Fentanyl Is Making Its Way Into Various Drugs Sold in the U.S. Here’s How It Gets There

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Judy Woodruff: Tonight, the second part of our series on the ravages of the synthetic opioid fentanyl. Last night, we took you to Mexico to see where illegal cartels make it. Tonight, the deadly cost of the drug just across the U.S.-Mexico border in Arizona. Again with the support of the Pulitzer Center, special correspondent Monica Villamizar and producer Zach Fannin report.

Monica Villamizar: A tall stretch of border wall separates Nogales, Arizona, from its sister city, Nogales, Mexico. Despite the heavy security measures, this area is a main smuggling route for fentanyl and other illicit drugs, both above and below ground. Border Patrol agent Kevin Hecht gave us a rare peek at subterranean tunnels designed a century ago to catch water run-off from Mexico. In recent years, tunnels have also been used by drug smugglers.

Kevin Hecht, U.S. Border Patrol: They tunnel through the floor in here, or tunnel through the wall, and dig to a house or dig into a drainage pipe in the U.S. And then they come out of the pipe, and they might go to a car, might have another short tunnel to the bottom of a car. Where the reflective yellow is, that's the border fence.

Monica Villamizar: Hecht also showed us this more cramped training tunnel, where his agents learn how to navigate to the land below Nogales. He says smugglers connect their illicit tunnels to the existing ones.

Kevin Hecht: If they know that there is a big long pipe here, why dig this, when you can use it? So they will breach it, and then will make — try and conceal it the best they can and put the whatever they — like, if they cut this out, they will glue it back in, or seal it back in, and then only open it when they need it. And then they will crawl this to the next point, where they don't have any more pipe, and then they will dig another illicit tunnel.

Monica Villamizar: So far in 2021, Hecht and his team have not intercepted any drugs in the tunnels. The vast majority of drug interceptions, including fentanyl, are caught by officers at U.S. ports of entry like this one in Nogales. Guadalupe Ramirez is the director of field operations for Customs and Border Protection's Tucson Sector.

Guadalupe Ramirez, Customs and Border Protection: Years ago, they'd make a compartment in the gas tank, so half the gas tank had gas, the other half had narcotics. And then they started going to the quarter panels. They started going to the tires. Now they're using drive shafts, transaxles, transmissions, even inside the motor. I guarantee you can, if you can imagine it, it's been tried.

Monica Villamizar: From August 2019 to July 2020, Ramirez and his officers seized just over 1,100 pounds of fentanyl. During that same period of time this year, they seized twice that amount, almost 2,300 pounds. Eighty miles to the east, Sargent Tim Williams works in a specialized unit for the Cochise County Sheriff's Department that tracks smugglers crossing a rural area of the border.

Sgt. Tim Williams, Cochise County Sheriff’s Department: My main strategy is using this little camera that we have here. It's called a BuckEye. These things allow us to get real-time information about what's crossing and what's not. So, we see a lot of, like, what we call military males, between 20- and 30-ish-year-old males crossing the border.

Monica Villamizar:The team was launched in 2017, and has caught over 400 drug smugglers so far. Their cameras have captured groups of drug mules crawling on the ground, and even this man with an automatic rifle. Just down the road, the border fence ended.

Sgt. Tim Williams: Where we're standing right now is where, in Cochise County, the fence officially ends on our Western border, and it doesn't start again until roughly around Nogales, which is about 70 to 80 miles away.

Monica Villamizar: After President Biden was sworn in earlier this year, he signed an executive order that stopped construction of former President Trump's border wall. Today, scattered pieces of wall and construction equipment dot the U.S. side of the Southern border, along with long stretches of the fenceless border. Arizona State Senator Christine Marsh's 25-year-old son, Landon, was one of last year's 90,000 overdose deaths. Since fentanyl is so inexpensive, it has made its way into virtually every illicit drug. Fentanyl is now found in cocaine, methamphetamine, heroin, and even the painkiller Percocet. Marsh says her son took a Percocet that was laced with fentanyl.

State Sen. Christine Marsh (D-AZ): He had one wild night with a childhood friend, and that resulted in his death. And I contend that one wild night shouldn't be a death sentence. And he didn't have a habit of taking anything. And I, unfortunately, know that, because I'm the one that went through all of his stuff. There's no evidence of any type of drug use.

Monica Villamizar: After her son's death, Marsh discovered that these testing strips that can tell users if fentanyl has been added into other drugs were illegal in Arizona.

State Sen. Christine Marsh: He was the kind of kid who was prepared for everything. I have no doubt that, had the strips been available, he would have used it.

