Finalist: The Washington Post

By Nick Miroff, Scott Higham, Steven Rich, Salwan Georges and Erin Patrick O'Connor 

During the past seven years, as soaring quantities of fentanyl flooded into the United States, strategic blunders and cascading mistakes by successive U.S. administrations allowed the most lethal drug crisis in American history to become significantly worse, a Washington Post investigation has found.

Presidents from both parties failed to take effective action in the face of one of the most urgent threats to the nation’s security, one that claims more lives each year than car accidents, suicides or gun violence. Fentanyl is now the leading cause of death for Americans ages 18 to 49, according to a Post analysis.

The Drug Enforcement Administration, the country’s premier anti-narcotics agency, stumbled through a series of missteps as it confronted the biggest challenge in its 50-year history. The agency was slow to respond as Mexican cartels supplanted Chinese producers, creating a massive illicit pharmaceutical industry that is now producing more fentanyl than ever.

The Department of Homeland Security, whose agencies are responsible for detecting illegal drugs at the nation’s borders, failed to ramp up scanning and inspection technology at official crossings, instead channeling $11 billion toward the construction of a border wall that does little to stop fentanyl traffickers.

The White House Office of National Drug Control Policy, the executive branch office headed by the “drug czar” and tasked with coordinating the government’s response, spent years fending off elimination and struggled to create an effective strategy to combat the scourge. The office lost its seat in the White House Cabinet and remains sidelined.

“Law enforcement did the best it could,” said David King, executive director of a federal drug task force in San Diego. “We can only do so much. But in Washington, they have been very slow to respond to this and now we are at the confluence of paralysis.”

The DEA said it is now taking direct aim at the Mexican cartels and the fentanyl epidemic. DEA Administrator Anne Milgram acknowledged that the government remained too focused on heroin at the onset of the crisis, as Mexican traffickers ramped up production of synthetic opioids.

“It is a new, deeper, more deadly threat than we have ever seen, and I don’t think that the full extent of that harm was immediately seen in 2015,” she said.

Narcotics agents say street-level demand for fentanyl is rising fast because so many new users are getting hooked. More than 9 million Americans “misused opioids” in 2020, according to the latest estimates by the Department of Health and Human Services. But the agency has not tracked the rise of fentanyl and does not know how many Americans are using it.

The Centers for Disease Control and Prevention is unable to track overdose deaths in real-time. Its published data is one year behind, obscuring the picture of what is happening on the ground in 2022. The agency continues to count the death toll for 2021 — in a provisional tally seven months ago, it calculated the overall number of drug overdoses at 107,622. Two-thirds were due to fentanyl.

When President Richard M. Nixon launched America’s first war on drugs 51 years ago, annual overdose deaths stood at 6,771.

There is one federal system that collects both fatal and nonfatal overdose data in real-time in several regions of the country. But the system, called ODMAP, is kept from public view. A database launched by the drug czar’s office last week maps some nonfatal overdoses, which can highlight regions where deaths are likely to follow.

Without comprehensive data, the federal government is driving blind.

“This is like tracking the epidemic by visiting cemeteries,” said John P. Walters, who served as drug czar during the Clinton and George W. Bush administrations. “We’re not measuring what’s coming into the country in real-time. We’re not measuring what’s happening with the health consequences and where to put resources to buffer those health consequences. Our drug-control strategy is an embarrassment, and it doesn’t begin to propose a way of reversing this problem.”

The American fentanyl crisis deepened during the coronavirus pandemic. From 2019 to 2021, fatal overdoses surged 94 percent, and an estimated 196 Americans are now dying each day from the drug — the equivalent of a fully loaded Boeing 757-200 crashing and killing everyone on board.

Ed Byrne knows better than anyone the cost of fentanyl on U.S. streets. Byrne, 54, a Homeland Security Investigations agent in San Diego, has kept his own count of the nearly 500 fatal overdoses he has witnessed. It was a way to impose some order on the snowballing disaster.

“It is so much useless death,” said Byrne, who began investigating fentanyl cases in 2018.

San Diego is ground zero for fentanyl trafficking into the United States. More than half of all the fentanyl seized along the southern border is confiscated there, much of it produced in clandestine drug labs and pressed into tablets by cartel networks in northern Mexico. Drug loads that cross the border undetected go to stash houses in Los Angeles and Phoenix before spreading eastward across the country. In Southern California, the cartels are renting Airbnbs to store drugs before shipping them across the country.

Byrne tracked fentanyl shipments as a key member of Team 10, a multiagency task force specializing in the drug. At death scenes, Byrne tested pills and powder and fingernails, a job that took him to $10 million mansions, rental apartments and homeless camps. Sometimes he went to suburban homes to find teenagers dead in their childhood bedrooms.

For all of Team 10’s success in catching dealers, the drugs and the overdoses kept coming. San Diego County tallied 92 fentanyl-related deaths in 2018, the year the task force was formed. Last year, there were 814.

Byrne and his colleagues printed hats and T-shirts with their own logo for Team 10: a lone wolf, howling into a void.

The roots of the epidemic reach back to the Bush administration, which did little as countless Americans became addicted to oxycodone and other prescription opioids while U.S. drug manufacturers, distributors and chain pharmacies made billions in profits.

During the Obama administration, amid a wider questioning of the U.S. criminal justice system, the government defunded and dismantled key drug-monitoring programs in the years before fentanyl hit. President Barack Obama demoted the White House drug czar position, removing the role from the Cabinet. And when heroin use rose after the government crackdown on prescription opioids, authorities treated fentanyl as an additive, rather than a distinct threat requiring its own specific strategy.

President Donald Trump took office just as the fentanyl epidemic was about to explode. He promised to build a wall along the U.S. southern border that he said would stop drugs. But Mexican traffickers were sneaking fentanyl right through the front door, hidden in passenger vehicles and commercial trucks passing through official ports of entry in California and Arizona. Today, the partisan border debate in Washington remains fixated on a physical structure that is virtually useless for stopping the deadliest drug U.S. agents have ever faced.

Since President Biden took office, his administration has amplified a public messaging campaign to warn about fentanyl’s mortal threat — “One Pill Can Kill.” He has stepped up efforts to improve scanning technology at border crossings and repair a broken counternarcotics partnership with Mexico. But with Republicans blaming Biden’s border policies for record numbers of immigration arrests, the president and many of his top officials have said little about the skyrocketing amount of fentanyl entering the country.

When the U.S. government cracked down on the U.S. opioid industry starting in 2005, it choked off street supplies of prescription narcotics but left behind a ravenous market. Mexican cartels filled it, first with crude heroin, then fentanyl. The cartels imported drugs and chemicals from China, hired chemists and purchased pill presses. But at the moment when the federal agencies responsible for preventing the drug from gaining a foothold in America were needed most, they fell short.

The amount of fentanyl seized along the U.S. southern border — the most reliable gauge of supply — has jumped ninefold during the past five years. Since July, border seizures of fentanyl have averaged 2,200 pounds a month, meaning U.S. authorities are confiscating more fentanyl in a single month than they did during all of 2018. Federal officials estimate they are capturing 5 to 10 percent of the fentanyl crossing from Mexico, but they acknowledge it could be less.

The drug is cheaper than ever because supplies are so abundant. On the streets of U.S. cities in the early 2000s, the most popular prescription pain pill was made by Mallinckrodt Pharmaceuticals, one of the nation’s oldest drug manufacturers. The company’s 30-milligram oxycodone tablets, known as “blues” or “M-30s,” sold for roughly $30 apiece on the black market. Today, fake M-30s made by Mexican cartels using fentanyl look identical but sell for $4 or $5 apiece on the streets of San Diego, and can be especially lethal to first-time users.

Byrne had been to 486 death scenes by the time his bosses decided he’d seen enough. They sent him this summer on a new assignment in the South Pacific. As he prepared to leave San Diego, the narcotics agents and prosecutors who worked with him threw a farewell party at the Tin Roof, a honky-tonk bar downtown in the city’s renovated Gaslamp Quarter.

“I can’t say we made progress,” said Sherri Walker Hobson, a tough, laser-focused former federal prosecutor who worked closely with Byrne, raising a toast to her best friend as the bar went quiet. “But we put up a good fight. We did the best we could to manage this.”

San Diego’s Gaslamp Quarter is lined with pricey new restaurants and old-style saloons that evoke the city’s history. They share the streets with thousands of people sleeping in tents and alleys, many gripped by addiction.

A few stood outside the Tin Roof, just beyond the sidewalk tables, on the night of Byrne’s farewell. At one point, a grubby, disheveled man with bulging eyes walked into the party and sat down among the cops. He didn’t speak, but he appeared to be under the influence of something powerful.

When one of the bartenders noticed and came onto the floor to confront him, the man ran to the back of the restaurant. Two of the plainclothes narcotics officers from Byrne’s party followed. They shooed the man out of the bar and back onto the street.

‘China, China, China’

By 2017, fentanyl had become the leading cause of overdose deaths in America. For three years, Hobson, then an assistant U.S. attorney in San Diego, had been tracking the steady rise in fentanyl seizures at the busiest land port in the nation — San Ysidro, 20 miles south of downtown San Diego. Fentanyl deaths had quadrupled in San Diego County between 2014 and 2017.

In the spring of 2017, Hobson formed the Fentanyl Working Group, a collection of federal and state drug agents, prosecutors and chemists, along with the medical examiner and other public health officials. It amounted to an emergency summit. Byrne joined the cause. They were hoping for a turnout of 15 people. Forty showed up.

The group began to collect drug overdose and seizure data and quickly realized that the doses of fentanyl that had been causing so many deaths in San Diego and across the country were coming from cartels in Mexico, not from traffickers in China.

“China was in the rearview mirror,” Hobson said.

Hobson and her colleagues tried to spread the word. They launched a local public awareness campaign. They created fact sheets and PowerPoint presentations to alert law enforcement agencies in the region. Hobson traveled the country, speaking at national drug policy conferences, where she sounded the alarm about the flood of fentanyl coming from Mexico.

From 2016 to 2017, fentanyl seizures at California’s ports of entry rose by 266 percent, from 573 pounds to 2,099. Most involved counterfeit M-30 pills. At the time, 2.2 pounds of fentanyl cost about $40,000. That amount could be turned into 1 million pills, netting the cartels millions in profit.

Hobson knew how the cartels operated because she had been prosecuting methamphetamine cases since the 1990s. The San Diego region had been a hub for small-batch, U.S.-made “biker meth.” Then Mexican traffickers figured out how to cook it cheaper, and make it purer. They put competitors north of the border out of business.

“I think a lot of people underestimated the Mexican cartels,” Hobson, who retired in 2020 after 30 years with the U.S. attorney’s office in San Diego, said in a recent interview. “I knew they were very innovative. They weren’t hesitant to adapt and try new things.”

Outside San Diego, Hobson’s warnings went largely unheeded.

The importation of fentanyl from Mexico was not the focus of the Trump administration. In October 2017, a Justice Department official said in an op-ed column that “most illicit fentanyl and fentanyl analogues come from China.”

The department announced an indictment against Chinese nationals, furthering the narrative that China was paramount. Reading through the indictment, Hobson realized that the allegations were old, dating back to 2014 and 2015. By 2017, it was clear to Hobson and members of the Fentanyl Working Group that the supply lines had shifted.

“There was so much focus on China, they didn’t look at where the ball was,” Hobson said. “They weren’t looking at the cartels in a serious way. It was all about China, China, China.”

‘A game changer’

Byrne caught a case in 2017 that confirmed the lightning-fast rise of the Mexican cartels. On Aug. 11, a U.S. Customs and Border Protection officer stationed at Los Angeles International Airport intercepted a package from China containing a chemical called 4-ANPP, a precursor used to make fentanyl. Byrne and Hobson, along with agents from the DEA and the U.S. Postal Inspection Service, devised a plan.

The team replaced the precursor with a bag of sand, put a tracking device on the package and followed it to San Diego. It was delivered to a post office box near the border linked to a man named Cesar Daleo. Byrne recognized the name from his days working as a U.S. Border Patrol agent before he joined Homeland Security Investigations. Daleo was once a Border Patrol agent, too.

The team members decided to allow Daleo to pick up the parcel. It would be the 14th time that he had signed for such a package since 2016. They hoped Daleo would take the interstate off-ramp from San Ysidro into Mexico. If he took the bait and drove onto the ramp, he would be making a commitment to entering Mexico. The team could then prove in court that the precursor chemicals were bound for the cartels.

On Aug. 29, 2017, Daleo picked up the parcel and opened the box, severing a hairline surveillance wire and sounding an alarm to the team. He tossed the box containing the bag of sand into his trunk and headed south, taking the off-ramp to Mexico. A Homeland Security tactical team cut him off. One of the agents tossed a stun grenade at Daleo’s car. He crashed into a guardrail. The agents smashed Daleo’s driver’s side window, dragged him through it onto the ramp and carted him off in handcuffs.

Daleo later pleaded guilty to drug conspiracy charges and was sentenced to 30 months in prison. For the first time, Byrne and Hobson had unassailable proof that the cartels were making their own fentanyl and cutting out the middlemen.

“It was a game changer,” Byrne said.

But in Washington, fentanyl was barely registering on the radar screen.

That year, the DEA published a 94-page resource document that devoted four pages to synthetic opioids. It made no mention that Mexican traffickers were producing fentanyl. Under “Drugs of Concern,” fentanyl was not listed. In the DEA’s 2017 National Drug Threat Assessment, the agency devoted 10 of 169 pages to fentanyl and other synthetic opioids. U.S. law enforcement agencies surveyed by the DEA identified heroin as the greatest threat facing the nation, followed by meth and prescription drugs. Fentanyl came in fourth, slightly ahead of marijuana.

There were other missteps. In the years before fentanyl hit the streets, crucial programs to monitor drug use were dismantled.

One, the Arrestee Drug Abuse Monitoring Program, gathered urine samples from recent offenders. The program, run by the White House drug czar, was scuttled in 2013 by budget cuts.

The Drug Abuse Warning Network, which collected drug use and overdose data from hospitals and emergency responders, was eliminated in 2011. The government brought back a version of the program in 2018, but by then, the fentanyl crisis was well underway.

“These programs, as imperfect as they were, at least gave us something. And they were defunded,” said Keith Humphreys, who served as a drug policy adviser to the George W. Bush and Obama administrations.

Soon after Trump became president, his administration proposed eliminating the drug czar’s office entirely. It became a backwater for political appointees, many of them with scant or no drug policy expertise. A 23-year-old Trump campaign worker was named deputy chief of staff, but no one had been nominated to head the office. Nearly nine months into his presidency, Trump selected Rep. Tom Marino (R-Pa.) — a former federal prosecutor and one of Trump’s first and most strident supporters in Congress — to be drug czar. But Marino soon withdrew his nomination after it was revealed in a joint Washington Post-“60 Minutes” investigation that he had co-sponsored legislation that made it more difficult for the DEA to hold drug manufacturers, distributors and pharmacies accountable when they violated federal law.

As the Trump administration was preparing to leave the White House in 2021, the drug czar’s office issued its annual National Drug Control Strategy to Congress. The document is supposed to detail the government’s plan to reduce drug demand and disrupt supply chains. But the 2021 strategy document was nearly identical to the one issued in 2020. Many of its sections had simply been copied from the previous year.

‘Hold people accountable’

One name on the medical examiner’s list of 2017 overdose deaths in San Diego is Leo Holz. The cause of death was “fentanyl toxicity.” His age: “zero.”

Leo was 10 months old. He was crawling around on the bed between his sleeping parents. Leo picked up a bright blue pill and put it in his mouth. When his parents woke up, their baby was cold and unresponsive.

Leo was the youngest person in San Diego to die because of fentanyl. Since then, the drug has killed two other children there before their first birthdays.

Byrne and Hobson investigated the Holz case, tracing the pills to a drug ring that included a U.S. citizen in Tijuana named April Spring Kelly. She told prosecutors she used heavyset women as “body carriers,” because they were less likely to be patted down, and sent them through Arizona and California crossings.

Couriers were smuggling packages taped to their thighs and abdomens, or in body cavities. “Stuffers,” as the agents called them, could sneak a pound of pills or powder through a port of entry. Kelly admitted in a plea agreement to smuggling nearly half a million fentanyl pills across the border. She was sentenced to 14 years.

The Trump administration was less focused on drugs than immigration. Trump officials were preparing to award contracts worth billions of dollars for the president’s border wall, and they invited construction firms to set up side-by-side prototype designs on a dusty lot near the Otay Mesa crossing, 27 miles south of downtown San Diego. The region was a natural choice. The fencing CBP had installed along the border there over the previous two decades was more formidable than anywhere else.

What Trump officials didn’t acknowledge was that the barriers made little difference to the cartels: The place with the mightiest fence was also the traffickers’ primary gateway for hard drugs.

“The cartels saw the void left by the U.S. pharmaceutical industry,” said John Callery, a 30-year veteran of the DEA who retired after running the San Diego field office. “Nature abhors a vacuum and they said, ‘Holy crap. We only have to get five pounds of fentanyl across the border instead of 7,000 pounds of meth. Perfect. And we can make 10 times as much money.’”

In the summer of 2018, a hard-charging local prosecutor in San Diego named Terri Perez proposed setting up Team 10 to investigate every fentanyl death and trace the drugs to the dealers. The team was headquartered at the DEA’s San Diego field office, and staffed by federal and local law enforcement officers from across the region.

“I had never seen anything like this. It’s impacting people from their early teens to their 40s and 50s, families being destroyed, parents losing their kids, schools losing their students,” Perez said. “We needed to hold people accountable.”

Perez turned to Byrne. He started to investigate dozens of overdose deaths, comforting family members while trying to gain access to the cellphones of the dead for leads.

Byrne and Hobson knew they were seeing only a small fraction of the drugs pouring across the border. And what they were hearing from DEA agents was not encouraging. Mexican President Andrés Manuel López Obrador was critical of his country’s drug war partnership with the United States and argued that it burdened Mexico unfairly and fueled violence.

Once López Obrador took office in December 2018, security and counternarcotics relationships with the United States had gone cold. He was distrustful of the DEA and the access U.S. agents had cultivated across the Mexican government.

In Washington, Trump had declared the opioid epidemic “a national health emergency” and pressured China to crack down on fentanyl shipments to the United States. But his administration’s focus at the border was to stop immigration. Trump, who falsely said Mexico would pay for the border wall, wanted the Democrats to provide $5 billion for the project. He shut down the government toward the end of 2018 when they wouldn’t give it to him.

The impasse ended after 35 days and led to a compromise on border security. Democrats agreed to furnish $1.4 billion for the wall. Republicans agreed to provide $564 million to add more-advanced “non-intrusive inspection” technology, known as NII, at the ports of entry.

“We asked: What would it take to stop the flow of drugs? Could we do a Manhattan Project for NII?” said a congressional staffer who worked closely on the funding plan but wasn’t authorized to speak publicly.

More than 228,000 cars and trucks were entering the United States each day from Mexico, but CBP officers were scanning only about 6 percent of commercial trucks and 1 percent of passenger vehicles.

Mexican traffickers were playing those odds, and winning. They could send the stuffers through the crossings, or just load the drugs into cars and trucks, and shrug off whatever losses they incurred as the price of doing business.

The border security plan that emerged in 2019 after the shutdown promised to change that calculus. Congressional appropriators set a goal for CBP to scan 72 percent of commercial trucks and 40 percent of passenger vehicles entering from Mexico.

To reach that objective, CBP needed software systems capable of processing the millions of images from the state-of-the-art scanning equipment. That required artificial intelligence to help agents quickly detect hidden compartments, altered engine parts and other anomalies.

The three-dimensional scans couldn’t find fentanyl buried deep in an engine block, but they could detect suspicious changes in densities. The drug loads show up as glowing bright spots because the X-rays pass through them so easily. CBP officers could route those vehicles to additional inspection.

“We gave them a huge pot of money,” the congressional staffer said. “We thought we had a good plan.”

The rising toll

After Byrne had responded to 100 fatal overdoses in San Diego, the pace suddenly picked up. Less than a year later, he was at his 200th death scene. Fentanyl was killing people in the most private and intimate of places — in their bedrooms, their bathrooms, in the hallways of their homes.

One of Byrne’s problems was that no one else wanted to test for fentanyl at crime scenes. In the early stages of the crisis, much of the DEA messaging had been geared toward alerting first responders to the dangers of fentanyl. They became so terrified that they would call in hazmat crews if they thought fentanyl was present.

But Byrne saw the downside to the scary messaging. Fentanyl is only a significant threat if the powder is dispersed into the air and inhaled. Touching the pills or handling bags of powder is not a mortal risk because the drug isn’t easily absorbed through the skin. Pharmaceutical fentanyl “patches” prescribed to manage intense pain use a chemical agent to allow the drug to be absorbed.

Fentanyl’s reputation made it hard for Byrne to get fellow officers and agents to do their own testing. So, they would call him, and he’d arrive in his Ford Explorer. In the back, he kept two MX908 mass spectrometers. He once found the crumbs of a pill under a dead teenager’s keyboard. The boy’s father hit the space bar, and when the monitor lit up, the boy’s message exchanges with the dealer popped up on the screen.

Sending samples to a lab that took weeks to process the results meant the loss of crucial time for investigative leads. And when a “hot,” or super-potent, supply was ravaging users in rapid succession, it was important to know right away that an especially lethal batch of fentanyl had hit the streets.

By 2019, fentanyl deaths in San Diego had risen 787 percent in five years.

“Just when we think it can’t get any worse, the latest numbers prove us wrong,” U.S. Attorney Robert Brewer said at a news conference that July.

