By Sarah Jane Tribble | Kaiser Health NewsDecember 12 at 5:15 AM
This Kaiser Health News story can be republished for free (details).The nation’s most influential science advisory group will tell Congress today that the U.S. pharmaceutical market is not sustainable and needs to change.
“Drugs that are not affordable are of little value and drugs that do not exist are of no value,” said Norman Augustine, chair of the National Academies of Sciences, Engineering and Medicine’s committee on drug pricing and former CEO of Lockheed Martin Corp.
The report, “Making Medicines Affordable: A National Imperative,” identifies eight steps to cut drug prices. It also provides a list of specific “implementation actions” for various federal agencies, including Congress, the Federal Trade Commission and the U.S. Departments of Justice and Health and Human Services.
Today’s hearing, which is the third in a series by the Senate Health, Education, Labor and Pensions committee, comes as Americans across the political spectrum say lowering the price of prescription drugs is a top priority. Yet, while individual states have passed laws for more transparency and price controls and President Donald Trump has publicly called for lower drug prices, Congress has stalled.
So, will the committee’s recommendations spur action? Kaiser Health News takes the political temperature, talks to experts and rates their chances:
Recommendation No. 1: Allow the federal government to negotiate drug prices
Current law prohibits the U.S. Health and Human Services Secretary from directly negotiating drug prices and the committee says that’s ridiculous.
The committee recommends Medicare and other agencies negotiate which drugs are placed on a list of covered drugs and, when necessary, exclude some drugs. This is not a new idea.
Some states are already restricting high-priced drugs in Medicaid, the state-federal insurance program for low-income Americans. But federal efforts to change Medicare are more complicated.
Just two months ago, top House Democrats introduced another Medicare negotiation bill. But don’t hold your breath, Trump hasn’t responded to multiple letters sent from Rep. Elijah Cummings (D-Md.) — including one after the most recent bill was introduced in late October. That bill hasn’t moved past the health subcommittee.
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Recommendation No. 2: Speed approvals of safe and effective generics and biosimilars
This recommendation has a strong ally at the Food and Drug Administration.
Commissioner Scott Gottlieb announced a “drug competition action plan” in June and followed it up two months ago with a new set of policies aimed at speeding the drug approval process for complex generics. More changes are expected too, as Gottlieb wrote in his blog post “if consumers are priced out of the drugs they need, that’s a public health concern that FDA should address.”
But the pharmaceutical world knows which games to play to keep competition at bay. The committee specifically recommends the U.S. Department of Justice and the Federal Trade Commission should watch for anti-competitive tactics, such as pay-for-delay and extending exclusivity protections. The U.S. Supreme Court weighed in on pay-for-delay, saying settlements between brand-name drug makers and generic rivals warranted antitrust review, The total number of these deals has fallen in recent years.
To further encourage generic approvals, Congress could include several proposed bills, such as the so-called CREATES Act, in a final year-end package, said Chip Davis, president of the generics and biosimilars lobby Association for Accessible Medicines.
“People are starting to pay more attention” to anticompetitive patent tactics, Davis said.
Recommendation No. 3: Transparency
The committee takes direct aim at drug prices by saying that Congress should make manufacturers and insurers disclose drug prices, as well as the rebates and discounts they negotiate. It also asks that HHS curate and publicly report the information.
States have taken the lead on price transparency with Vermont the first to pass a law, which requires an annual report on up to 15 drugs that cost the state a lot of money and have seen price spikes. In Congress, Sen. Ron Wyden (D-Ore.), introduced a bill in June that would impose price-reporting requirements on some drugs. It now sits in the Senate finance committee. The pharmaceutical industry has fended off most price disclosure efforts in the past.
Notably, the committee also recommends that nonprofits in the pharmaceutical sector — such as patient groups — disclose all sources of income in their tax filings. That’s a move that would reveal exactly how much the pharmaceutical companies are supporting advocacy groups.
Recommendation No. 4: Discourage the pharmaceuticual industry’s direct-to-consumer advertising
Now, the committee recommends Congress eliminate the tax deduction pharmaceutical companies are allowed to take on direct-to-consumer advertising.
This is an idea that should have wide support. Polls show that most Americans favor banning the ads and federal lawmakers have tried to change the rules on so-called DTC for years. The American Medical Association called for a ban on pharmaceutical advertising directly to patients in 2015, saying there were concerns that the ads were driving up demand for expensive drugs. The FDA provides guidance for the advertising and, in August, FDA Commissioner Gottlieb said he may reduce the number of risks manufacturers must reveal when advertising a medicine.
In a sign of just how entrenched the tax break is in D.C. politics, Sen. Dick Durbin (D- Ill.) introduced a bill last month that doesn’t eliminate the break but takes a step to rein in the advertising. Durbin’s bill would require manufacturers to provide the wholesale price of a drug in their advertisements.
Recommendation No. 5: Limit what Medicare enrollees pay for drugs
The committee ticks off a to-do list for Congress when it comes to what older Americans and those with disabilities are paying for drugs.
Their recommendations include asking Congress to establish limits on total annual out-of-pocket costs for Medicare Part D enrollees and telling Congress to make sure the Centers for Medicare and Medicaid Services efforts to guarantee enrollee cost-sharing is based on the real price of the drug as well as how well the drug works.
Turns out, there is already some limited movement on this one.
Medicare allows negotiations between the corporate insurers and pharmacy benefit managers who help administer the Part D program. CMS announced last month that it is exploring how to pass on the behind-the-scenes manufacturer rebates to patients, though it warns premiums may rise if they make this move.
Recommendation No. 6: Increasing oversight of a very specific federal drug discount program
The committee is stepping into a hot-button political issue by recommending increased transparency and oversight of a program that Congress created in 1992.
The program, known as 340B, requires pharmaceutical companies to sell drugs at steep discounts to hospitals and clinics that serve high volumes of low-income patients. Congress held two hearings this year, questioning who is benefiting from the discounts and the Centers for Medicare and Medicaid Services recently announced it was slashing Medicare reimbursement to some hospitals enrolled in the program.
