The CCTV images recorded on New Year's Eve were relayed to the Municipal Health Center which came to his aid.

"When I use drugs, I hear voices," the 24-year-old woman who is in rehab, her second in less than a year, told AFP today.

Rina has gone so far as to steal and even prostitute herself to obtain "H", a white heroin-based powder that can be snorted or smoked, sold for a dollar per gram.

Much cheaper than cocaine which trades between three and five dollars.

But much more toxic.

"We found lime, cement, ether, ketamine and even rat poison," says psychiatrist Julieta Sagñay of the Institute of Neurosciences, a Guayaquil-based NGO that comes to help for drug addicts.

This port city of nearly three million people has become a hub for drug trafficking in Latin America, with the number of traffickers and drug addicts on the rise.

According to official figures, some 162 kilograms of "H" were seized in 2022.

Julia Sagñay says she treats more and more "H" users, who suffer from an accelerated deterioration in their state of health compared to her other patients.

After six months of consumption, an "addicted to H", stamps constantly, scratches, sleeps or eats.

And the withdrawal syndrome cannot be supported without pharmacological treatment for at least eight days, explains this specialist with more than 30 years of experience in drug addiction.

A doctor examines a minor suffering from drug addiction problems at the Bicentenario hospital in Guayaquil, Ecuador, on January 6, 2023 © MARCOS PIN / AFP

"Nazi" clinics

Guayaquil has three public addiction treatment clinics that cannot cope.

About thirty private establishments exist but the cost is around 700 dollars a month in a country where the minimum wage is 450 dollars.

So when addiction eats away at them, some "H junkies" turn to underground rehab centers.

"They beat me, threw buckets of cold water at me and we ate chicken heads every day," Hugo Mora, who attended these illegal, "dirty", "windowless" clinics, told AFP. ", but where the "support" was "only $150".

For nothing.

After two unsuccessful attempts in these "Nazi" clinics, as he calls them for their inhuman treatment, this informal 24-year-old salesman has been in withdrawal for a week at the Bicentennial Municipal Hospital in Guayaquil, lying in one of the 14 beds of a large room with white walls.

Eleven are occupied by men curled up in their blankets.

The hands of a patient with substance abuse issues at Bicentenario Hospital in Guayaquil, Ecuador, on January 6, 2023 © MARCOS PIN / AFP

This hospital receives up to 150 patients a day, 90% because of their addiction to "H".

The Insight Crime research center says the "H" moved to Guayaquil around 2011 at the instigation of Colombian cartels seeking to develop the heroin market.

But the "H" powder contains less than 3% heroin, estimates Segundo Romero, a retired policeman now a forensic psychologist.

"It's because there is so little pure drug that the addict needs to consume more, therefore buy more," he says.

With one gram of heroin, the dealer makes 40 grams of "H".

The synthetic drugs contained in the rest of this dangerous cocktail cause psychotic symptoms and hallucinations.

In Cerro Las Cabras, the drug supermarket of Duran, a town on the other side of the Rio Guayas which crosses Guayaquil, the sale of "H" brings in, according to official estimates, up to a million dollars a month.

© 2023 AFP