A Los Angeles fentanyl dealer stands by, watching intently as a Mexican drug cartel operative prepares his latest shipment. The synthetic opioid narcotic is wrapped in foil, sealed in plastic, and then loaded into the gas tank of the inconspicuous car in which it will be smuggled.
Jay, not his real name, had previously crossed from the United States to this house run by a Mexican cartel. The house looks like any other in the neighborhood. We are ordered to enter quickly, and an iron gate closes behind us. They don't produce drugs here, but they are still careful not to attract attention. People speak in hushed voices and work quickly.
Their deadly business has become the center of a global economic conflict. The White House is using the smuggling of fentanyl across the U.S. border as a key argument for increasing tariffs on other countries. U.S. President Donald Trump has also vowed to "wage war" on the drug cartels.
The BBC has gained a rare insight into the cartel's operations along the border and their team travelled to the US to meet their end customers and check whether the international conflict is having any impact on the illegal flow of drugs.
The people we meet in the house are ordinary soldiers of a well-known cartel. The two who load the car admit that they sometimes feel guilty. But when I ask the man who packs the drugs into the gas tank if he feels guilty about the deaths caused by the pills, he smiles mockingly.
"We have families too, of course we feel guilty. But if I stop, it will continue. It's not my problem," he tells me, shrugging his shoulders.
The men keep their faces covered as they remove the back seat of the car to get to the fuel tank, careful not to spill fuel. The smell of gasoline in the car could alert customs officials on the other side of the border that the tank has been opened.
Light green pills, 5.000 of them, marked with the letter M, carefully packaged, just a fraction of what Jay says he sells each week in Los Angeles and across the northwest US.
"I try to get 100.000 pills every week," the dealer tells me quietly. "I don't send them in one vehicle. I try to spread them out in different cars. That way I reduce the risk of losing all the pills."
In response to the unacceptable influx of illegal drugs and immigrants into the U.S., President Trump imposed a 25% tariff on all goods from Mexico. Some of those tariffs were later delayed until April 2.
Combating the fentanyl trade is one of the main goals of the Trump administration, but Jay doesn't believe in its success.
"Last time he was in power, he tried the same thing, and nothing changed. There will always be demand. And where is the biggest demand? In the United States, lucky for us. We're here, on the border," Jay says with a smile.
So much of the drug is entering the U.S., mostly from Mexico, that, according to Jay, the price at which he sells fentanyl in Los Angeles has dropped from about $5 or $6 per pill last year to just $1,50 today.
Mexican police say cartels have massively switched to fentanyl, which is 50 times more potent than heroin, because, unlike other opiates made from poppy seeds, it is completely synthetic and far easier to produce and transport.
Fentanyl's potency and addictiveness have left a deep scar on American society: drug overdoses claim more lives in the US than firearms or car accidents.
The number of deaths has begun to decline, thanks in part to the wider availability of the opioid-reversing drug naloxone. But the latest figures are still alarming: 87.000 overdose deaths (mostly from opioids) from October 2023 to September 2024, down from 114.000 the year before.
To avoid punitive tariffs from the White House, Mexican President Claudia Sheinbaum has promised to send 10.000 National Guard troops to the border. The government has arrested more than 900 people in Sinaloa, a major drug trafficking hub, since October. In December, Mexico announced its largest seizure of fentanyl in history: more than a ton of pills. In fact, the country has seized more fentanyl in the past five months than in the previous year.
Mexico has also made it harder to import the key ingredient in fentanyl from China, forcing cartels to reduce the strength of each pill, making them less deadly.
In late February, 29 senior drug cartel members were extradited to the US, including members of five of the six Mexican crime syndicates that President Trump's administration recently designated as terrorist organizations.
President Sheinbaum also authorized the CIA to increase drone surveillance operations over Mexican territory in search of fentanyl labs, after the media revealed the secret missions.
Jay is aware of the dangers of his job, both for himself and his customers, but it doesn't worry him.
"They always try to blame us, that we are poisoning American citizens. But they are the biggest beneficiaries," he says coolly.
