It is a single letter but which causes titanic damage in Ecuador.
'H' is a cheap and highly addictive drug that is wreaking havoc among the country's poorest populations.
This heroin-based white powder that can be snorted or smoked is sold for one 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” in this drug, explains psychiatrist Julieta Sagñay of the Institute of Neurosciences, an NGO based in Guayaquil which helps 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.
A nightmarish weaning
Julia Sagñay says she is treating more and more “H” users, who are suffering 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.
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.
Clandestine rehab clinics
"They beat me, threw buckets of cold water at me and we ate chicken heads every day," says Hugo Mora, who attended these illegal, "dirty", "windowless" clinics four years ago, but where the “care” was “only $150”.
After two unsuccessful attempts in these “Nazi” clinics, as he calls them for their inhuman treatments, this informal 24-year-old salesman has been withdrawn for a week at the Bicentennial Municipal Hospital in Guayaquil, lying in one of the 14 beds of a large room with white walls.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.
This hospital receives up to 150 patients a day, 90% because of their "H" addiction.
The Insight Crime research center indicates that 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.
1 gram of heroin for 40 grams of "H"
“It's because there is so little pure drug that the addict needs to consume more of it, therefore to buy more of it,” 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.
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