That summer, Byrne responded to a call at an extended-stay motel in San Diego’s Clairemont Mesa district. A 30-year-old parolee named Major Williams, whom police had identified as a gang member, was found dead in his room. The cause of death: “fentanyl, cocaine and alcohol.”

Less than two years later, Byrne was back at the same motel to investigate another fentanyl death.

“It was the exact same room,” he said.

Glory days

During the 1980s and 1990s, DEA agents were seen as the rock stars of the law enforcement world, making major busts in the United States and helping to capture Latin American drug lords like Joaquín “El Chapo” Guzmán and Pablo Escobar.

The DEA has struggled during the past decade, losing nearly 1,300 staffers, 700 of them agents. Many agents retired early to take lucrative private-sector jobs. Today, the agency has more than 800 vacancies.

For six years, the DEA went without a Senate-confirmed administrator. Michele Leonhart, a 35-year veteran, announced her retirement in 2015 following revelations that DEA agents were attending sex parties with prostitutes hired by Colombian drug cartels.

Leonhart’s departure marked the beginning of a tumultuous time at the DEA. The agency went through five acting administrators, three of them during Trump’s tenure.

In 2018, DEA agent Fernando Gomez was charged with participating in a decade-long conspiracy to smuggle thousands of pounds of cocaine from Puerto Rico to New York. He was sentenced to four years in prison.

In 2020, DEA agent Jose Irizarry was accused of conspiring to launder money for a Colombian drug cartel while living a lavish lifestyle replete with wild yacht parties, bikini-clad prostitutes and homes in Cartagena, Colombia; Puerto Rico; and South Florida. He was sentenced to 12 years in prison.

More recently, a former agent, Manuel Recio, was accused of making payments to current agent John Costanzo Jr. in return for inside information about pending DEA cases. That information was then allegedly peddled to criminal defense attorneys hoping to recruit new clients. Recio and Costanzo could face more than 20 years in prison if convicted. They have denied the allegations.

A recent audit by the Justice Department’s Office of the Inspector General found that the DEA failed to effectively monitor its foreign offices and agents overseas. The DEA has ordered an outside review of the agency’s 92 foreign offices in 69 countries “to ensure integrity and accountability.”

Mark Coast, a retired DEA agent in San Diego who also spent 30 years as a Marine Corps reservist, said he saw the agency lose its operational muscle and strategic focus. “Everything is whack-a-mole,” he said in an interview. “A dealer pops up, they take that dealer out, and another one pops up.”

“There is no strategic plan,” he said.

Eighteen months ago, Milgram, a former New Jersey attorney general, became the first Senate-confirmed DEA administrator since 2015. She inherited the fentanyl crisis and has been scrambling to marshal a more robust response.

“This is not a war on drugs, this is a war to save lives,” she said in a recent interview at DEA headquarters in Northern Virginia, where the lobby walls are covered with more than 4,000 portraits of fentanyl overdose victims sent in by their families. They are almost entirely young faces, many of them in their teens and 20s.

“When you look at the faces, you have a sense of the enormity of what we’re losing,” Milgram said.

Since taking office, she has promoted the One Pill Can Kill campaign and begun targeting the two top Mexican cartels behind the flood of fentanyl — Sinaloa and Jalisco New Generation — going after their financial networks and global supply chains.

Between May and September, the DEA and other law enforcement agencies seized nearly 980 pounds of fentanyl powder and 10.2 million pills, and they investigated 380 fentanyl-related cases, connecting 35 directly to the two cartels. The DEA also investigated 129 cases of fentanyl ordered via social media platforms, including Snapchat, Facebook Messenger, Instagram and TikTok.

Milgram described the cartels’ push to expand markets by addicting more people as “deliberate, calculated treachery.”

Rahul Gupta, Biden’s drug czar and the first trained physician to hold that job, said in a recent interview that he is focused on flattening fentanyl’s death curve. He said he does not need the president to return his role to the Cabinet.

“The goal is really to address the crisis of today, not yesterday,” he said.

Gupta said the Biden administration is implementing a “harm reduction” approach that seeks to reduce deaths by supporting safe-use policies and expanding access to counseling and treatment. “Only 1 in 20 people who need the help are able to get it today in the United States of America,” he said.

Along the border, the administration is struggling to deploy the sophisticated scanning systems. Nearly four years after Congress gave the CBP money to expand inspections, new systems have been installed in Brownsville and Laredo, Tex., and at other border crossings. But they require officers to conduct labor-intensive reviews because the CBP lacks the ability to automate the process with artificial intelligence software and centralized command centers.

A House Appropriations Committee report published in June chastised the agency for its failures, saying it had a “paradigm-shifting opportunity” to “revolutionize” the inspection process. Instead, the strategy “continues to depend on CBP Officers to review thousands of images manually,” the report stated, calling it a shortsighted “failure to innovate” that is “inexcusable and must be immediately addressed by current DHS leadership.”

‘Just heartbreaking’

During a visit this fall to the medical examiner’s office in San Diego, 261 corpses in body bags were laid out on metal trays and stacked up on carts in the refrigerated morgue. Thirty-seven of the people had died of fentanyl overdoses. Fentanyl is now responsible for 1 in every 5 deaths handled by the San Diego County Medical Examiner’s Office. So many people are dying, it takes nearly four months to complete toxicology reports.

“It’s just heartbreaking,” said Medical Examiner Steven D. Campman, who reviewed 1,672 fentanyl-related deaths from 2014 through 2021.

“A fair number of families ask: ‘Shouldn’t I have done something? Couldn’t I have seen something?’ I tell them it shouldn’t be on them, and I can’t offer them much more.”

In October, after three months in the South Pacific, Byrne returned to San Diego. The city’s Deputy District Attorneys Association had named Byrne “Law Enforcement Officer of the Year” and invited him to pick up the award. Byrne looked 10 years younger, his face thinner and more tanned than when he had left San Diego.

After the awards ceremony, he went back to work. An old case among his 486 came to court for a sentencing hearing.

On Nov. 3, 2020, Sarah Elizabeth Fuzzell, 24, had been found dead in her apartment in Vista, Calif., 40 miles north of downtown San Diego. Byrne gained access to her phone. The drug dealer was unaware that one of his customers had just died. A Team 10 member texted the dealer, posing as Fuzzell on her phone. The man who had sold Fuzzell the fentanyl, Cole Salazar, fell for the ruse. Salazar was charged with selling the lethal dose.

The case took two years to wend its way through the courts. On Oct. 15, Byrne drove to the federal courthouse in downtown San Diego for Salazar’s sentencing. Fuzzell’s older sister, Megan, along with her mother, Mindy, had made the trip from their home in Oklahoma City. Megan, 30, was a medical researcher who had graduated magna cum laude from the University of Oklahoma and been a high school valedictorian and National Merit scholar. She volunteered at medical clinics to raise awareness about the dangers of drug overdoses.

Megan testified about the loss of her little sister.

“Since her death, I’m left with a hole in my heart that is irreparable and constantly present,” she told the judge. “I’m lost without her. My family feels incomplete and broken.”

That Wednesday evening, Byrne met Megan and Mindy for dinner in San Diego’s Little Italy. Even though the judge had sentenced Salazar to 10 years in prison, the mood was muted. The next night, the Fuzzells returned home to Oklahoma.

The following day, Byrne received a text message from Megan’s father.

“Mindy and I found Megan dead in her bed about 630 last night,” David Fuzzell wrote.

David and Mindy had lost their only remaining child. The autopsy results were still pending, but Byrne already knew. Megan was 487.

Six days later, he wrote to a Post reporter:

“I have been lucky to not have lost someone close to me in this battle, but I can sadly say I know all too well the heartbreaking sorrow of those who have. I accept Megan as 487. It impacted all of us from Sarah’s case like a knife in the gut. I still cannot speak with her mother. I know it’s not true but I somehow feel like I’ve failed the Fuzzells. How did we sit with her at dinner less than 48 hours before and not see or sense anything?

“In 2021, 107,000 souls were snuffed out from fentanyl in America. That number will be eclipsed this year. All the futures that have been lost, those still to be lost.

“Where’s the outrage?”

About this story

Reporting by Nick Miroff, Scott Higham and Steven Rich. Alice Crites also contributed to this report. Photography by Salwan Georges. Videos by Erin Patrick O’Connor and Jorge Ribas.

Design and development by Allison Mann and Tyler Remmel. Additional design and development by Laura Padilla Castellanos and Rekha Tenjarla. Data analysis by Steven Rich. Video graphics by Sarah Hashemi.

Jeff Leen, Trish Wilson and Courtney Kan were the lead editors. Additional editing by Sarah Childress, Christian Font, Meghan Hoyer, Jai-Leen James, Jessica Koscielniak, Robert Miller, Frances Moody and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Dunton, Jenna Lief, Osman Malik, Monika Mathur, Jordan Melendrez, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple datasets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House’s drug czar, by submitting a detailed research proposal to gain access.

By Sari Horwitz, Meryl Kornfield, Nick Miroff and Steven Rich 

COMMERCE CITY, Colo. — From the doorway of Apt. 307, District Attorney Brian Mason could see the five bodies inside. They lay awkwardly on the floor and couch, their arms and legs contorted — a sign of sudden collapse.

A man in jeans and closest to the door was splayed on his back, his left leg bent at an odd angle. Not far from him, a woman with long brown hair was slumped on the kitchen floor, her face pressed against a lower cupboard. Another woman, in a black sweatshirt, lay just past the kitchen counter nearby. On a love seat toward the back of the room, a man sat frozen. A woman in a gray T-shirt had toppled over him, her head resting on his chest. Blood dripped from their faces.

A mass murder, Mason thought.

Mason, a slim 45-year-old who grew up in Colorado, had arrived at the suburban Denver apartment complex shortly after 8 p.m. on Feb. 20. It was such a frigid night that his knees were shaking. He climbed the outside staircase to the third floor with Sgt. J.P. Matzke, the supervisor of a local drug task force.

The scene looked like a party gone terribly wrong, Matzke told Mason. Five people down. Crime-scene technicians collecting evidence inside were suited up in Hazmat gear. They were worried that whatever substance had caused so many people to die simultaneously might still be in the air. They had tested for carbon monoxide and ruled that out.

A partly empty Crown Royal whisky bottle stood on the kitchen counter among plastic cups, empty shot glasses and cut orange straws. In the middle was a mirrored tray with lines of white powder. A red heart-shaped balloon floated above, tied by a string to a bouquet, remnants of Valentine’s Day the week before. In the center of the room was an empty baby swing.

The first police officer on the scene, a mother herself, had found a crying 4-month-old baby girl in a pink bassinet in another room. She had been alone for nearly 12 hours. She was one of seven children who lost a parent that night.

Not everyone at the party had died, Matzke told Mason. The police officer had found a disoriented woman inside. At first, the woman tried to shield the white powder and told the officer she and her friends had all just fallen asleep.

“We took cocaine, and that’s it,” she mumbled before she was taken to a hospital.

But that wasn’t correct.

A gloved investigator sealed the white powder into plastic bags and scanned them with a handheld laser tool called TruNarc. Mason watched, fascinated. He had never heard of TruNarc, let alone seen it in action. The $30,000 device compared the substance with nearly 500 possible drugs.

The small orange screen flashed the word “Fentanyl.”

Exactly what Mason had feared. He had been warning people for months about deadly fentanyl mixed into recreational drugs.

The powerful, intensely addictive opioid has unleashed the most lethal narcotics crisis in U.S. history. Deaths caused by the drug are officially recorded as overdoses, but to Mason, that did not capture what really happened in Apt. 307.

It was a poisoning, he thought.

More than 107,000 people died in the United States last year by overdosing on illegal drugs. That is the country’s highest figure ever, and two-thirds of the deaths were attributed to fentanyl. Fentanyl deaths have nearly doubled since 2019.

Some of the dead had sought out the drug and used too much of it, but many others, like the five in Commerce City, had no idea that they were taking something that would kill them with the speed of cyanide.

Fentanyl is up to 50 times more powerful than heroin, putting users on a razor’s edge between intense pleasure — the high — and mortal peril. Under proper medical supervision, it is extremely effective for treating severe pain because of its ability to depress the central nervous system. But when too much fentanyl hits the bloodstream, it can quickly trigger respiratory failure and cardiac arrest.

The Denver area was becoming a transportation hub for the synthetic opioid. Mason had been briefed by the police and the federal Drug Enforcement Administration that Mexican cartels were sending massive amounts of fentanyl, either mixed into counterfeit pain pills or in powdered form, across the southwestern U.S. border.

From there, drug dealers moved the fentanyl through Arizona, California, New Mexico and Texas and into Colorado, where two large interstate highways converge. The loads were then smuggled to Chicago and out across the country. Police were finding fentanyl in cocaine, heroin and methamphetamine.

Last December, Mason gave a speech with the Colorado attorney general warning about the terrifying new threat. “Fentanyl is killing our kids,” Mason said.

Then, on the Sunday of Presidents’ Day weekend, the nation’s largest-known mass fentanyl poisoning hit his own district.

Mason left the apartment and walked back downstairs to a huddle of police officials. The parking lot of the North Range Crossings apartment complex was closed off with yellow tape and awash with flashing red lights and dozens of police officers, firefighters and crime scene technicians. Officers were trying to hold back neighbors and distraught family members crying and demanding to know what had happened.

Mason looked over at the reporters behind the yellow tape. He walked toward the glow of the lights readied for the 10 p.m. live newscast.

As a prosecutor for 15 years, Mason had made it a rule not to talk to the news media this early in an investigation. But tonight was different.

Mason, a father of three, was terrified. How much more of this bad batch of drugs was out there? he wondered. How many more people were going to die tonight?

“No drug is safe right now,” he told the reporters. “People who are taking drugs and not knowing that fentanyl is laced within them are dying. And tonight, tragically, it appears that five of our fellow citizens died because of it.”

As he turned away from the cameras, his mind pivoted back to the apartment. Who had sold them the drugs? If investigators found the dealer, could they prove that the person had intentionally added fentanyl? Did the dealer even know it was in the cocaine?

So much felt unknown to Mason that night. But he was sure of one thing: These deaths were not a blameless accident. They were a crime.

‘We’ll find them’

At a meeting of local and federal investigators a week later, Mason learned more about the five people who died in Apt. 307. On a screen, police shared a detailed timeline and what they knew about the victims.

The five were good friends who had gathered for a small party late at night. The hosts were Sabas “Sam” Daniel Marquez and Karina Joy Rodriguez, both in their 20s, who lived with their 4-month-old baby, Aria. Sam and Karina had gone to dinner with his sister, Cora Marquez, 29, and her husband, Humberto Arroyo Ledezma, 32, and invited them over afterward. Two friends from Karina’s waitressing job at Mickey’s Top Sirloin steakhouse, Jennifer Danielle Cunningham, 32, and Stephine Monroe, 29, joined them in the apartment.

From everything the detectives could piece together in the first days, no one at the party had meant to buy fentanyl. Whoever brought what they thought was just cocaine into the apartment had meant to share it for an evening of fun with friends. There was so much fentanyl in the white powder that the drug-testing device did not initially detect cocaine. By snorting the drug commonly sold in counterfeit pill form, the group ingested the fentanyl in one of the most dangerous ways because it hit the bloodstream faster.

The drug has challenged police and emergency responders as no other illegal narcotic has. A higher-potency batch can rapidly trigger a wave of overdoses, sending authorities racing to administer the opioid antidote naloxone, which can bring victims back from the brink of death. But fentanyl often kills before paramedics can arrive, especially in the case of users with no built-up tolerance for opioids.

Mason and the investigators knew that on Jan. 28, in another fentanyl poisoning, authorities had linked a string of deaths in D.C. to a bad batch of cocaine. The District’s police chief would later call the overdoses “probably the worst I’ve heard of.” In St. Louis, paramedics had returned again and again over a February weekend to an apartment complex where 11 people overdosed and eight died. All had smoked crack cocaine laced with fentanyl.

There would be more fentanyl mass poisonings in the next two months — at least seven separate instances resulting in 58 overdoses and 29 deaths. The drug is disproportionately killing Black people and Native Americans. In Cortez, Colo., three Native Americans died in a motel room. During spring break in South Florida, six young men, including five cadets from the U.S. Military Academy at West Point, overdosed but survived. Over an April weekend, 17 Black people in two D.C. neighborhoods overdosed, and 10 of them died.

The sheriff in Gadsden County, Fla., said that fentanyl “was not in my vocabulary” until police linked fentanyl-laced cocaine to at least six deaths and 10 nonfatal overdoses over a couple of days in July. “It hit us like a ton of bricks,” said Sheriff Morris Young.

Many of these people had used what they thought was cocaine or crack, authorities said. A Washington Post analysis of data from the Centers for Disease Control and Prevention found that in 2021, fentanyl was involved in 74 percent of heroin deaths, 71 percent of cocaine deaths and 54 percent of meth deaths. In fact, yearly cocaine fatalities over the past decade have quintupled, and 90 percent of that rise can be explained by fentanyl.

Law enforcement officials think many more mass poisonings have not been counted. But the U.S. government does not track mass-overdose events — not the DEA, the CDC or the White House Office of National Drug Control Policy.

As Mason listened to the investigators, he wondered why someone had put fentanyl in the cocaine used at the party.

Mason was often asked that question. In his many meetings with drug agents, he learned that dealers have been taking advantage of fentanyl powder’s cheap abundance and supreme potency to “spike” their cocaine, heroin and meth. The drug allows them to deliver a more powerful high and keep addicted clients coming back for more.

Counterfeit pills that have caused deaths are sometimes called “kill pills” or “hot pills.” Customers who can tolerate opioids often seek out the dealers who can deliver the more powerful high.

But in some cases, street dealers do not even know that fentanyl is in the cocaine they are selling. And the recipe is not consistent; like the distribution of chocolate chips in cookies, some of the mixed drugs have more fentanyl than others.

At the end of the hour-long presentation, Mason looked around at all the police brass. He was hopeful. The federal officials had said they would contribute any forensic resources investigators needed. Police detectives already had several promising leads.

“We’ll find them,” David Olesky, the then-acting assistant special agent in charge of the DEA’s Denver division, confidently told a local TV reporter.

This was the first big test of leadership for Mason, who just the year before at 44 had become the elected district attorney — the chief law enforcement official for Colorado’s 17th Judicial District. He had political ambitions. Mason, the son of an Air Force captain, had decorated his childhood bedroom not with sports stars but with posters of former U.S. presidents. After college, he got a job as a legislative aide in the Clinton White House and worked as a staffer for a Democratic congressman. His district attorney’s office displays photos of him with four presidents, along with models of Air Force One and Marine One.

Mason’s twin brother, Jeff, had become a prominent White House reporter in Washington. And from his own time in the nation’s capital, Mason knew how important it was for federal agencies to focus their attention and resources on a local case like this. He felt pressure to find those responsible for the five deaths and provide justice for the victim’s families.

Success in the Commerce City fentanyl case could raise awareness of the drug’s alarming dangers — and put Mason in the center of the national campaign.

Exhaustive investigation

Over the next weeks and months, Mason worked closely with the investigators, who traced the movements of everyone in that apartment in the two days before they died.

Mason learned that a camera on a neighbor’s doorbell had recorded when each person walked into Apt. 307 between 1 and 2 a.m. on Feb. 20. Investigators didn’t know precisely when they died. But they knew that they all fell to the ground suddenly — so quickly that no one had a chance to reach for their nearby cellphones.

About 12 hours later, Celina Fisher arrived at the apartment to check on her brother, Sam Marquez, because he wasn’t answering his phone. No one answered the door, which was unlocked.

She stepped inside and screamed. Her brother was lifeless on the floor near the door.

Jennifer and Stephine lay on the floor on either side of the kitchen counter. On the surface were alcohol and lines of white powder.

On the couch, Sam’s partner, Karina, slumped on top of her brother-in-law, Humberto.

Celina’s stepsister, Cora, was alive but dazed. She stirred. “We’re okay,” she told Celina as she was coming out of a stupor. “We’re okay.”

At first, Celina didn’t notice her brother’s 4-month-old baby in her bassinet. She was behind a closed door to the master bedroom.

Celina ran to her brother, yelling his name, trying to wake him. She pulled out a canister of the naloxone spray Narcan. She carried the overdose antidote because she had used opioids before and was aware of the dangers. She pushed the white tube up his bloodied nose, squeezing the medicine. But he was already cold to the touch. She left him and went around the room, shouting at the others, trying to wake them. No one moved. Celina called 911 at 3:37 p.m.

“There’s one, two, three, four, five people!” Celina shouted into the phone.

When the police arrived, Cora told them her husband, Humberto, was diabetic and needed medicine, not realizing he was dead. They ushered Cora and her baby niece into ambulances. Crime scene technicians spent the next 12 hours collecting evidence at the apartment. Detectives executed 10 search warrants for the phones, cars and homes of each person in Apt. 307.

They searched the GPS history on the victims’ phones to determine where they had been. They pulled together hundreds of hours of videos from surveillance cameras that covered the victims’ workplaces, homes, a bar where two of them had gone beforehand and the apartment where the five died. They read their texts and examined their call records. They scrutinized every detail in their lives — including the money and keys in their pockets and purses and the people in their social media networks.

One of the phones could not be cracked. It belonged to Jennifer, a manager at Mickey’s. Friends and relatives told police they didn’t know the password.

Investigators tested the baggies of white powder and examined the packaging for fingerprints and DNA. They analyzed the quantity and toxicity of the drugs found in the apartment.