Hospitals are fighting back, filing a lawsuit over the reimbursement cut. The committee, echoing concerns from House Republicans, recommends making sure the program helps “aid vulnerable populations.”
Recommendation No. 7: Revise the Orphan Drug Act
The committee wants to make sure the 1983 Orphan Drug Act helps patients with rare diseases.
The law, intended to spur development of medicines for rare diseases, provides financial incentives for drugmakers such as seven years of market exclusivity for drugs that treat a specific condition that affects fewer than 200,000 people.
The program has been under fire this year after Kaiser Health News, whose investigation is cited by the committee, reported that approved drugs often gamed this system and won won blockbuster sales for more common diseases. The Government Accountability Office has begun an investigation into the program after receiving a request from top Republican senators and FDA’s announced a “modernization” plan for the agency this summer.
The committee’s requests include limiting the number of exclusivity periods a drug can receive and making sure drugs that win the financial incentives really do treat rare disease. Finally, the committee says HHS should “obtain favorable concessions on launch prices, annual price increases,” and more.
Recommendation No. 8: Make sure doctors prescribe drugs for the right reasons
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Medical practices, hospitals and doctors should “substantially” tighten restrictions on office visits by pharma employees, and the acceptance of free samples, the committee recommends.
This isn’t the first time the national group has recommended controlling drug samples and visits. In 2009, the then Institute of Medicine said doctors and medical schools should stop taking free drug samples. It may have worked — to some extent. A study this year found that academic medical centers that limited visits saw changes in prescribing patterns.
Now, the National Academies committee says doctors in private practice should also stop taking free samples and welcoming pharmaceutical visits. The AMA, which is nation’s largest membership group doctors, supports physicians using samples on a voluntary basis, particularly for uninsured patients.
Imagine that you’re the parents of four children under the age of eight. Your home is strewn with stuffed animals and sippy cups. And, if you’re a couple named Colby and Lacey (a real couple from Utah), you keep drug paraphernalia next to the bassinet and smoke heroin in front of your children.For the life of me, I don’t know why anyone who is an addict would decide to become a parent and bring an innocent child into his or her sick drug den. My only conclusion is that some parents figure someone else will raise their children while they do drugs, drink, party, commit crimes, Snapchat, plant fake crops on FarmVille, and do anything but parent. They’d rather have the latest and greatest iPhone than help their children figure out eighth-grade algebra.
Thankfully, that’s not most parents in Louisiana, but it describes too many.
Life is precious. Anyone who’s looked into a newborn’s innocent eyes should realize how incredible it is to be blessed with a new life. That couple named Colby and Lacey allegedly gazed into their newborn’s eyes and then rubbed drugs into the child’s gums to hide the fact that she had been born addicted to heroin. Nurses say some parents do this all the time to hide their infant’s withdrawal symptoms.
Here’s my advice to couples like Colby and Lacey: Stop having children if you don’t plan to raise them.
A lack of good parenting sense isn’t just a problem for Colby and Lacey. Last month, an eight-year-old girl tested positive for cocaine in Baton Rouge, La., after a relative brought her to the hospital because her mother refused to do so. When authorities located the mother, she had cocaine and drug paraphernalia in her possession.
My heart aches for that child. At eight years old, you should be playing games, painting your fingernails purple, getting glitter on everything, and learning how to bake cookies. The last thing you should be doing at that age is testing positive for cocaine.
I don’t know that mother’s story, but I do know that she failed her child.
Too many parents are failing their children these days in Louisiana. Thousands of children are in the state’s foster care system. A woman in West Monroe was just honored for mothering 100 foster children over the years. Think about that: That one woman had to do the parenting for countless parents.
Too many people treat parenting like it’s the 20th item on their to-do list. Their social life, drug habit, and sleep schedule matter more to them than their children do. Talk to teachers and they’ll tell you: Children show up unbathed, unfed, and unprepared at school when they show up at all. Sometimes the system catches them and shuffles them into a foster home. Tragically, sometimes the system fails them like their parents did.
It’s not fair to those children, and it’s certainly not fair to our communities. Those children grow up broken. They don’t glue themselves together and get a scholarship to Louisiana State University. They often drop out of school, do drugs, commit crimes, and hold down minimum-wage jobs. They’re flushed down the toilet before they’re potty trained, and then taxpayers are left to take care of them.
Studies of high-performing schools tend to find a common thread: parental involvement. Those same studies show that the more interest you have in your children’s education, the better they do in school. The Southwest Educational Development Laboratory found that a family’s income does not determine how well kids score on tests or how often they show up for school. The determining factor is parental involvement.
Abraham Lincoln is a good example of the benefits of parental involvement. Lincoln easily could have died an illiterate farmer. He grew up on the frontier, where schoolteachers made sporadic appearances and lost his mother at a young age. An uneducated woman named Sarah Bush turned the tide for him. Sarah married Lincoln’s father and encouraged a rather feral Lincoln to nurture his love of reading. She thrust books in front of him. She ensured that he had a comfortable home and treated him like he was her natural child. That’s good parenting, and it helped shape Lincoln into one of this country’s greatest presidents.
But you don’t have to raise a future president. You just have to raise a child who has a little common sense, graduates from high school and stays off the road that leads straight to prison and drug addiction.
We launch public awareness campaigns to encourage people to recycle their soft drink cans, stop smoking and wear seat belts. Maybe we need to launch campaigns to encourage people to raise their children. Most Louisiana parents don’t need that encouragement. But if we are honest with ourselves, we have to admit that some do.
Having children is a blessing. Treat your children like the blessings they are or don’t have them at all. Our foster care system and jails already are at capacity. There’s no more room at the inn.
Sen. John Kennedy, R-La., was elected to the Senate in 2016. You can follow him on Twitter: @SenJohnKennedy
In the United States, we have been hearing a lot about the drugs that are made from this plant over the past few years. I admit to those of you who don’t know me that I am neither a scientist, psychotherapists nor a medical doctor. I am just an average 61-year-old person who reads a lot and who pays attention to reality the best that I can. Even though I am not the smartest person in the U.S. I am a person that strives to be bluntly honest about everything even if I don’t personally like the results of the answer. Truth has ‘no spin’ to it! I have said a few times before on this website that there really is only one real Truth, and that is ‘God’s’ Truth. When you/we/I have an argument concerning any issue, if we can honestly say that we would stand before our Creator, look Him in His eyes and tell Him that we are speaking the Truth, then that argument would be the Truth, to the very best of our personal knowledge anyways. Either that, or we would be acting like a total idiot and or a fool because we would be condemning our own self on purpose.
