What started as prescription painkiller is now the cause of a public health emergency. Where does it come from? Stephen Gibbs and Keiran Southern follow the money from China via Mexican gangs to the streets and suburbs of America.
It was a distinctive smell, similar to vinegar, seeping from the new-built home at the top of the hill that prompted a resident in Tijuana’s Lomas del Valle neighbourhood to make an anonymous call to the police in October last year.
A few nights later three patrol cars were seen heading up the potholed road to the elevated dusty area, a 50-minute drive and a world away from the souvenir stores and tequila bars of Mexico’s main northern border city. Their target was a squat, grey building that seemed in a permanently stalled state of construction.
As police drew close they spotted two men outside, loading bags into a car. Catching sight of their unwelcome visitors, the suspects bolted off into the darkness. The officers knew they had the right place and broke into the building. Inside they found a makeshift laboratory equipped with all the paraphernalia of synthetic drug production. There were buckets, blenders and a pill-pressing machine. A thin layer of acrid white powder coated every surface.
In one corner was a large icebox, the type that might be used to take cold drinks to a beach. It contained more than 300,000 light blue pills of pure fentanyl. In total police confiscated 207 kilograms of the synthetic opiate, enough to kill tens of millions of people, and with a street value of about £4 million (NZ$8.4m).
Fentanyl abuse is the world’s deadliest drug crisis. The front line of the calamity is just 16 kilometres from that raided lab, over the border in the United States. As many as 200 Americans a day are dying from overdoses of what some pushers call the “Crazy One”.
The drug is most commonly taken in pill form by abusers or injected. Some smoke it, which overcomes the struggle for hardened addicts of finding a vein. Users describe the “f-rush”, an out-of-body euphoria that lasts several hours, before the brain craves another hit. Each trip is a dance with death: the dose needed to produce a narcotic effect is just fractionally below the amount that can trigger unconsciousness, breathing difficulties and heart failure. Many users do not survive their first hit.
Last year the drug killed more Americans aged between 18 and 49 than traffic accidents or guns. In the Canadian state of British Columbia the statistics are more stark, with unregulated drug overdoses, mostly from fentanyl, the leading cause of death for all people aged 10-59, according to health officials. The impact in Europe has been minuscule by comparison. In the European Union about 200 people are believed to have died of fentanyl-related overdoses in 2023, while for the past five years in the UK the number has hovered around 60 deaths a year.
One theory to explain why, so far, this seems a peculiarly US and Canada-focused scourge is that both countries are seeing the effect of decades of overprescription of opioid painkillers by doctors. There were 227 million prescriptions issued for legal opioids in the US in 2015. Even if only a tiny fraction of those patients sought to continue their habit once their course ran out, that is a bonanza for the drug runners. British Columbia’s experimental decriminalisation of the possession of hard drugs, including fentanyl, in January 2023 has also been blamed for the rise in deaths there.
For pushers, fentanyl has some intrinsic advantages over other addictive drugs. Unlike cocaine and heroin, its ingredients do not have to be cultivated from coca or poppies: its chemical components, largely produced in China, can be bought easily online, often legally. From a business perspective, almost the only flaw of the drug is its efficacy in killing off its client base.
Politicians appear powerless to stop the scourge. In 2016 Donald Trump vowed as a presidential candidate to stem “100 per cent” of the flow of drugs, including fentanyl, into the US during his term of office. Opiate overdoses surged under his administration.
Shocking images of zombie-like addicts slumped on city streets from San Francisco to New York have prompted calls for urgent action — but the death toll has remained high under President Joe Biden, who has described the crisis as an “American tragedy”. Last year he made a series of pledges including expanded access to addiction treatment and heightened co-operation with China to stop the chain of supply. His administration has been the first to shift more resources to treatment than interdiction — a tacit admission that the flow can probably never be stopped.
Some experts warn that the best hope is that demand plateaus in a saturated market, now the drug has penetrated every corner of the country. “For the most part there aren’t any more places that are not yet hit,” says Jonathan Caulkins, a professor and drug policy researcher at Carnegie Mellon University’s Heinz College in Pennsylvania.
In 2022 the US recorded about 109,000 overdose deaths, according to the Centers for Disease Control and Prevention (CDC), of which 70 per cent were synthetic opioids including fentanyl — a slight increase on the 2021 death toll following two years of steep rises. “I think we’re at a peak but I don’t see the decline from the peak happening quickly,” says Caulkins, who believes the war may be unwinnable. “Fundamentally dangerous drugs” such as fentanyl, he predicts, are here to stay.
