Until now, fentanyl in Mexico seemed like a phantom threat; a background noise in the political conversation and a devastating reality, but only on the northern border and the United States, where the lethal drug is devastating wherever it goes. The lack of official data in the country on addiction and consumption of opioids, a substance 50 times more powerful than heroin, left the numbers in the realm of speculation. This week, for the first time, a study published in the medical journal Harm Reduction Journal has confirmed what experts had been predicting for some time: fentanyl has also reached the capital and its surroundings.
The research was carried out in 2021 at an outdoor electronic music festival near Mexico City (the name and exact location are not specified). A team of scientists analyzed 51 drug samples from 40 users, who volunteered for the free and anonymous test. The majority were men between 22 and 48 years old, a bias that experts hope to correct for the next study. None of the users expected to find fentanyl in the substances they had purchased, but the opioid appeared in 14 of 22 tested samples of MDMA and in two of four doses of cocaine. “The results show that fentanyl adulteration is no longer a phenomenon confined to the northern border of Mexico among vulnerable people who inject heroin or methamphetamine, but has reached young people who use psychostimulants,” the article concludes.
“The analysis was carried out in 2021, it is important to mention it because the official and very widespread discourse among users was that fentanyl was not being used in Mexico and that it was a problem confined to the northern border of the country,” explains Silvia Cruz, a of the authors of the study. “The users who tested positive for fentanyl were very surprised. Some did not know the drug. I think that is a first wake-up call. It is probably more identified now, but not almost two years ago,” continues the expert, one of the first researchers to analyze opioid consumption in Mexico.
Taking fentanyl without knowing you are taking fentanyl
There are several relevant points that the article offers, explains Cruz, who clarifies that the research had not been published until now due to the rigorous verification and review procedures that scientific journals such as Harm Reduction Journal. On the one hand, the profile of fentanyl users identified at the festival: “experimental”, sporadic users, who take drugs recreationally on specific occasions. One of the main risks is ignorance: “If these substances circulate in events in which users do not consume opioids, but rather stimulants and hallucinogens, basically MDMA or LSD, your expectations are not of an overdose, they are in any case of a bad trip. , something that could be unpleasant,” says Cruz.
With fentanyl, the chances of an overdose are very high due to the potency of the product. Just two milligrams of the opioid can be a lethal dose. Unlike heroin or morphine, its chemical structure allows it to cross biological barriers very easily and quickly reach the central nervous system, depressing it and causing the body to stop breathing. “It arrives so quickly that a person can die with the syringe in place,” Cruz illustrates. In the United States, around 70,000 people died from fentanyl overdoses in 2021 alone; or what is the same, almost 200 people a day, an increase of 94% compared to two years before, according to a study by the US Center for Disease Control and Prevention (CDC, for its acronym in English). In Mexico there is still no official data in this regard.
The adulteration of other drugs with fentanyl was already common in the United States and the border. Because the consumable doses of the opioid are much lower than those of, for example, heroin, it is much more economically profitable. Its production, which can be carried out in home laboratories using low-cost chemical precursors, also reduces costs. And being highly addictive, it is the perfect cocktail for a seller: it generates great demand at an unbeatable price in the current market.
For consumers like those at the festival where the study was conducted, this can be a death trap. “If MDMA or cocaine mixed with fentanyl is present in that population, there is no help measure, there is no antidote. They don't recognize it as an opioid overdose,” Cruz warns. Therefore, for her and the rest of the experts, starting to legally distribute naloxone, the remedy in case of overdose, is a matter of life or death. In the United States, which recognizes a public health crisis due to the massive consumption of this substance, naloxone is easily available, but in Mexico its access still remains very restricted and is almost impossible to find.
A growing trend
The researchers assume that, if the opioid was already present in 2021, the trend is that consumption has increased two years later. “Any person who consumes substances and does not know what they contain can potentially be exposed to fentanyl, it is important to identify the symptoms and have the antidote on hand. It is very important that you do not consume it while alone and that at the slightest sign of decreased respiratory rate or lack of muscle tone – people bend, fall – you suspect that there are opioids and go to the doctor,” says Cruz. .
The scientist, author of the book What you need to know about drugs, also highlights the need to carry out “quality testing” of the substances consumed in leisure environments such as festivals or meeting places for regular users. Currently, in addition to its value as risk prevention, it is one of the only ways to measure fentanyl consumption in Mexico, a relatively new phenomenon. In 2017, in the studio Cuqueando la chiva, carried out with more than 600 heroin users in Baja California, Sonora and Chihuahua, only six of them had taken fentanyl, the rest did not even know about it. Today, on the border, the number of users has grown exponentially, many of them with previous addictions to other substances such as heroin.
Studies like these or disaggregated figures from organizations and researchers are today the only way to get closer to the reality that fentanyl is leaving in Mexico. Beyond that there is no solid data. The Government of Andrés Manuel López Obrador decided to cancel the National Addiction Survey (Encodat), which had been carried out approximately every five years since 1998, due to its high cost. The last one available is from 2016, when the traces of opioids were minimal.
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