Fentanyl use spreads deeper into Mexico, worrying authorities
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[February 20, 2024]
By Laura Gottesdiener and Brendan O'Boyle
MONTERREY, Mexico (Reuters) - The teenager who arrived at Jose de Jesus
Lopez's drug rehab clinic in the industrial Mexican city of Monterrey in
December had unusual symptoms.
The 17-year-old's family had taken the boy to hospital a few days
earlier when he'd had trouble breathing and then passed out after
supposedly consuming cocaine, the director said. Now he was sweaty and
nauseous. He'd been vomiting and couldn't sleep.
"Something doesn't add up," thought Lopez, who is also the head of an
addiction center network in Nuevo Leon state, where Monterrey is
located.
The boy's symptoms looked more like opioid withdrawal, even though
Monterrey lies hundreds of miles to the southeast of Mexico's few heroin
and fentanyl hotspots in northwestern border cities like Tijuana and
Nogales.
Just in case, Lopez administered a urine test. It came back positive for
fentanyl.
Although Mexico is a major trafficking hub for the highly potent
synthetic opioid, it has so far avoided a consumption epidemic within
its own borders.
But interviews with over two dozen drug researchers and health
officials, as well as data obtained by freedom of information requests,
reveal that use of the drug is creeping further into Mexico, even though
the scale of consumption is clouded by a lack of data and testing.
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The fear among some researchers and officials is that use of fentanyl
could follow the trajectory of methamphetamine over the past decade, six
of the sources said. Meth started as a U.S.-bound product, but
transformed into a domestic drug problem over the last decade.
Mexico's mental health and addiction commission (CONASAMA) has
classified fentanyl as an "emerging drug" because of an uptick in users
seeking treatment, even though opioid users make up less than 2% of the
some 168,000 people who sought drug treatment in 2022, the most recent
year for which data is available.
"Fentanyl is not a public health problem at this moment," said Evalinda
Barron, the general director of CONASAMA. Still, she said, "it's a
concern."
Unlike in the United States, where potent synthetic opioids like
fentanyl cause tens of thousands of deadly overdoses per year, Mexico
officially logged less than two dozen opioid-related deaths in 2021, the
latest year for which government data is available.
Mexico's health ministry has publicly acknowledged gaps in the data. The
ministry did not respond to a request for more recent statistics. The
president's office did not respond to questions for this story. The
security ministry referred Reuters to public comments by minister Rosa
Icela Rodriguez that Mexico was working with the United States and
Canada to stop synthetic drug trafficking.
Mexico is far less predisposed than the United States to a fentanyl
epidemic, some health officials and experts say, because it does not
have the same history of prescription pain medication abuse and heroin
consumption.
Still, officials are sounding the alarm, including through a public
information campaign warning of the drug's risks across the radio,
internet and in schools.
Mexican President Andres Manuel Lopez Obrador said in January that while
fentanyl consumption was low, the country "has to be careful of it" and
he was seeking more information about its use in different states.
In Nuevo Leon, the number of dead bodies that test positive for fentanyl
has been rising, data from the attorney general's office shows.
In 2013, one corpse tested positive. In 2018, there were 47. By 2023,
180 bodies tested positive, about 4% of the thousands of autopsies the
attorney general's office performed last year.
The traces in Nuevo Leon bodies do not mean fentanyl was the cause of
death. Autopsies in the state are often carried out when the suspected
cause of death was vehicular accidents or homicide. Some may have had
legally-administered medical fentanyl in their systems.
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Still, said Carlos Magis, a public health professor at the National
Autonomous University of Mexico, the data points to "the reality of a
growing epidemic."
"The increase is very serious," said Magis, whose research with
colleagues, including tracking local media reports, estimates that
hundreds of Mexicans may be dying from opioid overdoses annually.
LACK OF DATA
Data on fentanyl use in Mexico is far from comprehensive.
Forensic authorities in more than a third of states lack equipment to
detect whether the drug is present in corpses, according to responses to
freedom of information requests Reuters made to all 32 states.
Seventeen states said they had equipment to detect it in cadavers,
ranging from rapid urine tests to advanced methods like liquid
chromatography–mass spectrometry machines, which analyze chemicals in
biological samples.
In 13 states, including populous Mexico City and the State of Mexico,
state forensic services lacked capacity for specifically detecting
fentanyl. One state said it was unable to find records of testing
capacity. Another had not replied at the time of publication.