Skid Row to wealthy suburbia
In the homeless areas of San Francisco and Los Angeles, fentanyl users are easy to spot by their stupor-like demeanour mid-hit. More than a dozen cases can be found in a 10-minute walk around Skid Row in LA , where about 4500 homeless people congregate every day. One heavy-set man is smoking a pipe at a bus shelter and speaks only to confirm, nonchalantly, that the white smoke he is exhaling is from fentanyl.
Other addicts take refuge in their tattered tents. Clutching burnt foil in swollen hands, a man and a woman in their twenties are getting high on the drug together. They seem not to notice the rat scurrying over their filthy bedding.
Others in Skid Row tell stories of their brushes with death. Nicole Cosio, 45, painfully thin, with her skin drawn tightly over protruding shoulder blades, says she overdosed some months ago and had to be revived with naloxone — the antidote that can reverse the effects of opioids and restore breathing. She describes the whole experience as terrifying.
“It’s worse than heroin,” says Cosio, who is also a crystal meth user. She says her fentanyl trip left her awake for four days in a delirious paranoid state, convinced that her neighbours in Skid Row were trying to steal her disability cheques. She counts fentanyl as her biggest mistake. “It’s the craziest thing I have ever done,” she says, her hollow face a testament to years of drug abuse.
While these squalid scenes are the most publicised images of fentanyl abuse, one of the striking aspects of the drug is how it crosses class boundaries. Previous drug epidemics, such as crack cocaine in the 1980s, came to be associated with poorer communities. Fentanyl finds its victims at every level of society.
The Leopolds were a picture-book American family. Michelle, 58, and her husband, Jeff, 57, run six hardware stores in Marin County, a short drive across the Golden Gate Bridge from San Francisco and the fourth richest county in all of America. Living in the small community of Greenbrae, their beautiful home is surrounded by hills forested with oaks. The year-round sun and ready access to the San Francisco Bay make the area perfect for rowers and boaters.
Trevor Leopold, a handsome teenager with blue eyes, grew to love the outdoor life on the doorstep of his family home. A former boy scout, he was an avid birdwatcher able to identify almost any species from its call. He collected rocks and had an encyclopaedic knowledge of gems and minerals. “He loved learning,” says his mother, who bears a striking resemblance to her son.
In 2016 the Leopolds noticed a change in Trevor’s bright disposition, just as he turned 15. They knew he was occasionally smoking strong cannabis. “His personality completely changed,” Michelle says. “I learnt about today’s high-potency THC [tetrahydrocannabinol] and realised that was what was causing this lovely, sweet, caring, gentle person to become violent.”
Desperate to get their son back, the Leopolds sent Trevor on wilderness retreats, with little success. They also booked him into several rehab centres. By the time he turned 18 there were signs of improvement. He graduated from high school and began studying at Sonoma State University. But just months into his degree, in November 2019, he was dead. Trevor, his mother says, had bought four pills, believing them to be prescription painkillers. One was laced with fentanyl. Michelle, Jeff and their 21-year-old son, Parker, now live with the grief that afflicts thousands of American families.
The China connection
Fentanyl was first developed by the Belgian physician Dr Paul Janssen in the late 1950s. Approximately 100 times more powerful than morphine, it was designed as an intravenous anaesthetic to alleviate severe pain following cardiac and vascular surgeries. It soon gained a place on the World Health Organisation’s list of essential medicines and is still used today as a highly effective painkiller, particularly in the care of terminal cancer.
By the early 2000s reports began to emerge of illicit recreational use, with drug addicts chewing on the slow-release medical patches or squeezing out the gel inside and injecting themselves. In 2016 millions heard the name of the drug for the first time when it was revealed that the pop superstar Prince had died from an overdose.
It has been over the past three years, though, that illegal use has exploded. Some experts say boredom during the pandemic drove abuse. There has also been speculation that China, as the main source of the chemicals needed to produce fentanyl, is deliberately allowing the US to be flooded by a drug that undermines its society from within — just as Britain and other Western powers were accused of doing, in reverse, during the Opium Wars of the 19th century.
Beijing has consistently rejected this accusation, saying the West is seeking to blame others for its own degeneracy.
Yet there can be no hiding China’s role, willing or not, in the production of the drug that is sometimes known on streets of Los Angeles as “China Girl”. The main reason is a logistical one. China has the biggest chemical manufacturing sector in the world — with about 45 per cent market share. If anyone, from drug cartels to legitimate medicine manufacturers, needs chemical ingredients, China is a first port of call.
