Clara Fleiz1,2, Jaime Arredondo3,4, Alfonso Chavez3, Lilia Pacheco3, Luis A Segovia3, Jorge A Villatoro1,2, Silvia L Cruz5,2, María E Medina-Mora1,2, Juan R de la Fuente2,6. 1. National Institute of Psychiatry, Ramon de la Fuente Muñiz (INPRM), Mexico City, Mexico. 2. Members of the Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico, (UNAM), Mexico City, Mexico. 3. Prevencasa A.C. Tijuana, Tijuana, Mexico. 4. Drug Policy Program (PPD), Center for Research and Economic Teaching (CIDE), Aguascalientes, Mexico. 5. Department of Pharmacobiology, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav), Sede Sur, Ciudad de Mexico, Mexico. 6. Ambassador of Mexico, United Nations Organization, New York, NY, USA.
Abstract
BACKGROUND AND AIMS: Results from a recent study among 750 heroin users in three Mexico's northern border cities revealed an increase in white powder availability (also known as China white) and preference for this product among heroin users, as well as a general perception of increased overdose cases among this population. Here, we questioned whether those findings reflect an increased presence of heroin laced with fentanyl, which is associated with greater risks of overdose but that, until now, has not been described in Mexico. DESIGN: We tested fentanyl using highly sensitive test strips in syringe plungers, metal cookers and drug wrappings associated with heroin use. SETTING: Three injection sites in Tijuana, Baja California, México. PARTICIPANTS: Eighty-nine heroin users who interchanged paraphernalia for new syringes. MEASUREMENTS: We tested 59 residues of 'pure' white powder. The rest were white powder with black tar (n = 5) or white powder with crystal meth (n = 9), black tar with crystal meth (n = 1), black tar only (n = 13) and crystal meth only (n = 2). FINDINGS: Users believed that they consumed either white powder heroin, white powder heroin with crystal meth, white powder with black tar heroin or black tar heroin only. Analyses revealed that 93% (n = 55) of the 'pure' white powder samples had fentanyl. All (n = 9) the white powder samples mixed with crystal meth and 40% (n = 2) of the white powder with black tar were also laced with fentanyl. CONCLUSIONS: In a sample of 89 heroin users in Mexico, most white powder heroin users were unknowingly exposed to fentanyl, with fentanyl detected in 93% of white powder samples.
BACKGROUND AND AIMS: Results from a recent study among 750 heroin users in three Mexico's northern border cities revealed an increase in white powder availability (also known as China white) and preference for this product among heroin users, as well as a general perception of increased overdose cases among this population. Here, we questioned whether those findings reflect an increased presence of heroin laced with fentanyl, which is associated with greater risks of overdose but that, until now, has not been described in Mexico. DESIGN: We tested fentanyl using highly sensitive test strips in syringe plungers, metal cookers and drug wrappings associated with heroin use. SETTING: Three injection sites in Tijuana, Baja California, México. PARTICIPANTS: Eighty-nine heroin users who interchanged paraphernalia for new syringes. MEASUREMENTS: We tested 59 residues of 'pure' white powder. The rest were white powder with black tar (n = 5) or white powder with crystal meth (n = 9), black tar with crystal meth (n = 1), black tar only (n = 13) and crystal meth only (n = 2). FINDINGS: Users believed that they consumed either white powder heroin, white powder heroin with crystal meth, white powder with black tar heroin or black tar heroin only. Analyses revealed that 93% (n = 55) of the 'pure' white powder samples had fentanyl. All (n = 9) the white powder samples mixed with crystal meth and 40% (n = 2) of the white powder with black tar were also laced with fentanyl. CONCLUSIONS: In a sample of 89 heroin users in Mexico, most white powder heroin users were unknowingly exposed to fentanyl, with fentanyl detected in 93% of white powder samples.
Authors: Joseph Friedman; Fernando Montero; Phillippe Bourgois; Rafik Wahbi; Daniel Dye; David Goodman-Meza; Chelsea Shover Journal: Drug Alcohol Depend Date: 2022-02-26 Impact factor: 4.852
Authors: Joseph Friedman; Philippe Bourgois; Morgan Godvin; Alfonso Chavez; Lilia Pacheco; Luis A Segovia; Leo Beletsky; Jaime Arredondo Journal: Int J Drug Policy Date: 2022-04-11
Authors: Chelsea L Shover; Titilola O Falasinnu; Candice L Dwyer; Nayelie Benitez Santos; Nicole J Cunningham; Rohan B Freedman; Noel A Vest; Keith Humphreys Journal: Drug Alcohol Depend Date: 2020-09-28 Impact factor: 4.492
Authors: Mathew V Kiang; Rolando J Acosta; Yea-Hung Chen; Ellicott C Matthay; Alexander C Tsai; Sanjay Basu; M Maria Glymour; Kirsten Bibbins-Domingo; Keith Humphreys; Kristen N Arthur Journal: Lancet Reg Health Am Date: 2022-03-19
Authors: Cho-Hee Shrader; Annick Borquez; Tetyana I Vasylyeva; Antoine Chaillon; Irina Artamanova; Alicia Harvey-Vera; Carlos F Vera; Gudelia Rangel; Steffanie A Strathdee; Britt Skaathun Journal: AIDS Behav Date: 2022-08-08