All Aboard The Pharmacia Express: Adventures in Black Market Pharmacuticals.

"I believe in no God, no invisible man in the sky. But there is something more powerful than each of us, a combination of our efforts, a Great Chain of industry that unites us. But it is only when we struggle in our own interest that the chain pulls society in the right direction. The chain is too powerful and too mysterious for any government to guide. Any man who tells you different either has his hand in your pocket, or a pistol to your neck."
- Andrew Ryan, Bioshock

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Here in Mexico, just along the US border region, you can find people from everywhere, from all walks of life, but in a city with a rough census of just over 10,000 permanent residents there is one type of person you find more than any other, and most of them have Texas license plates.


Make no mistake, Nuevo Progreso is like a journey to an illicit Mecca for the 'Build the Wall', 'Git 'er Done' types of all ages. They adore the cheap dentistry, the cheaper doctors, the cheaper medications, and the amazing street food. I've seen more than a few proclaiming via t-shirt (the truest expression of American political identity, second only to the bumper sticker) their adoration of Trump and his perpetually-just-about-to-be-built wall. Though it would seem that their enthusiasm for this particular as-yet unfulfilled campaign promise has been somewhat blunted by the duel revelations that came soon after the election.


1. "The Wall" will most likely be built by seizing huge areas of land from poor American farmers and ranchers along the border, land that, to date, Mexico has no intention of paying for. Not that they have much to worry about, as the chances of it getting built rank up there with the odds of James Cameron no longer being mad that he lost the Best Picture Oscar to his bitter and damned talented ex-wife Kathryn 'Near Dark' Bigelow (She rightly won for 'The Hurt Locker', but 'Near Dark' will always be my favorite work of hers).


2. The Pharmaceutical Mecca that is places like Nuevo Progreso will become much harder to access, and thus will mean many less trips south of the border to their favorite grey market, and sometimes straight-up black market, pharmacies. Tighter border security goes both ways, and while a very small percentage of illegals cross via legit border crossings hidden in vehicles, or crossing the Rio Grande in the middle of the night, most simply enter the US legally easily and overstay a tourist visa. Build that wall, they chant, not realizing who, and what, its really going to be keeping out.


So what does that mean, besides a sudden crash in the local economy leaving hundreds of young men desperate for work. Jobs the cartels are happy to offer. They can take their chances crossing "The Wall" for a better life living illegally on the margins of the United States. 'The Wall', a supposedly 30 ft monstrosity built upon land seized from poor American farmers, is portrayed as an insurmountable obsticle for illegals to pass, but the last time I was at a home improvement store I did notice ladders that go higher than that.


Ah, technology, like the best mistress she is harsh and moves very quickly.


But enough about 30 ft walls and the wondrous technological innovation of the 31 ft ladder, let us instead turn our attention back to a more pleasant topic: illicit pharmaceuticals. Its no longer any sort of secret that the United States consumes roughly 80% of the worlds supplies of prescription (and non-prescription) opiates. Tylenol with Codeine, Darvocet, Vicodin, Percocet, Demerol, Oxycontin, Heroin, Fentanyl, and good old fashioned Morphine.


Americans have an insatiable appetite for narcotics. Oh sure, most of us down them with a glass of water or a few fingers of scotch at the end of a rough day (full disclosure: scotch + opiates + a comfy leather chair, while not recommended by any reputable medical professional, is just about the best thing ever at the end of a rough day), but no matter how we take them, be it swallowing, snorting, chewing, injecting, or even for those rare few who swear by it, straight up the ass. However we choose to get those happy little alkaloids into our bloodstream one thing is for sure; we crave more.


For a good long while Americas drug dealer of choice was any doctor willing to write whatever prescription for pain the pharmaceutical companies wanted them to push. Whatever the hot new thing was which the pharmaceutical reps were singing the virtues of (Stronger! Cheaper! Non-addictive!) while wining and dinning doctors at steak houses too expensive for most young internists to comfortably afford. To prescribe the new hotness instead of their usual stand-bys, instead of what the patient might actually need. With zero regard for how this might be affecting their patients in the long term.

"You can hear it in the valley where live the lame and the blind. They climb the hill out of it’s belly. They leave with mean black boots on.

I just made a simple gesture, they jumped up and nailed it to my shadow. My gesture was a hooker. You know, my shadow’s made of timber.