Fentanyl sold as a recreational drug has no set formula. There are several varieties, using a combination of chemicals — as many as 10 — in the production process. Most of the ingredients are also used to manufacture mainstream products, from paint to pesticides. One, sodium borohydride, is a common bleaching agent.
In the early 2000s both pure fentanyl and the chemicals needed to manufacture it would normally be shipped directly from China to the US. Intense pressure from Washington to curb that trade, culminating in a May 2019 declaration by the Beijing government that fentanyl and two of its precursors would be categorised as controlled substances, led to a sharp drop in the number of seizures at US ports.
The smuggling did not stop, however. It just shifted south, to Mexico.
The Mexican drug cartels step in
Over the past 15 years synthetic drugs — the first was crystal meth — have begun to cut into a market long dominated by cocaine and heroin. As that business has grown, important cross-Pacific links have been formed between Mexican cartels — with their decades of experience of trafficking drugs to the US — and their Chinese chemical suppliers. It has proved enormously profitable for both sides.
A window into this deadly alliance was provided last year by a former senior figure in the most established criminal group in all of Mexico: the Sinaloa cartel.
Dámaso López-Serrano, who is currently co-operating with US prosecutors under a witness protection scheme, is a godson of Joaquín “El Chapo” Guzmán, the founder of the Sinaloa cartel and the most notorious drug lord alive today. El Chapo was extradited to the US in 2017 and is serving a life sentence for murder and other offences.
In an interview with a Mexican journalist published on the CrashOut substack site last year, López-Serrano detailed how members of the Sinaloa cartel made several visits to China over the past decade, specifically to discover how to make fentanyl.
“We sent people who worked with us to China and there they were introduced to everything, from how it is made, what it has, what it doesn’t have, how much you have to put in,” López-Serrano told the journalist Luis Chaparro. He described how, once his former associates began to import the precursor chemicals from China to produce their own version of fentanyl, they realised they had hit the jackpot. For every dollar invested, the criminal organisation was getting back $20. Even small-time smugglers, López-Serrano said, were able to net “30 or 50 million dollars” a year.
One of the early alleged pioneers of the China-Mexico drug trade was the Shanghai-born Mexico-based businessman Zhenli Ye Gon. In 2007 his sumptuous mock-château home in Mexico City was raided by police. Inside they found US$207m in cash, spilling out of cupboards. The haul, weighing two tonnes, took detectives two days to count. US drug agents claimed the magnate, a colourful character who once boasted he had lost $126m in Las Vegas casinos, used his legally registered pharmaceutical company as a front to provide the Mexican gangs with the chemicals needed to make crystal meth, a predecessor of fentanyl.
“He was the one who really set up this alliance between the Mexican drug cartels, the Mexican drug trafficking networks and the Chinese pharmaceutical industry,” says Ioan Grillo, author of Gangster Warlords, an account of the drugs-driven violence in Latin America.
Ye Gon, who faced charges — later dropped — in the US for importing an ingredient used to produce crystal meth, has always maintained he is innocent.
The control of fentanyl trafficking in Mexico is now dominated by what is known as the “narco juniors”, mostly sons of the drug lords who established their dynastic fortunes smuggling cocaine in the 1980s onwards. The Guzmán family and the Sinaloa cartel still play a key role in this business, despite the imprisonment of El Chapo. Since his arrest, four of his sons, known as the “Chapitos”, have helped steer their father’s empire into the trafficking and production of fentanyl, according to Mexican investigators and US prosecutors.
In 2023, in a US indictment against two of the brothers — Iván and Jesús Guzmán Salazar — it was alleged that they used to test the correct dosage of the fentanyl they were developing by injecting it into kidnap victims, until they overdosed.
Manzanillo, gateway to China
The city of Manzanillo, on Mexico’s Pacific coast, was once best known for its glorious natural bay and big-game fishing, which made it a go-to destination for the 1970s jet set. It was here that a bead-haired Bo Derek emerged from the sea in the 1979 film 10, starring Dudley Moore. The money in Manzanillo now comes not from louche sunlounging tourists but from trade, of all kinds, with Asia.
