A deep smell of decomposition is evident through the doors of the Forensic Medical Service (Servicio Médico Forense - SEMEFO) in Mexicali, Baja California. Despite the fans whirling at full power in the waiting room, the smell permeates clothes and skin. In this city, where temperatures can reach over 50 degrees Celsius, refrigeration cannot contain the stench of bodies in the morgue.
SEMEFO's Mexicali headquarters is a large, white, modern building. It is surrounded by funeral parlors waiting to sell their services to people leaving SEMEFO needing to bury their dead. Inside are a waiting room and administrative offices, where César Raúl Vaca, the director, greets us.
*In northern Mexico, the rise of synthetic drugs has come with serious consequences. In this three-part series, InSight Crime looks at the social, public health, and environmental impacts of large-scale synthetic drug production and related consumption at the local level in the states of Sinaloa and Baja California. See parts one and two.
Between 9,000 and 10,000 dead bodies arrive at Mexicali's SEMEFO each year. Causes of death include suicide, homicide, and unfortunate accidents. But, more recently, an increasing number of bodies have begun to arrive that show the same range of characteristics: death due to respiratory or cardiorespiratory arrest, blue or purple coloration of the body, and, in many cases, syringes still stuck into the person's arm or leg.
SEE ALSO: In Sinaloa, Mexico, a Deadly Mix of Synthetic Drugs and Forced Disappearances
The growing consumption of fentanyl is behind this increase. The drug is so potent that users overdose in a matter of seconds, falling unconscious even before they can remove the needles from their bodies, according to Vaca.
Fentanyl is a synthetic opioid. It is 50 times stronger than heroin and 100 times more potent than morphine. It has found its way into Mexico's growing synthetic drug market dominated by methamphetamine. Today, Mexico's criminal groups are increasingly focused on the production and distribution of fentanyl. While most is destined for countries such as the United States, a small percentage remains in Mexico's northwestern cities.
The drug already represents a public health problem. With the increase in consumption, an increase in harmful effects on the health of users and a growing number of overdoses have arrived. Despite a rising body count at the country's morgues, the phenomenon remains almost invisible as medical and healthcare centers lack the capacity to measure it systematically.
To try and gauge fentanyl's impact, SEMEFO Mexicali began to implement rapid tests for drug use, including fentanyl. Of the rapid tests carried out on bodies between June and August 2022, 55% returned positive results for drug use, with fentanyl showing up in 33% of them. Fentanyl is already the second most popular drug in Mexicali after methamphetamine, Vaca told InSight Crime.
SEMEFO cannot rule that these deaths are due to a fentanyl overdose despite the test results. The tests show consumption, but they don't show the quantity of the drug present in the body and cannot count towards overdose deaths in national statistics. Without definite data, the size of the problem is misunderstood and ignored.
The dynamics of consumption in Mexicali have been heavily influenced by the city's proximity to the United States and its role as an important transit zone for drug trafficking across the border. This same influence is seen in other places in northwestern Mexico, including Tijuana and Culiacán.
Fentanyl Spreading in Mexico
The demand for treatment for fentanyl use has been growing in Mexico since 2017. While that year only one person sought treatment, by 2021, there were 184 requests for help, according to data from the Mexican Observatory of Mental Health and Drug Consumption.
Fentanyl has been seen in Tijuana, Baja California, since 2017. Prevencasa, a civil society organization that provides health care to vulnerable populations, observed how, faced with a shortage of black tar heroin, illegal sellers began to market a white powder they called "China White" -- in reference to white heroin. Unbeknownst to buyers, it contained fentanyl, Lilia Pacheco, a university professor and expert medical nutritionist with the organization, told InSight Crime.
The sale of heroin, cocaine, and methamphetamine containing fentanyl soon spread to other cities in northwestern Mexico.
In these cities, fentanyl is already a widespread reality. According to Lourdes Angulo, director of Verter, a social organization focused on serving vulnerable populations in Mexicali, almost all drugs currently circulating in the city contain fentanyl. There, as in Tijuana, a market for the drug is already present.
SEE ALSO: Methamphetamine Production in Mexico Is Toxic for the Environment
The consumption of fentanyl has those who work with drug users on alert. The risks are high when as little as two milligrams of fentanyl can be lethal.
Added to the drug's inherent risks is the problem of illegal producers, who are often unaware of the actual amounts of fentanyl contained in their doses. The potential for users to overdose therefore increases. In cases where the drug arrives already prepared, overdoses can happen within minutes.
In Tijuana and Mexicali, this risk is already a reality. In Tijuana, Prevencasa has responded to around 500 fentanyl overdoses in the last couple of years, including dealing with six overdoses in just one morning. In Mexicali, during the first eight months of 2022, 600 overdoses were attended to by organizations such as Verter, the Red Cross, and users trained to provide naloxone, a medication used to reverse the symptoms of opioid overdoses. This figure exceeds the total number of cases registered between 2019 and 2021.
In Sinaloa, at least three cases of fentanyl overdose deaths have been officially registered this year, while five were registered in Tijuana. However, experts agree that underreporting is high, considering the lack of available infrastructure to measure drug overdose deaths.
"We cannot turn a blind eye to this issue. We cannot hide something so obvious," said Vaca, director of Mexicali SEMEFO.
*Victoria Dittmar, Parker Asmann, and Marcos Vizcarra contributed reporting for this article.
*In northern Mexico, the rise of synthetic drugs has come with serious consequences. In this three-part series, InSight Crime looks at the social, public health, and environmental impacts of large-scale synthetic drug production and related consumption at the local level in the states of Sinaloa and Baja California. See parts one and two.
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