isn’t an opioid and therefore won’t respond to a tool like Naloxone to reverse an overdose.
“It doesn’t take too much of your drugs,” outreach coordinator Iannacone tells one person about the test strips, organizing the supplies in the back of the van while explaining.
When taking harm reduction tools to local communities, they’ve found people can be particularly hesitant to accept test strips. “I’ll usually begin by casually outing myself as a drug user to convey that I’m a peer to alleviate concern of judgement,” Iannacone said.
They try to make a few key points about a substance like xylazine in the time they’re sharing supplies: “I always emphasize that it’s still best practice to administer Naloxone and perform rescue breathing regardless. And, that they still have the right to use, but that it might be a good idea to do so with someone nearby in case they become unresponsive.”
Those skills are at the core of what helped Iannacone themselves. After years of cycling through 12-step programs, harm reduction offered a caring way to engage with the realities of drug use in their life.
“When people are celebrated for incremental, attainable successes, they’re far more capable of making decisions about their own lives than any system built on control will ever allow,” they told Arizona Luminaria in an email. “I feel a fitting analogy of the abstinence-only model is comparing it to sex education in schools. When abstinence is the standard, people aren’t actually equipped with the information they need.”
Cochise Harm Reduction started solely with a focus on supporting people using drugs, but now takes that harm reduction approach to issues of poverty, offering hot meals and pantry staples as a key part of their work.
St. David resident Sandra Falls met the group because they were helping her friend. She lives in a mobile home off an isolated sandy road, about a seven minute drive from the town but with miles and miles of desert to her west.
“They give me food, they’ve given me socks and gloves for the winter, give me a sleeping bag. They gave me this igloo type thermos — I take it to the store and fill it up with soda and ice,” Falls says.
When they offer her condoms on Tuesday, Falls laughs and suggests she might make balloon animals with them.
Right now, they come once a month to visit her, but say they will try to come more regularly.
“They always text me, ‘hey do you need us to stop by today?’ and I’ll text them back and tell them ‘yeah.’”
Falls says she will go into Benson to get food at a local food bank about once a month, but otherwise relies on Cochise Harm Reduction to support her with extra food. In St. David, she might buy food at the Dollar General, but there isn’t much else in town.
Cochise County has a poverty rate of 14.2%, several percentage points above the national rural poverty rate of 12%.
“It’s a Mormon town — there is nothing really in St. David. There is a Dollar General, one beauty salon, and schools,” she says. “The houses are so far apart. You can go down one road and it might only have four houses on it.”
A local church in St. David that is part of the Church of Jesus Christ of Latter-day Saints has raised money for the group. “We have had immense community support, and that has been vital,” Funk says.
Extreme weather
Adam lives in a mobile home park in St. David. A wooden ramp leads up to the door of his RV, where a small air conditioner wheezes in the window. Adam, who gets around by wheelchair, pays $400 to rent the land under his home. He estimates utilities run him about $150 but can easily get over $200 in the summer.
“‘Air conditioning does not work in this place no more,” says Adam, who is wearing a leather vest, two silver necklaces and a black beret with “ADAM E.” laid out in rhinestones.
Because he’s in a wheelchair, his mobility is limited, making the support of Cochise Harm Reduction key. “I can’t go nowhere,” he says.
It’s an unusually hot spring, and on March 17 in the early afternoon, the heat is inching up. It will hit 91 degrees by 3 p.m.
In the Cochise County area, where the winter night temperatures can be bitterly cold, the reminder of the coming swing to a new weather extreme is on the minds of Funk and Iannacone.
The people served by Cochise Harm Reduction are vulnerable in multiple ways.
Heat, homelessness and drug use are a deadly cocktail. Being outside, and having ingested either methamphetamine, fentanyl or both, also increases a person’s vulnerability to heat.
In 2023, more than 60% of heat deaths in Pima County took place outside. Of the heat-related deaths in Pima County, 40% were people who ingested methamphetamine, fentanyl or both.
Living in mobile homes, where many of the people on Tuesday’s stops live, also could mean higher risk of heat-related illness or death.
In Pima County, 30% of heat deaths between May 2023 and September 2024 that took place indoors were in mobile homes or RVs. The housing represents about 10% of housing in the county.
Jaden Paul T., who uses methamphetamines, says he has asked the harm reduction folks how to know when he is having a heat stroke — what’s the difference between just feeling hot and a dangerous level of heat?
That comes for Jaden Paul T. months after struggling with the cold. “I don’t want to be dying of heat, or freezing,” he says.
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