Here's what the deadliest drug-related public health crisis in American history looks like

It's one fentanyl overdose every seven minutes. Teams of paramedics responding to frantic emergency calls, trying to revive victims, often arriving too late.

The deceased are sometimes sprawled out in the dark, as if they were shot, but the accessories to death are needles or pills or powder, strewn next to the bodies. The fentanyl they consume - in some cases unsuspectingly - is trafficked into the United States in hatchbacks and sedans, stashed in trailer parks and homes that are occasionally the sites of dramatic busts. But law enforcement officials now recognize their limits: They seize only a fraction of the fentanyl that enters the United States.

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It is not only an American crisis. Fentanyl is now manufactured in Mexico - and it flows through the country on its way to the border. Much of it remains in cities like Tijuana, where communities of deportees have become addicts. Paramedics there are stretched even thinner than their American counterparts, trying to save overdose victims in a country where naloxone, which reverses the effect of opioids, is almost impossible to find.

In Tijuana, the trafficking of synthetic drugs like fentanyl has prompted a surge of violence - and it's the users who are frequently victims. They sleep outside, next to heaps of garbage, sometimes swallowed up by feuds with the men who sell them fentanyl. Traffickers and dealers have taken over much of the city, converting even piñata factories into fronts for their drug businesses.

Mexican authorities seize thousands of pounds of drugs there a month. Much of it is stored as evidence in a converted garage - even though many fentanyl cases never come to trial. Vast quantities are incinerated at a military outpost outside Tijuana. But most of the fentanyl makes it to the border and then across it, a bulk destined for the thousands of Americans who will die almost immediately after consuming the drug.

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