TIJUANA, Mexico — Members of one of Mexico's few harm reduction centers distributed clean needles and first aid packages on a hot Friday morning in July below a bridge just across the U.S-Mexico border. Word spread quickly among the local residents of the tunnels within the dried-up Tijuana River, and a line formed for those eager to receive the supplies.
Traffic whizzed by, both overhead and in nearby side streets, as more and more of Tijuana's most vulnerable came out of tunnels that feed the river. Most were from a notorious area known as El Bordo about half a mile from the San Ysidro border crossing between Tijuana and San Diego that has become a home base of sorts of the city's drug-addicted and forgotten.
The city has recently seen a drastic change in the drug market, from heroin to fentanyl, that has led to not just a spike in overdoses but also a war for control that’s sent Tijuana’s homicide levels skyrocketing. The street population and those trying to help them are left struggling to adapt and respond.
“When I began, it wasn't so bad. Now, I don't know what they're putting in the drugs, but a lot of people are dying,” said 32-year-old Stephanie, who asked that her last name be withheld. When asked if she thought it was fentanyl, she said she'd heard that it was, but she wasn't clear on exactly what the dangerous synthetic opioid was. She referred to it by its common street name in Tijuana: la china.
Stephanie has become accustomed to living in El Bordo after being deported three years ago from the U.S., where she'd lived since she was two.
“Everyone uses. Everyone sets up, injects, stays there passed out, and, well, sometimes the police arrive and take some of us, or run us out of there,” she said. “Every day, it's the same, it's a routine. It's a normal life, well, with drugs.”
A worker from the PrevenCasa harm reduction group, which provides free healthcare, condoms, and needles to those in need, handed Stephanie a small vial of naloxone, a medication that counteracts the effect of opioids and can stop overdoses. Then she explained how to use it.
The fentanyl trend seen in Tijuana is also appearing in cities across the border, and although President Andrés Manuel López Obrador pledged to address the issue after taking office in December 2018, the problem is getting worse. This year, the border state of Baja California, for instance, has seen an expanding market of fentanyl in pills, heroin, and potentially mixed with uppers like methamphetamine and cocaine.
And the growing presence of fentanyl in Tijuana’s drug supply may foreshadow a crisis that could spread south through Mexico, say experts.
Jaime Arredondo, a researcher who accompanied PrevenCasa to the Mexico bridge, compared the situation to a “powder keg” that could explode at any moment.
“Tijuana is like a thermometer for Mexico, and things are hot. Overdoses, violence, insecurity,” said Arredondo.
López Obrador's government is doing little to help. It not only put harm reduction on the backburner but has also cut funding for organizations like PrevenCasa that are trying to advocate for safe spaces for people with addictions, Arredondo lamented.
He looked out on the green patch below the traffic where about a dozen men sat consuming drugs quietly in broad daylight. Several of the men took a garbage bag from PrevenCasa after using and began cleaning up the area. Others returned their used needles to a staffer and left with new ones for future use.
“Look, we made a safe injection site right here,” said Arredondo, smiling slightly. There is no official safe injection site anywhere in Tijuana.
PrevenCasa's permanent location is housed in Tijuana’s notorious Zona Norte, just between the border wall and the city's red-light district. But harm reduction clinics are few and far between in Mexico, existing in only a handful of the country's 32 states. Heroin addiction hasn't been much of a problem in Mexican history, even though the massive West and South Sierra Madre mountain ranges that traverse numerous states contain some of the world's most fertile terrain for the production of the poppy plant that produces opiates. Mexican traffickers realized long ago that they could cultivate the native plant, cheaply produce bricks of heroin, and smuggle them north for much more money than selling locally.
In recent years, Mexican drug trafficking organizations have made a massive push into the production of fentanyl, a synthetic opioid that’s 50 times more powerful than heroin. And like the heroin that is pushed north over the border, fentanyl is catching on in cities that straddle the U.S. border.
“There's been a transition from natural opiate-based heroin to synthetic heroin. It's incredibly obvious,” said Alfonso Chávez, PrevenCasa's harm reduction coordinator.
The main type of heroin produced in Mexico used to be black tar, a dark, sticky substance usually smoked or dissolved and injected. But since 2017, a new, white powder “heroin” has emerged in Tijuana and other border cities that is becoming increasingly popular with people who use drugs. Unless Mexican cartel producers collectively changed their method overnight, white heroin (la china) could only be one thing: the dangerous synthetic opioid fentanyl.