Nationwide, the DEA has found that the potency of pills with fentanyl has increased in samples taken over the years, from 1.3 milligrams per pill in 2017 to 2.34 so far this year — just above the lethal dose. It is a sign the nation’s opioid tolerance is going up. The cartels are boosting the potency of their fentanyl pills because habituated opioid users want the higher doses. Those who do not frequently use opioids or have never taken them are most at risk of being killed by the stronger drugs.

Autopsies conducted on the five found marijuana, alcohol, cocaine and fentanyl in their blood. The amount of the synthetic opioid in their systems was far more than a lethal dose. Fentanyl reduces blood pressure and slows breathing, and fluid fills the lungs. Lack of oxygen turns fingertips and lips blue or purple and damages the brain. As the heart rate drops, blood seeps from the nose and mouth along with a white foam.

The investigators set up an anonymous tip line to identify suspects. They offered a reward for any information about fentanyl distribution in the area.

Two months in, Mason studied the scattering of evidence that police had gathered. There were the drugs: Police had the white powder found on the kitchen counter. They also found three baggies of cocaine in the apartment — two on the kitchen counter and one in a purse. Two bags were laced with fentanyl, one was not, Commerce City Police said. One was older and had accidentally been washed in the laundry, making it even more difficult to determine who could have sold it.

Detectives had narrowed their focus to three “people of interest” in the area who could have been the source of the drugs. But which of those three was connected to a bag that contained fentanyl?

Text messages showed that Jennifer, Stephine and Karina had met up earlier at Jennifer’s house and shared cocaine. The group then separated: Jennifer and Stephine went to a bar together, and Karina returned to Apt. 307, where she and her partner, Sam, would host the others. About midnight, Karina sent a text to the women at the bar asking if they could get more cocaine. If not, she said, they should come over for a drink anyhow. Stephine replied, saying that Jennifer had a bag she found in her laundry. They told Karina they were trying to get some more and mentioned the names of two people they could ask. But no text message indicated that they managed to find cocaine from a specific source.

Detectives weren’t getting the break they needed. Two potential suspects denied responsibility; the third had died in the apartment. One man police questioned said that he did sell cocaine to someone connected to the party the night before, but that his powder did not have fentanyl in it because he and his brother had sampled it and would have died.

Cora, the sole survivor, cooperated with police but did not provide any information that could help them trace the source of the fentanyl.

Mason’s case was becoming a messy, forensic jigsaw puzzle.

Prosecuting fentanyl dealers

Even if investigators could make the connection, Colorado did not have a charge for “distribution of fentanyl causing death.” First-degree homicide was off the table because the charge required that the dealer intended to kill the customers — and there was no evidence of that so far. Without being able to tie anyone to the drugs in the apartment, Mason wasn’t even going to be able to bring a misdemeanor charge.

This was a huge case, with shattered family members pleading with Mason to do something. Legislators already had been looking at stronger laws, and the horror of the Commerce City deaths created new momentum.

Even as the details of Mason’s prosecution case remained cloudy, the political urgency was clear.

For Mason, the case was a platform to advocate for harsher penalties for future fentanyl crimes.

In mid-April, he sat before a packed hearing room inside the gold-domed Colorado Capitol in Denver to argue his case for legislation that would make distribution of fentanyl causing death a crime in Colorado. At least 23 states and Congress have passed similar legislation, increasing penalties for dealers whose drugs kill users.

He felt the tension in the room. Several legislators and activists were fighting the bill because they thought it furthered the failed war on drugs, targeting people of color and sending people struggling with addiction to prison rather than providing them treatment.

“As most of you surely know, just a few months ago, we lost five people in one single incident of fentanyl poisoning in Commerce City. And at the time, it was the single largest number of deaths from fentanyl poisoning in the country,” Mason said. “I knew then and predicted then that we would not keep that record for long, and we haven’t. But it is a challenging example and a powerful example of how much fentanyl is ravaging this state.”

Later in the hearing, Karina’s sisters, Feliz Sánchez García and Mileiah Rodriguez, testified.

Karina’s sisters and her mother, Debby Garcia, were still mourning Karina’s death — and caring for her baby girl, Aria, who had been left alone for 12 hours in Apt. 307. They were struggling to comfort Karina’s 10-year-old son, Josiah, who lived with his father.

Feliz vividly remembered the cold night she waited at the edge of the police perimeter for news about her sister. She had spotted an officer who seemed to be in charge. People were shouting at him, trying to find out what happened.

Maybe if I just ask nicely, he’ll say my sister is alive, she thought.

Now a photo of Karina’s smiling face was pinned to her sweater as she sat beside her sister Mileiah in the statehouse hearing room.

The sisters said they hoped their prepared remarks, read from their cellphones, would finally correct the false impression in news reports that their sister was an irresponsible mother addicted to drugs. They feared what their niece and nephew might read online about their mother when they grew up.

“Four month-old girl orphaned after her mom and dad took her to drug-fueled house party in Colorado where they died after taking ‘fentanyl-laced cocaine,’ ” one headline had read.

They testified that their sister was not a regular drug user. She had been devoted to the baby girl she had always wanted, Feliz said. She didn’t use drugs while she was pregnant, nor while she was breastfeeding. Karina spent most nights at home, because she didn’t want to leave her baby with anyone else.

“She didn’t have a drug problem, but she decided to have a little fun one night,” Mileiah, the other sister, testified through tears. “And she was poisoned. Even if she did decide to use cocaine that night, she didn’t deserve to die. She was murdered.”

“She was not a person who struggled with addiction,” added Feliz, who was sitting beside her sister. “She said in the weeks before her death that she was the happiest she had ever been.”

Mason listened to the sisters with rapt attention. Up to this point, he had avoided interacting with any of the victims’ relatives because he knew that investigators were interviewing family members to determine whether any of them might be linked to the drugs.

As Mason watched the sisters testify, he decided he wanted to meet them.

Mason approached them in the hallway outside the hearing. He hugged them.

“I am so sorry for your loss,” he said as they wept.

The hearing lasted 12 hours, and legislators passed the bill in May.

Mason joined Colorado Gov. Jared Polis (D) on the steps of the Capitol as Polis signed the fentanyl law. Karina’s family and other victims’ relatives stood behind him, holding up photos of loved ones who had been killed by fentanyl.

Feliz and another family member read off the names of 23 people killed by fentanyl whose families had attended the hearing.

“They all had names, and they’ll never be forgotten,” she said.

Mason embraced Feliz. Her testimony had been critical to the bill’s passage. But the district attorney could not use the newly created charge retroactively in her sister’s case.

“No one should die from fentanyl poisoning,” Mason said from the lectern. “This bill is a start.”

As she left the Capitol that day, Feliz wondered when Mason would hold a big news conference to announce that he was charging a drug dealer with murder for the deaths of her sister and the four others.

Haunted

Two months later, on July 27, Mason gathered the federal and local investigators in his office’s law library. He went around the table and asked each of them what evidence had been gathered and whether there were any developments.

When they finished, he had one final question: “So what you all are telling me is that we don’t have the evidence right now to charge this crime?”

They all said yes.

On Sept. 14, Mason gave the news conference he had long dreaded. Flanked by the deputy U.S. attorney in Colorado, J. Chris Larson, and Commerce City Police Commander Dennis Flynn, Mason looked glum.

“Five residents of our community died from fentanyl poisoning in what was one of the largest mass incidents of this nature in the United States,” he began. “Since that time, we have had a multiagency, massive investigation into their deaths.”

“As of this moment today, we do not have the evidence to charge anyone with these deaths,” he said.

For now, the Commerce City case was cold.

“I genuinely hope that someday we will be able to find and hold accountable those who are responsible,” he said. “But, based on the evidence that we have today, we do not have the ability to charge anyone today. And I do not know that we ever will.”

Karina’s sister Mileiah was watching Mason’s news conference on Facebook at the doctor’s office where she worked. Mason had already alerted her family, but she still couldn’t believe what he was saying.

“As a family member, we’re extremely disappointed,” she immediately wrote on Facebook.

Derron Reed, the partner of Stephine, could not even watch Mason’s news conference. He had been frustrated and angry over the pace of the investigation all along. And now, after six months, the police had no answers. How was he ever going to explain to their two children, 10-year-old Ezra and 4-year-old Kendall, that their mother had been killed and that no one was going to be punished?

Amid the grief of losing his partner of 15 years, Derron had been struggling to help his children make sense of their mother’s death. He told his son that adults sometimes did things to relieve stress that children should not do.

“She was just having fun. She didn’t take her own life,” he said. “She was poisoned.”

The investigation had faded, but the impact on Commerce City was lasting. Denver authorities reported a sharp increase in requests for the opioid reversal drug naloxone. The grisly image of five dead men and women flashed back into the mind of the first police officer on the scene every time she drove by the apartment complex. A police trainee was so traumatized by what he had seen that he quit the force. The former Commerce City police chief said that in his nearly 31 years in law enforcement he had never seen anything so horrific.

Celina Fisher, who had found her brother and the others dead in Apt. 307, struggled with the trauma. Her substance abuse worsened, according to a relative.

On Halloween night, Celina was found unconscious in a park. She was rushed to a hospital and died the next day. The medical examiner listed alcohol and methamphetamine toxicity as the cause of death.

Mason returned to the North Range Crossings apartments one more time. He parked his car and walked to the building where the five had died. He hadn’t been back there since that night in February when he saw what he was sure was a mass murder.

The vibrantly colored apartment complex looked and felt completely different to him in the daylight. Mason thought about how everyone had wanted answers that night — and had worked so hard subsequently to get them. It didn’t matter. He couldn’t make a case, and it haunted him.

He walked back to his car. The fentanyl crisis in the Denver area and across the country was growing worse.

Later that week, Mason would announce that he was charging two suspected drug traffickers with the death of their 1-year-old. She had ingested 10 times the amount of fentanyl that would kill an adult.

How are we ever going to be able to stop this? Mason wondered.

If you or someone you know needs help with mental health or substance use issues, you can call the government’s National Helpline at 1 800 662-HELP(4357). You can also reach the National Suicide Prevention Lifeline at 988, or a crisis counselor by messaging the Crisis Text Line at 741741.

CORRECTION

An earlier version of this story incorrectly described the TruNarc device used by law enforcement to identify narcotics as a mass spectrometer. The device is a Raman spectrometer, which employs a different technology. The story has been edited to remove the words “mass spectrometer.”

About this story

Sari Horwitz and Meryl Kornfield reported from Commerce City, Colo. Nick Miroff and Steven Rich reported from Washington. Alice Crites and María Luisa Paúl also contributed to this report. Photography by Salwan Georges. Video by Jorge Ribas.

Design and development by Tyler Remmel. Additional design and development by Allison Mann, Laura Padilla Castellanos and Rekha Tenjarla. Graphics by Júlia Ledur and Aaron Steckelberg. Data analysis by Steven Rich. Video graphics by Sarah Hashemi.

Trish Wilson and Courtney Kan were the lead editors. Additional editing by Manuel Canales, Sarah Childress, Gilbert Dunkley, Chiqui Esteban, Christian Font, Meghan Hoyer, Jai-Leen James, Jessica Koscielniak, Thomas LeGro, Robert Miller and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Dunton, Jenna Lief, Osman Malik, Monika Mathur, Jordan Melendrez, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Data for the fentanyl death rates graphic is from the Centers for Disease Control and Prevention. Sources for the crime scene graphic are police reports, photos and interviews with family members and first responders. Sources for the mass overdose events box are the DEA, court documents, CBS 3 KMTV, Riverfront Times, Denver Gazette, Travis County Medical Examiner’s Office, Columbus Dispatch and Florida’s District 2 Medical Examiner’s Office.

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple data sets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House Office of National Drug Control Policy, by submitting a detailed research proposal to gain access.

By Mary Beth Sheridan and Nick Miroff 

MEXICO CITY — The small American surveillance plane took off from a Mexican navy base in Baja California and flew high across the Sea of Cortez. Charting a course for the Sierra Madre mountains — cartel territory — the aircraft did not appear on any flight trackers or public logs. An orb-shaped device about the size of a beach ball was mounted on the fuselage, bristling with sensors and antennas.

U.S. agents called it “the sniffer.”

The device was an experimental version of a mass spectrometer, used to identify chemicals. As the U.S. aircraft banked over the forested hills of Sinaloa state, it dipped lower, sampling the air for wafting fumes.

The sniffer, whose secret use in the skies over Mexico has never been reported, had been deployed by the Pentagon and the CIA to target heroin production sites in Afghanistan. By 2018, faced with deadly synthetic narcotics pouring across the U.S. border, the Drug Enforcement Administration, Customs and Border Protection and other U.S. agencies adapted it to go after Mexico’s clandestine drug labs, according to current and former American officials.

Waiting on the ground were the forces of the Americans’ most trusted ally in Mexico, a man more valuable to the DEA than any novel gadget. Adm. Marco Antonio Ortega Siu, the head of the navy special operations unit, had worked with the United States for nearly a decade.

Ortega Siu was known for his fearlessness — he and his men had taken down dozens of major traffickers, including Joaquín “El Chapo” Guzmán. But the admiral, a short, taciturn man with a shock of white hair, kept such a low profile that he was practically a ghost to the Mexican public. The Americans knew him by his code name, “El Águila.” The Eagle.

As the plane reached the target that day in August 2018, it confirmed a tip from DEA informants about the location of a lab. Once the surveillance was complete, Águila’s men swooped in.

Beneath dense foliage and plastic tarps, they found vats of solvents and barrels of precursor chemicals. Burlap sacks stuffed with methamphetamine filled 12-foot-deep pits. In all, they discovered an estimated 50 metric tons of crystal meth, one of the biggest seizures in Mexican history.

“It was incredible,” said Matt Donahue, who ran the DEA office in Mexico at the time. “We never thought meth could be produced in those amounts.”

The bust was a triumph for the tactical alliance between the United States and the Mexican navy’s special forces that for a decade had defined the nations’ anti-drug fight. It rested on a delicate division of labor. The United States provided technology and intelligence; Mexico furnished muscle and resolve.

Yet just months after the giant meth haul, that partnership began to unravel. A new Mexican leader rejected the $3 billion anti-narcotics agreement that had spanned three U.S. presidencies, known as the Mérida Initiative. Andrés Manuel López Obrador, a veteran leftist who took office in December 2018, argued that the drug war strategy had sent homicides spiraling in Mexico while failing to curb U.S. demand.

The sniffer flights stopped. Águila was sidelined and his battle-hardened commandos were reassigned. López Obrador rebuffed U.S. offers for new drug-detection technology. Mexico shut down a pivotal base where the special forces had worked with U.S. agents. It even took away the parking spot for the DEA’s plane at an airport outside Mexico City.

The fissure opened just as Mexico was poised to become the No. 1 supplier of fentanyl to the United States, overtaking China, according to the DEA.

This account, based on interviews with more than 30 current and former U.S. and Mexican officials, is the untold story of America’s most dependable drug war ally, and how the relationship with Mexico fell apart just as a river of synthetic drugs flooded the United States.

The Mexican admiral’s work was so sensitive that his full résumé remains a state secret. After months of negotiations with The Washington Post, Águila agreed to provide written answers to some questions.

He declined to comment on Mexico’s current security policies or the circumstances of his departure, saying he took an unpaid leave of absence in July 2019, and has been “helping my children with their daily lives.”

In the years since Águila left, traffickers have ruthlessly exploited the breakdown in bilateral cooperation, as they transitioned from plant-based drugs such as marijuana and heroin to deadlier synthetic narcotics.

U.S. fatalities from drug overdoses surpassed 107,000 in 2021, the highest ever. Two-thirds of the deaths involved fentanyl.

U.S. law enforcement agencies have confiscated more than 45,300 pounds of fentanyl through the first 11 months of this year, up from 5,800 pounds in 2018, according to a Post analysis of the latest government data. In November, U.S. authorities seized 2,900 pounds at the southern border, the highest monthly total ever.

Biden administration officials aren’t concealing their frustration. “Mexico needs to do more. We believe that they can do more,” DEA Administrator Anne Milgram said in an interview. “We think it’s vitally important that Mexico work on these issues as tirelessly as we do.”

The amount of fentanyl seized in Mexico is just 15 percent of what U.S. authorities confiscate, Milgram said.

“Extraditions from Mexico are down,” she added. “What is up is fentanyl. And what is up is fentanyl coming into the United States.”

Roberto Velasco, a senior Mexican Foreign Ministry official, countered that the previous strategy had “failed in the two main objectives” — to reduce violence in Mexico and curtail drug trafficking in both countries.

“We had an increase in deaths from fentanyl use, we had an increase in violence in Mexico, so this approach was evidently not successful, and obviously we weren’t successful in dismantling the criminal organizations that existed in the two countries,” Velasco said.

The governments hammered out a new agreement, putting more emphasis on fighting addiction and the illegal sale of U.S. guns to cartels. But it wasn’t announced until October 2021 — nearly three years after López Obrador became president.

Combating fentanyl would have been daunting under the best of circumstances, because it is so cheap to make and so easy to smuggle. But the U.S.-Mexico rupture made a difficult situation worse. The two governments have been unable to agree on even basic facts, such as whether Mexico is a major manufacturer of the opioid or mostly a transshipment point. The chill in relations has left DEA agents scrutinizing press releases to figure out the types of narcotics and precursor chemicals the Mexican military has seized.

Many drug war veterans blame López Obrador’s policies for the rift. Yet interviews in both countries reveal a more complicated picture.

The U.S.-Mexico security partnership was in trouble well before López Obrador took over. For a decade, the countries had promised to tackle two crucial sources of the drug crisis: Mexico’s weak justice system and Americans’ demand for powerful narcotics. Neither side met its mandate.

The result: The American effort to combat the flow of drugs had become more and more reliant on one man.

“Águila became the white knight. The favorite son,” said John Feeley, a former U.S. ambassador who was second-in-command at the U.S. Embassy in Mexico from 2009 to 2012. “Why? He delivered.”

Unlike many police and army officers, Águila didn’t appear to be in league with the very cartels he was supposed to be fighting. To the Americans, he seemed to be made of pure guts. He would sometimes accompany his men on raids, wielding his UMP45 submachine gun.

“He was the first guy through the door,” said Joe Evans, a former DEA director in Mexico. “He wasn’t like other forces, where the ‘jefe’ is sitting back in the office.”

Yet Águila worked in a country with a broken legal system, where less than 2 percent of crimes were ever solved. And by the time López Obrador took office, it was a country where 20 percent of national territory was under cartel control, according to CIA estimates obtained by The Post.

A country where relying on the military brought its own set of problems.

‘Never a leak’

The alliance with Águila got off to a bad start. In December 2009, he went to the DEA office in Mexico City to explain how one of the country’s most notorious drug traffickers had escaped.

“We screwed up,” Águila told the DEA, according to Evans, the agency’s regional chief at the time. “Give us another shot.”

For years, the DEA had been trying to bring down Arturo Beltrán Leyva, a wily kingpin who gunned down cops and bought off politicians. Evans had worked with Mexico’s powerful army as well as the federal police. But this time he’d taken a chance on the much-smaller Mexican navy — in particular, on a promising senior officer known as El Águila.

The DEA had gotten word that Beltrán Leyva was at a barbecue in Cuernavaca, south of Mexico City, Evans told the Mexican officer. The navy dispatched a heavily armed team, but the “Boss of the Bosses” slipped away.

“So we’re like: ‘Here we go again,’” recalled Evans, who assumed there’d been a leak. Águila persuaded Evans to give his men another chance.

Five days later, on Dec. 16, 2009, commandos rappelling from helicopters surrounded a luxury condo complex in Cuernavaca.

Bullets whizzed through the trafficker’s second-floor apartment, tearing holes the size of golf balls in the walls. A 30-year-old marine, Melquisedet Angulo, was hit by a grenade blast in a stairwell and slumped to the ground, fatally wounded. The gun battle lasted four hours, and when the fight was over, Beltrán Leyva and four of his bodyguards lay dead.

It was the biggest takedown since President Felipe Calderón had gone to war against the cartels in 2006, deploying tens of thousands of troops. Angulo was honored with a widely publicized hero’s funeral.

Hours later, gangsters hunted down and killed Angulo’s mother, two siblings and aunt. U.S. agents were horrified. For the Mexican forces, the incident laid bare that it would be a war without military parades and public honors. They would have to fight the cartels from the shadows. “We had to adapt and adjust,” Águila said.

Organized-crime groups were carrying out acts of spectacular violence and growing savagery, ambushing military and police convoys on rural highways and filling mass graves with travelers hauled off buses. U.S. officials grew alarmed as violence exploded in Monterrey and other northern Mexico cities where Fortune 500 companies had invested heavily in plants and factories after passage of the North American Free Trade Agreement.

With the threat to the stability of the Mexican government worsening, both countries were hungry for a crime fighter who could stand up to the cartels.

Using informants, wiretaps and surveillance, U.S. agents tracked drug bosses and relayed their locations to Águila’s commandos for the kind of “high-value target” operations the Americans used successfully in Iraq and Afghanistan.

Águila’s forces didn’t hold back. Mexican commandos in helicopters took out Gulf cartel boss Antonio Cárdenas Guillén, a.k.a. “Tony Tormenta,” in a wild urban gun battle in 2010 that left bodies scattered in the border city of Matamoros. Two years later, special forces killed the leader of the Zetas, Heriberto “The Executioner” Lazcano, after a firefight against cartel gunmen wielding a grenade launcher.