I have a question for each of us, do we/you/I believe that the politicians in D.C. are looking out for our best interest or their own best interest? Do you believe that your Congressman/woman, Senator or President cares more about you, or about the lobbyist who is funding their next campaign and or their personal lifestyle? Now, before I get into the meat of this article on the Opium issue I will tell you up front that Marijuana legalization is something that I totally agree with. I believe, excuse me, I know, that Marijuana helps with nerve pain, I am 100% sure of that. Back when I was in the U.S. Army I was directly struck by a lightning bolt. Even Social Security says I am disabled even though the VA doesn’t agree that the lightning has anything to do with me being disabled no matter what the non-VA Doctors and other experts have to say about it. As most of you know the Federal Government and the crooked ignorant putz AG Jeff Sessions say that Marijuana is just as or even more dangerous than Heroin and they class Marijuana as a class one narcotic, just like Heroin. To believe the Federal Government’s argument a person would have to be either clueless just plain ignorant or ‘on the take.’ The Feds say that Marijuana has no medical value even though that is totally contrary to all of the scientific evidence that says the Feds are lying.
So, the argument comes down to, why does the Fed’s keep lying? Or, do you really believe they are simply that ignorant? As long as the Federal government continues this policy the VA is not allowed to prescribe Marijuana to the service-connected disabled Veterans. The VA has no problem pumping many billions of taxpayer dollars worth of pills into the disabled Vets every year whether we need them or not but they refuse to allow the Veterans to use God’s given Herbs for pain relief. What is even worse is that if the VA in one of their blood or urine test finds THC from Marijuana in your system, they will cold turkey you off of the drugs they are giving/selling to you. This is even though doing this to people on some of these medications can easily kill a person. Why would any remotely honest or caring person do that to people? The answer to this is simple folks, its money.
For those of you who don’t believe me, I am going to offer you some cold hard facts as to why I used the title of this article. Even if you are a person who says they would never ever smoke Marijuana, does that mean that you have any right to insist that others cannot, no matter what? I am going to use last November’s Elections in Arizona as a perfect example. This example shows just how dirty big Pharma is, I am going to show you just how much they want people to die from Opium use and the reason is simple, money!
Within everyone’s brain, there is what is called an MU Opioid Receptor. This is something that Opium sticks to in a person’s brain. Morphine is an Opioid drug, just like Heroin is so I am going to use them in this example. Even though Pharma made drugs like Morphine and Oxycontin are very expensive even on the street drugs like Heroin are amazingly cheap. Yet there is another man-made drug called Fentanyl, a synthetic form of Heroin that is even cheaper and easier to make than regular Heroin. Trouble is this that this street drug Fentanyl is about 100 times more powerful than Heroin and it is very deadly even to come into contact with very much of it at all. Fentanyl has become a major problem for first responders, EMS and Police as they do come into contact with it many times every day. These days Ambulances and Police Vehicles are being required to carry the ‘antidote’ for their own safety’s sake.
This ‘antidote’ is called Narcan and Narcan is a drug that is big Pharma made and distributed. Concerning Opium products like Heroin and Morphine the antidote, Narcan works quite well at knocking the Opium off of the MU Receptor yet it does very little to help get the Fentanyl off of the MU Receptor. Don’t get me wrong, people are still dying every day from Opioid overdoses also. The Fed said that Opioid overdoses are up more than 400% here in the U.S. since the year 2000. The big Pharma company’s who make Narcan know this fact very well, so do the politicians yet they prove to all of us that they do not care about all of these thousands of people who are dying nor their families, nor even the First Responders.
Now back to the 2016 Elections in the State of Arizona. The facts show that in the States that have made recreational Marijuana legal that Opioid overdoses and deaths are down about 50%. On a side note, in these states alcohol sales are down about 25%, think of how many people aren’t getting into car accidents because of drinking and driving. Also, think of how many domestic violence deaths aren’t happening in those States and how many fatal ‘bar fights’ aren’t happening. Yet the reality is that big Pharma companies make billions from their pharmacy-made drugs so just like last November in Arizona they pumped in many millions of dollars in false advertisements to try to get the people of Arizona to vote down making Marijuana legal in their State. The sad part is, they were successful in Arizona. The big Pharmaceutical companies have been pushing hard to get Narcan into every ambulance, police car, school, and home in America. There is only one reason for this and that is money, to heck with people’s lives, the only thing that really matters is a company’s profits. These Pharmaceutical companies know that Marijuana is a natural painkiller but they aren’t making any money off of a plant that anyone can grow in their own garden. Now, you do understand why I said that the politicians and people like AG Jeff Sessions want to keep Marijuana illegal don’t you? The answer is very simple, campaign contributions from these big Pharma Companies and because of many who own stocks in these same big Pharma Companies.
Here are some of the companies who put huge amounts of money into last November’s ‘anti-pot’ vote in Arizona. I got this information from (The Guardian, US News And World Report, Business Insider, the Huffington Post, and from Equities.com News.)
These companies are:
Walgreens Boot’s Alliance Inc
Amphastar Pharmaceuticals Inc
Opnet Technologies Inc
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The poll found that 51% of Republicans support marijuana legalization, a figure up nine points from a Gallup poll conducted last year.
The increase in legalization support comes as Attorney General Jeff Sessions, a Republican who has frequently criticized the use of marijuana, hasn’t yet announced whether he’ll continue to abide by more lenient Obama-era guidance and avoid enforcing federal law in states that have legalized the drug.
A record-high percentage of Americans — 64% — support marijuana legalization. Support was only 12% in 1969 when Gallup first started polling adults on this issue. A majority of Americans have supported legalization since 2013.
