The Hamilton Spectator

Both Sides of Border See Fentanyl Abuse

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WHITEWATER, Colorado — Two women lifted a corpse from the ground, revealing a squirming bug in the dirt.

“That one is a live larva!” said Alex Smith, the lab manager of Colorado Mesa University’s Forensic Investigat­ion Research Station, plucking the larva off the ground and stuffing it into a glass tube. Maggots are potential evidence, Mr. Smith explained. “You can actually test the larvae and pupa casings for drugs,” he said.

His audience was a group of Mexican medical examiners who traveled last month to the Colorado facility, known as a “body farm,” where dozens of donated dead bodies are laid in the sun to be studied as they decompose. They came to learn about testing for fentanyl.

Their trip had been organized by the U.S. State Department, whose officials hoped it would help achieve a key diplomatic goal: getting Mexico’s government to contend with its own fentanyl problem.

In northern Mexico, aid groups and rehabilita­tion centers have sounded the alarm about a rise in fentanyl use, reporting a wave of opioid overdoses along parts of the border with the United States. The Mexican government says that

the drug’s spread is contained and that overall consumptio­n remains relatively low. In reality, no one knows how common fentanyl use is in Mexico. There is little recent data on drug abuse at a national level.

“You don’t see cases of fentanyl overdose, not because people aren’t dying of fentanyl, but because we aren’t testing them,” said Dr. César González Vaca, the chief medical examiner of Baja California state.

Mexico is the main source of the illicit fentanyl trafficked into the United States, according to the U.S. government, and while the Mexican armed forces reported an increase in drug seizures last year, opioids continue to flood across the border.

So, on a brisk February morning, more than a dozen forensic examiners and chemists from northern Mexican states piled into the Denver Office of the Medical Examiner to watch the autopsy of a middle-aged man found dead on his garage floor. The night of his death, he told his girlfriend that he had taken “10 blues,” probably referring to fentanyl pills.

Ian Puffenberg­er, a forensic pathologis­t, squeezed the man’s lungs and foam came out. This, he said, was “a common finding” in opioid deaths, as breathing slows and lungs fill with fluid. And the bumps on his brain, called gyri, looked less bumpy than normal. “If there’s swelling of the brain,” another effect of opioid overdose, Dr. Puffenberg­er said, “those gyri push up against the skull and flatten out.”

The Americans had an array of expensive tools to confirm that the man had died of an overdose. They did preliminar­y blood tests in a Randox Laboratori­es machine that costs over $30,000, which turned up positive results for fentanyl, methamphet­amine and amphetamin­es. Then they sent samples to a laboratory in Pennsylvan­ia for a full toxicology screening. “We felt like we were in Disneyland,” Dr. Vaca said. “They have everything.”

Mexican medical examiners, he said, often prop up necks with soda bottles and cut skulls with saws normally used on metal. They often earn little, he said, to assess cause of death in a country where criminals specialize in making their victims unrecogniz­able.

After watching fentanyl become a mass killer in the United States, Dr. Vaca began pushing to test bodies in Baja California. He has had to resort to dipping test strips in urine, blood or other bodily fluids, and is testing only in Tijuana and Mexicali, its two biggest cities. Since June 2022, over half of all the bodies that came into those morgues have tested positive for drugs, and fentanyl showed up in 20 percent of them.

The last time Mexico conducted its national drug survey, in 2016, the number of Mexicans who said they used illegal narcotics had nearly doubled from 2008. Demand for drug treatment in Mexico has grown rapidly since 2018, according to a separate government study. Fentanyl has been found in counterfei­t pills sold at pharmacies in northern Mexico as well as in party drugs like cocaine and M.D.M.A. at a music festival near Mexico City.

“It’s cheap to make and simple to distribute,” said Manuel López Santacruz, a medical examiner for Sonora state, across the border from Arizona.

 ?? PHOTOGRAPH­S BY MERIDITH KOHUT FOR THE NEW YORK TIMES ?? Medical examiners from northern Mexico traveled to a “body farm” in Colorado to learn about testing bodies for fentanyl.
PHOTOGRAPH­S BY MERIDITH KOHUT FOR THE NEW YORK TIMES Medical examiners from northern Mexico traveled to a “body farm” in Colorado to learn about testing bodies for fentanyl.
 ?? ?? The larvae and pupa casings of maggots can be tested for drugs, said Alex Smith, a forensics lab manager.
The larvae and pupa casings of maggots can be tested for drugs, said Alex Smith, a forensics lab manager.

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