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![](../images/022024PIX/health14.jpg)
Activist Julian Rojas from the NGO Programa Companeros, which
implements programs and projects aimed at vulnerable social groups,
shows a vial of Naloxone used to rapidly reverse opioid overdose, in
Ciudad Juarez, Mexico July 24, 2023. REUTERS/Jose Luis Gonzalez
![](http://archives.lincolndailynews.com/2024/Feb/20/images/ads/current/bennet_lda_010722.png) Barron, whose responsibilities also
include mental health, said such testing was important but there
were other, more pressing data gaps affecting her work, such as
accurate tracking of suicide deaths.
"There's always a shortage of resources," she said.
Still, the lack of tests makes it hard to get a handle on the scope
of fentanyl's reach in Mexico.
"We're undercounting, for sure, the number of people who are dying
from overdoses," said Cecilia Farfan-Mendez, a Mexico security
expert at the University of California San Diego.
Mexico's deputy health minister Hugo Lopez-Gatell, during a press
conference in April, acknowledged possible underreporting in
opioid-related deaths, while noting that the body count would still
be lower than in the United States even if it were off by a factor
of 100.
SUPPLY ROUTES
In Mexico, current fentanyl consumption is most prevalent along the
U.S.-bound transportation routes, especially in the border regions.
That's because Mexican cartels often leave small amounts of drugs
along the way in order to create local markets, cover operational
costs, and pay salaries in kind, said Mexican security consultant
David Saucedo, who works with state governments and companies on
national security issues.
The border cities where the drugs enter the United States become
the biggest markets. Shipments criminal groups aren't able to
smuggle are instead sold on the Mexican side, said Josue Gonzalez, a
former federal Mexican security official.
Indeed, nearly 60% of the 333 people shown by CONASAMA data to have
sought treatment for fentanyl use in 2022 were in only four border
municipalities - Tijuana and Mexicali in Baja California, and
Nogales and San Luis Rio Colorado in Sonora - which all lie along
the Pacific route, the most utilized path for fentanyl trafficking,
according to U.S. seizure data.
But criminal groups have diversified and expanded their routes,
moving smaller quantities of the drug through central and eastern
Mexico, said Gonzalez.
"What criminals want is to have innovation, new routes, and the
least risk possible," he said.
![](http://archives.lincolndailynews.com/2024/Feb/20/images/ads/current/humanesociety_sda022411.png)
Shifting routes pave the way for consumption in new parts of the
country, Saucedo said.
Authorities seized 150 kilograms of U.S.-bound fentanyl in Nuevo
Leon over the last year and a half - an "unprecedented" amount for
the state, its security secretary Gerardo Palacios told Reuters.
Juan Roque, head of mental health and addiction for Nuevo Leon's
health department, said the state has recorded just a handful of
fentanyl consumption cases, and said the users picked up the habit
elsewhere. He and Palacios said there was no evidence fentanyl is
being mixed into other drugs, such as cocaine or meth, that
circulate locally.
But, in the rehab clinic in Monterrey, that's what Lopez thinks
happened to his teenage patient, who said he'd never consumed
fentanyl intentionally, and whose urine also tested positive for
methamphetamine.
"Many people could die if we don't pay attention to this," said
Lopez, who now keeps fentanyl testing strips on his desk.
In Mexico's traditional opioid heartlands, fentanyl's rise has been
well documented.
A 2020 study found 93% of 59 heroin samples collected in Tijuana
were laced with the drug. More recently, 126 of nearly 900 bodies
that came through the Tijuana morgue tested positive between March
2023 and December 2023.
In Mexicali, a neighboring border city with its own history of
heroin use, the number rose to nearly a quarter of the 1,764 corpses
tested since June 2022, state data shows.
Traces of fentanyl are appearing elsewhere in the country. A
recently published paper based on testing at a 2022 music festival
outside Mexico City found 2 of 4 cocaine samples and 14 of 22 MDMA
samples were adulterated with the opioid.
Roque, at Nuevo Leon's health department, said the rise of
methamphetamine in Mexico more than two decades after its use first
surged in the United States made him worry the same would happen
with the far more deadly synthetic opioid.
Nationwide, treatment for meth use has soared over the last ten
years, from less than 10% of people seeking rehabilitation treatment
in 2013, to nearly half in 2022, according to nationwide government
data.
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"More of it began to stay on this side of the border," Roque said
of the meth wave.
"The same thing could happen to us with fentanyl."
(Reporting by Laura Gottesdiener in Monterrey, Brendan O'Boyle in
Mexico City, additional reporting by Jackie Botts in Mexico City;
Editing by Frank Jack Daniel)
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