“Tactically, they were just awesome,” Evans said. But the special forces were trained to kill, not to make arrests and gather evidence for criminal prosecution. Their targets were extremely dangerous, but Evans would offer a “friendly reminder” that from time to time “it might be good to bring the guy back alive.”

In his response to The Post, Águila wrote that drug bosses were killed because they resisted arrest. “We never planned an operation to eliminate anyone,” he wrote.

To the Americans, the navy commandos seemed to be the rare entity capable of quickly launching complex, dangerous operations. Águila was indefatigable, working 16-hour days. He didn’t drink or smoke. And when U.S. agents shared sensitive information, Águila and his commandos acted fast — unlike the army. “There was never a leak,” Evans said.

One DEA agent recalled following Águila, then in his 50s, as he bounded off a helicopter during a hunt for a drug kingpin in northern Mexico. “I’m trying to catch up to him,” recalled the agent, who was not authorized to comment on the record. “I was embarrassed. Here I am, this younger buck, fumbling with my stuff.”

Even more startling: The Mexican officer wasn’t wearing a bulletproof vest. He rarely did; it was too bulky. “He had no fear,” the American agent said.

The DEA agents knew little about Águila’s personal life or why he didn’t seem tainted by some of the worst aspects of Mexican officialdom — the corruption, the timidity, the wariness of foreigners. Maybe, they figured, he was a kindred spirit.

“He’s blue-collar,” said Donahue, the former Mexico DEA chief. “Just like us.”

Indeed, the admiral was the son of a small-town salesman in Mexico’s southern Veracruz state, and the grandson of Chinese immigrants. “My family fought to get ahead every day,” Águila said in his written responses.

He entered the Heroic Naval Military School in 1975, a shy, diminutive 15-year-old in a world of “juniors” — sons of high-ranking officers. The academy was so rigorous that half his class of 150 dropped out before graduation, recalled a former classmate, retired Rear Adm. Jesús Canchola Camarena. Águila joined the marines, like other young men “drawn to adventure,” Canchola recalled. But what stood out was the young cadet’s leadership; he often served as coach in the students’ informal wrestling matches. He eventually became a decorated helicopter pilot.

Later, under Calderón, when the navy sought senior officers to build a top-flight special forces corps, many were reluctant, recalled another of Águila’s former classmates.

“It was very, very risky,” he recalled, speaking on the condition of anonymity to be frank. “The navy had to protect itself from everyone” — both drug traffickers and their allies in government.

Águila was undaunted.

“He felt that if they called on him, and he had the ability, he should do it,” the friend said.

Águila’s forces racked up an astonishing record. They dismantled the upper ranks of the Zetas, a vicious group dominated by former army special forces soldiers. In February 2014, they captured El Chapo, working with U.S. agents who had cracked the drug lord’s encrypted phone network.

The Sinaloa cartel leader tunneled his way out of prison the following year, and was hunted down by Águila’s commandos and caught again in 2016.

Águila declined to comment on which operations he led personally, citing security reasons. His special operations force grew to several thousand commandos, whom he hand-picked. “The level of training of our teams became the best in the world,” he said.

In 2017, guided by a U.S. Predator drone, Águila’s special forces parachuted into a mountain redoubt to capture a suspect wanted in the killing of U.S. Border Patrol agent Brian Terry. The late-night operation, executed with skilled precision, wowed U.S. officials and cemented Águila’s reputation as a heroic ally.

Despite the tactical wins, lasting victory in the drug war was elusive. U.S. demand for narcotics was growing. A DEA crackdown on U.S. opioid manufacturers and distributors left a vacuum that was filled with Mexican heroin, and then fentanyl. Plans to reform the Mexican justice system had stalled because of a lack of funding, as well as pushback from politicians and judges.

“The hard part is that, after you catch a bad guy, you have to pass him to the legal system,” said a retired naval officer who had worked with Águila, speaking on the condition of anonymity because of political sensitivities. “And it’s rotten.”

For all the commandos’ bravado, they were painfully vulnerable. When they left their bases, they’d sometimes hear a whirring sound above: drones, sent by the narcos to track their movements. They got used to attending funerals for comrades.

“The pain never goes away,” Águila said. “We carry their families on our shoulders.”

At one point, cartel assailants fatally shot a U.S.-trained navy commando nicknamed “Máquina” (Machine). Máquina was a favorite of the DEA agents, a rising star who spoke excellent English. The American agents were desolate.

“We lose people all the time,” a former agent recalled Águila saying. He told everyone to get back to work.

‘A vicious circle’

President Donald Trump didn’t mince words when he got on the phone with Mexican President Enrique Peña Nieto on Jan. 27, 2017.

Mexico wasn’t doing enough about its “tough hombres,” Trump told him, according to a transcript of the call. “Maybe your military is afraid of them,” he said, “but our military is not afraid of them.” Mexican media buzzed with reports that Trump was threatening to send U.S. troops.

Two weeks later, a Mexican navy helicopter clattered through the humid night air of Tepic, capital of the western state of Nayarit. It paused over a three-story house, casting a spotlight below. Then, as startled neighbors watched, the helicopter’s .50-caliber machine gun opened up with a roar of bullets.

Juan Patrón Sánchez — a protege of the Beltrán Leyva trafficking family — became the latest kingpin to die at the hands of Águila’s men.

Cellphone videos of the attack pinged around social media, along with questions about why the military was using so much force. The navy said it was necessary: Patrón Sánchez’s bodyguards had been using the third floor as a sniper’s nest, to pick off the special forces troops in the street. That explanation didn’t satisfy Mexico’s future president.

“Why did they annihilate them [the bodyguards]? Why, if they investigate, and supposedly have foreign intelligence assistance, do they massacre them?” López Obrador asked in a speech in Nayarit the next day. He demanded to know whether the operation was carried out to appease Trump.

The Mexican politician wasn’t the only one asking questions. The U.S. Justice Department investigated an allegation that Águila had set out to kill Patrón Sánchez because the cartel leader had information on army corruption, according to four U.S. officials who had direct knowledge of the probe.

The accusation came from Edgar Veytia, a former Nayarit state attorney general arrested at the U.S. border in March 2017 on drug-trafficking charges. The investigation into Águila was ultimately closed because of questions about Veytia’s credibility, said the officials, most of whom spoke on the condition of anonymity because of the sensitivity of the issue. Veytia’s allegations were reported last week in a ProPublica-New York Times investigation.

“We never saw any direct information or evidence” that Águila had committed abuses in the operation, said Paul Craine, who led the DEA office in Mexico until 2017.

Veytia is serving a 20-year sentence in U.S. federal prison.

The Nayarit episode added to the concerns of politicians, human rights activists and academics about the U.S.-backed security strategy. More than 100,000 people had been killed in drug-related violence since the start of Calderón’s term in 2006. Human rights complaints had soared. Most focused on the army. But the navy had its scandals, too.

Then, in early 2018, people started disappearing in Nuevo Laredo, a gritty trade hub across from Laredo, Tex.

A father of two was hauled out of a mechanic’s shop on Feb. 3. His body was found in a field the next day. A few weeks later, two young men went out for a nighttime drive, then vanished after being detained. In late May, U.N. human rights chief Zeid Ra’ad Al Hussein went public with his alarm. His investigators had documented 23 disappearances in just four months. The culprits, he said, appeared to belong to a “federal security force.”

He didn’t elaborate, but everyone knew who had been deployed to Nuevo Laredo: Águila’s commandos.

The navy responded by reassigning some of its forces while multiple investigations were launched. The case would haunt Águila for years.

The DEA had other worries. Methamphetamine seizures at the U.S. border were soaring. U.S. agents had identified a second, more ominous trend: Traffickers were pressing fentanyl into pills resembling popular oxycodone tablets, rather than simply selling the powder as a booster for heroin. And the potential market of people misusing prescription medications was “almost 10 times that of the heroin user population,” the DEA warned.

As the flow of synthetic drugs intensified, DEA agents in Mexico got a lucky break. Informants turned up at a DEA office in the United States, offering the locations of numerous meth labs in Mexico.

U.S. agents working with Águila got a green light from the Mexican military to run the sniffer flights and drone surveillance, according to two former U.S. officials who spoke on the condition of anonymity to discuss the operations.

The navy special forces blitzed a string of superlabs, uncovering the 50-ton cache on Aug. 16 and an additional 36 tons within days, according to navy press releases. Figures maintained by the DEA were even higher: 128 metric tons — more than what U.S. authorities typically confiscate along the Mexico border in a whole year.

U.S. and Mexican officials celebrated as they viewed videos and photos of the seizure.

Yet, on closer inspection, the raids underscored the limits of the partnership. The operations didn’t lead to a single arrest. The mega-busts never appeared in the Mexican government’s drug seizure statistics, according to data obtained through Mexico’s freedom-of-information system.

The reason? No one from the Mexican attorney general’s office was ever summoned to weigh and analyze the drugs and open an investigation, two navy officials confirmed. In the end, Águila’s men simply destroyed the methamphetamines.

The lack of follow-up from the justice system was a common problem. “What are the repercussions of this?” asked Josué Ángel González Torres, a former Mexican security official. “What we have every day: More than 90 percent of crimes are never punished.”

With little fear of arrest, he said, drug traffickers simply build new labs and shrug off their losses. “It’s a vicious circle.”

‘Hugs, not bullets’

By late 2018, Águila was one of the navy’s most decorated admirals, honored with numerous awards from both the United States and Mexico. Yet his position was increasingly tenuous.

López Obrador had won the presidency that July. As his aides considered candidates for navy secretary, they heard concerns about Águila and his force’s aggressive tactics.

“Ortega Siu was relentless. But he made mistakes,” said Raúl Benítez, a national security expert with deep ties to the navy who teaches at the National Autonomous University of Mexico. That was especially true in Nuevo Laredo, where egregious human rights violations occurred, he said.

There was a second strike against Águila. The incoming president didn’t want the armed forces “subordinated” to foreign countries, he told the leftist daily La Jornada.

“This is an error that the navy committed in recent years,” López Obrador said. “We’re going to fix that.”

The era of spectacular kingpin busts was over, he pledged. Instead, Mexico would focus on fighting the government corruption that enabled organized crime to thrive. People would be lured from crime by jobs and educational opportunities. He dubbed his policy “hugs, not bullets.”

Navy special forces troops were reassigned to the coasts. Águila was replaced as special operations chief.

Mexico’s presidential spokesman, Jesús Ramírez, said the move was part of the “normal changes” of a new administration.

In Sinaloa, Águila’s men dismantled the makeshift base they had used for key operations like the Chapo arrest and the meth busts.

“They were instructed to stop working with us,” said Donahue, the former regional DEA chief. “And then that unit was disbanded.”

The DEA losses began piling up. The Mexican government dissolved the federal police. They were replaced by a new national guard, whose leader had no interest in U.S. training or a DEA liaison unit. The sniffer flights ended.

The U.S. agents thought López Obrador “would take out a room here, a room there — not demolish the whole house,” said another retired DEA official who had worked in Mexico. He spoke on the condition of anonymity because his current employer still does business with the agency.

The pullback went beyond the DEA. Amid a broad austerity drive, the Mexican government slashed the staff in the U.S.-based liaison offices of Mexico’s police, attorney general’s office, and tax and customs agencies. Mexico removed its team from the National Targeting Center in Sterling, Va., where U.S. officials tracked planes and ships suspected of transporting drugs as well as suspicious travelers. Extraditions of Mexican suspects to the United States slowed.

Some U.S. diplomats thought López Obrador had an instinctive mistrust of American technology. He rejected a U.S. offer to provide six giant X-ray scanners to look for drugs in trucks crossing the U.S. border. Also nixed were handheld detectors for port authorities to identify narcotics or chemicals used in the production of synthetic drugs. Millions of dollars in anti-drug aid for Mexico was returned to the U.S. Treasury.

For the new Mexican president, sovereignty was the bigger concern. His team was astonished to discover how much the U.S. government quietly pulled levers in the country. For example, U.S. officials were training police, prosecutors and prison officials in Mexican states — many led by López Obrador’s opponents.

The Mexican government didn’t have a clear picture of what the United States was up to, according to Martha Bárcena, who was López Obrador’s ambassador to Washington at the time. And there was no process to jointly evaluate how effective the programs were.

A U.S. official involved in the program denied that the federal government was kept out of the loop, or that there was any “political map” for distributing the aid. Velasco, the Foreign Ministry official, said the incoming government had realized that some equipment donated by the United States was barely used because of maintenance and training problems. “We wanted to analyze more closely what we were doing” before accepting more, he said.

The DEA and U.S. congressional investigators would later conclude that 2019 — López Obrador’s first year in office — was when Mexico became the top source of fentanyl reaching the United States, as its cartels took advantage of a crackdown in China.

Yet the Mexicans weren’t the only ones who missed signs of the looming crisis. Trump’s priority was to slow migration and build a border wall, not fight narcotics trafficking. To the frustration of Mexican officials, he named three interim DEA directors during his tenure.

“What we should have been doing was continuing to focus on drugs, and in practice, it shifted to other aspects of border management, even before López Obrador came in,” said Earl Anthony Wayne, U.S. ambassador to Mexico from 2011 to 2015.

Less than a year into López Obrador’s term, his strategy suddenly seemed to take a tougher turn. On Oct. 17, 2019, soldiers and police surrounded a posh townhouse in the Sinaloan capital, Culiacán, and detained Ovidio Guzmán, one of El Chapo’s sons. He was one of the top traffickers of fentanyl and meth to the United States, according to Mexican officials. The U.S. government was requesting his extradition.

It was the kind of operation that Águila would have led before 2019. But this time, the Mexican army was in charge. Its soldiers had no search warrant. As they waited for the paperwork, hundreds of cartel gunmen streamed into the city, some wielding .50-caliber rifles that fired armor-piercing bullets the size of carrots.

Gunmen blocked roads to the airport, preventing the army from flying in reinforcements. The operations base built by Águila had been dismantled. Fearing an all-out battle that could leave hundreds dead, López Obrador told army commanders to let Guzmán go. He remains a fugitive.

“Ovidio’s escape was the first indication of [López Obrador’s] level of commitment and what costs they were willing to endure to get high-level criminals,” said one high-ranking U.S. official, who spoke on the condition of anonymity to speak frankly about tensions with Mexico. “If they had gone with the marines, it might have been different.”

Mexican officials have denied they’re less committed to the security partnership. “We’ve continued to work very closely with the United States,” Velasco said, including on the detention of important traffickers.

By that December, U.S. Attorney General William P. Barr was getting worried. “I felt the Mexicans were dragging their feet,” he said in an interview. He flew to Mexico City to press for more cooperation, including a greater effort to target fentanyl labs. Within weeks, the navy special forces had returned to the forefront of the anti-drug effort.

The coronavirus pandemic hampered the U.S. effort to restart cooperation, but it was an arrest in a DEA case in October 2020 that nearly severed the relationship.

Salvador Cienfuegos, a former defense minister, was detained as he arrived at Los Angeles International Airport on vacation. U.S.-based DEA agents had been investigating the 72-year-old on allegations he worked with drug traffickers during his term from 2012 to 2018.

Mexico’s army leadership was livid. López Obrador had become more dependent on the military for everything from fighting crime groups to building airports. He accused the DEA of relying on flimsy evidence and questioned whether the agency was trying to weaken the Mexican government or its armed forces.

Barr, alarmed that cooperation with Mexico could tank again, agreed to let Cienfuegos return to Mexico in November 2020.

But the damage was done. Mexico’s National Congress passed a law limiting U.S. law enforcement agencies’ access to Mexican officials at all levels. As seizures of fentanyl on the U.S. border rose, the Mexican government held up visas for more than 20 DEA agents.

‘Out of gas’

While on leave from the navy, Águila opened his own private security company in an upscale neighborhood of Mexico City. Only a select clientele knew of it; the firm’s name wasn’t even listed on the directory in the lobby.

But the past wouldn’t go away.

In 2020, the Mexican government’s human rights commission issued a blistering 331-page report examining 26 disappearances in Nuevo Laredo during a six-month stint by the navy special forces. The report didn’t mention names, referring to officials by letters and numbers. It urged federal prosecutors to investigate special forces personnel in the kidnappings — including their commander, “AR-1.”

El Águila.

The number of disappearances would eventually grow to 47. The cases crawled through Mexico’s justice system. By 2022, only four of the kidnappings had led to indictments, and even those ran into trouble. A judge tossed out charges against 23 navy personnel, citing a lack of evidence, and left just seven suspects in jail.

Águila was not charged. The human rights report said he had accompanied special forces troops on a patrol on May 21, 2018, during which they allegedly detained a young man who subsequently disappeared. The navy said its forces had engaged in a firefight with gunmen, who then fled.

Asked about the disappearances, Águila said he was “confident the judicial processes will clarify these incidents properly.”

While no one was convicted in the disappearances, the navy last year issued a rare formal apology to the victims’ families.

It was not the end of Águila’s legal troubles.

In August 2022, a government Truth Commission concluded that a second scandal, the 2014 disappearance of 43 students attending the Ayotzinapa teachers college, had been a “crime of state” involving the army, police and politicians. A vast array of security officials were involved in a subsequent coverup organized by Peña Nieto’s administration, it said, and one of them was Águila. It provided no details of his alleged role and he has not been charged. The navy has denied any illegal actions.

The legacy of the U.S.-Mexican “kingpin strategy” was mixed. Águila’s commandos had smashed several powerful cartels, but the captures did not significantly reduce the supply of drugs or the death toll in Mexico. Old mafia groups fragmented and reemerged under different names, adapting their tactics to stay a step ahead.

U.S. officials say there was little more they could have done to weaken the traffickers, especially given Mexico’s unwillingness to invest more in its justice and security sectors, and to break the links between politicians and crime groups.

“We were too dependent on Águila, but we didn’t have good alternatives,” said Roberta Jacobson, who worked with the admiral when she was U.S. ambassador to Mexico from 2016 to 2018.

Yet both sides have acknowledged that the two countries failed to live up to their promises under the Mérida Initiative. While Mexico and the United States built a robust economic partnership, there was no equivalent of NAFTA for security.

The Mexican government had been heartened when President Barack Obama framed his drug strategy as “co-responsibility” — recognizing the role of U.S. narcotics demand. “This was seen as a significant achievement in Mexico,” said Alfonso Motta-Allen, a security analyst and former Mexican diplomat. But, he said, “it was just talk. The lack of trust remained.”

While Trump squarely blamed Mexican cartels for the flood of narcotics reaching the United States, his ambassador to Mexico City, Christopher Landau, came to believe that reducing U.S. consumption of drugs was fundamental. U.S. authorities have seen a boom in the supply of fentanyl and a corresponding surge in overdose deaths, but federal health agencies do not know how many Americans are using the deadly opioid. Major federal programs that monitored drug use were eliminated in the years before the crisis hit U.S. streets.

“If the success of our counternarcotics strategy depends on Mexican law enforcement, we are in trouble,” he said. “They do not have a functional criminal justice system.”

Mexican officials say López Obrador’s strategy has succeeded in turning around steep annual increases in homicides. They note that Mexico is confiscating more fentanyl than ever. In early July, the army and national guard seized a half-ton of the opioid from a warehouse, the largest such bust in history. The president has put the navy in charge of ports to crack down on illegal shipments of precursor chemicals for drugs.

Yet even with the new agreement, known as the Bicentennial Framework, the two sides don’t share a basic understanding of the fentanyl trade.

“Fentanyl consumed in the United States doesn’t come only — or mostly — from Mexican territory,” Ricardo Mejía, Mexico’s undersecretary for public security, said in an interview.

U.S. agents say otherwise, pointing to significant busts in Mexico of precursor chemicals used to make fentanyl and the soaring quantities of powder and pills seized along the U.S. southern border.

“If there are more chemicals coming from China and more fentanyl is being produced, the Mexican government and Mexican authorities will have to do more to stop that from happening,” said the DEA’s Milgram. “The vast, vast majority of fentanyl is coming from Mexico and is attributable to the Sinaloa and [Jalisco] cartels.”

After four years, López Obrador’s promise to refocus Mexico’s security strategy on social programs hasn’t weakened the grip of armed groups. He has increasingly turned to Mexico’s military to fight organized crime.

In an echo of the past, the navy special forces have returned to targeting cartel leaders. In July, after a nine-year manhunt, they captured one of the most storied kingpins — Rafael Caro Quintero, wanted in the 1985 killing of a DEA agent.

American drug-war veterans texted one another the stunning news: The raid was led by Águila’s old team.

But the enthusiasm was short-lived. A navy Black Hawk helicopter crashed during the operation, killing 14 commandos.

The López Obrador government said the aircraft ran out of gas.

About this story

Mary Beth Sheridan reported from Mexico City and Nick Miroff reported from Washington. Steven Rich, Alejandra Ibarra Chaoul and Gabriela Martinez also contributed to this report.

Design and development by Tyler Remmel. Additional design and development by Allison Mann, Laura Padilla Castellanos and Rekha Tenjarla. Data analysis by Steven Rich. Photo research by Robert Miller. Video editing by Jorge Ribas.

Trish Wilson, Jeff Leen and Courtney Kan were the lead editors. Additional editing by Christian Font, Meghan Hoyer, Jai-Leen James, Jessica Koscielniak, Frances Moody and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Childress, Sarah Dunton, Jenna Lief, Monika Mathur, Jordan Melendrez, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the Unites States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple datasets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House’s drug czar, by submitting a detailed research proposal to gain access.

Three worlds overlap in Mexico’s new fentanyl capital, where violence and synthetic drugs are bound dangerously together. Addicts, journalists and police navigate a city in disarray.