PrevenCasa, along with researchers from some of Mexico's top universities, published results of a 15-month collaborative study in December 2019 funded by Mexico's National Institute of Psychiatry (INPRM) and the U.S. State Department that detailed the unprecedented fentanyl boom along the border. They tested samples taken from syringe plungers, metal cookers, and drug wrappings collected at three needle exchange points throughout the city, and the results were staggering. They found fentanyl in the majority of white powder and crystal meth samples, while the only substance to come back negative 100 percent of the time was pure black tar, which suggested that it's more difficult to unknowingly adulterate.
There was also a concern that methamphetamine was now being mixed with fentanyl, but the researchers are unsure if the positive tests were due to the meth being produced in the same barrels as the fentanyl, or if it's a deliberate attempt to mix the two drugs. Either way, the results can be devastating due to the body's inability to handle both an upper (meth) with a downer (fentanyl) simultaneously.
But while the products appearing along the Mexican side of the border are evolving, Chávez doubted the traditional theory that the drugs found on Tijuana's streets were leftovers that didn't cross to the U.S. Instead, he argued that “it's a market designed for this population because it's easier to produce it [because it is synthetic]. You don't have to wait for a [poppy] plant to grow.”
A person using drugs doesn't get to choose what they want to be addicted to.
In the nearby Callejon de Venado (Deer Alley), nine men huddled together shooting dope. One man, Omar, tied himself off above a fading yin-yang tattoo and prepared to stick himself with what he said was la china.
“The china hits harder and faster compared to the negra (black tar). The effect is five times more," Omar said. "It’s stronger, but so is the malilla.”
Malilla is slang for withdrawal, and Omar’s fear of it is why he spends every day doing whatever he needs to obtain his next hit.
At 15 years old, Omar left the western state of Michoacan and moved to the wealthier state of Baja California and its seaside resort Ensenada, looking for a better life. There, he married and had three children. But after six years in Baja, he ended up trying heroin with a friend. Now, in his mid-30s, his kids “wouldn't even recognize the man I am now as their father.”
Omar took three attempts at finding a spot on his arm unharmed enough to accept the needle. Blood trickled down over his tattoo. He passed the syringe to an old man in a wheelchair, then blew into his fist to expose his neck veins as the disabled man injected him slightly below his right jaw.
“We all find a way to survive to get by,” Omar said while reflecting on life on the streets of Tijuana.
The exact number of people living on Tijuana's streets is unknown, but homelessness is shockingly evident throughout the city, with certain blocks lined with tents and makeshift beds much like Los Angeles' Skid Row. But in Tijuana, those living rough and addicted are particularly at risk as violence related to control of the city's internal drug market rages.
The Baja California smuggling corridor, one of the most lucrative on the U.S./Mexico border, has seen some of the largest drug seizures in U.S. history; the Southwest border accounted for more than three-quarters of all drug seizures in 2020, according to U.S. Customs and Border Protection. That, combined with a disproportionate amount of substance abuse, has resulted in a vicious turf war in the state, primarily among the Jalisco New Generation Cartel (CJNG), the Sinaloa Cartel, and the remnants of two factions of the Arellano Félix Cartel. The fighting has seen Tijuana hit staggering levels of violence in recent years, ranking it as the deadliest city in Mexico in both 2018 and 2019.
The Baja California State Police Commissioner for Security and Investigations, Carlos Alberto Flores, told VICE World News that the city's recent homicide crisis is directly related to the “local consumer market.”
“Indeed, drug trafficking [into the U.S.] does cause deaths due to disputes, due to trafficking routes of the drugs,” said Flores. “However, it is in no way comparable to the homicides generated by street-level drug dealing—or as it's also known, the war for the corners.”
He was keen to point out that the city had seen a drop in homicides in 2020, although still topping the list of most total homicides in the country. But last month, homicides again reached critical levels, according to Flores, noting the state attorney general held a meeting in early July to once again adjust their strategy.
A majority of the homicide suspects and victims in Tijuana are “people of a very low level within the criminal structure, really, because the ones who are fighting for the corners move around in a cheap vehicle, have poor-quality weapons, and kill other very low-level salespersons,” said Flores.
These kinds of street-level conflicts over the internal drug market have increased dramatically in Mexico since traffickers began pushing meth throughout the country around a dozen years ago, and have become a significant factor in the rise in homicides since then. Meth has rapidly surpassed all other drugs in terms of addiction in Mexico (excluding marijuana, which will likely be federally legalized in 2021) and can now be found in all of the country's 32 states, according to government statistics.
For now, internal fentanyl consumption has remained mostly in border cities in the states of Baja California, Sonora, and Chihuahua, but it's constantly evolving in its use.
There's also been numerous cases of overdoses linked to the synthetic opioid being mixed with cocaine. The overdose crisis has been mostly ignored by local authorities, but recently it hit the police close to home: In May, local investigative weekly Zeta Tijuana reported that four cops in Tijuana were hospitalized after inhaling cocaine mixed with fentanyl at a party.