Among Democrats and Independents, legalization support is now 72% and 67%, respectively.
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A number of states and the District of Columbia have legalized marijuana at the state level and more than two dozen, including the district, have legalized it for medical purposes.
The Gallup poll is based on telephone interviews conducted October 5-11, 2017, with a random sample of 1,028 adults, aged 18 and older, living in all 50 US states and the District of Columbia.
CNN’s Laura Jarrett contributed to this report.
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Despite wider recognition in recent years of the pervasive opioid epidemic spreading throughout the US, death rates from prescription drug overdoses have continued to skyrocket. Deaths from heroin and opioid painkiller overdoses have more than quadrupled since the start of the millennium and have now surpassed car accidents as the leading cause of accidental deaths in the country. But while admission of a problem is the first step to recovery, identifying and eventually addressing the numerous factors that led to this point will still take years, if not decades, to repair.
Until then, over 125 people are dying each day on average from drug overdoses—well over half of which are from heroin or prescription painkillers like hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), codeine, and related drugs. It’s a frightening statistic, and government and health officials around the country have been desperate for something to help them get a handle on the spiraling epidemic. That’s a primary reason for the exploding interest in Naloxone, a life-saving drug that counters opioid effects, including reversing overdoses.
On Monday, Walgreens (WBA) announced that it is making Naloxone, a medication that counters opioid overdose, available in more than 110 of its pharmacies in Alabama without a prescription. The rollout is part of Walgreens’ nationwide plan announced in February to make Naloxone available without a prescription in 35 states and Washington DC. Thus far, New York, Rhode Island, Massachusetts, Indiana, Ohio, Pennsylvania and now Alabama have expanded access to the medication. The program is expected to expand Naloxone availability to 5,800 of Walgreens’ 8,500 locations in the US. CVS (CVS) is also rolling out the drug in 14 states as well.
Pennsylvania, meanwhile, also made news recently when health officials introduced a plan to make Naloxone available at all of its high schools. Drug overdoses accounted for 2,000 deaths in the state last year.
The Race to Make Naloxone a Household Drug
Approved by the FDA in 1971, Naloxone is a generic drug that has actually been around for decades. It was used primarily in hospitals and by paramedics, but in recent years, higher demand for first responders and police officers to have the medication kits on hand has driven up the price of the drugfrom only $1 as recently as a decade ago to over $40 today. While the drug has been increasingly heralded by government and health officials as a biotech wonder drug and critical weapon against the growing epidemic in recent years, the outcry over aggressive price hikes has also been getting louder.
Now, with Naloxone becoming readily available over the counter across the US, demand is only going to increase, especially if consumers are being told they need to keep the medication handy in case of an emergency situation, however improbable that may be.
In November 2015, Adapt Pharma Ltd.’s NARCAN Nasal Spray formulation was approved by the FDA, opening the naloxone market up to the OTC market. The NARCAN Nasal Spray is based on the intranasal opioid antagonist platform technology of Opiant Pharmaceuticals, Inc. (OPNT)—which changed its name in February from Lightlake Therapeutics. In March, Opiant received a $2.5 million milestone payment from Adapt following the first commercial sale of the NARCAN Nasal Spray. Under the licensing deal, which was signed in December 2014, Opiant could receive total potential milestone payments of more than $55 million, and up to double-digit percentage royalties on net sales.
Suddenly, a Rapidly Crowding Market
But Adapt isn’t the only game in town. Hospira (a subsidiary of Pfizer [PFE]) and Amphastar Pharmaceuticals (AMPH) have been the leading providers of injectable naloxone for years, and the principle drivers of the price hikes.
Amphastar has also been selling an intranasal application, which administers its injectable formulation with an atomizer, for some time now. The company has also said it’s working on a naloxone nasal spray. In 2015, naloxone sales accounted for $38.6 million of the company’s $251.5 million in annual revenue, but was its fastest-growing segment with increased volume and higher average prices.
Another competitor, Kaleo Pharmaceuticals, is selling a naloxone auto-injector called Evzio at a considerably higher price of about $700-$800 per dose. Biotech giant Mylan (MYL) also sells a naloxone injectable formulation after obtaining FDA approval in 2014. Embattled INSYS Therapeutics (INSY)—which has seen its stock price collapse in the past year as a result of backlash to its opioid-based painkiller Subsys Fentanyl—also got its naloxone candidate designated on the fast track by the FDA.
More Price Hikes to Come?
For all the life-saving benefits of naloxone, it’s important to remember that, at best, it’s just a stop-gap solution to treat a symptom—albeit an incredibly significant one—rather than a cure for a condition. Critics of wider naloxone availability point to the possibility that expanded access creates a moral hazard and doesn’t address the crux of the problem—which is the actual opioid addiction. But again, that is a systemic problem that will take years, if not decades, to resolve.
In the meantime, pharma companies know they have yet another life-saving drug in their pipeline and the means to leverage it for more dollars from willing buyers. But one of the key advantages that companies like Hospira and Amphastar had a few years ago was that they owned an essential monopoly on the naloxone market—largely due to competitors leaving the space over time and thus reducing price competition. But as the field continues to get more crowded over time again, the window to maximize profits could be beginning to close. It’s just a matter of supply and demand at this point.
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It had only been a few weeks, maybe a month, since Jose Camacho had been relieved of his prison shackles and stepped off a U.S. immigration bus into the dusty streets of Ciudad Juárez to set about building a new life south of the border. That’s when an old friend showed up. Not a friend, really — someone he knew. A guy he’d met on the inside. “Let’s get a beer,” he suggested. Camacho didn’t drink anymore, and he told the guy so. But the guy was persistent. Squinting over the guy’s shoulder, Camacho could see someone else in the car, a man he didn’t know, but he recognized the tattoos. This wasn’t an invitation.
“Entra,” the stranger said. Get in. Then Camacho made yet another mistake in a life that had no shortage of them.
“I should’ve never got in the car,” Camacho tells me, recalling the story several years later between drags on an off-brand cigarette, a poor man’s substitute for the Marlboro Reds he can no longer afford.