And the storm is a-rolling And the storm is a-rolling All down on me." 
- Nick Cave, Black Crow King

Rural communities got hit the hardest when a decade of rampant overprescribing came to an abrupt end. It seems one day the local doctor was no longer able to write anyone who came in with a 'bum knee' or 'bad back' a prescription for a sack full of Oxycontin or Hydrocodone. A friend of mine from such a rural area of Appalachia was once prescribed 30 10mg Hydrocodone for a tonsillectomy, 30 for each tonsil, both of which were removed in the same procedure. She ended up taking two of them, and then gave the remaining 58 generic 10mg Vicodin to me as she no longer needed them and knew I enjoyed such things on occasion. That made for a damned enjoyable summer. Drugs are fun, but even more so when drop-dead gorgeous women give them to you for free, but I digress.


The issue as illustrated by the recollection above was that this gross and dangerous over prescribing had been going on for around ten years or so, it had become frighteningly commonplace. Then, suddenly, as if by magic, the DEA and the FDA took notice. Which meant a lot of average Americans were suddenly faced with the horrors of opiate withdrawal and the untreated continuation of whatever condition brought them to the doctor in the first place. Some, like my gorgeous friend, could have easily ended up an addict from that one procedure. Others, especially those with persistent conditions or predispositions to addictive behavior, were not so lucky.

For most of the country the answer was as simple as it was repulsive: heroin. Cheap. easy to acquire, and if you 'know a guy', widely available. A lot of people seemed to suddenly 'know a guy'. Suddenly heroin was no longer an inner city problem, suddenly it was no longer an 'African American' or 'Latino' problem, suddenly it was an upper class white kid "slumming it" problem, it was a hard working blue collar problem, a suburban housewife problem, a white collar businessman problem. A problem he or she may very well have shared with mom and dad, or the neighbors, and not even realized it. It was a problem for the impoverished, it was a middle class problem, it was a problem for professionals in pretty much every field, in very short order it was everyone's problem in some way.

"People use drugs, legal and illegal, because their lives are intolerably painful or dull. They hate their work and find no rest in their leisure. They are estranged from their families and their neighbors. It should tell us something that in healthy societies drug use is celebrative, convivial, and occasional, whereas among us it is lonely, shameful, and addictive. We need drugs, apparently, because we have lost each other." 
- Wendell Berry, The Art of the Commonplace: The Agrarian Essays 

Much like Americas need for cheap labor, their need for cheap weed, and starting in the 1970's their seemingly insatiable hunger for cocaine, Mexico was there to help. Like your cool friend in the apartment downstairs who always seems to have what you need without asking questions, that friend you never seem to invite to your parties for one reason or another, Mexico was there once again to offer America some neighborly help.


If you know just the right places, on or off of main street, that is exactly what can be had in Mexico. The pills, so many pills, and the cocaine or crack if you know just the right spot or the right people. Heroin is much, much harder to come by down here as 'The Cartels' export nearly all of that product to the United States. Partly due to the United States seemingly insatiable demand, and partly because they simply don't want to see Mexico end up with the same opiate problem the US is currently dealing with.


Hell, cartel members who develop a bit of a coke problem are sent to "a farm" of sorts, rural rehabilitation clinics. That is not a euphemism. They don't mind their people partying, but when you get a little too dependent on your own product they send you somewhere for awhile to get cleaned up. If this happens too many times you might end up losing a finger as a sterner warning, but for the most part crippling addiction is simply not tolerated. This goes for non-cartel members friendly with cartel members. Neighbors, friends-of-friends, family, that kind of thing. They take care of their own.

"I've got no strings,
so I have fun,
I'm not tied up to anyone.
They've got strings
But you can see,
There are no strings on me." 

- Pinocchio, I've Got No Strings (lyrics: Leigh Harline & Ned Washington )

Simply walking the streets shortly after I arrived here I found a cornucopia of drugs available the likes of which I have never known. At three different establishments of varying degrees of apparent legitimacy I was offered, and shown, Tylenol with Codeine, Vicodin, Percocet, and their non-acetaminophen containing pure counterparts Hydrocodone and Oxycontin (in 30mg or 80mg tablets), and even boxes of sealed ampules of pure liquid morphine. The pharmacist even explained to me the correct starting dosages, best needles, and offered an entire junkie starter kit to go with the morphine at no extra cost. The box, clearly from a US pharmaceutical company, containing the same sealed ampules you will find in the narcotics cabinet of any US hospital, was as legit as it gets.


I confess that despite my distaste for needles the offer was rather tempting, the price was right, and the salesman nether pushy nor shady. It was about as casual as choosing paint schemes at a big chain home improvement store. "Oh, you don't like needles? Well, we got oxy's in 30 or 80 milligram pills, or you can always mix the morphine with vodka and take a shot that way." I walked out of that particular pharmacy, one of the slightly more out of the way locations yet still close to main street, sorely tempted by the sales pitch.