Monica Villamizar: Earlier this year, Marsh brought a bill to Arizona's state Senate floor that proposed the legalization of these fentanyl testing strips. It was signed into law weeks ago.

State Sen. Christine Marsh: The law was signed on the one-year anniversary of Landon's death. I'm very grateful that there was there was that tiny bit of, "We're going to turn around and save some other lives on Landon's death date."

Danielle, Graduate Student: Next semester is all going to be research, and then I have to do two comprehensive exams.

Monica Villamizar: This is Danielle. She didn't want to give us her last name. She is in her 30s and is currently a graduate student at a university in Phoenix.

Danielle: I'm supposed to produce a dissertation, prospectus, defend it. Yes, then I will get my fancy little cap, and I will be a doctor.

Monica Villamizar: Danielle is probably not the image most people think of when they picture a heroin addict who's been using for over a decade.

Danielle: I think that there is a reason that people kind of scapegoat the most visible type of struggling person that they see.

Monica Villamizar: Just over a decade ago, Danielle hid her addiction from her employer. The result was so graphic, we are blurring our footage.

Danielle: I would try to avoid injecting in my arms or somewhere visible. I would inject in my legs. I also wasn't aware that, even if I wasn't sharing syringes, that reusing dull needles could traumatize the circulation in my legs.

Monica Villamizar: First, she got a skin infection. She says, over time, that her tissue damage progressed.

Danielle: Part of what you see is like venous insufficiency now. So, without that blood flow there to bring oxygen, the, like, soft tissue dies, and then it doesn't heal ever. If someone had just been like, hey, if you are going to continue to inject drugs, here are some things you can do to prevent this from becoming a lifelong issue for you.

Monica Villamizar: Danielle wishes she could have received transparent information about how to use heroin as safely as possible. She said she had to suffer because drug users are often stigmatized.

Christopher Abert, Founder, Southwest Recovery Alliance: All drug users are pretty much routinely despised, hated, and feared in our society.

Monica Villamizar: Danielle's friend Christopher Abert, who is also a drug user, is the founder of the Southwest Recovery Alliance. Despite having the word recovery in the group's name, their main focus is to help decriminalize drugs in the U.S. and help drug users reduce harm.

Christopher Abert: The idea of, like, focusing on the drug itself is the problem, and it's not the conditions and concurrent illnesses that accompany some people's drug use that are actually the root of the problem. So, if you focus on this idea of this, like, chaotic drug user who's dangerous, then you lose the picture of the fact that human beings have been doing drugs for a millennium, and doing them without the — what is ailing our society, like, right now, death, disconnection, destruction, disease.

Monica Villamizar: The group also laments that fentanyl has flooded the illegal drug market and has made heroin harder to procure.

Christopher Abert: I can inject heroin, and about eight hours later, I will start coming out of that high. And then, eventually, the withdrawal will set in, and I will have to start again. But with fentanyl, it's about four hours after I do the shot. So people are having to use more and more and more. So, I think, for me, personally, I would much prefer heroin.

Monica Villamizar: One hundred and fifteen miles south, in Tucson, the newly elected Democratic county attorney, Laura Conover, is changing how the criminal justice system treats drug users. Today, that means passing out food aid to her constituents.

Laura Conover, Pima County, Arizona, Attorney: We're here out in the neighborhoods that have been decimated by the war on drugs. What we want to look at is a new way forward in making sure that we are not continuing to attempt to incarcerate our way out of substance use disorder.

Monica Villamizar: At the New Jerusalem Baptist Church, Conover is trying to personally connect with this Black and Latino community that's been disproportionately affected by the war on drugs.

Laura Conover: Good to see you. How are you?

Monica Villamizar: To get the word out that her office is not prosecuting all drug offenses.

Laura Conover: When we're talking about simple possession because there's a substance use disorder, we are looking to make sure that we are moving those people back into the medical and behavioral health realm, where that belongs.

Monica Villamizar: However, Conover cautions, her office is not legalizing the sale of narcotics.

Laura Conover: When we are talking about high-level distributors, those who are making a profession of causing harm in our community, we have the resources and labor ready to hold them accountable and prosecute them.

Monica Villamizar: For the past 50 years, the demand for drugs in the United States has proven insatiable.

Laura Conover: If addiction is always going to be with us, then let's treat it like the illness that it is. When we bring people back to healthy lives, the demand for the product goes away.

Monica Villamizar: From crack, to heroin, to methamphetamine, to the most deadly illicit opioid America has seen, fentanyl. For the "PBS NewsHour," I'm Monica Villamizar in Arizona.