It’s a hot afternoon in late April, and Camacho and I are at the home of Jose Francisco Lopez, a 73-year-old U.S. Army veteran, who is tending to a wok full of taco meat while a handful of men — mostly ex-military, plus a reservist from El Paso — swap stories about their time in uniform. Spools of concertina wire run along the wrought iron bars that flank the small, square courtyard. All of the houses in this part of Juárez are like this. Every street looks like a row of jail cells. But Camacho isn’t referring to the local architecture when he describes Juárez as being “like prison.” He’s talking about the gang culture, which is deeply rooted on both sides of the border. Here, there’s no escaping your past.
The friend was working for a drug cartel, and he was approaching Camacho with a proposition. Work with us. Camacho, a former Army cavalry scout, had a skill set that was very much in demand. “They knew I had been in the Army because of what I had to do in prison to survive,” he continues, explaining that he had also done a stint behind bars in California for home invasions. He gestures toward the rest of the guests. “Ask any of these guys. If you’ve been in prison over there and you live in Juárez, you’ll get approached.”
At 61, Camacho would be a top contender for the World’s Scariest Grandpa award. He resembles a Danny Trejo character, but with a longer rap sheet and more prison tattoos. Like many career criminals, his resume is inscribed in permanent ink on his body, in a constellation of words and symbols that people who’ve lived the sort of life Camacho has can readily interpret. There are a lot of those people in Juárez. At least one tattoo identifies him as having once been affiliated with a Mexican-American gang aligned with La Linea, the armed wing of the Juárez cartel. On his forearm, there’s an image of an American GI accompanied by the words Vietnam Veteran Recondo.
Camacho didn’t fight in Vietnam, but he did serve in the U.S. military between 1974 and 1980, first in the Army and then the Navy, and was honorably discharged from both. His DD214 lists his military occupational specialty in the Army as armor reconnaissance specialist (hence the tattoo). He never got a chance to put his combat skills to work in the jungles of Southeast Asia, but he’s spent most of his life after the service applying those skills elsewhere. “Military experience is money in Mexico,” he says.
Camacho kept his mouth shut as the car left the city limits. “I had to agree right away,” he says, “because if you don’t, they’re going to beat you up or probably kill you. Period.” Eventually, the men dropped him off at a compound in the middle of the desert. There, he says, he was paid to teach members of one well-known cartel the weapons skills and small-unit tactics he’d learned in the Army. He tells me he wasn’t the only U.S. military veteran who worked on the compound. (Although Task & Purpose was unable to confirm this claim, more than one source described it as an open secret.)
“Over there, we were wetbacks. Here, we’re gringos.”
Camacho eventually fled the compound and made his way “across the goddamn sierra” back to Juárez. Last year, he heard about a safe house for deported U.S. military veterans in Tijuana called The Bunker and contacted the group that runs it to see if they could help him secure his military benefits, and possibly get him back over the border, where he hopes to spend the remainder of his days in peace. They put him in touch with Lopez, whose house will soon double as the official Bunker in Juárez. Not long ago, the house was, more or less, an actual bunker. Lopez recalls waking up many nights to pitched gun battles being fought in the neighborhood. Sometimes he’d think he was back in Vietnam.
“I wanted to move to Tijuana, but then I heard the Gulf Cartel is there,” Camacho says. “They’d just kill me on the spot if they saw my tattoos.”
Camacho graciously accepts a plate of tacos from our host and then sets it aside, noting that he’s trying to eat healthy. He doesn’t strike me as the clean-living type, but staying physically fit, he explains, is important when you’re a debt collector in Juárez. That’s what Camacho does for work now — he’s a strongman for local businessmen in a city with a notoriously corrupt police force. It’s not a complete departure from his former life, but it’s certainly an upgrade. He lifts up his shirt to reveal a back brace and sighs. “My bones are getting dry,” he says. “There will come a time when I can no longer make money.” It’s hard to rough people up when you have dry bones. It’s also hard to run.
“I stay in one house for three or four months, and then I move. If I see something I don’t like, I boogie,” Camacho says, explaining that he’s biding his time, waiting for the people who still know him from his prison days to die off. “Eventually, they will. I just have to survive that long.”
That evening, Camacho and several other deported veterans gather around a table to discuss their predicament — the first of many such meetings that will happen here. The conversation eventually turns to President Donald Trump’s stance on immigration and his calls to seal up the border. Everyone agrees it’s the right thing to do.
“What if you invited me into your house, and I start fucking your wife, and spit in your food, and rob you?” one guys asks. “What are you going to tell me? You’re going to say, ‘Fuck you, homey. Get the fuck out of my house.’” But by virtue of their service, he adds, veterans merit a different sort of treatment. He compares the military to a street gang that works together to defend its turf from rivals. “Then I fuck up and you tell me I’m no longer welcome on this turf? Hold on, ese, I fought for this turf. My mom lives on this turf.”
I bring up The Wall. Will the migration stop if it gets built? The question is met with laughter. Camacho answers first: “Can they build it miles underground? Can they build it into the sea? Nothing can stop people from getting over. Nothing.” Behind us, Lopez and a few other deportees have begun arranging legal documents on a table for the men to fill out. There’s not a single person in this group who hasn’t broken the law. Some have committed crimes much worse than crossing the border illegally. But they’ve come to The Bunker to try a new approach, and, in many ways, it’s the path of most resistance. Nobody in their situation has ever been allowed to return to the United States.
There are currently three ways for an immigrant veteran who’s been deported following a conviction for an aggravated felony to return to the United States legally.
One option is to appeal the case, but it has to be done quickly. “From a practical point of view, if someone has already been deported and is now in their home country, this is no longer an option,”says Sophia Gregg, an immigration attorney with the Legal Aid Justice Center in Virginia.
Another option is for the deported veteran to secure a pardon, either from the president or the governor of the state they were convicted in. This doesn’t guarantee re-entry into the United States, but it is a necessary step before one reapplies for legal resident status. Only three deported veterans have received such pardons. So far, none have returned to the States.
The other option, statistically more feasible, is to die; all veterans discharged under conditions other than dishonorable, even if they’ve been deported, are entitled to a military funeral and burial with full honors.