By Kevin Sieff, Salwan Georges, Erin Patrick O'Connor and Rekha Tenjarla 

A dried-up canal slices through the heart of Tijuana, a streak of negative space in a city where every other square foot appears to be claimed. The canalización, as people call it, is a place now emblematic of the city's ills, an underworld in plain sight. The headlines are daily:

"Another homicide in the canalización."

"A boy executed in the canalización, in front of Costco."

"More than a thousand people found living in the canalización."

The chaos has spilled outward across Tijuana. There have been 1,900 homicides here this year so far, making it the deadliest city in Mexico. It is a place where language has adapted to new forms of violence, macabre and hyper-specific. The word "encobijado," for instance: a murder victim wrapped in a blanket.

Propelling that violence is a shift in the drug trade. Tijuana has long been a major transit point for illicit goods into the United States: alcohol during Prohibition, waves of marijuana and cocaine after that. Now, it is a city of fentanyl. It is the most prolific trafficking hub into the United States for the drug and, increasingly, a city of users.

It is their lifeless bodies that paramedics find on the streets. They are just as frequently victims of overdoses as violence. The turf war between local drug dealers has provoked a nightly shock of killings.

The crisis has penetrated unlikely parts of Tijuana. Fentanyl labs have been disguised as piñata shops. Traffickers have turned modern townhouses into drug warehouses.

Men emerge, zombielike, between downtown restaurants, seeking available drugs wherever they can find them.

Chapter 1: José

He woke up next to a pile of trash two blocks from the U.S.-Mexico border, on a patch of sidewalk that has been claimed by this city's fentanyl addicts, almost all of them deportees from the United States.

José González folded his blanket on the concrete and checked to see whether anything had been stolen from him while he slept. Most of the men around him — he's careful not to call them friends — had already taken their first hit of the day. They stared blankly ahead or at the ground, oblivious while José inventoried his things.

"This goddamn place," he said.

José had been the starting right tackle at Redlands High School outside of San Bernardino, Calif., a teenager who had passed as all-American until his friends learned that he was undocumented, brought to the United States as a 4-year-old. By the time he was deported at 23 for selling drugs, he had a girlfriend and a daughter in San Bernardino. His English was far better than his Spanish.

Not that anyone in Tijuana cared about his biography. Not the cops, who had arrested him 12 times for violations as minor as loitering, sending him to jail for a day or two at a time. Not his junkie neighbors, who had once again, it seemed, stolen his stuff while he slept.

He had remained here after being deported in 2013 to be close to his daughter in California. He kicked his drug habit. He got a job at a call center. He bought a closet full of button-down shirts.

But after a few months — alone and depressed — he began using again. At first, it was a few hits of heroin every few days before work. By 2020, though, fentanyl had displaced almost every other drug in Tijuana.

The first time he tried fentanyl had been a revelation; a shimmering crack in the universe into which he tumbled. Since then, addiction had reordered his life. He sometimes spoke of his own descent as if it were happening to someone else, a vortex of bad decisions that at 32 he couldn't pull himself out of.

"Why would my daughter want to visit her drug addict father?" he asked. She had visited him once and never came back. "What the hell am I doing here?"

It was a Friday morning. Children in their school uniforms walked by José's encampment on their way to school. He had just enough fentanyl to avoid the ache of withdrawal. Because he'd run out of visible veins, he asked a friend to inject the needle in his neck. He bent down to receive it and put his hands on his knees while the high rushed in.

In another five hours, he would be strung out, hurting for another hit. He needed to make 100 pesos (about $5) to buy enough drugs to fill another syringe. He started loading his backpack full of scavenged items to sell in downtown Tijuana: iPhone cases, a calculator, a dictionary, a used pair of shorts.

Every day was the same cycle, a hustle he had regimented. Make enough cash to buy drugs; do the drugs; maybe find some food; start over again. This day was no different.

Except it happened to be a particularly hot one, and the smell of trash wafted over José's patch of sidewalk.

Except he was losing weight, his pants slipping off his waist.

Except for a more immediate problem: what José had for sale — much of it was garbage.

He threw on his black backpack, its zipper broken, and walked past the row of encampments that have sprung up on the outskirts of downtown Tijuana. A block of strip clubs and bars glittered in the distance.

His best chance at earning the 100 pesos, he thought, was a Victoria's Secret pouch he had found with some skin-care products. The words "Love Made Me Do It" were scrawled below the zipper. He headed to a block lined with prostitutes and presented it to the women, who fanned themselves in the shade. Most of them shook their heads at José's attempt. Some just stared ahead blankly.

"They think they're too good for me," he said. "But I'm offering them a really good deal."

He walked across the street and carefully arranged his wares on a black tarp. He pulled out used medical goggles, an extension cord, watch bands, an array of used phone cases. Around him, other people had set up their own items for sale.

A young man came up to him.

"You know where I can score?" he asked.

José could tell he was a meth user, so he told the man where the meth dealers worked.

He had come to know the city's panorama of addicts: where different kinds of junkies scored their drugs, how to treat them if they overdosed. It happened all the time.

He had saved four people from fentanyl overdoses by using naloxone, a medication that reverses the effect of opioids. It is regulated as a controlled substance by the Mexican government and is almost impossible to find legally outside of several hospitals. But American nongovernmental organizations began smuggling it into Tijuana as overdoses mounted.

José usually kept a bottle in his pocket. Even though he had built up a tolerance to fentanyl, he knew one day he might be the one who needed to be revived.

Hours passed with barely any customer interest. He could feel his body asking for another hit. He decided to return to his encampment for a few items he had left behind, hoping they would improve his sale. He packed everything up. Walking back, he started to feel worse.

José paused at an intersection, his forehead dotted with sweat.

"I don't know what the f--- to do," he said.

"Sometimes I just want to turn myself into a rehab. I'm getting tired of this."

He scratched his left forearm, with the tattoo of his daughter's face as a 4-year-old, when he last saw her. She was 12 now. A different person, he thought.

He kept walking, now a little slower, trying to sell a few things on the way back to his block. A woman stopped him, introduced herself and asked a question.

"Why do you need the money?"

"To be honest," he said, "for a cure," referring to the fentanyl hit.

"You're too young to be using," she said. "You know, they have meetings to help people with problems like that, three times a week."

José thanked her and started walking away. It was the kind of intervention that rarely occurred in this part of Tijuana.

He said her name out loud: "Beatriz."

"Everything happens for a reason," he said, "even meeting her."

He had tried twice to get clean, but maybe, he thought, it was time to try again.

Or he could work the streets again, trying to sell more stuff. He could let the universe decide if he deserved another hit.

"Everything happens for a reason," he said again, even though it was rarely clear what the reason was.

Chapter 2: The journalists

The text message came from a source in the local police: A car was burning along the Tijuana highway that traces the Pacific Ocean. There was a body in the back seat — another apparent homicide.

Inés García Ramos received the tips multiple times a day as the editor of Punto Norte, one of the city's only independent newspapers. She chronicled the drumbeat of violent crimes carried out not just to kill, but to impress and intimidate. It was as if the murderers of Tijuana were competing against one another to see who could commit the most gruesome acts.

García, 33, was born in Los Angeles, but grew up here, the daughter of a hairdresser whose clients were the wives and girlfriends of the city's drug-trafficking elite. Making sense of Tijuana's spasm of violence became her central journalistic objective.

"Is there anything else you want to do?" García's mother pleaded.

There still wasn't.

And so, just before sunset, she drove toward the burning SUV. She parked on the side of the highway. Then García inched closer, until she could make out the charred body in the back seat. She took out her cellphone and began broadcasting on Facebook Live.

"This is the 1,569th murder this year," she said.

Her viewers shot messages back asking for more details. Some of them had relatives who had disappeared and were wondering if the victim might be their loved one.

"So far we don't have any details on the deceased," García told her audience.

What she didn't say: Most likely, she never would. The killing would almost certainly not be solved; only about 2 percent of crimes in Mexico are each year.

But García had her own explanation for the city's soaring homicide rate. She had watched as the spike in violent crime mirrored the surge in the trafficking of synthetic drugs. She had written about how large quantities of fentanyl remained on this side of the border, too, turning swaths of the city into open-air drug markets.

The violence and the drugs — she was sure they were connected. For over a year, she had been looking for a way to document that link. García dispatched Punto Norte photojournalists across Tijuana to investigate the city's wave of crime.

Arturo Rosales and Margarito Martínez Esquivel photographed the city nearly every night, chronicling the nonstop violence after sunset.

Martínez was Punto Norte's first photographer. He started shooting crime scenes by accident in 2003, snapping a few photos of a killing he happened upon. It was a natural fit: Martínez quickly became the heart of the city's press corps, his camera always in the passenger seat. Rosales was a taxi driver who learned from Martínez, publishing his photos on Facebook until he got his own contract.

In January, at 49, Martínez was killed. He was gunned down while he sat in his beige Ford Escort outside his home. Witnesses saw a man shoot him and flee the scene. Martínez's wife and teenage daughter found him lying on the ground.

The slaying marked the beginning of another year of historic violence for Mexican journalists. Since 2019, 50 journalists have been killed in Mexico, making it the most dangerous country in the world for media workers.

The day after the killing, García and her colleagues gathered in their unmarked newsroom above a shop selling quinceañera dresses. An undercover security guard monitored the perimeter.

They decided they needed to find out who was behind Martínez's death.

Their run of coverage began in January when García and her colleagues published a story about the gun used to kill Martínez, tracing it to several other homicides across the city.

"The 9mm pistol that took his life had been used in various crimes related to territorial disputes between drug dealers," the Punto Norte team wrote, "and used by criminals who had been detained over and over again, but were set free to continue committing homicides."

In Martínez's slaying, the journalists saw a concrete example of how drug trafficking, drug use and soaring violence were all linked.

In March, at the first hearing in Martínez's case, García was the only journalist in attendance. The prosecutor read aloud the text message exchange between the men who allegedly ordered Martínez's killing, a criminal network that reported to David López Jiménez, known as "El Cabo 20," who had been affiliated with the Arellano Félix and Jalisco New Generation cartels.

"I need a soldier to commit murder," José Heriberto, one of López Jiménez's affiliates, said in a message. "He'll be paid 20,000 pesos [about $1,000]."

Listening to the messages, García noticed that the men ordering Martínez's killing kept two conversations open at the same time. One was about the homicide, and the other was about drug dealing.

"Today is Saturday, a good day for sales," Christian Adán, another member of the group, wrote to Heriberto, referring to their local drug business.

Then the conversation immediately returned to the killing.

"Send me Margarito's location," Heriberto responded.

García stopped taking notes and sighed.

"It just shows you how closely these two crimes are linked," she said. "Selling drugs and killing people."

She had seen more proof of that link in February, when Mexican authorities arrested 10 suspects in the case. In the same raid, they also seized a stash of drugs that included cocaine, heroin and methamphetamines.

López Jiménez, she learned, had been detained and released six times before he allegedly arranged Martínez's killing, a case study in the way the judicial system cowers before powerful criminals. Four of those arrests were related to selling drugs, including a charge that he had operated a drug laboratory in central Tijuana. He was arrested in August for arms possession; prosecutors later said he was responsible for Martínez's killing.

There was something both satisfying and heart-rending about getting to the bottom of the crime, García said. It happened so rarely in Mexico. Prosecutors appeared to take Martínez's case more seriously because of the amount of attention it received, including from the U.S. government.

The case is ongoing, but the court dates are infrequent. García's days are once again consumed mostly by routine crime coverage, like the story of the charred corpse in the back of the SUV.

After she ended her Facebook Live segment, the waves crashing behind her, García ran through the possibilities of what happened to the victim in the back seat. Maybe it was the violent end to a lover's quarrel. Or a drug dealer deposing his rival.

She would try to follow up with her sources the next day. She would try to get more details on the crime.

But by then, she knew, there would be another homicide to cover; another alert on the police scanner of an overdose death; another load of synthetic drugs seized at the scene of another violent assault, never to be solved.

Chapter 3: The federal agents

The drugs arrived in a garage in an upscale Tijuana neighborhood, blocks of crystal meth wrapped in plastic in the bed of a pickup truck, kitchen containers of fentanyl in the back seat.

"Where does this stuff go?" asked one of the movers, clutching a tower of plastic containers with "fentanyl" scrawled in black marker on the side.

He was an agent from the Mexican attorney general's office, responsible for seizing and holding drugs.

He took a deep breath. The smell from inside the garage was overpowering — enough to knock out a first-timer. It was already full of thousands of pounds of fentanyl, meth, marijuana and heroin.

"Oof," he grunted.

But there was a more immediate problem for the movers. There was barely any room for the newest load.

The drugs arrive there almost every day from the clandestine laboratories and stash houses that now pepper Tijuana. Others were manufactured farther south, in the state of Sinaloa, and were moved through the city on their way to the border.

The government's garage of seized narcotics, federal authorities say, is proof of their efforts to stop the flow of drugs and secure evidence for ongoing trials. It fills so quickly that once a month, to make more room, they take thousands of pounds of drugs to a desolate military outpost and set them on fire.

But the fire is as much a spectacle as it is a way to destroy drugs. Local journalists are invited to photograph the agents, who pose in front of the flames.

García has gone several times, watching a plume of narco-smoke rise over the city. Each time, she wondered: "Who are these images meant for?"

Were they an attempt to assure the citizens of Tijuana or prove to the Americans that Mexico was stemming the flow of drugs?

The shift in fentanyl production from China to Mexico in the past several years has flooded the border with synthetic drugs. Seizing labs and narcotics would be a monumental task for any law enforcement agency. But in parts of Mexico, where organized crime often has more power than the government, the more important question has become: Are authorities even trying?

In almost no time, after each incineration, the garage is full again.

And the cartels know exactly where it is. Members of the Jalisco New Generation cartel last year released a video of several gunmen driving by the warehouse. One of them held a gold-plated rifle. It quickly went viral.

"We're in Tijuana, sons of bitches," they said. "We're hunting you down, sons of bitches."

On four separate high-profile raids, Washington Post reporters watched as Mexican authorities arrived at the alleged homes of fentanyl traffickers and manufacturers, only to find them empty.

"The target left for Sinaloa yesterday apparently," said one agent, walking back to his car after the most recent of those failed busts, in October.

On their better days, the agents sometimes find pill presses imported from China and barrels full of chemicals used to make fentanyl. The pill presses aren't illegal; many of them are purchased on the Chinese retail website Alibaba.

After they're seized, authorities send them to the same warehouse where the piles of drugs are kept. In many cases this evidence is not brought to trial.

It can take days or weeks to get a search warrant from Mexican judges. That's enough time for information about a planned raid to leak to drug traffickers. Those trafficking synthetic drugs like fentanyl are the least likely to be caught.

That's in part because of how easy it is to produce and move the pills, which are small and odorless. They are labeled "M-30" — counterfeit versions of the oxycodone pills manufactured by Mallinckrodt Pharmaceuticals, based in St. Louis.

Between May 2013 and June this year, the federal government made 462 arrests for fentanyl-related crimes, according to a freedom-of-information request, compared with 116,689 arrests for producing, trafficking or selling large quantities of other drugs during that same time period. In many cases, Mexican authorities seized large loads of fentanyl without arresting anyone.

In October, federal police stopped a white passenger van loaded with 150,000 fentanyl pills and 1,500 pounds of meth outside Ensenada. Authorities watched as the traffickers fled the scene.

"The [traffickers] chose to leave the vehicle when they identified the presence of authorities, dispersing in different directions," the attorney general's office wrote in a press release.

The power that drug-trafficking organizations wield is normally difficult to assess. But periodically the scale becomes clear, an invisible army suddenly emerging to strike.

That's what happened on the afternoon of Aug. 12 in Tijuana. It had begun as an uneventful day in the attorney general's office, where officers catalogued their most recent fentanyl seizure. Before sunset, the calls started coming in.

Criminals had stolen a public bus and set it on fire. Then a taxi. Then another bus. Within minutes, Tijuana was riddled with narcobloqueos, or cartel road blocks, paralyzing the city and effectively shuttering the world's busiest land border crossing.

"We're going to create mayhem so the f---ing government frees our people," a message that circulated on WhatsApp said. "We're the Jalisco New Generation cartel. We don't want to hurt good people, but it's best they don't go outside. We're going to attack anyone we see on the streets these days."

By midnight, 42 vehicles had been set aflame. It was a rare moment when all of Tijuana was jolted by the same event. The U.S. government ordered diplomats to shelter in place. Factory workers slept under conveyor belts. Bus drivers abandoned their buses for fear that their vehicles would be hijacked.

García covered it live.

"We've never seen anything like this before," she said in one broadcast.

José González could see the smoke rising from his encampment near downtown Tijuana. At first, he assumed it was a car accident or a house fire. Then someone nudged him.

"Narcos," the man said, pointing to the smoke.

José considered the connection between the men who sold him tiny bags of fentanyl powder and those who had just set the city on fire. It was like seeing the true size and power of a machine he knew only superficially.

Chapter 4: José's choice

It was late afternoon when José returned to downtown Tijuana, with more items to sell.

The day's second attempt to earn 100 pesos began. He added a few new products to his tarp: plastic bags of granola, a few DVDs, two pairs of shoes, a red hat.

He displayed them meticulously on Calle Artículo 123, which had been converted to an open-air market.

He knew his prospects were still bad. The sun was setting and tourists were beginning to pour into Tijuana from across the border. But they didn't want what he was selling.

They were mostly here for cocktails and cheap tacos and strip clubs.

José leaned against a car and watched the crowds pass by. Other addicts pitched their junk to a mostly uninterested clientele, shouting out prices. José's approach was more Zen. If they want it, he thought, they'll come.

Each sale would tilt the scale toward his next hit of fentanyl. Or he would strike out.

"Everything happens for a reason," he said.

It might be a sign that he should drag himself to rehab.

Then a man bought a black tank top for 20 pesos. A woman came up and purchased two bags of granola for 20 pesos each.

José looked at them in disbelief.

"It's always the things you least expect to sell," he said after they walked away.

Suddenly, he had 60 pesos.

Then a man bought his last two bags of granola. A woman bought a light switch.

One hundred ten pesos in five minutes.

The streak of luck felt impossible.

"Enough to get cured," he said, and he began rolling up the tarp.

He took a left at a convenience store and met one of his dealers outside a house. He walked away with two tiny bags: one of fentanyl and one of crystal meth. It was his cocktail of choice, which he believed smoothed out the high.

He needed someone to help him shoot up. Normally he would offer a volunteer a taste of his supply for help. But when he walked up to his encampment, the men were either semiconscious or unwilling to help.

"You can't count on anyone in this place," he said.

It was getting dark and the neighborhood looked even bleaker. Police cars streaked by with their sirens on.

José wandered toward another heap of garbage next to an alley. An older man, also high, was picking through the trash. José tapped him on the shoulder and asked if he would help with the needle.

Across the street, an open-air church service had begun. Families in folding chairs prayed for the junkies. The voice of the pastor blared through loudspeakers.

"God loves you," he said. "You are the children of God."

José got on his knees, peering down solemnly.

The needle went in, just above the collar of his T-shirt. The hit was too much for him. He grabbed his knees like he had finished a sprint.

"My heart," he said to the old man.

"I messed up the dosage," he said.

He was usually careful. He had only overdosed once, nothing compared with most of the other men.

He took a few deep breaths and swallowed hard.

"I'm okay now," he said, his eyes wide. He didn't look okay.

He threw his backpack over his shoulder. He walked back toward the lights of downtown. He had to find a way to make another 100 pesos.

About this story

Reporting by Kevin Sieff. Steven Rich and Alejandra Ibarra Chaoul also contributed to this report. Photography by Salwan Georges. Video by Erin Patrick O'Connor.

Design and development by Rekha Tenjarla. Additional design and development by Allison Mann, Laura Padilla Castellanos and Tyler Remmel. Data analysis by Steven Rich.

Reem Akkad, Jessica Koscielniak, Robert Miller, Ann Gerhart, Matthew Callahan and Courtney Kan were the lead editors. Additional editing by Sarah Childress, Christian Font, Meghan Hoyer, Jai-Leen James, Jordan Melendrez and Frances Moody.

Additional support from Steven Bohner, Sarah Dunton, Jenna Lief, Monika Mathur, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Garland Potts, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Additional photos and videos by Omar Rosette/Punto Norte, Jorge Duenes/Reuters, Carlos Moreno/Sipa via AP Images and the Mexican attorney general's office.

Cartel Rx

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple data sets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open-records requests in both countries, retrieved data from government websites to create data sets, and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House's "drug czar," by submitting a detailed research proposal to gain access.

By Kevin Sieff

ST. GEORGE, Utah — The meth was expensive. The federal agents were running out of money.

They had been buying loads of drugs in undercover operations, trying to trace the pipeline of methamphetamine and fentanyl into this sleepy city of retirees, out-of-town hikers and Mormon churches.

Brady Wilson, one of just two Drug Enforcement Administration agents in southern Utah, begged his bosses for more cash. The case felt big — a window into how Mexican organized crime had penetrated even suburban America.

“It was a gut feeling,” Wilson said. A Mexican cartel, he suspected, had set up shop in St. George.

Wilson, a bald, trim 42-year-old, operated out of an unmarked building, across the street from a car wash. He looked around St. George, a city of about 100,000 surrounded by jagged red-rock cliffs and waves of cookie-cutter suburbs. Few places in America would make a more incongruous outpost for Mexican drug traffickers.

And yet synthetic drugs had arrived here much as they had in other small cities and rural areas across the United States — abruptly and with immediate, devastating impact. In Utah, fentanyl overdose deaths had increased 300 percent over a three-year period, killing 170 people in 2021, according to the state health department.

