Juan (not his real name) is a 58-year-old addicted to heroin and fentanyl. He lives completely alone in Mexicali, Baja California, since 2007, when he arrived in that city. He assures that, despite his addiction, “crooked” thoughts do not come to his mind, although, “sometimes, suicide does.” His great desire is to have a partner: “I don’t want to be another statistic, like my colleagues who have died from being alone due to an overdose.
He only encourages himself and says that if someone is there, he can help them and help with naloxone (…) but then he collapses and blurts out: “Honestly, I’m afraid of dying alone.”
He is just one of the dozens of people who suffer the ravages of opioids on the streets of the Baja California capital, which, along with Tijuana; San Luis Rio Colorado and Hermosillo, Sonora; Ciudad Juárez, Chihuahua and Culiacán, Sinaloa, suffer from a severe public health problem, derived from the illegal consumption of fentanyl.
The problem is that this substance abounds and is responsible for a growing number of overdose cases, which can be dealt with with naloxone, but it turns out that it is a difficult antidote to obtain because in Mexico it is considered a psychotropic substance, despite the fact that it is not.
Although there are no official figures that allow us to have a precise idea of the number of people addicted to fentanyl in Mexico, what is clear is that cities in Sinaloa, Sonora, Chihuahua and Baja California face a delicate situation, says Nadia Robles, Director of the Mexican Observatory of Mental Health and Drug Consumption of the Ministry of Health.
According to the official, in recent years, Mexico has experienced a process of epidemiological transition. In 2013, the demand for psychological treatment derived from substance use was related to the use of marijuana, alcohol and some cases of methamphetamine; however, in 2021, methamphetamines, especially Crystal (speed, meth, ice, glass, chalk), already represented the main substance for which treatment was demanded and represented 45% of the population that attended care, which were around of 130,000 people.
It details that there are currently 21 states where there has been a marked increase in the use of this type of substance.
The biggest problem, he highlights, is that the detection of methamphetamine adulterated with fentanyl has increased, which is worrying.
In the area of El Bordo and El Canal in Tijuana, in the Center of Mexicali or in the Center of San Luis Río Colorado, for example, fentanyl abounds, with its multiple presentations and names: Apache, dance fever, friend, goodfellas, jackport, murder 8, tango & cash, China White, M30 or speed ballwhen it is known that it is mixed with heroin.
He refers that in the cities mentioned above, fentanyl has been found in more than 50% of the samples of substances consumed by people who go to community centers requesting attention to their addiction problem.
He recalled that in 2013 and 2014, five people came to the Observatory, “if applicable”, seeking attention for fentanyl use. However, by 2021 the number has increased to 184 and by 2022 the number has risen to 319.
Meanwhile, a study carried out by Brown University between June 2019 and May 2021 in Mexicali, identified that overdose events increased by about 30% during the Covid-19 pandemic and registered a total of 464 in two years. cases.
In the United States, more than 100,000 overdose deaths are recorded each year, 64% of them caused by synthetic opioids, mainly fentanyl, and Mexico is the main supplier of illicit fentanyl to that nation and Canada.
Exponentially increases seizures
The increase in the presence of fentanyl in Mexico is also reflected in the increase in seizures of illegal drugs made by the authorities. According to the Secretary of National Defense (Sedena), from December 1, 2018 to March 7, 2023, 6 tons and 661 kilos of fentanyl were seized, which represents an increase of 1,152%, compared to everything seized. during the previous six-year period. Each kilo is equivalent to one million doses.
On January 17, the head of that agency, Luis Crescencio Sandoval, explained that from December 1, 2018 to January 16, 2023, six tons and 273 kilograms of fentanyl had been seized, which meant a growth of 1,079%, compared to the 532 kilograms seized between October 15, 2014 and November 30, 2018.
To the report of that date must be added 388 kilos insured between February 17, 2023 and March 7, 2023.
An idea of the routes of transfer of this drug is given by the seizures. In 2022 alone, 43 seizures were registered, of which 12 occurred in Sonora, 10 in Baja California, six in Sinaloa, and four in Tijuana.
While the amount of methamphetamines seized has been much higher than fentanyl, the rate of growth in fentanyl seizures is much faster.
From October 2014 to November 30, 2018, 93 tons and 110 kilos of methamphetamine were seized and from December 1, 2018 to January 16, 2023 there were 179 tons and 843 kilos, that is, the seizure increased 93 percent.
For its part, the United Nations Office on Drugs and Crime points out in its world report on drugs 2022, published a few days ago, that the vertiginous expansion of the methamphetamine markets can be observed, for example, in Mexico. , where the number of treatments initiated for that drug has surpassed those for alcohol and where the number of people undergoing treatment for methamphetamine use disorders increased 218% between 2013 and 2020.
The fact is that fentanyl is on the streets and in greater quantity every day, with all that that implies, since it is a synthetic opioid, similar to morphine, but between 50 and 150 times more powerful. In the medical sector it is used to treat severe pain and is sold legally. The problem in the streets is caused by what is produced and distributed illegally.
For her part, the researcher at the National Institute of Psychiatry, Clara Fleiz Bautista, reports that 9 out of 10 patients who undergo treatment to stop using opioids have relapses.
He qualifies the situation on the northern border of the country as a complex public health problem because people who consume heroin and crystal (and increasingly mixed with fentanyl), whether injected or smoked, are the ones who are most overexposed to overdose.
It indicates that there are studies that indicate that in that region of the country 70% of opioid users have overdosed. The problem is accentuated because of them, only 1.25% had access to naloxone, which is the substance used as an antidote to reverse the effect, and only 30% to methadone in clinics or youth integration centers.
And it is further aggravated if one considers that 32% have resorted to injecting themselves with salt water, putting ice on their genitals, slapping themselves, among other “methods” to “manage risks” and the consequences when they are at the beginning of an episode of overdose.
He emphasizes that in 2021 a study was carried out that resulted in 90% of heroin being adulterated with fentanyl, which shows that adulteration is becoming more normalized every day.
In addition, it is striking that a large number of addicts live on the streets and consume drugs up to five times a day and in some cases up to 10 times.
The specialist points out that the main risk of fentanyl is that people can easily overdose. “For this reason, it is urgent to declassify naloxone from our Health Law (there has been an initiative for that purpose in the Senate since February 2021) and to reactivate the supply of methadone, which is another synthetic narcotic and is used in the treatment of addiction. to other narcotics, as well as for assisted therapies to reach communities to save lives”, he remarks.
While this is happening, Juan (and dozens of others) continues in the riding halls of Mexicali, tempting his luck, betting that he will not be the victim of an overdose that attacks him alone and without access to naloxone, which could save his life.