Over the past half-century, mirroring the rise of China, Manzanillo’s port has grown to become the busiest in Mexico, handling 3.4 million containers a year. But only a tiny fraction of those containers is ever inspected. Since 2020, after years under civilian control, Mexico’s customs posts have been overseen by the military. That change was made by President Andrés Manuel López Obrador in an effort to battle corruption. Four years on, an insider, speaking on condition of anonymity, believes the situation has deteriorated.
“Right now corruption is the worst it has been in 20 years. It’s unbelievable,” says the businessman, whose operation is based inside the port. Synthetic drug interdiction, he insists, is barely happening. The first problem is that most of the precursor chemicals enter Mexico legally. The cartels set up fake pharmaceutical companies inside the country, as Ye Gon allegedly did, and then order chemicals from China — with all the paperwork intact.
The US has attempted to close this loophole. In October last year the Department of Justice unsealed eight indictments against Chinese companies and their employees, several of which have addresses in the central city of Wuhan, on charges of sending fentanyl precursors to Mexico and the US. Some of the company owners have said they are being falsely targeted; others appear to have vanished. The US also says some Chinese companies change the composition of the chemicals they export so they appear to be for legitimate industrial use, such as pesticides.
The businessman in Manzanillo says such deception is in fact unnecessary because, in his experience, a modest bribe paid at the port enables anything to pass through.
By way of example, he says the tax and duties on a container with $100,000 worth of goods should be about $30,000. But a $6000 “donation” paid at the port means the tax bill is waived and the container can leave without any further questions. He adds that containers set aside for inspection — usually owing to a tip-off regarding drugs — often disappear by dawn. “They say the cranes move alone in the night here,” is his wry explanation.
This conversation is held at an outdoor café in the heart of touristy Manzanillo. Young families in beachwear browse the nearby street stalls as the businessman spells out the malignant power of corruption inside the vast port.
“You don’t get mugged in the street here. You can leave your car open and nothing happens,” he says. “But when you go inside the world of drugs, everything changes. Then you can get killed.”
No one knows this better than the mayor of Manzanillo, Griselda Martínez. A petite, determined woman, as a child she dreamt of becoming a nun. She was elected mayor in 2018, having run on a promise to clean up the police force. By then it had been heavily infiltrated by two gangs: the Sinaloa cartel and its rival, the Jalisco New Generation. Martínez admits she was naive when she began her role. Nine months after taking office she survived an assassination attempt while being driven through the city on a routine trip. Her car was not armoured.
“There were 36 shots,” she says. One grazed her slightly, while her bodyguard was shot in the face. He survived.
After that Martínez was warned by intelligence officials she could never live in her home again. For the past four years she has been staying, alone, in government buildings: a naval barracks, her city offices and a support centre for vulnerable women. She barely sees her family. Just one of her three children still lives in Manzanillo.
At least 10 guards with assault weapons keep watch outside during our interview. “I really don’t have a life any more,” she says. “I breathe and I work. It is not a normal life.”
Martínez, 55, was born in the centre of Manzanillo, which she remembers as a quiet fishing backwater. “Everything we wanted was right there in the sea in front of us — crabs, shrimp, whatever we needed.” Crime, she recalls, was almost unheard of. “In hot weather we all slept with the doors open, with the windows open.”
The port, she says, has “polluted” her home town. “With it came all this movement of goods — and the movement of drugs. They called the port progress, but progress is quality of life, not this.”
Anyone in law enforcement is a potential target. Martínez mentions, almost in passing, that the second-in-command of her police force survived a murder attempt just a few days before we meet. Nizandro Gonzaga had stopped to get a haircut at a barber shop near his office when two armed men burst in and unleashed a rain of bullets, seriously wounding him. It was the second attempt on his life in months and the suspects are still at large. The barber shop remains closed, its glass frontage riddled with bullet holes.
Tijuana, gateway to America
The left-wing President López Obrador has made modest steps to assist the United States in tackling this crisis. One welcome move last September was the extradition to the US of 33-year-old Ovidio Guzmán, El Chapo’s youngest son. He is facing fentanyl trafficking charges.
Yet the López Obrador government formally maintains the pretence that fentanyl is not produced at any scale in Mexico. In March 2023 its foreign ministry declared that the security services had “no record” of any domestic fentanyl production at all. The US Drug Enforcement Agency and others, however, have evidence that hundreds of labs have been uncovered in Mexico.
Tijuana’s mayor, Montserrat Caballero, just like her counterpart in Manzanillo, no longer lives in her home. She has moved to an army base for protection after receiving threats. For security reasons Mexican police forces are largely prohibited from giving press interviews on fentanyl-related stories. Those who accompany The Sunday Times in Tijuana have their faces hidden by balaclavas and all identifying numbers on their bulletproof vests are concealed.