Mexican criminal groups had become experts in producing fentanyl and meth across the border. Now, Wilson knew, they were honing their role in retail distribution in the United States, where synthetics had reshaped the geography of drug demand. There was money to be made in places like St. George.

In early 2020, Wilson got his first tip. Someone walked up to the FBI field office in St. George with a claim that appeared to leap from Wilson’s subconscious.

“The message was: ‘You’ve got a major player in your area who has significant ties to Mexico.’”

According to the informant, a Mexican man was running a drug distribution ring from a small ranch on the edge of St. George. Wilson and other federal law enforcement officials launched an investigation. They were about to learn how deeply Mexican cartels have penetrated the heartland of America. What follows is based on court documents and information Wilson and several other federal officials shared with The Washington Post.

At first, the work was tedious. They conducted stakeouts in strip-mall parking lots. They interviewed detained drug dealers. They weren’t getting enough evidence to advance the case.

Then, in 2021, the agents made a breakthrough. They traced a shipment of drugs to Ángel Rubio Quintana, a 41-year-old from Michoacán, Mexico. Deported years earlier, he had returned to southern Utah, where his relatives had a popular fast-food restaurant known for its burritos and carne asada.

He was a short, chubby man with a goatee. He shepherded his four children around St. George in a used SUV. They posed for photos in front of the mall; in front of their Christmas tree; in front of a flower shop, wearing matching plaid shirts. The agents didn’t need to work hard to get his contact information. Rubio sold used cars in front of his in-laws’ Mexican restaurant, scrawling his phone number on the windshields.

When agents found out where Rubio was living, Wilson shook his head in disbelief. The man suspected of importing drugs into St. George had moved his family into one of the city’s immaculate suburbs, on a street lined with American flags and pickups. It wasn’t far from Wilson’s own home.

What Wilson needed to learn was how Rubio ran the operation. Could agents build a strong enough case against him to cast a net over the entire trafficking ring?

The evidence trickled in. The first time agents purchased a large load of meth from Rubio, they said, it arrived in a five-pound tub of sour cream called La Crema Mexicana. The agents wondered whether there was a connection between the extended family’s restaurant and Rubio’s drug trade.

The tub solved one of Wilson’s problems — what to call the investigation: Operation Sour Cream.

As a young DEA agent, Wilson had studied the architecture of America’s drug war.

Drug trafficking routes through Mexico, he learned, are the product of years of turf wars, shifting alliances and continually refined smuggling techniques. Nearly a century after early opium smugglers lugged their loads across the Rio Grande, Mexico has been carved into criminal fiefdoms. Different cartels own different stretches of the border.

The Sinaloa cartel has risen to become the world’s premier fentanyl producer. The group manufactures fentanyl and meth throughout northwestern Mexico, in labs that span the mountains of Culiacán and dot the residential streets of downtown Tijuana. Those drugs are loaded into hidden compartments in cars and trucks and sent across the border into California and Arizona.

What happens once those drugs enter the United States — the pipeline from the border to the user — has been less clear. How involved are cartels in the distribution and sale of their own products? Historically, most dealers don’t know whose drugs they’re selling.

But with the explosion of fentanyl, which can be pressed into tiny counterfeit pills or mixed into other drugs like cocaine and heroin, the question of how the products arrive at their final destination is of urgent importance. More Americans are dying of drug overdoses than ever before. The tentacles of Mexican criminal organizations are lengthening in the United States, their distribution methods becoming more efficient as their drugs become more dangerous.

Wilson had seen the outlet of that pipeline in Seattle, where he got his first job with the DEA in 2009. Mexico’s two biggest criminal organizations, the Sinaloa cartel and the Jalisco New Generation cartel, both operated in the city, ordering up drug shipments directly from their counterparts in Mexico. That phenomenon has continued: From May 23 through Sept. 8 of this year, the Justice Department investigated 35 fentanyl cases with direct links to those two groups.

Wilson noted how both cartels established outposts in Seattle as if they were inaugurating a shadow consulate. The cartels recruited from within immigrant communities, exploiting recently arrived Hondurans, for example, who were pressured to pay back human smugglers by dealing drugs.

As Wilson settled into St. George, Sinaloa-linked busts were being made in unlikely places, away from major American cities. Trafficking rings were uncovered in western Pennsylvania and Battle Creek, Mich. Authorities found one Sinaloa affiliate using a bootleg phone to operate out of a federal prison in Henderson, N.C.

But Wilson felt good about the St. George assignment. He was a Utah native, looking for a quiet place to live with his young family.

“This is going to be a much slower pace,” he remembers thinking.

Throughout the 2010s, the closest drug cartel outpost to St. George was Las Vegas, about a two-hour drive away. Small-time drug dealers transported modest loads — sometimes just a few ounces — from there to southern Utah.

“Most of our cases were just these local people going to Vegas to pick up an ounce or two, or 100 pills, maybe 200 pills,” Wilson said.

In 2015, the DEA published a map of “Areas of Influence of Major Mexican Transnational Criminal Organizations.” St. George wasn’t mentioned — a market not big enough to warrant recognition by the cartels.

But demand for synthetic drugs had increased in southern Utah just as supply had surged in Mexico. St. George had itself boomed; it is now the nation’s fastest-growing metropolitan area. Not long after Wilson arrived in Utah, he and his colleagues were finding fentanyl everywhere — in pillowcases and glove compartments during routine traffic stops, next to the bodies of overdose victims, once in a plastic bag in a Panda Express bathroom.

The drugs that arrived here from Las Vegas were no longer enough. St. George had apparently gotten its first hookup directly to Mexico.

Ángel Rubio was no one’s idea of a cartel kingpin. He was illiterate. He was constantly in debt. His drug business was perpetually short-staffed, so he enlisted his teenage son. Even the front for his operation — a 10-acre ranch on the edge of town — gave the appearance of an amateur. The cows kept escaping, wandering into the suburbs.

And yet his ability to order up drugs from Mexico was impressive to the agents watching him. At some point in his early middle age, Rubio had connected with the Sinaloa cartel.

To build their case, federal agents began purchasing larger and larger quantities of drugs from Rubio, using an undercover buyer to determine the scale of his operation.

“We were buying meth at $4,000 a pound,” said Jay Tinkler, then the top DEA agent in Utah and Wilson’s boss.

Tinkler pleaded for more government funds to buy more drugs, partly at Wilson’s insistence.

“I’m calling my boss and telling him: ‘It’s a really good case, I’m telling you,’” Tinkler said.

Those purchases eventually helped the agents get a court-ordered wiretap on Rubio’s phone. That’s how they got a glimpse into the life of St. George’s cartel connection. The surveillance was 24/7; a team of interpreters was employed.

Rubio repeatedly called the same two men in Sinaloa state, sometimes multiple times a day.

I need buttons, they heard him say, which meant fentanyl pills.

I need glass, he said, which meant meth.

Rubio also referred to drugs as goats and sheep, according to court documents in the case, “hoping it would go undetected because he literally sold goats and sheep from his corral.” The small-town nature of the investigation complicated things. Several times agents ran into an unsuspecting Rubio or his associates at the grocery store.

“You’ll never guess who I saw at the store,” one of the agents told Wilson after returning to the office one day.

It became clear over time that the two men in Mexico were affiliated with the Sinaloa cartel. Federal agents and prosecutors referred to them jointly as “the Mexican supply,” but their names, which would later appear in a federal indictment, were Ramon Higuera-Cota and Presciliano Galax-Felix. They could dispatch drugs to St. George rapidly, responding immediately to demand.

It wasn’t that Rubio worked as an underling for the Sinaloa men. He negotiated his own prices — often ruthlessly lowballing Higuera-Cota and Galax-Felix. The federal agents began to realize that the cartel wasn’t operating in St. George under a corporate hierarchy. Rubio hadn’t been sent here with orders from Sinaloa. He was the semiautonomous leader of his own mini-fiefdom, able to order fentanyl, meth and cocaine like a pizza delivery.

The drugs would arrive a day or two after his orders were placed, crossing the border near San Diego and then moving on to stash houses, often on the outskirts of Los Angeles. Then Rubio would arrange transport to St. George. He would sometimes lecture the drivers himself, federal agents said.

“He’d tell them: ‘Bring your kid so it’s less obvious. Always get your vehicle serviced so you don’t break down,’” Wilson recalled.

Those cars would travel along what has increasingly become America’s main fentanyl artery, Interstate 15, which connects Los Angeles to much of the country. It passes directly through St. George, where signs for available real estate continue to spring up. “A new standard of life is beginning,” reads one billboard.

When the drugs arrived in St. George, Rubio stashed some of them on the ranch he rented. He hid other loads in storage units. Others he left in the homes of friends or buried in the horse corral. His neighbors, mostly White retirees, grew suspicious. DEA agents installed a camera in the backyard of one neighbor’s home. Another neighbor, Mark Correll, a retiree from Texas, bought night-vision goggles to keep an eye on the ranch.

“There was a lot of traffic late at night,” Correll said. “A lot of fancy cars. We knew something was up. We just weren’t sure what.”

Rubio and his colleagues, court documents said, “pocketed some revenue as profits and wired payments to Mexican sources of supply.”

“This cycle — ordering from Mexico, picking up from California, distributing in Southern Utah, wiring payments back to Mexico — resulted in large quantities of narcotics flowing into the local community,” the documents said.

Rubio’s fentanyl usually arrived in the form of counterfeit oxycodone pills called M-30s, about a thousand in a bag, worth some $40,000 on the street. Those pills have become increasingly popular — and lethal — as cartels have tried to cater to drug users with rising tolerance. Rubio, agents estimate, was selling 20,000 to 30,000 pills a month.

An agent recalled one conversation in which Rubio tried to place a fentanyl order and was rebuffed:

“We already moved over 25,000 pills yesterday,” one of the men in Sinaloa said. “You should have given me an order. It’s already all gone.”

But more frequently, the Sinaloans appeared to have an endless supply. Sometimes, Rubio’s connection would send him thousands more fentanyl pills than he had ordered.

When Rubio asked why traffickers had sent so many pills, he was told not to worry about it, said one federal official, who spoke on the condition of anonymity because he wasn’t authorized to discuss the case.

“He was told he could pay them back once it was sold,” the official said. “They’re literally pushing drugs because the quantity on the Mexico side is so high.”

At least twice, Rubio’s debt to the Sinaloa men grew to dangerous levels. The men in Mexico began threatening him.

“They were like, ‘We’re going to come up there and we’re going to hunt you guys down,’” one agent recalled.

Remarkably, Rubio called their bluff.

“He said, ‘Hey, this is America. You guys can’t come here and just be running around with guns.’”

But when people didn’t pay Rubio on time, he was the one who threatened violence. The federal agents, monitoring those threats in real time, sent police on what appeared to be routine patrols, meant to deter Rubio from hurting anyone. There was no indication that he did.

Rubio had originally moved to the United States more than two decades earlier. One of his first stops was Salt Lake City, where he worked construction. One day, he was buying food at a drive-through. A young Mexican woman named María de los Ángeles Acosta took his order.

Eventually the two got married. They had three kids. When people asked her, de los Ángeles described their lives in St. George as peaceful and happy. The city wasn’t as crime-ridden as some of the other American cities where Mexican migrants ended up, she said. “Thankful and blessed,” she posted on Facebook under photos of the family.

Her husband’s clients in St. George came from a range of backgrounds. Some were the service workers who catered to the tourists passing through the city. Others were locals who thought they were purchasing oxycodone, a prescription drug used to treat severe pain.

Dmytro Luke, 22, who worked for a flooring company, died after taking a counterfeit M-30 pill in February 2021. His case drew public attention after his mother began alerting local journalists to the wave of fentanyl in southern Utah that had led to her son’s death. She’s still not sure whether the pill that killed Luke was trafficked by Rubio.

The agents faced a particular dilemma with Rubio’s fentanyl business. If they knew deadly pills were circulating during their investigation, agents said, they couldn’t sit idly by. So they frequently intervened by buying them through informants.

It was a complicated decision. The more pills they purchased, the higher demand could appear to Rubio, giving him an incentive to import more.

The agents knew that some of their most valuable evidence was against Rubio’s suppliers in Sinaloa. Arresting Higuera-Cota and Galax-Felix was a crucial part of the case.

Those men appeared to be on the front line of the explosion of fentanyl. Aside from the M-30 pills, they offered Rubio cocaine and meth laced with fentanyl.

“They talked about that like, ‘Hey, this is some new hot stuff like you should get,’” one agent said.

Later, Rubio would tell people that he was merely working for the two men in Sinaloa. He was a small fish, he said.

Because Higuera-Cota and Galax-Felix were in Mexico, the U.S. agents in Utah couldn’t arrest them. It was a source of deep frustration. Agents believed they were exporting fentanyl and meth across much of the southwestern United States, potentially pushing millions of M-30s across the border every year.

“You have this great material and there’s nothing you can do with it,” said one official who worked on the case.

The agents in Utah shared their evidence with Justice Department officials in Washington, according to a former U.S. official who spoke on the condition of anonymity because he wasn’t authorized to comment. They hoped the case they had built against two men in Mexico would lead to their arrest. But that has not happened.

Mexican officials have not pursued either Higuera-Cota or Galax-Felix, according to the country’s attorney general’s office. That office would not comment on why it had not issued arrest warrants.

Neither man could be reached for comment.

In St. George, federal agents decided they needed to move forward alone. By early this year, agents believed they had enough to build a case against Rubio and his associates in the United States. On a bulletin board in Wilson’s office, they had mapped the dense web that connected Rubio to his team of dealers and suppliers in Mexico. They were ready to make the arrests. “Takedown day,” they called it.

On Feb. 15, dozens of officers from several SWAT teams along with federal agents prepared for raids against Rubio and his accomplices. Some were low-level drug dealers selling fentanyl to pay for their own drug habits. Others were Rubio’s friends and relatives to whom he paid a fraction of his proceeds.

Agents planned to conduct more than nine raids across Utah, many of them simultaneous. The DEA flew several aircraft overhead. The agents discussed what would happen if Rubio tried to shoot his way out, or if he tried to flee into the suburbs.

They arrived at Rubio’s beige-stucco suburban home just before sunrise. It was a clear, crisp morning. They fired a stun grenade upon entering the house. They dragged Rubio, pajama-clad, from his bedroom without a fight.

He was charged with conspiracy to distribute fentanyl and methamphetamine and conspiracy to launder money. He was also charged with unlawful reentry into the United States.

Neighbors in the neatly kept suburb were alarmed. Many were armed. One young woman, living in the property next to Rubio’s, loaded her handgun and sat in a lawn chair in case anyone tried to jump over her fence.

Agents also raided the 10-acre ranch, a few miles from Rubio’s home. By the end of the day, they had arrested 12 people — including Rubio’s 19-year-old son, Carlos Rubio-Acosta. Agents seized thousands of fentanyl pills, as well as cocaine and meth.

Rubio was taken to jail in Cedar City, just north of St. George. In July, he pleaded guilty to trafficking fentanyl, methamphetamine and marijuana, and to laundering the proceeds. He is awaiting sentencing.

It’s possible that he could be deported after his prison sentence, probably a more dangerous consequence than prison, given the money he owes to the Sinaloa cartel.

“He left a lot of debts on the table,” said one agent, who spoke on the condition of anonymity because he was not authorized to talk about the case.

“A lot,” said another agent, who also spoke on the condition of anonymity. “I can only speculate how much, but he owes a lot of money.”

Several months after Rubio’s arrest, a Post reporter walked into Alvaro’s Mexican Food, the family’s fast-food restaurant, located in a St. George mall parking lot, next to a tuxedo rental.

A middle-aged woman was standing behind the counter. She stood next to a painting of the pre-Columbian city of Teotihuacán. She was on the phone.

It was Rubio’s wife, María de los Ángeles Acosta. She was talking to her husband in prison.

“Do you want to talk to him?” she asked.

Rubio’s voice then boomed through the speaker.

“Of what they are saying about me, 99 percent is false,” he said.

“I was living a quiet life with my wife and my family,” he said.

He didn’t want to talk in detail about the accusations over the phone. He said he wanted to meet in person.

When Rubio hung up, de los Ángeles sighed.

She was torn. She knew nothing of Rubio’s drug business, she said. She had been diagnosed with breast cancer in 2021, and the family had scrambled to pay for her medical care. She didn’t think her husband would resort to drug trafficking to pay those bills. But she said she believed U.S. law enforcement.

“The authorities cannot be wrong,” she said. “If I trust anyone 100 percent, it is the U.S. authorities.”

As far as she knew, she said, Rubio had been a struggling livestock trader. But he had been acting strange lately, she admitted.

He had created a policy for the family of turning all cellphones off at home. He seemed anxious all the time.

“I just assumed he was having an affair,” she said. “One day I’d like to know the truth.”

Later, she said she was planning to divorce Rubio.

His lawyer, Trinity Jordan, said his client did not want to speak to The Post.

“I talked to my client about your story and at this time he prefers to not participate,” Jordan wrote in an email.

Rubio’s son Carlos Rubio-Acosta pleaded guilty to conspiracy to distribute fentanyl, conspiracy to distribute marijuana and conspiracy to launder money. He was sentenced in August to 15 months in prison.

“He followed his father’s lead and instructions while participating in the organization,” the sentencing document said.

Rubio’s own sentencing hearing is scheduled for later this month. Agents found no evidence of a connection between his extended family’s restaurant and the drug business.

Wilson left the DEA this year for a job at the U.S. attorney’s office. He’s still working on the Rubio case, as well as other drug-related cases in St. George.

Rubio’s arrest appeared to have an immediate impact, Wilson said. The flow of drugs arriving here appeared to diminish — mostly smaller loads arriving from Las Vegas at higher prices.

But Wilson knew that wouldn’t last.

In recent months, the sizes of drug seizures in St. George have increased once again. In October, local police stopped a 19-year-old Mexican man with 62,000 counterfeit M-30 pills near the St. George exit of I-15. The load was twice as big as those Rubio had handled.

There was no confirmation yet, but Wilson recognized the signs. Soon, it would be time to start again.

About this story

Reporting by Kevin Sieff. Steven Rich also contributed to this report. Photography by Salwan Georges and Ronda Churchill.

Design and development by Allison Mann and Tyler Remmel. Additional design and development by Laura Padilla Castellanos and Rekha Tenjarla. Graphics by Júlia Ledur. Data analysis by Steven Rich and Alejandra Ibarra Chaoul. “Post Reports” production by Ariel Plotnick, Reena Flores and Elahe Izadi.

Trish Wilson and Courtney Kan were the lead editors. Additional editing by Chiqui Esteban, Christian Font, Meghan Hoyer, Jai-Leen James, Jeff Leen, Jordan Melendrez, Robert Miller, Frances Moody and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Childress, Sarah Dunton, Jenna Lief, Monika Mathur, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Data for graphics is from U.S. Customs and Border Protection, High Intensity Drug Trafficking Areas, U.S. Drug Enforcement Administration, Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple datasets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House’s drug czar, by submitting a detailed research proposal to gain access.

By Mary Beth Sheridan, Eva Herscowitz and Alejandra Ibarra Chaoul 

MANZANILLO, Mexico — Griselda Martínez lost her freedom in a hail of bullets one warm July night. Gunmen on two motorcycles sped up to the mayor’s SUV, firing 36 times, as it crawled through traffic in this Pacific coastal city. Martínez was grazed by a bullet but survived.

Today she lives at Manzanillo’s city hall, protected by 15 bodyguards. Her husband drops off groceries for her to cook in a kitchenette. She rarely sees her children or 4-year-old granddaughter.

“Really, I’m a hostage,” said the mayor. “I have no personal life.”

Manzanillo was once famous for its beaches, immortalized by a young Bo Derek jogging through the surf in the movie “10.” Later, it became home to Mexico’s No. 1 container port. Now, it has another distinction. As Mexican crime groups inundate the United States with methamphetamine and fentanyl, the city has become a crucial hub for the synthetic-drugs industry.

Cartels are increasingly manufacturing drugs entirely from chemicals, rather than relying on plants. If Mexico’s kingpins once owed their fortunes to rural fiefdoms of marijuana and heroin poppy, they now depend on a stream of chemicals, many of them arriving from China. Seaports, airports and postal facilities are critical. The Mexican navy has confiscated around 600 tons of “precursor chemicals” in Manzanillo since 2007, making it a top entry point, according to military news releases and data obtained by The Washington Post through the country’s freedom-of-information system.

Andrés Manuel López Obrador assumed the presidency in 2018 vowing to end the U.S.-backed war on drug kingpins, which he blamed for an explosion of violence. He promised to focus instead on the government corruption that allowed traffickers to flourish. He ordered the navy to take charge of Mexico’s graft-ridden seaports in a bid to choke off the torrent of imported precursor chemicals.

Yet detecting the chemicals is far harder than identifying fields of coca or poppy plants. Thousands of shipping containers, filled with car parts, telephones, mattresses and other goods, are hauled in and out of Manzanillo each week. The illicit chemicals, which the smugglers often mask with false labels, are easily hidden in a vast sea of legitimate goods.

Complicating matters further are Mexico’s weak institutions. López Obrador announced in 2019 that he was overhauling the Manzanillo customs office, where corruption had “reached an extreme.” But the U.S. Treasury Department said last year that the Jalisco New Generation cartel continued to operate in the port, which it called a “significant gateway” for precursor chemicals, “including those used to synthesize fentanyl.”