Cartels often use American citizens to smuggle drugs across the border because they are less likely to be stopped by U.S. customs. The driver, who identifies himself as Charlie, has an American passport. He too is indifferent to the suffering caused by the fentanyl epidemic.
"I need money," he says. Asked how many times he's transported drugs, he replies, "Too many." (I later learned that 5.000 pills in the tank crossed the border without a problem.)
Speaker Sheinbaum recently pointed out that the US fentanyl crisis began with the legal but "irresponsible approval" of painkillers like OxyContin back in the late 1990s. "The US government must take responsibility for the opioid crisis that has claimed so many lives," she said.
Across the border, Derek Malc, the interim head of the DEA, is promising aggressive operations against the cartels. But he admits that targeting the cartels alone will not solve the problem: "We have a serious problem with demand in America."
Malc says that targeting cartel organizations alone will not solve the opioid crisis.
"The cartels are bad people," he says. "They are transnational criminals. They are narco-terrorists. But there is a big demand problem in America, we have to address the reason why our population is turning to drugs as a way to help."
For the past six years, the number is 2.931. She turns the pages, and that number, written in red, comes alive in the memories of the people she has saved and those she has lost.
She begins to list: "A man in his sixties... a man in his thirties... a woman in her thirties, very thin, no hair." Next to each name on this list of fentanyl victims is the number of doses of Naloxone, sold under the brand name Narcan, that she used to try to revive people.
Ms. Picardo, who runs a support center called Sunshine House, operates what she calls a "judgment-free zone." She is disgusted by the terms "junkie," "junkies," and "zombies" that have been used to describe people in her neighborhood. Instead, she calls everyone "sunshine."
Some he doesn't remember, and others he will never forget.
"Look at this one, seven years old, two doses of Narcan," she points out. Ms. Pichardo was called to a neighbor's house where a woman was holding a child who had turned blue. Ms. Pichardo went in and the child was lying on the floor, but as she entered, the child's father ran up the stairs carrying a bag. "I thought, if that was my child, I would run to help," she recalls.
At first she thought it might be epilepsy, but then she noticed the drugs and plastic bags on the table. The child's father was a dealer; the seven-year-old was poisoned from his stash and overdosed. "I was furious," she says.
Those two doses of Narcan were enough to save the child's life.
On the second page, a woman, six months pregnant, two doses of Narcan. She survived too.
In Kensington, drugs are cheap and readily available, and people do drugs in the open. As she walks through the neighborhood, Ms. Pichardo finds people passed out on the sidewalk, a woman in a stupor with her pants down, a man lying by a subway entrance, another man in a wheelchair, his eyes closed and money in his hands.
He, like a growing number of opiate users, has had his leg amputated. A new street drug, the veterinary sedative Xylazine, is mixed with fentanyl. It causes open wounds that become infected. In some places, the air is stifling.
John White is 56 years old and has been battling addiction for 40 years. At Sunshine House, Mrs. Picardo serves him a bowl of homemade soup.
"I've been in this city my whole life," he says. "The fentanyl and opiate epidemic is the worst I've ever seen. Fentanyl infects you so you have to take more. That's why they put it in everything."
Mr White suffered a fentanyl overdose after smoking a joint laced with the drug: it is added to all kinds of illegal drugs, including heroin, cocaine and marijuana.
Ms. Pichardo doesn't see much hope that, even if the fentanyl trade is stopped from Mexico, it will improve the lives of people in Kensington.
"The problem with the war on drugs is, it didn't work then, and I don't believe it will work now," she explains.
When the supply of one drug is cut off, another one takes its place, she says. "It used to be heroin, now it's gone. Now it's fentanyl. When there's no more fentanyl, there's Xylazine. So they'll find a way to keep people addicted, so they can make money off of them, off of people's suffering," Ms. Picardo says.
Directly from “Sunshine House,” a young woman is found collapsed on the sidewalk. Ms. Picardo quickly arrives on the scene, with her medical kit, once again administering Naloxone. The woman ultimately survives.
In Kensington, the largest open-air drug market on the East Coast of the United States, Rosalind Picardo has been leading a rescue mission for six years. Her notebook is overflowing with the names of those she has revived with naloxone.
As he saves another life, he adds a new number to the last page of his worn Bible.
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