People Are Dying of Overdoses in Mexico Because They Can’t Get Naloxone

CIUDAD JUÁREZ, México — People in northern Mexico are dying from drug overdoses in record numbers because the Mexican government won't give them naloxone, which is readily available across the border for cheap.

The lifesaving drug naloxone, used to reverse opioid overdoses, is highly controlled in Mexico because it’s considered a psychoactive substance. 

That makes it expensive and hard to find, even for emergency services and hospitals. Naloxone costs around 500 Mexican pesos ($25) a dose and requires a doctor’s prescription, while the same medicine is available just across the border for as low as $2 a dose and is readily found in paramedic kits. (It’s best known in the U.S. under the brand name Narcan.)

“If we could have had this medicine available this year, we could’ve saved 96 percent of the deaths by overdose,” said Pablo González Nieto, coordinator for the harm reduction nonprofit Verter, based in Mexicali. He was speaking this week at a news conference called by Verter and PrevenCasa, another harm reduction group based two hours west in Tijuana, to appeal for help from the Mexican government.

Mexico's National Commission against Addictions (CONADIC), Mexico’s health ministry, and the Mexican Institute of Health and Wellbeing (INSABI) did not respond to requests for comment.

Opioid overdoses in Mexico’s border cities, where the country’s heroin users are concentrated, have been rising over the past five years, largely as a result of fentanyl-laced heroin.

Last year alone, Tijuana registered 100 opioid overdoses, according to data gathered by PrevenCasa.

Official data on drug overdoses is patchy but still shows a dramatic increase: Opioid overdoses across Mexico rose in 2020 to 1,735, up from 242 the year before and 181 in 2018, according to CONADIC. Although those figures are low compared to the more than 100,000 overdose deaths registered in the U.S. last year, the real number in Mexico is likely much higher. 

Since early 2018, the heroin market in Mexican border cities has been switching from “Black Tar,” a chewy brownish paste, to “China White,” a white powder that looks similar to cocaine. This allows dealers to mix heroin with cheaper fentanyl to make more money out of each dose.

“The problem is people have no way of knowing exactly what they are using, and in the majority of the [fatal overdose] cases, the cause was fentanyl-laced heroin,” González Nieto said. 

Sixty to 70 percent of the total heroin tested during a seven-month period in Tijuana was laced with fentanyl, according to an investigation last year by Verter and PrevenCasa. 

“It is a huge challenge to bring the medicine to Mexico. We are forced to go to NGOs on the other side of the border, at the risk of facing legal problems,” said Alfonso Chávez, PrevenCasa’s coordinator in Tijuana. COVID restrictions on travel also made bringing the medicine across the border near impossible.

If Mexico continues to restrict naloxone as a controlled substance, people will keep dying from overdoses all over the country, said Chávez, urging the government to “reevaluate its classification” and find a way to allow organizations like his to legally import it. 

The most recent attempt in Congress to lift restrictions failed in February 2021, when a senator from the ruling MORENA party, Ricardo Monreal, introduced a proposal to “eliminate Naloxone from the list of psychoactive substances,” highlighting its nature as an overdose treatment. The bill failed to pass the first committee.

“The answer was pretty obvious: They have no interest in this issue. The government has other priorities,” Chávez said.