A bipartisan U.S. congressional report warned in February that the flow of precursors to Mexico “remains almost unabated.” It attributed the problem, in part, to China’s inability to regulate its fast-growing chemical and pharmaceutical sectors, and to corruption and an inadequate security budget in Mexico.

But real progress against fentanyl could come only by addressing the U.S. appetite for the drug, the report said: “Failure to intervene in ways that appropriately reduce demand and decrease the risk of fatal overdose will almost certainly result in the deaths of hundreds of thousands more Americans.”

Mayor Martínez, 54, has watched the synthetic-drug revolution transform her hometown, which once prided itself on being the “sailfish capital of the world.” Hundreds of soldiers, sailors and national guard troops patrol Manzanillo, which is coveted by crime groups both for its port and for the local drug market. Cartels pump out so much cheap methamphetamine that they no longer can sell it all in the United States. In two years, annual seizures of meth sold on Manzanillo’s streets have soared from 820 individual doses to more than 6,800.

“This is a phenomenon we didn’t have 40 years ago,” the mayor said. In those days, American tourists descended on Manzanillo thanks to “10,” which was filmed at a Moorish-style luxury hotel on a secluded beach. Now, she said, “we have people with psychological problems wandering the streets, like in other parts of the world.”

At every level, the government is besieged or has been penetrated by organized crime. Three customs agents disappeared after leaving work at the Manzanillo port in September 2021, their bodies later found in a paupers’ graveyard. Bryant García, the attorney general of Colima state, said in an interview that the killings appeared to be linked to an illegal shipment of precursor chemicals. No one has been arrested.

One longtime customs broker said government agents often face bribe-or-bullet ultimatums from crime groups. “They go to your house and say, ‘Hey, you have a family, a wife, a child. If you see this container, I want you to clear it. If you don’t, I’ll kill you,’ ” the broker said, speaking on the condition of anonymity out of concern for his safety. “So what do you do?”

Martínez was a women’s activist who took office in October 2018 as a member of López Obrador’s center-left Morena party. She discovered that many of Manzanillo’s police officers were working with the Sinaloa and Jalisco New Generation cartels, she recalled — and fired about half of the 200 officers. Gunmen ambushed her SUV nine months later.

In a sign of how deeply drug money has permeated the region, there are a number of theories in the still-unsolved assassination attempt. Prosecutors have looked into whether the mayor was attacked in retaliation for her investigations into political corruption or for her refusal to issue certain permits. Martínez said it was no secret that some politicians and business executives had ties to drug gangs.

“It’s very likely that economic or political groups asked one of these crime groups for a favor,” she said. “To eliminate the mayor.”

A chemical revolution

Since Spanish colonial times, Mexico’s ports have been thriving centers of contraband, as merchants and citizens dodged taxes and protectionist barriers. Salvador González, who worked as a supervisor at the Manzanillo port in the 1970s, recalled cargoes of bootleg lamps, batteries and ornamental music boxes. “We didn’t hear about drugs,” he said.

That changed a decade later. As U.S. forces squeezed Colombian smuggling routes that passed through the Caribbean, cocaine traffickers shifted to Mexico. Authorities captured massive loads near Manzanillo: nine tons of cocaine in 2001 on a tuna-fishing boat; 26 tons in 2007, hidden in shipping containers of soap and plastic floor tiles.

Less noticed were growing cargoes of the precursor chemicals used to make meth. A Colima family, the Amezcuas, emerged as pioneers in the trade. They made deals in Asia and Europe to import ephedrine, a key ingredient in cold medications that eased stuffy noses and sinuses. The Amezcuas’s operatives “cooked” the precursors into meth in clandestine labs.

Few people at the time realized the extent to which synthetic drugs would change the game. Most of the world’s opium poppy had come from just three countries — Afghanistan, Myanmar and Mexico. Another three nations, Colombia, Peru and Bolivia, produced nearly the entire supply of coca, the base ingredient in cocaine. But chemicals are made all over the globe.

Even state-of-the-art ports can search only a small fraction of the containers arriving each day. A further complication: Some of the chemicals used in meth or fentanyl are “dual-use”: They are needed to make everyday goods such as cheese, soap and epilepsy medication.

“You can’t stop this stuff, otherwise you’d seriously disrupt the global economy,” said Bryce Pardo, who until recently was the associate director of the Drug Policy Research Center at the Rand Corp.

Crime groups play a cat-and-mouse game with regulators. When authorities put chemicals on watch lists, subjecting them to more scrutiny, traffickers combine legally available substances — “pre-precursors” — to make similar compounds.

“You can’t control [all the chemicals] because they have licit uses, like in pharmaceuticals,” said Sofía Díaz Menció, the project coordinator in Mexico for the U.N. Office on Drugs and Crime. “And organized crime, in any case, will find substitutes.”

Traffickers have begun making ever more complex drug cocktails. The Colombo Plan, an intergovernmental organization, has analyzed samples of the drugs sold on U.S. streets over the past six years and found that about one-third have been “cut,” or adulterated, at least 15 times. Some samples contained not one kind of fentanyl but four or five.

There’s been “an explosion of new synthetic compounds,” said the group’s chief executive, Thom Browne Jr. “We’ve never seen this before.”

Now, traffickers mix fentanyl with veterinary tranquilizers such as xylazine and pain relievers such as metamizole, also known as dipyrone. These substances can amplify the impact of drugs but also deplete white blood cells and cause other health problems. It is not clear whether the substances are being added in Mexico or after the drugs have crossed the U.S. border.

“We are in a chemical, creative cesspool right now,” said Dan Ciccarone, a professor of medicine at the University of California at San Francisco who studies drug abuse.

‘A message of force’

A few minutes before midnight on Sept. 29, 2021, two Mexican military trucks pulled up to the headquarters of Cofepris, the national food and drug regulatory agency, in a middle-class neighborhood in the capital. About 15 marines in camouflage hopped out.

Hours later, as the agency’s senior managers showed up at their offices, many found marines guarding their computers. Nineteen managers were fired and replaced by new employees who had been secretly trained off-site.

“It was important for us to send a message of force,” said Alejandro Svarch, 34, who had become director of Cofepris months earlier.

The Mexican agency had long been plagued by corruption. But even Svarch had been stunned by what he found on taking over. In one case, he said, criminals used a fake permit to import 40 tons of tartaric acid. The substance can be used as a food additive but also to boost the purity of meth.

On paper, Mexico has a network of civilian agencies, including Cofepris and the customs agency, to monitor imports and investigate businesses that divert chemicals to drug traffickers.

Increasingly, though, the Mexican government is calling in the military.

When Svarch became the director of Cofepris, he quickly determined that the permit system for dual-use chemicals was out of control. “Mexico had very likely become the number one importer of chemical precursors” in the world, he said.

Svarch was a doctor and Health Ministry official. “We are not a criminal justice entity.”

He asked the navy secretary for help.

Today, Cofepris is trying to convert an unwieldy, paper-based system into an online platform to monitor permits and keep track of dual-use chemicals. The navy helps run the agency.

On a recent day, four military analysts in orange vests sat studying computer screens at a new intelligence center at Cofepris. In the past year, the unit’s work has led to the seizure of more than 300 tons of suspect chemicals and medications, Svarch said.

U.S. officials say that they are impressed but also that the agency is woefully understaffed. Cofepris officials declined to say how many people were assigned to the intelligence center.

A lack of resources is a common problem throughout the government. López Obrador has tried to fill the gap with army and navy officers. But they must work with a civilian bureaucracy that is often shorthanded and inefficient. The customs agency, for example, has just 4,000 employees nationwide — a deficit of 2,000 — according to a speech in July by Citlalli Navarro, a customs official, that was reported by the newspaper El Economista.

In a sign of the agency’s turmoil, López Obrador has gone through three customs directors.

His administration has seized more precursors in four years than his predecessor did in his entire six-year term, according to the Mexican freedom-of-information data. Yet, even tracking the busts is difficult. U.S. and Mexican officials say the government lacks storage space and incinerators for the confiscated chemicals. In some cases, officials say, crime groups have stolen the chemicals from warehouses used by authorities or bought them back from corrupt officials.

The most critical institutional weakness is in Mexico’s understaffed justice system. Svarch’s anti-graft campaign offers a case in point. It has steadily moved forward, with 36 Cofepris employees dismissed. But such cases often rely on information gathered by military intelligence that is inadmissible in court, diplomats say.

None of the 36 have faced criminal charges.

A cat-and-mouse (and dog) game

Everyone was afraid Emma might pass out. A small crowd watched as she sat, calmly, in an internal patio at the Criminal Investigation Agency (AIC), Mexico’s version of the FBI. A truck stood ready to whisk her to the hospital. A medical professional had a vial of Narcan just in case.

And then, the 6-year-old German shepherd stood up, bounded over to a line of cardboard boxes, sniffed around and stopped. She sat again.

Emma had found benzyl chloride, a chemical used to make perfumes, lubricants — and meth.

The September 2021 exercise marked the start of one of the world’s few programs to train dogs to detect precursor chemicals. Mexico had already been using dogs to search for fentanyl and meth. “We realized that the scent of the precursors is similar,” said Israel Zaragoza, the head of the canine unit at the AIC.

A year later, about 40 precursor-trained dogs are working across the country, sniffing packages at homes, bus stations and international courier facilities. The AIC plans to train hundreds of dogs that are already employed by Mexican police, the army and the navy. Like Emma, most of the dogs were donated by the U.S. government.

So far, the AIC’s dogs have sniffed out 366 liters — almost 100 gallons — of precursors, including 4-ANPP, which is used in fentanyl, and methylamine, a meth ingredient that became widely known because of the TV series “Breaking Bad.”

Yet, the canine detectives have found little 4-AP, one of the main chemicals used to make fentanyl. There’s been an overall plunge in Mexican seizures of 4-AP, from nearly 300 kilos (about 660 pounds) in 2020 to almost nothing this year, U.S. and Mexican officials say.

The sudden change may indicate that traffickers have switched to other precursors since 4-AP was put on Mexico’s watch list last year. “The more substances you put under control, the more traffickers use very skilled chemical engineers to find new substitutes,” said one U.N. official, who was not authorized to comment on the record.

Mexico learned that years ago. Starting in 2005, the government cracked down on ephedrine, and supplies of meth dried up. But cartels adapted their recipe, turning to a liquid called phenyl-2-propanone, or P2P. It could be created with cheap and widely used industrial chemicals — such as cyanide and mercury. The new meth ingredients were, however, more toxic.

Crime groups are changing other tactics, too. Although they’ve used seaports for years to import meth precursors, they are turning to airports to bring in fentanyl precursors, which are needed in smaller volumes, U.S. officials say. Drug agents are seeing yet another pattern: exporters sending small packages of precursors directly to homes in Mexico.

Retired Adm. Salvador Gómez Meillón, the administrator of the Manzanillo port, has won praise from local officials since taking over in 2020. His team has created an ID system for thousands of employees and visiting truckers that uses facial recognition and QR codes.

“Now, there’s no access for people who shouldn’t enter,” he said. About 230 navy personnel protect the port and help screen cargo.

Yet, suspicious precursors continue to arrive. This year, authorities at Manzanillo have destroyed more than 16 tons of the meth precursor benzyl chloride and three tons of 2-bromoethyl benzene, which can be used to synthesize fentanyl.

Gómez Meillón doesn’t underestimate the criminals. “These people are like rats,” he said. “They try to get in every which way.”

Drug experts such as Pardo say interdicting precursors is so hard that governments will have to emphasize other measures — such as stricter know-your-customer rules for chemical exporters in China and other countries. Ultimately, analysts say, the crisis cannot be resolved without slashing the demand for illegal opioids in the United States.

That’s been difficult to do — even though the U.S. federal budget for drug control has surged in the past decade, reaching more than $39 billion in 2022. In a sign of shifting priorities, more of that money is now being spent on treatment and prevention than on law enforcement efforts aimed at curbing supply.

However, it is not clear whether that has translated into a decline in the number of people abusing opioids including fentanyl, heroin and prescription pills. The U.S. government lacks rigorous data on the use of such narcotics, said Beau Kilmer, the director of Rand’s drug policy center. One figure that’s unambiguous: the soaring total of deaths caused by fentanyl, which is 50 times as powerful as heroin.

Pardo, now at the U.N. drug office, offered an example of how the demand factor has often been overlooked. He helped coordinate the recent U.S. congressional report on fentanyl — an exhaustive effort involving high-level officials from the Drug Enforcement Administration and the Departments of Defense, Homeland Security and State.

The officials quickly realized how daunting it would be to curtail shipments of synthetic drugs and how vital it was to focus on demand. Yet, Congress had called for the report to look only at cutting the supply.

“We realized, once we started sitting, we’re really missing half the equation here,” he said.

About this story

Mary Beth Sheridan reported from Manzanillo, Mexico. Eva Herscowitz reported from Washington and Alejandra Ibarra Chaoul reported from Mexico City. Steven Rich in Washington and Pedro Zamora Briseño in Manzanillo also contributed to this report. Photography by Salwan Georges. Video by Luis Velarde.

Design and development by Allison Mann and Tyler Remmel. Additional design and development by Laura Padilla Castellanos and Rekha Tenjarla. Graphic by Steven Rich. Data analysis by Alejandra Ibarra Chaoul and Steven Rich. Video graphics by Sarah Hashemi.

Jeff Leen, Trish Wilson and Courtney Kan were the lead editors. Additional editing by Gilbert Dunkley, Chiqui Esteban, Christian Font, Meghan Hoyer, Jai-Leen James, Thomas LeGro, Robert Miller and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Childress, Sarah Dunton, Jenna Lief, Osman Malik, Monika Mathur, Jordan Melendrez, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Data for graphic is from the Controlled Substances Act of 1970, the Federal Register and a U.S. Drug Enforcement Administration list of Scheduling Actions.

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple datasets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House’s drug czar, by submitting a detailed research proposal to gain access.

107,622 died of drug overdoses in the U.S. in 2021. Fentanyl was responsible for two-thirds of those deaths.

The number of Americans killed by the drug has jumped 94 percent since 2019. On average, one person dies of a fentanyl overdose in the United States every seven minutes.

Fentanyl kills more people than automobile accidents.

Fentanyl kills more people than gunshots.

Fentanyl kills more people than suicides.

By Courtney Kan, Nick Miroff, Scott Higham, Steven Rich and Tyler Remmel

Fentanyl's catastrophic surge came after the Drug Enforcement Administration cracked down on the excesses of the U.S. opioid industry. Millions of Americans who had become addicted to prescription pain pills suddenly found them difficult or impossible to get.

Mexican cartels stepped in to fill the vacuum. Traffickers, who relied for decades on plant-based drugs such as heroin, cocaine and marijuana, are now using chemicals in clandestine laboratories to manufacture fentanyl powder and pills to meet the ever-increasing demand in the United States.

Fentanyl is 50 times more potent than heroin, and its compactness makes it far easier to smuggle. The synthetic opioid is so powerful that a year's supply of pure fentanyl powder for the U.S. market would fit in the beds of two pickup trucks.

In a seven-part investigation, The Washington Post traced the synthetic-drug crisis from the back alleys of Tijuana, Mexico, to official Washington and from warehouses in northern Mexico to neighborhoods in Utah, Colorado and San Diego.

As fentanyl trafficking boomed, U.S. counternarcotics cooperation with Mexico deteriorated. U.S. border authorities are now overwhelmed, and, since July, the volume of fentanyl seized coming across the Mexico border each month has doubled from earlier in the year.

Despite record numbers of American deaths, federal officials have been slow to react. The DEA said it is now taking direct aim at the cartels and the epidemic.

Shifting operations

Early shipments of illicit fentanyl came from China, much of it ordered through the dark web and concealed in small parcels sent through the mail.

Mexican cartel chemists learned to make fentanyl themselves, quickly replacing China as the main source of the drug and operating on a much larger scale, according to the DEA.

It takes months and acres of land to grow and process poppy into opioids, but fentanyl can be manufactured in a small lab with relatively accessible chemicals. The entire process to a finished product can take just a few days.

Seizing the precursor chemicals that traffickers need is extremely difficult. Many are used to make basic goods, such as medicines, pesticides and soap.

The vast majority of fentanyl seizures occur at U.S.-Mexico border crossings in California and Arizona.

The cartel transportation networks use the U.S. interstate system to reach wholesale markets in Los Angeles, Las Vegas, Chicago and East Coast cities, where street-level drug dealers take over.

Increasing demand

U.S. health officials do not have reliable estimates of the number of fentanyl users or recent deaths in the country. Key monitoring programs that could have alerted authorities to the increased flow of fentanyl were defunded by the federal government just as the drug was hitting U.S. streets.

Since the early 2000s, three waves of the opioid epidemic — fueled first by prescription pain pills, then by heroin and now by illicit fentanyl — have taken the lives of nearly three-quarters of a million Americans. The damage to U.S. communities cost the economy $1.5 trillion in 2020 alone, according to a congressional analysis.

U.S. drug agents say it has been nearly impossible to stop fentanyl trafficking. Border authorities can screen only a small fraction of the more than 219,000 vehicles crossing from Mexico each day.

Federal agents estimate that they are seizing about 5 to 10 percent of the drugs coming from Mexico — if that much.

U.S. law enforcement agencies are on pace to confiscate more than 23,000 pounds of fentanyl powder this year, up from 4,000 pounds in 2018, according to a Post analysis of the latest government data. The number of fentanyl tablets seized is projected to reach 35 million, up from 289,000 in 2018.

At the southern border, U.S. authorities have seized an additional 16,200 pounds of fentanyl through the first 11 months of 2022, an analysis of the most recent Customs and Border Protection data shows. In November, the agency seized 2,900 pounds of fentanyl at ports of entry along the southern border, the highest monthly total ever, an amount that easily eclipses what the agency confiscated during the entirety of 2018.

Cascading failures

President Donald Trump told Americans that a wall along the border with Mexico would stop the torrent of drugs. But nearly all the fentanyl entering the United States passes through official border crossings — not through the deserts and mountains.

Successive administrations failed to deploy technology to detect the drugs.

The surge of fentanyl into the United States has been exacerbated by a breakdown in the U.S.-Mexico drug war partnership. After taking office in 2018, Mexican President Andrés Manuel López Obrador rejected the security agreements that had underpinned anti-drug cooperation for a decade, saying that approach intensified violence in Mexico.

"Mexico needs to do more. We believe that they can do more," DEA Administrator Anne Milgram told The Post. "We think it's vitally important that Mexico work on these issues as tirelessly as we do."

Congress commissioned an extensive report, published in February, which determined that progress against fentanyl would be achieved only by pairing enforcement with a reduction in U.S. demand.

Mass overdose deaths

Fentanyl is eclipsing heroin and prescription pain pills as the go-to opioid.

Drug dealers in the United States have been spiking drugs with fentanyl to boost potency and get more customers hooked. Many users have no idea. New or infrequent opioid users are at a far greater risk of fatally overdosing.

Today, the drug cartels also are churning out counterfeit oxycodone pills masquerading as what was once the most sought-after pain pill on U.S. streets — Mallinckrodt Pharmaceuticals' baby blue 30 mg tablets known as blues or M-30s.

Batches of "rainbow" tablets have been seized on U.S. streets and on the border in recent months. Narcotics agents think the colors are meant to signal that the pills contain fentanyl.

The epidemic has hit the young with alarming speed and disproportionately killed Blacks and Native Americans in recent years. In 2020, overdose death rates increased 44 percent for Black people and 38 percent for Native Americans.

More people are overdosing in groups because of fentanyl's potency.

In Colorado, five friends died in an apartment in February after using cocaine they did not know was spiked with fentanyl. At the time, it was the largest reported mass fatal overdose in the nation.

As police raced to uncover who supplied the drugs, the answers they would find underscore the challenge of holding dealers accountable for the deaths of their customers.

About this story

Reporting by Nick Miroff, Scott Higham and Steven Rich. Mary Beth Sheridan, Meryl Kornfield and Sari Horwitz also contributed to this report. Photography by Salwan Georges. Videos by Erin Patrick O'Connor and Luis Velarde.

Design and development by Tyler Remmel. Additional design and development by Allison Mann, Laura Padilla Castellanos and Rekha Tenjarla. Graphics by Júlia Ledur. Data analysis by Steven Rich. Video graphics by Sarah Hashemi.

Editing by Gilbert Dunkley, Chiqui Esteban, Christian Font, Meghan Hoyer, Jai-Leen James, Jessica Koscielniak, Jeff Leen, Thomas LeGro, Jordan Melendrez, Robert Miller and Martha Murdock.

Additional support from Steven Bohner, Matthew Callahan, Sarah Childress, Sarah Dunton, Jenna Lief, Osman Malik, Monika Mathur, Angel Mendoza, Sarah Murray, Ben Pillow, Sarah Pineda, Andrea Platten, Kyley Schultz, Casey Silvestri, John Taylor and Mael Vallejo.

Data for graphics is from the U.S. Drug Enforcement Administration and U.S. Customs and Border Protection.

Cartel RX

In a seven-part investigation, The Washington Post followed the fentanyl epidemic from Mexican labs to U.S. streets.

Methodology

The Post analyzed data from a range of sources to measure the rise of fentanyl in the United States and Mexico. Among other topics, reporters compiled data on drug seizures, overdose deaths and reversals, border crossings and fentanyl potency.

The data was collected from more than three dozen federal, state and local sources across the United States and Mexico. For example, for the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. To measure data seizures along Route 15 in Mexico, reporters standardized multiple datasets from agencies including the Secretaría de la Defensa Nacional, Fiscalía General de la República, Secretaría de Marina and the Guardia Nacional.