As much as I enjoy the mans writing, all I could imagine was my life taking a very, very William S Burroughs direction if I had said yes. Thankfully I never shot my wife by accident, she merely divorced me on purpose. Still, Nuevo Progresso could pass for Interzone easily if one is wandering around at 3am with a head full of weird ideas, poor impulse control, and an arm full of American manufactured high-test medical grade junk.


My primary source among the pharmacy market, we shall call him simply 'El Doctor', has been in the business for over ten years at this point. He began his career as a 'flyer guy', one of the countless touts who stand in front of pharmacies and on street corners on the main drag through Nuevo Progresso. They call out to the tourists in broken English for drugs of all varieties, all legal more or less. The less legal, the more hushed the tones. If the pharmacy they seem to work for won't sell the good stuff over-the-counter with no questions asked, they are always ready to usher you to one that will. Usually its not far, most of the time it seems to be right next door.


El Doctor worked his way up from flyer guy to full fledged pharmacist with his own shop, which appears just as legitimate as any other in the area. Because it is. He has a talent for the business to be sure, regardless of your ailment or intentions. He asks questions when the customer seems unsure of what it is they need, legal or otherwise. This wasn't for my benefit, he was doing this long before I revealed myself as something other than just another American looking for opiates with no questions asked. El Doctor knows his trade, no matter how honest your conditions or intentions.


It took a little while to gain his confidence enough for a proper sit down interview to be sure. El Doctor is a friendly guy, easy going, but not by any measure stupid. He took his time to check out my credentials, to make sure I was indeed who I claimed, even watched a few short films I wrote, and then still took time to make sure I was indeed serious. He is every bit as gregarious as I come off, but no less paranoid. I can honestly say I like El Doctor, caution and healthy paranoia in ones business dealings are something I can deeply appreciate.

"A paranoid is someone who knows a little of what's going on." 
- William S. Burroughs

About 80% of the stock in El Doctors fine establishment is purchased above-board, from legitimate worldwide pharmaceutical companies. The other 20% comes from the United States illicitly. People trade their unwanted or unused narcotics for drugs they do need but can't afford due to one medical insurance issue or another. This ratio seems to apply to a lot of the pharmacies along the border. In Nuevo Progresso, El Doctor estimates, only about 4 pharmacies have completed the nightmare of bureaucracy required to obtain a proper license to dispense controlled substances, specifically narcotics. The rest obtain them the same way he does, or by other means.


Interestingly enough all of the pharmacies deal with 'The Cartel' (whichever one is currently in charge of the region) but not like you might expect. Protection money is paid, of course, cost of doing business in any area where organized crime is prevalent. No different than the Italian or Jewish mafias in the US, the Bratva in Russia (and in the last few years, some areas of the US), or the Yakuza in Japan. Some things are the same no matter where you hang your hat or do business. All that differs is the currency exchanging hands.



Its the supply provided by 'The Cartel' that I found surprising. Not narcotics like one might expect, El Doctor revealed that instead the most popular item they have been providing the pharmacies for years now is generic Viagra from China. Carbon copies of the American name brand and generics in every way. Viagra is the drug the pharmacies can't keep in stock, and so turn to 'The Cartels' to enhance their supplies. 'The Cartels' don't deal with US pharmaceutical companies, too much red tape, too much risk, so they simply buy knock-offs-so-good-your-aging-erection-can't-tell-the-difference from their Chinese counterparts.

[[All aboard the Ancient Erection Express! Toot! Toot!]]

The other fact I learned, which I found much less surprising, is just how aware of the ins-and-outs of this illicit trade in their products US pharmaceutical companies are. According to El Doctor they are very, very aware, how could they not be? They just don't give a shit where their products end up. As long as they got paid initially by someone legit so they can show the DEA and the FDA they are complying with the law, they give exactly zero fucks.


Despite my initial experiences, El Doctor says only about 50% of the pharmacies will dispense narcotics illicitly. Most are legitimate pharmacies looking out for their customers, and even among the ones that do deal in black market medical grade junk you still find honest pharmacists looking out for their clients best interests. Their American clients best interests.


A much, much smaller percentage of pharmacies will sell narcotics sans prescription to locals/Mexicans. For the exact same reason the cartels don't sell heroin locally, they don't want Mexico to have the same opioid crisis currently ravaging the United States. They see the effects on the evening news, most people down here have American satellite TV, they read the reports in the newspapers, and they see the victims crossing the border to find a friendly pharmacy that will feed their addictions. The Mexican government, and even the cartels, simply don't want that happening to their people. No matter how good the business could be. Short term vs long term investment, cost-benefit analysis, these people are men of business after all, and an epidemic of that sort isn't good for business, or anyone for that matter.


