The Report on the situation of mental health and substance use in Mexico 2024, prepared by the Mexican Observatory of Mental Health and Addictions, of the National Commission of Mental Health and Addictions (Conasama), revealed that from 2019 to 2023, the demand for medical treatment in public and private institutions for fentanyl use multiplied, going from 25 cases to 518 last year.
Baja California, Sonora, Sinaloa and Chihuahua are the states with the highest consumption of fentanyl, according to the report. On an annual basis, Conasama documented that not only have cases of fentanyl use gradually increased in the country since 2013, but that each year a greater number of new cases are registered and before 2018 the annual figure had not exceeded 10 cases. From that year on, they began to grow gradually, going from 10 to 25 (2019) and 72 (2020), and then jumping to more than double in 2021, when they reached 184. By 2022, they totaled 333 and by 2023, the figure had shot up to 518 cases.
Since 2021, the Observatory had warned that fentanyl use occurred mainly among men in Baja California and Sonora, and that, although the number of cases was low, they were increasing and were concentrated on the border with the United States, where their use was already a public health crisis.
“Currently, opioid use in Mexico is not high compared to other countries, and they are even limited for medical purposes (for example, in palliative care); However, illicitly produced fentanyls stand out, the consumption of which has proliferated to a greater extent in certain localities in the north of the country,” it says in the Report on the situation of mental health and substance use in Mexico 2024.
Fentanyl and more adulterated drugs
On April 8, the Ministry of Health of Mexico (Ssa), together with Conasama, issued an alert for its personnel in border cities, due to the possible adulteration of heroin and fentanyl with xylazine.
Health authorities warned about “the possible presence of xylazine as an adulterant in samples of heroin and heroin combined with fentanyl in cities on the northern border, urging health service personnel and first responders, especially those in the state of Baja California, to reinforce surveillance and timely care for the symptoms of possible acute poisoning or overdose by xylazine among people who use substances such as heroin or fentanyl.”
Health authorities also warned that xylazine is a sedative that can hinder opioid overdose reversal treatments. In addition, xylazine is associated with the presence of skin abscesses that can compromise people’s health and lives. The substance is popularly known as the “zombie drug” and has been found in combination with other substances such as fentanyl. Xylazine has worsened the opioid epidemic in American cities such as Philadelphia in recent years.
Clara Fleiz, a researcher at the National Institute of Psychiatry in Mexico, is currently conducting a study in which 300 samples of drug residues were analyzed with mass spectrometry in the cities of Tijuana and Mexicali. The researcher told the EFE agency that she has identified xylazine as an adulterant in 35 residues of heroin mixed with fentanyl and 26 residues of fentanyl.
The study, which is ongoing and funded by Mexico’s National Council of Humanities, Science and Technology (CONAHCYT), seeks to identify the presence of adulterants in the remains of doses from the cities of Tijuana and Mexicali, but not specifically xylazine.
“We were surprised to find xylazine,” said Clara Fleiz.
Fentanyl mortality
A research group made up of specialists from the National Institute of Public Health (INSP), the Psychiatric Care Services of the Ministry of Health, Temple University and Drexel University, conducted a study to learn about the trends in overdose deaths in Mexico between 2005 and 2021.
The findings of the study were published in the American Journal of Public Health. The data in the article show a national rate among people aged 15 to 64 of 0.53 overdose deaths per 100,000 inhabitants during the period analyzed.
The INSP research team highlighted that the increase in overdose death rates is consistent with the increase in opioid consumption, mainly in the border area, driven in part by its social and economic ties with the United States of America, a country currently experiencing an epidemic of opioid consumption, including synthetic ones such as fentanyl.
When fentanyl is used as a controlled drug, it is an effective analgesic, and can also be used as an anesthetic in short surgeries; however, when used inappropriately, through an intravenous administration route or by smoking, it is highly addictive.
About the findings
One of the conclusions reached by the researchers is that “lethal overdoses have doubled in the last 15 years in Mexico. Overdose rates are particularly high and are increasing in cities near the border between the United States and Mexico.”
The results of the research found that between the years 2005 to 2014, the rate remained stable; However, from that year onwards it began to rise considerably, going from 0.44 in 2014 to 0.79 in 2021.
“The special analysis of the data shows large differences in overdose mortality between cities, from a maximum of 9.84 deaths per 100,000 inhabitants in San Luis Río Colorado, Sonora, to 0.05 in San Juan Bautista Tuxtepec, Oaxaca. The highest rates were observed in cities in the northwest of the country, especially in the border states, where 11 of the 15 cities with the highest overdose mortality rates were located,” the researchers mentioned in a publication by the INSP.
It is not a new consumption, but it is more lethal
The researchers refer to the fact that Mexico has historically been a country with low consumption of opioids. However, since 2015 multiple factors have emerged and converged that have increased opioid consumption and the risk of overdose. “The causes of the increase in consumption are concentrated in the northern border region and include a greater availability of psychoactive drugs from cocaine trafficking and synthetic opioids destined for the United States, regional methamphetamine production and cross-border access to pharmaceutical opioids and strong social and economic ties with the United States during its opioid epidemic,” it is mentioned.
In 2019, the civil organization Verter, in its fentanyl verification program, found that 93% of the white powder heroin samples in Tijuana contained fentanyl. The organization has a harm reduction program in Mexicali, where it observed a 30% increase in overdoses between 2019 and 2021.
Verter has a substance identification program where, with highly sensitive reactive strips, they verify the presence of fentanyl in drugs that consumers bring to the safe consumption room.
Source: lasillarota