Reporters made open records requests in both countries, retrieved data from government websites to create data sets and obtained and analyzed seizure data from High Intensity Drug Trafficking Areas, run by the White House's drug czar, by submitting a detailed research proposal to gain access.

The powerful opioid is the leading cause of overdose deaths in America.

By Julie Vitkovskaya and Courtney Kan

Fentanyl, a powerful painkiller developed nearly 60 years ago, is at the center of the deadliest drug epidemic in American history. More people have died of synthetic-opioid overdoses than the number of U.S. military personnel killed during the Vietnam, Iraq and Afghanistan wars combined. Fentanyl is now the leading cause of death for Americans ages 18 to 49, according to a Washington Post analysis of death data for 2021 from the Centers for Disease Control and Prevention.

One of the greatest dangers of fentanyl is its potency. Deaths attributed to the drug began to climb in 2013, when traffickers began mixing illicit fentanyl with other drugs including heroin, counterfeit pain pills and cocaine. In some instances, drug users have no idea that fentanyl has been added.

Here is what you need to know.

What is fentanyl?

Fentanyl is a man-made opioid used to manage severe pain. It is typically administered to cancer or surgery patients. The drug was created by a Belgian physician in 1960 and approved for use as an anesthetic in 1972. Pharmaceutical fentanyl is reserved for patients who experience powerful pain that requires a stronger opioid dosage, and most patients who receive fentanyl have already been taking some type of opioid.

Fentanyl is much more powerful than morphine or heroin. Fentanyl can produce feelings of euphoria similar to heroin. The drug can also cause reduced blood pressure, sedation, dizziness and respiratory depression, according to the Drug Enforcement Administration.

What makes fentanyl so deadly?

It takes about 2 milligrams of fentanyl to overdose. The opioid is 50 times more potent than heroin.

Drug dealers have been selling straight fentanyl, which is more profitable for them, but fentanyl also can be combined with street drugs such as heroin and cocaine. Users are at a higher risk of dying as they take pills without knowing they contain a lethal dose of fentanyl or any fentanyl at all.

Fentanyl analogues — or chemical variations of the drug — pose a major problem to law enforcement. Chemists can tweak the analogues to make versions of fentanyl that are not banned by law. Thus begins a game of cat and mouse: Federal officials race to identify and ban the analogues while chemists continue to make new ones.

What is being done to address the crisis?

Many police officers and paramedics carry naloxone, a drug that can help reverse an overdose. Naloxone can be injected into the body or be administered as a nasal spray. It works as an antidote, blocking the effects of opioids and helping restore breathing.

In recent years, the Centers for Disease Control and Prevention, the Food and Drug Administration and the U.S. surgeon general have called for expanded access to naloxone for first responders and community organizations. In one study, opioid deaths in 19 Massachusetts communities fell by 11 percent after the state implemented a naloxone distribution and education program.

The Biden administration has announced spending and a multipart strategy directed at fighting the growing opioid crisis through harm reduction and drug-use-prevention measures. In March 2023, the FDA approved over-the-counter sales of Narcan, a spray version of naloxone, but accessibility may depend on pricing and insurance plan coverage.

U.S. border authorities are overwhelmed by the volume of fentanyl entering the country. Congress commissioned an extensive report, which determined that progress against fentanyl would be achieved only by pairing enforcement with a reduction in U.S. demand.

What does fentanyl look like?

Pharmaceutical fentanyl comes in tablets, patches, sprays and lollipop-like lozenges.

Illicit fentanyl is a white, powdery substance and can be pressed into counterfeit prescription pills.

Multicolored “rainbow” tablets have been seized, which narcotics agents think are meant to signal to users that the multicolored pills contain fentanyl.

Does fentanyl have other names?

Fentanyl can be called many street names, including Apace, China Girl, China Town, China White, Dance Fever, Goodfellas, Great Bear, He-Man, Poison, and Tango and Cash, according to the DEA.

What are the signs of a fentanyl overdose? What should you do if you suspect an overdose?

Symptoms of a fentanyl overdose include cold and clammy skin, unconsciousness or near-unconsciousness, blue discoloration of the skin, very small pupils, coma and respiratory failure.

If you suspect someone is experiencing an overdose, the CDC recommends the following:

1. Call 911 immediately.
2. Administer naloxone, if it is available.
3. Try to keep the person awake and breathing.
4. Lay the person on their side to prevent choking.
5. Stay with him or her until emergency workers arrive.

Can fentanyl be absorbed into the skin?

This is a common myth and should be clarified. The risk to emergency responders is “extremely low,” according to the American College of Medical Toxicology (ACMT) and the American Academy of Clinical Toxicology (AACT).

Their current position states: “To date, we have not seen reports of emergency responders developing signs or symptoms consistent with opioid toxicity from incidental contact with opioids.”

Andrew Stolbach, one of the lead authors of the ACMT statement and a Johns Hopkins medical toxicologist and emergency physician, said fentanyl does not pose a risk to first responders who take basic precautions.

“Fentanyl is absorbed very poorly through the skin,” Stolbach said. “For routine precautions, simple nitrile gloves are more than sufficient. If powder does get on the skin, washing it off with water is sufficient.”

Michael J. Moss, a toxicologist and the Utah Poison Control Center’s medical director, led the writing of the ACMT and AACT’s position statement and said first responders or family members shouldn’t assume that just being around fentanyl will make them sick.

“Fentanyl is potent, though it is very unlikely — extremely unlikely — that anyone would be exposed from incidental contact, and we don’t want people to be afraid to take care of someone who might have overdosed because they think fentanyl could be around,” Moss said.

What is naloxone? Is it available over the counter?

Naloxone is a prescription medication but is available for purchase without a prescription through some pharmacies and community organizations. Naloxone is available for purchase without a prescription at CVS pharmacies in all 50 states, the District of Columbia and Puerto Rico. Walgreens also offers naloxone without a prescription. An over-the-counter version of Narcan, a spray version of naloxone, was approved for purchase without a prescription by the FDA in March 2023.

The medication works to rapidly reverse or block the effects of opioids and can be administered via a nasal spray or through an auto-injector. Naloxone will work for only 30 to 90 minutes, so a person may need multiple doses or still feel the effects of an overdose after the naloxone wears off.

How many people have died of fentanyl overdoses?

The United States has experienced three major waves of opioid deaths. They began in the late 1990s, when Americans increasingly began to overdose on prescription painkillers, such as OxyContin and Vicodin. The next wave began in 2010, when addicts turned to heroin as supplies of prescription opioids dried up. In 2013, fentanyl overdoses started to skyrocket.

In 2016, fentanyl surpassed heroin as the opioid most responsible for overdose deaths. That year, 19,720 people died of overdoses related to synthetic opioids, most of those cases involving fentanyl. In 2021, synthetic-opioid overdoses rose to 71,238.

Which parts of the country are most affected?

Some of the highest death tolls are concentrated in the Northeast and Midwest.

The first signs were detected at the state morgue in spring 2013 in Rhode Island with a sudden increase in overdose deaths. In 2021, the highest rates of overdose deaths were recorded in West Virginia, D.C., Tennessee and Kentucky.

Where does illicit fentanyl come from?

Fentanyl manufactured in clandestine labs has been traced to Mexico and China, according to the DEA.

Some of the illicit fentanyl made in Chinese labs was sent to the United States in small packages through the U.S. postal system or overnight shipping companies, making it difficult to detect. The Department of Justice announced its first indictment against Chinese fentanyl manufacturers in October 2017, when officials in North Dakota charged two Chinese nationals with selling fentanyl over the internet. The department alleged that one of the suspects operated at least two chemical plants capable of producing tons of fentanyl and fentanyl analogues.

It is also smuggled into the country across the country’s land borders, especially in California and Arizona. Fentanyl seizures at the southern border have skyrocketed since 2016. Traffickers use the U.S. interstate system to reach wholesale markets in Los Angeles, Las Vegas, Chicago and East Coast cities, where street-level drug dealers take over.

Who manufactures fentanyl?

It is important to note that there are two types of fentanyl: medicinal and illicit. The Belgian physician Paul Janssen developed fentanyl in a lab in 1960, and the FDA approved it in 1968. When fentanyl was created, it was the most potent opioid in the world. It mimics the effects of opioids including opium and morphine.

Medicinal fentanyl is prescribed to patients who experience extreme pain. It is distributed by pharmaceutical companies under names including Actiq, Duragesic and Sublimaze. Janssen’s team intended for it to be used as a painkiller that can be administered through an IV. Now, the drug is available in a pill, spray or patch.

Illicit fentanyl is created by illegal labs or drug traffickers. Fentanyl is a synthetic, man-made opioid — no plant material is required to produce it. It can be manufactured in a small lab, with relatively accessible chemicals, in just a few days. The DEA thinks that most synthetic opioids found in the United States are produced abroad.

METHODOLOGY

For the count of overdose deaths in the United States, The Post used mortality data from the Centers for Disease Control and Prevention. Reporters combined relevant causes of death together and found that fentanyl caused more deaths than car accidents, suicides, guns or falls for those between the ages of 18 and 49.

Since 2016, The Washington Post has been investigating the opioid epidemic that has ravaged communities and claimed the lives of more than 500,000 people nationwide. The series of investigations is collectively known as The Opioid Files.

The work has been honored over the years with a George Polk Award and a public service award from the News Leaders Association, as well as recognition as a finalist for the Pulitzer Prize in Public Service. A joint investigation by “60 Minutes” and The Post extending the work resulted in a two-segment ″60 Minutes” broadcast and a subsequent broadcast that won DuPont, Emmy, Murrow and Peabody awards.

The Post’s efforts culminated on July 16, 2019, with the disclosure of a previously unreleased Drug Enforcement Administration database that tracks the path of every pain pill sold in the United States. The confidential database was obtained by lawyers representing 3,000 cities, towns, counties and tribal nations in a civil action alleging that nearly two dozen drug companies conspired to saturate the nation with opioids. The database and additional court exhibits were made public after a legal challenge by The Post and the owner of the Charleston Gazette-Mail in West Virginia.

In 2021, HBO presented “The Crime of the Century,” a two-part, four-hour documentary tracing the arc of the opioid epidemic in America, focusing on the roles of the drug companies that initiated and fueled it. The documentary, by acclaimed filmmaker Alex Gibney, was based in part on The Post’s work.

In 2022, The Post published an adaptation from Scott Higham and Sari Horwitz’s book, “American Cartel: Inside the Battle to Bring Down the Opioid Industry.” In the story, Post reporters detailed how lobbyists, lawmakers and K Street attorneys thwarted efforts to stop the deadly flow of pain pills.

Here are the major findings from the reporting:

• In 2016, The Post’s first investigation documented how major drug companies had fought back against an aggressive decade-long DEA campaign to target wholesale companies that distributed huge volumes of opioid pills to corrupt pharmacies and pill mills. The Post’s investigation also showed that 13 drug distributors knew or should have known that hundreds of millions of pills were ending up on the black market, and some distributors ignored DEA or external warnings of drug diversion.

• In 2017, The Post launched a second investigation, in collaboration with “60 Minutes,” to reveal the pressure exerted by drug industry lobbyists and members of Congress to restrain the DEA. At the height of the epidemic, Congress effectively stripped the DEA of its most potent weapon against large drug companies and personally attacked the leader of the agency anti-opioid campaign, who was forced into retirement. Days after the investigation appeared, President Donald Trump’s selection to be the nation’s new drug czar, who had led the efforts backed by the drug industry in Congress, removed his name from consideration.

• In 2018 and in early 2019, as drug abusers who had been addicted to opioids increasingly turned to heroin and the synthetic painkiller fentanyl, Post reporters documented how the Obama administration failed to grasp fentanyl’s threat or to organize an effective strategy as deaths soared.

• In mid-2019, The Post obtained and published the DEA’s ARCOS database, tracing the distribution of billions of oxycodone and hydrocodone pain pills across the country. The Post initially learned 76 billion pills saturated the country between 2006 and 2012. Additional reporting revealed the breadth of distribution between 2006 and 2014: more than 100 billion pills. Just six companies distributed 76 percent of the pills during this period. The Post made the database public so it could be available to other researchers and media organizations, and more than 100 newspapers across the nation used the data to publish stories of their own.

• In 2022, a cache of more than 1.4 million records revealed the inner workings of Mallinckrodt Pharmaceuticals, the largest manufacturer of opioids in the United States. The documents, made public after years of litigation and bankruptcy proceedings, shed new light on how aggressively Mallinckrodt sought to increase its market share as the epidemic was raging.

• In late 2022, The Post published a seven-part investigation into fentanyl’s deadly surge. In 2021, 107,622 died of drug overdoses in the United States. Fentanyl was responsible for two-thirds of those deaths. The epidemic has hit the young with alarming speed and disproportionately killed Blacks and Native Americans in recent years. The amount of fentanyl seized along the U.S. southern border — the most reliable gauge of supply — has jumped ninefold during the past five years. Despite record numbers of American deaths, federal officials have been slow to react and the surge has been exacerbated by a breakdown in U.S.-Mexico counternarcotics cooperation.

‘We was addicted to their pill, but they was addicted to the money’

Norton, Va., was flooded with 306 pain pills per person per year from 2006 to 2012. Now, those devastated by the opioid crisis are demanding accountability.

Here are some other stories that tell the struggles of those affected by the crisis:

• ‘They looked at us like an easy target’: Inside West Virginia’s opioid battle
• Flooded with opioids, Appalachia is still trying to recover
• Opioid crackdown forces pain patients to taper off drugs they say they need

The battle in the courtroom

The fight over who is accountable for the epidemic has led to the largest civil case in U.S. history and involves nearly two dozen major drug companies. The 2,500 cases from around the nation have been consolidated in U.S. District Court in Cleveland. In October, several drug companies reached a $260 million settlement with two counties in Ohio. Johnson & Johnson, which owned two companies that processed and imported raw material to manufacture oxycodone, reached its own settlement. The remaining cases are pending.

Purdue Pharma, the drug manufacturer accused of triggering the nation’s epidemic through its sale of OxyContin, filed for bankruptcy in September 2019.

Dig deeper into the drug industry

Throughout its reporting, The Post learned how drug company lobbyists allied with members of Congress to derail the DEA’s efforts to go after distributors. The Post further helped shed light on the drug industry’s efforts to lobby for a law that weakened one of the government’s most powerful drug enforcement tools.

In the middle of the epidemic, the drug industry used aggressive marketing practices to ramp up the sale of opioids. Watch how they made it happen in our documentary below.

Explore two other companies involved in the distribution and sale of pain pills: McKesson Corp., the nation’s largest drug company, and Mallinckrodt Pharmaceuticals, one of the nation’s largest manufacturers of oxycodone.

The Post’s coverage over the years

2016

n early 2016, The Post began investigating how hundreds of millions of highly addictive pain pills that are sent along a tightly regulated pharmaceutical supply chain were fueling a growing, deadly epidemic.

• Starting in 2006, the DEA launched an aggressive campaign to curb the rising opioid epidemic, targeting wholesale companies that distributed hundreds of millions of highly addictive pills and to the corrupt pharmacies and pill mills that illegally diverted the drugs to the black market. But the industry fought back, and soon officials at DEA headquarters were delaying and blocking enforcement actions.

• Thirteen drug distributors knew or should have known that hundreds of millions of pills were ending up on the black market, according to court records, DEA documents and legal settlements in administrative ­cases reviewed by The Post. Even when the companies were alerted to suspicious pain clinics or pharmacies by the DEA and their own employees, some distributors ignored the warnings and continued to send drugs.

• Pharmaceutical companies have hired dozens of officials from the top levels of the DEA during the past decade. The hires came after the DEA launched an aggressive campaign to curb the rising opioid epidemic.

2017

In 2017, reporters dug deeper into the issue, working with “60 Minutes” to explore in greater depth the pressure that had been exerted on Congress by the drug industry and its lobbyists and its impact on some key DEA investigations into large drug companies.

• At the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the DEA of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets. The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken DEA enforcement efforts by working behind the scenes with lobbyists and key members of Congress.

• After two years of painstaking investigation, a DEA team was ready to move on the biggest opioid distribution case in U.S. history. Instead, top attorneys at the DEA and the Justice Department struck a deal that was far more lenient than the field agents wanted, according to interviews and internal government documents.

• In 2012, distributor Cardinal Health got word that the DEA was about to take action against a Florida warehouse that supplied millions of painkillers to customers every month. Cardinal retained one of Washington’s best-connected power lawyers, Jamie Gorelick, who had served as deputy U.S. attorney general from 1994 to 1997. She reached out to her old agency on the company’s behalf, and the impact was immediate.

2018 and 2019

In 2018 and 2019, The Post turned its focus to the synthetic painkiller fentanyl, the latest wave of the opioid crisis, which claimed the lives of about 30,000 that year. Pain pill addiction had given rise to heroin use, which in turn created a soaring demand for fentanyl, which is 50 times as powerful as heroin.

• Federal officials failed to grasp how quickly fentanyl was creating another — and far more fatal — wave of the epidemic. In the span of a few short years, fentanyl became the drug scourge of our time. If current trends continue, the annual death toll from fentanyl will soon approach the yearly toll from guns or traffic accidents.

• The depth of the fentanyl problem continues to overwhelm the government’s response, and the administration has yet to produce a comprehensive strategy that is legally required by Congress. Health policy experts say treatment funding is not nearly enough, and the Trump administration’s response was hobbled by the failure to appoint a drug czar in its chaotic first year and confusion over who was in charge of drug policy.

• The flow of fentanyl into the United States from China was facilitated for years by the illicit use of the U.S. Postal Service and other persistent vulnerabilities at the nation’s ports of entry.

• As deaths mounted from fentanyl overdoses, Congress took little action to address the epidemic or stop the flow of the deadly drug into the United States.

In July 2019, The Post obtained the DEA database of opioid distribution. Among the findings:

• America’s largest drug companies distributed billions of oxycodone and hydrocodone pain pills across the country. The Post initially learned 76 billion pills saturated the country between 2006 and 2012. Additional reporting revealed the breadth of distribution between 2006 and 2014: more than 100 billion pills. Just six companies distributed 76 percent of the pills during this period.

• The volume of pills handled by the companies climbed as the epidemic surged, increasing 51 percent during a seven-year time frame. An interactive database of pain pill shipments shows the locations that were inundated with opioids.

• Deaths from opioids soared in the communities that were flooded with pain pills. The highest per capita death rates nationwide were in rural West Virginia, Kentucky and Virginia.

• Internal documents showed the pressure within drug companies to sell opioids in the face of numerous red flags. The exhibits reveal concerns by some drug company employees about the huge number of pain pills being distributed.

• Records show that by 2006, as the number of overdose deaths grew, a handful of obscure generic-drug manufacturers were selling the bulk of opioid pills flooding the country.

• Walgreens dominated the nation’s retail opioid market. The company handled nearly 1 in 5 of the most addictive opioids and acted as its own distributor.

2020 and 2021

Post reporters continued delving into the aspects of the opioid epidemic and related developments for a fifth year, even as the covid-19 pandemic overtook the country.

• One story documented how Johnson & Johnson companies had used a ‘super poppy’ developed in Australian to make narcotics for America’s most-abused opioid pills.

• Another investigation revealed that Native American tribal lands were flooded with opioids and especially hard hit with skyrocketing deaths as the epidemic progressed. A plan by a Native American tribe to build an opioid treatment center was blocked by neighbors.

• During the course of 2020, efforts to hold the drug companies accountable bore fruit. In October, Purdue Pharma agreed to plead guilty to federal criminal charges in a historic $8.3 billion settlement with the Justice Department over the opioid crisis. In November, Johnson & Johnson and the “Big Three” wholesale drug distributors, McKesson, Cardinal Health and AmerisourceBergen, reached a tentative settlement of $26 billion deal on the opioid litigation. However, the companies were also seeking $4.5 billion in tax deductions for those costs.

2022

• More than a quarter of the doctors ranked by Mallinckrodt Pharmaceuticals as its top prescribers of opioids during the height of the pain pill epidemic, in 2013, were later convicted of crimes related to their medical practices, had their medical licenses suspended or revoked, or paid state and federal fines after being accused of wrongdoing, according to a Washington Post analysis of the Mallinckrodt documents. The documents are part of a cache of 1.4 million records, emails, audio recordings, videotaped depositions and other materials the company turned over as part of its $1.7 billion bankruptcy settlement in 2020.

• A federal judge rejected claims that the nation’s three major drug distributors bore responsibility for the opioid crisis in a West Virginia community that was among the hardest hit.

• The Post published an adaptation from Scott Higham and Sari Horwitz’s book, “American Cartel: Inside the Battle to Bring Down the Opioid Industry.” The Post reporters detailed how lobbyists, lawmakers and K Street attorneys thwarted efforts to stop the deadly flow of pain pills.

• A 17-year-old’s death in California shows how fentanyl-laced pain pills, often sold on social media, are killing record numbers of unsuspecting Americans. Anne Milgram, head of the Drug Enforcement Administration, said Snapchat and other social media firms should do more to protect their users.

• In November 2022, Customs and Border Protection seized 2,900 pounds of fentanyl at ports of entry along the southern border, the highest monthly total ever, an amount that easily eclipses what the agency confiscated during the entirety of 2018. The Cartel RX series traced the fentanyl epidemic from the back alleys of Tijuana to official Washington and from warehouses in northern Mexico to neighborhoods in Utah, Colorado and San Diego. Despite record numbers of American deaths, federal officials have been slow to react and the surge has been exacerbated by a breakdown in U.S.-Mexico counternarcotics cooperation.