El Doctors American drug connections come across the border with all sorts of things to trade for drugs, not just money. Computers, cell phones, TVs, anything of value to potentially trade, mostly electronics, and, of course, other drugs. The suppliers he has for narcotics also tend to come with other narcotics to trade, like Fentanyl patches (which can be cut into four equal squares in order to get 72 hours of opiate enjoyment per square, instead of just a single serving). One of the more popular, and thus more expensive products is rather shocking; Suboxone.


For those unfamiliar Suboxone is an opioid-agonist, used in the long-term treatment of heroin or other narcotic addictions. The most popular form of this is the sub-lingual strips, dispensed at rehab clinics because of its ease of ingestion and difficulty for the patient to slip it into their cheek to save up for a larger dose later. Despite being used in the treatment of addiction it still has some of the euphoric properties of opiates, not unlike its predecessor in the opiate treatment market, Methadone (interesting aside, methadone was developed by the Nazi's during WWII as a substitute for morphine, of which their supplies were dwindling near the end of the war).

 "I have always been here before
allowing my mind's call of no love
incorporate more never stops his flow
I have always been here before
that that is pleasing
that that is real
that that is forever keeps filling never filled
that that snuck up on you in the night
that that you remember him an early child delight
that that was supposed to have frightened you
but somehow you never took to fright." 

- Roky Erickson, I Have Always Been Here Before

The sub-lingual Suboxone strips usually arrive in boxes from the US, still sealed, and fetch top dollar for yet another strange reason. They, in some form I am not exactly savvy to the particulars of this practice, are easy as hell to smuggle into jails and prisons. Due to the fact that one can get an opiate-like high from them and they are easy to smuggle into controlled environments they are very, very popular.


El Doctor trades for them, usually for Xanax, rarely does he have to pay for them from the American suppliers. El Doctor estimates that nearly all of them sold in Mexico came first across the border into Mexico from the United States, then right back across the border. Most apparently bound for a federal correctional facility outside of Houston, Texas as well as other prisons in the region. None of the pharmacists that El Doctor deals with can keep the sub-lingual Suboxone strips, or pills even, in stock for any appreciable amount of time, at nearly any price. They go for top dollar in Mexico, and even more in American prisons. Better than toilet Merlot I guess.

"The only time I have any fun anymore Is when I'm drunk,

but I just can't drink no more or I'll die.

The only time I have any fun anymore Is when I'm stoned, but I can't get stoned no more or I'll die, and I don't wanna die tonight." 
- Those Poor Bastards, The Only Time

Despite having worked in such a fashion as to call myself a journalist of any sort only a handful of times in the past I feel that in the interest of full, honest and no doubt shocking disclosure I have not always walked out of the more illicitly stocked pharmacies empty handed. One product purchased due to the ever-present-and-occasionally-crippling spinal pain which despite a stack of x-rays and MRI scans clearly showing that my spine is "all kinds of fucked up" to actually, seriously quote one of my doctors, no US doctor will prescribe me anything stronger than ibuprofen. Which I took in the prescribed massive quantities despite feeling no relief whatsoever for so long that it eventually fucked the lining of my stomach and I started vomiting daily, until I stopped taking it. Good times. I did get a prescription for Tramadol/Ultracet once and found it only slightly effective, I also discovered I was allergic to it. Lucky me. Another doctor once told me being perfectly frank was that there were three reasons I would be unlikely to get a prescription for anything useful. I am male, of Hispanic descent, and under 50. Three things I can do very little about.


The other product I walked out with, also for pain, but of a much, much higher caliber, was less for therapeutic reasons and more just to see if I could and how easy it would be. Turns out I could, it was easy, and I've frankly had a fantastic time with it. Makes a beer and a shot-or-three of Wild Turkey after work seem rather passe, and much, much less effective. Nothing involving needles, despite those initial temptations and availability. Its funny, every doctor has told me to stop drinking so much despite that being all I had for the pain. Like some haphazard Old West dentist, whiskey was the only anesthetic I had available. Now I have easy access to pain medication and find my alcoholic ass drinking much, much less. Not that I have entirely given up drinking, that is doubtful to ever happen.


Unlike my drinking, America giving up its junk problem will probably happen at some point, but not until the people making literal dump trucks full of money on the war on drugs, on both sides of the border, stop making as much from it as they are. Or start treating the problem as some saner countries are, as a public health issue rather than a criminal one. I'm not talking about the local pharmacies here in Mexico, they are a symptom of a problem, not the problem itself. Like Suboxone strips smuggled into prisons in no doubt embarrassing ways, if people want something they will do/pay whatever it takes to get that very thing.

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This post copyright James Radcliff, and has been brought to you by Mexico, tequila, and generally poor decision making. If you would like to donate to support this bizarre little travelogue, feel free to do so via Patreon or PayPal. As always, this strange and debaucherous adventure has been brought to your screen by viewers like you. Thank you.

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