In that scenario, the VA will pay $300 toward the cost of returning the body to the United States. Federal law mandates that the ceremony must be performed by an honor guard detail consisting of no fewer than two active members of the armed forces. The casket remains draped in the American flag until “Taps” is played (by a bugler if one is available), and then the flag is meticulously folded into a triangle and presented to the deceased’s next of kin.
Under Trump, those are likely to remain the only options. After all, guys like Camacho are exactly the type of immigrants to whom the president was referring when he said, “We have some bad hombres and we’re going to get them out.” Why would he want them back? Still, Camacho and a growing cadre of deported veterans living Mexico believe they can find sympathy among even the staunchest conservatives in Washington. Because it was also Trump who vowed to “take care of our veterans like they’ve never been taken care of before.”
As a country, we go to great lengths to ensure that military veterans are cared for. We shower them with praise and free meals at Applebee’s. We pay for their college and give them access to free health care. When they get in trouble for minor crimes, we send them to special courts that take into account the hardships they endured in the service. We even spare them the death penalty when they’ve massacred innocent civilians. But for veterans who are non-U.S. citizens, the support stops the moment they’re convicted of an aggravated felony.
The biggest challenge for deported veterans wanting to return to the United States legally is persuading people — specifically, American policymakers — to view them as former U.S. service members who made mistakes (and paid for them), rather than run-of-the-mill undocumented criminals.
It doesn’t help that many have settled in the dangerous border towns of Mexico, where jobs are scarce and crime pays. They have done so not because they enjoy the scenery but because many have family just across the border, and their occasional trips south represent the veterans’ only remaining connection to the lives they once lived. To leave the border towns would mean to give up on the dream of return.
Ironically, however, their proximity to the border has placed them in the crosshairs — at risk not only of being killed in one of the most dangerous places on earth, but of being pressed into service by the cartels, forced into a criminal lifestyle they have long since left behind. Nearly all of the veterans I met in Juárez told me they’d been approached by the cartels. Left to build new lives among the drug traffickers and sicarios that Trump’s wall is meant to keep out, many must rely on skills they acquired in the military and behind bars to survive.
Lopez is the director of the recently established Juárez chapter of Deported Veterans Support House, a Tijuana-based nonprofit founded in 2013 by Hector Barajas, a former Army paratrooper, who was deported to Mexico in 2004 and is now the leading advocate for deported U.S. military veterans worldwide. The Department of Homeland Security, which is responsible for tracking deportations, has no idea how many veterans of the U.S. military have been deported. Some estimates put the number in the thousands. Barajas says his organization has helped 300 deported veterans scattered across 36 different countries.
Through grassroots activism and social media, Deported Veterans Support House has managed to bring together a small network of nonprofit groups, veterans organizations, and individual volunteers to help deported veterans secure military pensions and benefits, and perhaps one day return to the United States. To date, their efforts have yielded only one notable success story: In 2016, an Iraq War veteran named Daniel Torres was allowed to return to the United States five years after he was deported to Mexico from France. (After the Marine Corps had discharged Torres upon discovering that he had used a fake birth certificate to enlist, he’d tried to join the French Foreign Legion.) But his situation was unique: he had never been convicted of an aggravated felony.
Aggravated felony is a term of art used in U.S. immigration law to describe a broad category of criminal offenses, from violent crimes like murder and sexual assault, to drug possession and theft. A host of petty offenses — filing false tax returns, for example — can also be labeled an aggravated felony if immigration authorities deem the circumstances around it to be evidence of “bad moral character.”
“Sometimes it is simply a misdemeanor plus another petty charge,” Gregg explains. “For example, it can be a petty drug charge plus a petty trafficking charge. But that doesn’t necessarily mean you were moving cocaine in from Guatemala to sell it in Texas. It can be as simple as, you got caught taking a joint of marijuana from one county to another. That could be called ‘trafficking.’”
Meet The Men Of Deported Veterans Support House
Deported Veterans Support House is a nonprofit founded in 2013 by Hector Barajas, a former Army paratrooper, who was deported to Mexico in 2004 and is now the leading advocate for deported U.S. military veterans worldwide. The Department of Homeland Security, which is responsible for tracking deportations, has no idea how many veterans of the U.S. military have been deported. Some estimates put the number in the thousands. Barajas says his organization has helped 300 deported veterans scattered across 36 different countries. Task & Purpose’s Adam Linehan went to Juarez to hear their stories in person.
The deported veterans who have banded together in Juárez include criminals of all stripes. But they rarely discuss their pasts. Their focus now is on the future — “getting back home” — and helping each other survive in the meantime. The mission binds them like soldiers at war. A brotherhood with few allies on either side of the border, they are men without a country.
“Over there, we were wetbacks,” one tells me. “Here, we’re gringos.”
On March 16, 1966, a U.S. Army reconnaissance platoon was moving down a narrow jungle trail in Vietnam’s Long Khánh Province to reinforce a battalion of paratroopers engaged in a massive firefight, when it inadvertently walked into the rear of an attacking North Vietnamese Army formation. The pointman spotted the enemy first and motioned for a grenadier to come forward and initiate a hasty ambush. He didn’t have time to get off a single shot before a barrage of enemy grenades and machine-gun fire began pummeling the platoon from all directions. They were pinned down.
The platoon medic was a man named Spc. Alfred Rascon. Over the course of the engagement, which lasted between 10 and 20 minutes, he was wounded four separate times, beginning with a bullet that entered his hip, rode up his spine, and exited through his shoulder. But that’s not why there’s a school for Army combat medics named after him.
“You have this man who served his country, who went to the Middle East, and now he sleeps on a couch in a house that didn’t even have running water when he showed up.”
Rascon earned the Medal of Honor that day. His medal citation is one of the more exhaustive on record, owing to the fact that Rascon used his own body to shield his comrades from enemy grenades — not once, but a total of three times. One explosion Rascon absorbed was so close it blew his helmet off. But he never stopped fighting. In fact, he refused to be airlifted out of the jungle until he had treated everyone else in the platoon who’d been wounded. He barely survived.
