A “body farm” could help fight fentanyl use

WHITEWATER, Colo. – The two women lifted a stiff corpse from the ground, revealing an insect writhing in the dirt.

“That’s a live larva!” said Alex Smith, laboratory director at Colorado Mesa University’s Forensic Investigative Research Station, picking the larva off the ground and placing it in a glass tube.

Worms aren’t just worms, Smith explained: They are potential evidence.

“You can actually test the carcasses of larvae and pupae for drugs,” he enthused.

Their audience was a group of Mexican medical examiners who last month traveled to the Colorado facility, known as a “body farm,” where dozens of donated cadavers They are exposed to the sun to be studied as they decompose.

Mexican forensic specialists came to learn how to test corpses for fentanyl, and so they ended up in a field of corpses, watching as an investigator searched the dirt for worms.

His trip had been organized by the US State Department, where officials hoped he would help achieve a key diplomatic objective:

convince the Mexican government to address its problems fentanyl problem.

In northern Mexico, aid groups and rehabilitation centers are warning of an increase in fentanyl use in recent years, reporting a surge in opioid overdoses along parts of the U.S. border.

The Mexican government says the spread of drugs is content and that overall consumption remains relatively low.

In fact, no one knows exactly how common fentanyl use is in Mexico.

There is little recent data on drug abuse nationwide and for most Mexican forensic pathologists they do not analyze systematically fentanyl regulators, coroners and US officials support.

“We don’t see cases of fentanyl overdoses in Mexico, not because people aren’t dying from fentanyl, but because we’re not testing for them,” said Dr. César González Vaca, chief medical examiner for the state of Baja California.

And he added: “We are not looking for him.”

According to the U.S. government, Mexico is the largest source of illicit fentanyl trafficking into the United States, and although the Mexican military reported a substantial increase in drug seizures last year, synthetic opioids They continue to cross the border.

One strategy to get Mexico to do more to stem the flow, U.S. officials say, is to demonstrate that fentanyl isn’t just an American addiction: It’s killing Mexicans, too.

Strategy

The trip to Colorado “was an effort to help Mexico recognize that it has a problem, no matter how inconvenient it may be,” said Alex Thurn, an official in the U.S. Embassy United’s international narcotics and law enforcement bureau in Mexico.

Then, on a cool February morning, more than a dozen medical examiners and chemists from the northern Mexican states gathered at the medical examiner’s office in Denver to witness the autopsy of a middle-aged man found dead on the floor of your garage.

On the night of his death, he intermittently told his girlfriend that he had taken “10 blues“, likely referring to the fentanyl pills, the pathologists said.

Ian Puffenberger, a forensic pathologist, squeezed the man’s lungs and a stream of foam came out.

This, Puffenberger said, is “a common finding” in opioid deaths, as a person’s breathing slows and their lungs fill with fluid.

The cut in his skull revealed another sign of overdose: The lumps in his brain, known as convolutions, appeared less irregular than they should.

“If there is inflammation of the brain,” another effect of opioid overdose, Puffenberger said, “those twists push against the skull and they flatten“.

In addition to the top-of-the-line knives and shiny equipment (the subject of some conversation among Mexican coroners), American pathologists also had an array of expensive tools at their disposal to confirm that the man had died of an overdose.

They ran preliminary blood tests on a Randox Labs machine that costs more than 30,000 dollars, who tested positive for fentanyl, methamphetamine and amphetamines.

They then sent samples for full toxicology testing to a drug testing lab in Pennsylvania.

“We felt like we were at Disneyland,” Vaca said.

“They have everything.”

Mexican medical examiners, Vaca said, often hold necks with two-liter soda bottles and cut open skulls with saws normally used for cutting metal.

They often earn very little, he said, to assess the cause of death in a country where criminals specialize in making their victims unrecognizable.

“Here you don’t see people dismembered, put in bags, burned, with 200 bullet holes,” Vaca said.

The Chief Medical Examiner is a lesson in how much can be done with less.

After seeing fentanyl become a mass killer in the United States, Vaca began pushing for body testing in Baja California.

It had to resort to a low-tech method (soaking the fentanyl strips in urine, blood or other body fluids) and is testing only in Tijuana and Mexicali, the state’s two largest cities.

But the results are surprising.

From June 2022, more than half of all corpses those who arrived at the city’s morgues tested positive for drugs, and fentanyl appeared in 20% of them.

“It’s a public health emergency,” Vaca said.

Consumption

For decades, America’s voracious appetite for narcotics has fueled the rise of vast criminal networks in Mexico, but historically large-scale drug use in the country has not occurred.

But drug use is becoming more common, research shows.

The last time the Mexican government conducted its national drug survey, in 2016, the number of Mexicans who reported using illegal narcotics had nearly doubled since 2008.

Demand for drug treatments in Mexico has grown rapidly since 2018, according to a separate government study.

Fentanyl was found counterfeit pills sold in pharmacies in northern Mexico, as well as party drugs such as cocaine and MDMA at a music festival near Mexico City.

“It’s cheap to produce and easy to distribute,” said Manuel López Santacruz, a medical examiner in the state of Sonora, just across the border from Arizona.

Fentanyl pills, he said, cost as little as $3 each, making it possible for almost anyone to feed their addiction.

The government recently restarted the national survey of drug use after a year-long hiatus, but experts say it is unlikely to capture the true spread of synthetic opioids because many users may not admit to taking them.

He death tracking as fentanyl would more reliably reflect the scale of the problem, experts say, but requires significant investment from authorities.

In Denver, lead investigator Erin Worrell offered tips for identifying potential overdoses.

Projecting photographs of recent death scenes onto a screen, Worrell highlighted a man who had died with a half-lit cigarette still in his hand, and who was later found to have fentanyl and a cocktail of other drugs in his system.

“If you’re having a heart attack or something like that, you’re going to have to touch things,” he said.

“It’s going to be more, you know, chaotic.”

Tracks

Worrell said one clue was the location of the body.

People who fall asleep and die after taking opioids are often found hunched over with their legs tucked under them.

He knows to look for laxatives, because opioids cause constipation.

Sometimes overdose deaths appear to be homicides, such as the case of a man who was found with wounds all over his back.

“They look like defensive wounds,” said one of the Mexican examiners, looking at photographs of the gruesome scene.

In reality it was an overdose and, before dying, the man had been mutilated.

“A lot of times people start scratching,” Worrell said. “They think they have bugs.”

Once Worrell’s presentation concluded, Vaca walked over and showed him a photo on his phone: a man killed so quickly by fentanyl that the syringe was still stuck in his neck.

“We see it all the time,” Vaca said.

c.2024 The New York Times Company