In the past year, authorities have seen a large uptick in seizures of fentanyl pills known as M-30. The small white pill, with “M” stamped on one side and “30” on the other costs only around $2.50 USD, according to what people who've recently tried it told VICE World News. It's typically swallowed as is, ground up and snorted, or injected, and is most certainly fentanyl. These pills have also been appearing around the U.S.
But what has particularly worried Flores is the change in how they're seizing the fentanyl.
“What we were seeing when I began in November 2019 was loads: five, seven, nine kilos of fentanyl. When we see those amounts it's for the purpose of being trafficked to the United States,” said Flores. “In 2021 we began to see smaller seizures, 30, 50 fentanyl pills. When we start to see these types of quantities, it means there is already a local consumer market for these types of fentanyl drugs.”
If Mexican traffickers decided to push an internal fentanyl market throughout other parts of the country, the consequences would be disastrous.
The year after López Obrador entered office, he specifically took aim at the looming threat of both “fentanilo” and “cristal” [methamphetamine] as an immediate focus of his administration's anti-addiction policy, Juntos Por La Paz, or Together for the Peace.
“We are going to dedicate a day a week showing advances in our plan: why fentanyl is spreading, its effects, everything,” said López Obrador during an October 2019 speech to kick off the 50th-anniversary ceremony of the country's youth rehabilitation programs.
That didn't happen.
In fact, he’s aggressively cut funding to nonprofits and foundations among his many austerity measures aimed at rooting out corruption and fixing the economy. So harm reduction clinics in Mexico have had to rely on foreign aid and donations.
“Probably, [harm reduction advocates] are right when they say they have not had all the support from the government that they could use,” Gady Zabicky, the head of Mexico's National Commission against Addictions (CONADIC), told VICE World News. “We are in the middle of a pandemic and we are in a big transformation of our government… But we have the aim. We share the same principles and the same objectives as the (harm reduction community.)”
He explained that the government is currently operating on an “equation” where it prioritizes prevention, followed by treatment, with harm reduction being the end-of-the-road option. And emphasized they’ve been working on adding psychologists and addiction specialists to hospitals around the country.
But activists complain the government has done nothing to fund independent harm reduction projects and state-run initiatives are few and far between.
So one place took matters into their own hands.
In downtown Mexicali, a couple of hour’s drive from Tijuana east along the U.S/Mexico border, the Verter harm reduction center operates as the only semi-legal open injection site in the country. It is behind a barred window, and nestled between a shop selling sombreros and a new museum commemorating Mexicali's storied Chinese cuisine.
The clinic allows women to inject in one of three booths in a back room, explained its director and co-founder, Lourdes Angulo. Unfortunately, they can't allow men; if they did, she said, “it would always be full.”
The fentanyl appearing in Tijuana is also popping up in Mexicali, said Angulo.
“We've seen an increase in injections of meth mixed with heroin in the last year and a half,” she said, explaining how they began using fentanyl testing strips particularly on the drugs used in the safe space in the back. “When we started, there were really few cases of positive results with fentanyl. Of every 10, we could identify one or two (with fentanyl).”
But in recent months, she said, the tests show six or eight out of 10 containing fentanyl. “And at the same time, the number of overdoses that we treat has also increased,” she added.
As the products on the street are in flux, Verter has struggled to stay open with no support from the federal government and a movement within the local Mexicali government to have the center shuttered or moved.
Angulo co-founded Verter in 2013, and on their fifth anniversary, November 23, 2018, a week preceding López Obrador's inauguration, they'd attempted to open the safe injection site after a year of legal preparations with proper permits and international funding. But when opening day came, authorities shut Verter down. The city government sued the clinic while Verter filed a complaint with the state Human Rights Commission. After nearly half a year of back and forth, the clinic opened to women using a legal loophole where it’s registered as a business when in actuality it's a nonprofit. But how long that will last is uncertain, especially as the city invests in a gentrification of Mexicali's downtown core that will play up the city's historic connection to China, including the new museum.
“Everyone wants to see the historic downtown pretty as well, but inclusive,” said Lourdes, as construction roared outside. They have resisted overtures from the city government to move Verter out of the downtown “because in this area is where the population injects, it knows the space, and we are in a strategic location.”
She saw the attempts to move Verter as an effort to displace the city's vulnerable addicted population away from the downtown core. Throughout the day numerous men stop by to receive needles and naloxone, while two women disappeared into the back booths at Verter under the off-and-on watchful eyes of a staff member. They remained there for hours, allowed to not only consume safely, but also wind down. Anything can happen on the streets of Mexicali.