Lengthy as it is, Rascon’s citation does not mention that he had immigrated to the United States from Mexico when he was a child. Nor does it mention that he didn’t become a naturalized citizen until after he returned home from Vietnam. And why would it? Those details aren’t relevant to the story. “The men I served with did not even know that I was not a citizen, nor did they care,” he later recalled in an interview. “They just called me ‘Doc.’”
Rascon’s actions in Vietnam won him a spot in America’s pantheon of war heroes, but they also place him among a long overlooked subclass of warriors that has been vital to the military since its inception. Like millions of immigrants before him, Rascon chose to enlist in the Army; however, many others were drafted during Vietnam, as they had been during all of the major wars before that (approximately 18% of GIs who served in World War I were foreign-born). Which is to say, countless immigrants — whether enlistees or conscripts — have bled and died fighting on behalf of the United States.
Even in the all-volunteer era, immigrants have continued to serve in high numbers. In fact, one of the first U.S. service members killed in action in the Iraq War was Marine Lance Cpl. Jose Gutierrez, an orphan from Guatemala who smuggled himself into the United States and was only naturalized after his death. He was one of approximately 3,000 non-citizens who participated in the invasion of Iraq, and one of 10 who were killed within the first month of the war. To some extent, those numbers were by design.
By 2002, with the war in Afghanistan underway and the march to Baghdad on the horizon, it became clear in Washington that special measures would be required to fill the ranks of an all-volunteer military tasked with a massive mission. On July 3 of that year, President W. Bush signed an executive order to provide expedited naturalization for “aliens and non-citizen nationals serving in an active-duty status.”
Previously, non-citizens serving in peacetime were required either to have lived legally in the United States for five years or to have served three years on active duty before they were eligible to apply for citizenship. Bush’s order cut the wait time for post-9/11 immigrant service members down to one day.
Bush was doing what presidents before him have done during virtually every major conflict since the Civil War: Entice immigrants into the military by dangling the promise of U.S. citizenship. Of course, not all immigrants enlist for citizenship. Many are drawn to service for the same reasons citizens are — money and other benefits, job stability, a sense of patriotism, the desire to fight for a cause greater than themselves. Still, the executive order appears to have had an impact. Between December 2000 and February 2003, the number of non-citizens on active duty jumped from 23,000 to 37,000, with thousands more in the reserves.
In the years that followed, a series of additional laws and programs, including one that made it possible for foreign-born recruits to take the Oath of United States Allegiance upon graduating basic training, were implemented. Between September 2001 and 2015, roughly 102,000 immigrant service members and veterans from all generations were sworn in as U.S. citizens.
Given the unprecedented access to citizenship through military service, why have so many veterans been deported? That question was the focus of a July 2016 report by the American Civil Liberties Union. Entitled “Discharged, Then Discarded,” it blamed the issue on “bureaucratic bungling” and “government indifference.”
“The federal government’s failure to help naturalize immigrants serving in the U.S. military has led to the deportation of untold numbers of veterans, all of whom were entitled to become citizens because of their service,” read a statement from the ACLU that accompanied the report.
“Deported veterans were in the United States legally and sustained physical wounds and emotional trauma in conflicts as far back as the war in Vietnam,” the statement continued. “Once they returned from service, however, they were subject to draconian immigration laws that reclassified many minor offenses as deportable crimes, and were effectively banished from the country.”
The “draconian immigration laws” the ACLU was referring to are the result of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, signed into law by President Bill Clinton, which among other things greatly expanded the definition of “aggravated felonies” to encompass a range of offenses, including some misdemeanors that previously would not have led to deportation.
Life as an immigrant in the United States only got more precarious from there. By 2013, Obama had deported more people than any other U.S. president in history, at a rate of about 400,000 a year, and so far under Trump, ICE arrests are up nearly 40 percent. Still, U.S. Immigration and Customs Enforcement insists that it takes military service into account when determining whether or not an immigrant’s crimes should qualify as a deportable offense.
ICE “respects the service and sacrifice of those in military service,” agency spokesman Thomas Byrd said in a statement to Task & Purpose, adding that such cases are “authorized by the senior leadership in a field office, following an evaluation by local counsel.”
He also noted that ICE views military service as “a positive factor that should be considered … when deciding whether or not prosecutorial discretion should be exercised.” Nonetheless, he said, “applicable law requires ICE to mandatorily detain and process for removal individuals who have been convicted of aggravated felonies.”
“They knew I had been in the Army because of what I had to do in prison to survive. … Ask any of these guys. If you’ve been in prison over there and you live in Juárez, you’ll get approached.”
The ACLU report sparked widespread media interest in deported veterans. Soon, American journalists were flocking to Tijuana. Veteran motorcycle clubs arrived from the States with food and supplies to stock The Bunker. Volunteers, including off-duty employees from the Department of Veterans Affairs, began caravanning in on the weekends to help the veterans file for pensions and other benefits remotely. The ACLU even agreed to provide free legal assistance to deported vets who it thought stood a fighting chance of securing appeals or government pardons.
Meanwhile, in March of this year, Rep. Raúl M. Grijalva of Arizona introduced a bill, The Veterans Visa and Protection Act of 2017, that would prevent noncitizen service members and veterans from being removed from the United States unless they were convicted of a violent crime. The bill would also require the Department of Homeland Security to establish a program to permit eligible deported veterans (ones who have not been convicted of violent crimes) to return to the United States.
“They made a mistake, and many citizen veterans have made those same mistakes upon their return,” Grijalva tells Task & Purpose. “Are we setting up a special status for a group of deportees that no other deportee has? Yes, because they do have that special status. Serving in the military is special.”
To date, the bill has been co-sponsored by 48 members of the House, all Democrats.
“The majority of these guys were deported because of crimes related to addiction,” says Alexander Heaton, director of the Veteran Action Coordination Committee, which is lobbying members of Congress to sign the bill. “So, really, this is a veterans health issue. Many got in trouble while self-medicating because of things that had happened to them in the service. But getting that through to Congress has been really difficult, because a lot of them just see it as another immigration issue.”
