This illustration image shows tablets of opioid painkiller Oxycodon delivered on medical prescription taken on September 18, 2019 in Washington,DC. - Millions of Americans sank into addiction after using potent opioid painkillers that the companies churned out and doctors freely prescribed over the past two decades. Well over 400,000 people died of opioid overdoses in that period, while the companies involved raked in billions of dollars in profits. And while the flood of prescription opioids into the black market has now been curtailed, addicts are turning to heroin and highly potent fentanyl to compensate, where the risk of overdose and death is even higher. (Photo by Eric BARADAT / AFP)
Shaking and delirious, Rina ambles half-dressed beside a dump in Ecuador’s port city of Guayaquil. She is under the psychotropic effects of “H,” a cheap and addictive drug that is ravaging the poorest sectors of Ecuadoran society.
The scene was captured on video on New Year’s Eve and relayed to the municipal health centre, which came to her aid.
“When I consume [the drug] I hear voices,” the 24 year old, who is using a pseudonym, said. For the second time in less than a year, she is following a drug rehabilitation programme.
In her desperation, Rina stole and even worked as a prostitute to buy H, a heroin-based white powder that is sold for $1 (about R17) a gram. H is cut with all sorts of toxic materials.
“We have found lime, cement, ether, rat poison and even ketamine, an analgesic used on horses,” in the white powder, said psychiatrist Julieta Sagnay, from the Guayaquil-based Neuroscience Institute, an NGO that supports drug addicts.
Guayaquil, a city of almost three million people, has become a hub of drug trafficking and addiction. Officials say 162kg of H were seized in 2022.
Sagnay, an expert with more than 30 years of experience treating addicts, said the number of patients she treats for H use is increasing every day.
And their physical condition deteriorates quicker than other patients. In just six months, H addicts are constantly moving their legs, scratching and not sleeping or eating.
Withdrawal symptoms are so severe, said Sagnay, that it is unbearable without at least eight days of pharmaceutical treatment.
There are three public clinics in Guayaquil for addicts and there are more than 30 private ones, but they can cost up to $700 a month in a country where the minimum wage is just $450.
Some addicts turn to back-alley detox centres.
“They beat me, they poured a bucket of cold water on me and we ate chicken heads every day,” said Hugo Mora, who was treated in a dirty, dark, illegal centre with no windows. It only cost $150 but it was a failure.
After trying out two such clinics, the 24-year-old street vendor spent a week in a municipal hospital. The hospital takes in up to 150 daily patients, 90% of whom are suffering from an H addiction.
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The InSight Crime think-tank says H arrived in Guayaquil in 2011, pushed by Colombian cartels hoping to develop the heroin market.
But the H powder contains less than three percent heroin, according to forensic psychologist and retired police officer Segundo Romero.
“As there is so little pure drug, the addict needs to consume more and buy more.” In Cerro las Cabras, the drug supermarket in Duran, a town opposite Guayaquil along the Guayas river, H sales bring in $1 million a month, according to official estimates.
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