Last March a police officer spotted a man putting a bag of pills into the boot of a Toyota Corolla with California licence plates in the Colinas del Sol neighbourhood, just 25 minutes from the US border. The suspect attempted to escape but was swiftly apprehended. This led police to a safe house that it transpired was run by the Sinaloa cartel. One hundred kilograms of fentanyl and crystal meth was recovered. One of the suspects arrested in that operation was from the same small city — Badiraguato, with a population of only 3700 — as El Chapo himself.
A 20-minute drive from the Tijuana safe house are the neatly tarmacked hills of the exclusive Buena Vista neighbourhood. Pristine three-storey homes, which would not look out of place in Beverly Hills, boast sweeping views of the city. A closer look at one Dallas-style townhouse at the bottom of the hill shows it is riddled with bullet marks, the remnants of a police shootout with a senior cartel leader who was living in the building.
Five minutes up the road, in a gated community, is another house indistinguishable from the elegant residences alongside. Last year police raided the property and recovered 75kg of fentanyl in pill form, as well as 14 handguns and five assault rifles. The home is less than 10km from the US border, the busiest road frontier in the world.
Cartels hire both Mexican and US citizens to smuggle the easily concealed pills across the border. Most of the fentanyl in the US is believed to arrive via legal entry points. The potency and concentration of the drug means just three lorryloads would be enough to supply the entire US market for a year. The going rate for a courier, or “mule”, travelling by foot and taking 1000 pills, is about $500 per crossing. Cartels recruit many of the young carriers via social media, with discreet job opportunity adverts.
Amid heightened checks on the US side there has been a recent surge in the number of “body carriers” caught at the border — those who conceal the pills in packets that are often stuffed into their rectal or vaginal cavities.
A patchwork of solutions
The US response to the crisis has so far varied across states, cities and counties. In California, where fentanyl claimed more than 7300 lives in 2022, prosecutors have either begun or have announced plans to charge dealers with murder. In the state of Virginia, Loudoun County — a wealthy area roughly an hour west of Washington — has announced plans to sweep high schools with sniffer dogs to combat rising overdose deaths among teenagers.
At the federal level, last year the Food and Drug Administration approved over-the-counter sales of the overdose reversal drug naloxone, a move that proponents of the so-called “harm-reduction model” have demanded for years. Supporters of the decision say that putting naloxone kits in as many hands as possible will save lives. New York state has also made naloxone available free from vending machines.
Those calling for international action have been encouraged by discussions between presidents Biden and Xi Jinping at a summit held in California last November. On the fringes of talks about Taiwan, Washington and Beijing presented a joint plan to curb the flow of fentanyl into the US, with China agreeing to do more to pursue producers of the precursor chemicals.
Biden praised Xi’s “commitment” on the issue, although when pushed on how much stock he could put in his counterpart’s promises, he fell back upon a phrase Ronald Reagan often used when referring to the Soviet Union’s pledges on nuclear disarmament during the Cold War: he said he would take a “trust, but verify” approach.
‘Equal opportunity murderer’
“Fentanyl is an equal opportunity murderer,” says Michelle Leopold, the grieving mother of Trevor in San Francisco. “It does not discriminate.”
Only briefly does her voice crack during our conversation — mostly she displays a steady stoicism. She has discovered a new purpose: making sure that as few parents as possible have to go through what her family has endured, by raising awareness about the drug that killed her son.
Most weekends she can be found outside one of her family’s hardware stores in a purple T-shirt bearing the slogan “Overdose awareness”. She always carries a shot of naloxone with her and pleads with others to do the same. When Michelle began her mission in 2019, she says hardly anyone listened. Now, after hundreds of thousands of deaths, parents are waking up to the danger. Michelle’s meetings are packed.
“Almost everybody knows somebody” who has died from fentanyl, she says. The statistics show that is not the exaggeration it might seem: four out of 10 Americans in one recent survey said they knew someone who had died from a drug overdose.
Michelle believes that the US government still isn’t doing enough to inform Americans of the risks posed by fentanyl. That task, she says, has fallen into the hands of an “army” of devastated families. “The education is coming from parents with first-hand experiences,” she says. “We just don’t want anybody else to join this horrific club of having to bury your own child.”
Written by: Stephen Gibbs and Keiran Southern
© The Times of London