How a ‘Body Farm’ can help tackle fentanyl abuse

The two women lifted a stiff corpse from the ground, revealing a wriggling insect in the mud.

“That’s a living larva!” said Alex Smith, the laboratory manager of Colorado Mesa University’s Forensic Investigation Research Station, as he picked the larva from the ground and placed it in a glass tube. Maggots aren’t just maggots, Mr Smith explained – they are potential evidence.

“You can actually test the larvae and pupal casings for drugs,” he said excitedly.

His audience included a group of Mexican medical researchers who traveled last month to the Colorado facility known as a “body farm,” where dozens of donated dead bodies are laid out in the sun to be studied as they decompose.

The Mexican forensic specialists learned more about testing cadavers for fentanyl, which is how they ended up in a field of corpses, where they observed as a researcher searched the mud for maggots.

Their trip was organized by the U.S. State Department, where officials hoped it would help achieve a key diplomatic goal: getting the Mexican government to deal with its own fentanyl problem.

In northern Mexico, aid groups and rehabilitation centers have raised alarms about increased 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 the drug is under control and overall consumption remains relatively low.

In reality, no one knows exactly how common fentanyl use is in Mexico. There is little recent data on drug abuse nationally and most Mexican forensic pathologists do not systematically test dead bodies for fentanyl, medical researchers and U.S. officials say.

“In Mexico you don’t see fentanyl overdose cases, not because people aren’t dying from fentanyl, but because we don’t test them,” says Dr. César González Vaca, the chief physician of the state of Baja California. and added: “We don’t look for it.”

Mexico is the dominant source of illegal fentanyl smuggled into the United States, the U.S. government said, and although Mexican forces reported a significant increase in drug seizures last year, synthetic opioids continue to flow across the border.

One strategy to get Mexico to do more to curb the flow, U.S. officials say, is to show that fentanyl isn’t just an American addiction — it’s killing Mexicans, too.

The trip to Colorado “was an effort to help Mexico recognize that it has a problem, as difficult as it may be,” said Alex Thurn, an official in the Bureau of International Narcotics and Law Enforcement Affairs at the U.S. Embassy in Mexico.

So on a crisp February morning, more than a dozen forensic examiners and chemists from the northern Mexican states filed into the medical examiner’s office in Denver to attend the autopsy of a middle-aged man found dead on the floor of his garage. was found.

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

Ian Puffenberger, a forensic pathologist, squeezed the man’s lungs and a stream of foam came out. This, said Dr. Puffenberger, was “a common finding” in opioid deaths, as a person’s breathing slows and the lungs fill with fluid.

Sawing into his skull revealed another sign of an overdose: the bumps on his brain, known as gyri, looked less bumpy than they should.

“If there is swelling of the brain,” said Dr. Puffenberger, another effect of an opioid overdose, “those gyri push against the skull and flatten out.”

In addition to their top-of-the-line knives and gleaming facilities—which were the subject of much talk among Mexican coroners—the American pathologists also had an array of expensive tools to confirm that the man had died of an overdose.

They ran preliminary blood tests in a Randox Laboratories machine costing more than $30,000, which returned positive results for fentanyl, methamphetamine and amphetamines. They then sent samples for a full toxicology screening to a drug testing laboratory in Pennsylvania.

“We felt like we were at Disneyland,” said Dr. Vaca. “They have everything.”

Mexican medical researchers, said Dr. Vaca, often prop up necks with two-liter soda bottles and cut off skulls with saws normally used to rip through metal. They often earn very little, he said, for determining the cause of death in a country where criminals specialize in making their victims unrecognizable.

“Here they don’t see people chopped up, bagged, burned, with 200 gunshot wounds,” said Dr. Vaca.

The chief medical examiner will teach you how much you can do with less.

After watching fentanyl become a mass killer in the United States, Dr. Vaca to push for body testing in Baja California. He has had to resort to a low-tech method — dipping fentanyl strips in urine, blood or other bodily fluids — and is testing only in Tijuana and Mexicali, the state’s two largest cities. But the results are astonishing.

As of June 2022, more than half of all bodies entering the city’s morgues tested positive for drugs, and 20 percent of them contained fentanyl. “It’s a public health emergency,” said Dr. Vaca.

For decades, America’s voracious appetite for narcotics has fueled the rise of vast criminal networks in Mexico, but historically drugs have not been widely consumed in the country. But drug use is becoming increasingly common, research shows.

The last time the Mexican government conducted its national drug investigation was in 2016 number of Mexicans who said they used illegal narcotics had almost doubled compared to 2008. The demand for drug treatment in Mexico has grown rapidly since 2018, according to a separate government survey.

Fentanyl has been found in counterfeit pills sold at pharmacies in Northern Mexico, but also in party drugs such as cocaine and MDMA at a music festival near Mexico City.

“It’s cheap to make and easy to distribute,” said Manuel López Santacruz, a medical researcher for the state of Sonora, across the border from Arizona. Fentanyl pills, he said, cost as little as $3 each, making it affordable for almost anyone to feed their addiction.

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

Tracking fentanyl deaths would more reliably reflect the scale of the problem, experts say, but would require significant investment from authorities.

In Denver, the head of investigations, Erin Worrell, offered tips for identifying possible overdoses.

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

“If you have a heart attack or something, you’re going to want to achieve things,” she said. “It’s going to be more, you know, chaotic.”

Ms Worrell said one clue was the position of the body. People who fell asleep and died after taking opioids are often found hunched over with their legs curled beneath them. She knows to look for laxatives because opioids cause constipation.

Sometimes overdose deaths resemble murders, such as the case of a man found in a blood-stained bathroom with wounds all over his back.

“Those look like defensive wounds,” the Mexican investigators said, looking at photos of the gruesome scene. It was actually an overdose, and before he died, the man had mutilated himself.

“A A lot of times people start to get itchy,” Ms Worrell said. “They think there are bugs on them.”

As Ms. Worrell’s presentation ended, Dr. Vaca came over and showed her a photo on his phone: a man killed so quickly by fentanyl that the syringe was still in his neck. “We see that all the time,” said Dr. Vaca.