All of the congressmen Heaton approaches want to know why the deported veterans didn’t get their citizenship in the military. It’s a perfectly reasonable question, and one that Heaton is uniquely qualified to answer. Born in the United Kingdom, Heaton became a naturalized U.S. citizen in 2008 while serving the Marine Corps.
“I only found out that I could be naturalized through the military by my interpreter in Iraq,” he says.“It’s not something that is mentioned to you, because once you get to the fleet, everyone assumes you’re American. You have to initiate it yourself and you have to follow up on it yourself. You know how military paperwork is — if you want it done right once, you have to submit it three times.”
Efforts on both sides of the border to draw attention to deported veterans appear to be paying off, albeit slowly. Last month, Barajas and two other veterans living in Mexico received full pardons from California Gov. Jerry Brown, making it possible for them to re-apply for legal resident status.
Several days after he received word of his pardon, Barajas flew to Juárez for the official opening of a second Bunker — the one at Lopez’s house. Additional Bunkers are planned for Monterey and Jamaica. Barajas has every intention of returning to the States if he’s allowed to — he was raised in Los Angeles, and his daughter still lives there — and the decision could be made within the next several months. Still, he says, he won’t stop “fighting for his brothers” until all of them come home.
Once a week, Ivan Ocon, a 39-year-old U.S. Army veteran, takes a bus ride into downtown Juárez to buy sheets of cured leather from the only shop in town that will sell them to him. He’s not sure why the others won’t. Maybe it’s his gringo accent, or the prison tattoos, or the baggy plaid shirts he likes to wear buttoned all the way up to the top.
Ocon grew up just north of the border, in Las Cruces, New Mexico. He has broad shoulders and a slight paunch, the sort of physique men develop when they lift a lot of weights in prison.
Ocon became a craftsman during his time behind bars: Nine consecutive years in federal penitentiaries in Colorado and Texas, followed by a 10-month stint in an immigration detention center on the outskirts of Houston. He specializes in handmade leather wallets and belts, which he adorns with intricate designs. Leatherwork is how Ocon made his commissary money in prison. He honed his skills as an illustrator by drawing pictures for his daughter, whom he hasn’t seen since she was 3 years old. She’s 15 now.
“The cartels are waiting for you. They know you’re desperate. They know you’ve spent time in prison. … if they pick you up, there’s three ways it can go. They’ll either kill you, recruit you, or kidnap you and hold you for ransom.”
These days, Ocon’s workshop is a converted storage closet in his grandmother’s house, a tiny, one-bedroom concrete dwelling behind a spike-tipped wrought-iron gate on a sun-bleached street in Juárez. Ocon moved in a year ago, after he was deported from the United States. The neighborhood is safe, he says — “There have only been a few killings.” At night, he sleeps on the couch.
But he doesn’t sleep much — not since he began receiving threatening Facebook messages. They came from an account he thought belonged to a woman interested in hooking up, but that later turned out to be a fake profile run by gang members. They had seen Ocon on the local news talking about the plight of deported veterans, and pegged him as a rich man. The messages demanded money — a lot more than Ocon could afford — and included photos of his family. He deleted his Facebook account and tried not to think about it.
“All I can do is try to be more careful,” Ocon says. “But at the end of the day, I’m a soldier, and I’m going to have to do what I have to do.”
How Mexican Cartels Target Deported Veterans
Living in Juárez, Mexico, places deported veterans in the crosshairs — at risk not only of being killed in one of the most dangerous places on earth, but of being pressed into service by the cartels, forced into a criminal lifestyle they have long since left behind. Nearly all of the veterans Task & Purpose met in Juárez said they’d been approached by the cartels. Left to build new lives among the drug traffickers and sicarios that Trump’s wall is meant to keep out, many must rely on skills they acquired in the military and behind bars to survive.
Between 1997 and December 2003, Ocon was, in fact, a soldier. He served as a generator mechanic in the U.S. Army. His workshop is crowded with mementos of his time in uniform: A wooden box he bought in Japan filled with regimental coins, pictures from his deployment to Jordan in support of Operation Iraqi Freedom, a plaque mounted with a pair of crossed tomahawks that was given to him at the end of his tour in Korea with the 2nd Infantry Division.
“For a job well done,” it reads. “We wish you well in pursuing your future. Hope you can make it without your soju. Good luck from the motorpool.”
Also on the wall is a framed photograph of Ocon’s cousin, who was killed in a drive-by shooting in Las Cruces in the early 90s. He was 15, a gangbanger. His killers belonged to a rival crew. Ocon turns somber telling the story. They were best friends, he explains — just a couple of Mexican kids growing up poor in a small American town.
Like many kids from crime-infested neighborhoods, Ocon didn’t need to join the Army to learn how to shoot a gun, and he didn’t need to go to war to see combat. But the military offered a noble departure from the streets. And there was another bonus, as the recruiter pointed out: Serving his adopted country could be a fast track to citizenship. Although it didn’t quite work out that way, Ocon knows he’s partly to blame.
“I started asking about citizenship after I got back from Korea,” he says. “I went to JAG and they were like, ‘We don’t know nothing about that.’ They couldn’t even tell me where I needed to go, or what I needed to do. So I just went back to doing my job, just being a soldier, not really thinking about it.”
In 2006, Ocon was involved in a kidnapping in El Paso. The details are hazy, but somehow the 16-year-old nephew of a certain drug dealer wound up on the other side of the border, and the kid’s family got a series of calls requesting money. One of those calls was traced to Ocon’s phone. While he denies playing a role in the abduction, a jury convicted Ocon of aiding and abetting in a kidnapping — “because I didn’t report my brother” — and sentenced him to 10 years in prison.
A decade later, in early 2016, Ocon stepped off a U.S. immigration bus in the Mexican city of Nuevo Laredo, with $80 to his name. His skin was paler than it had ever been. His muscles were soft. For the previous 10 months, he had been confined to a cell in an ICE detention center 23 hours a day. Sometimes weeks would go by before the guards would let him outside. It was worse than prison, he says. Much worse. He arrived in Mexico with shoes but no shoelaces, which worried him because he knew that his first few minutes on the ground were crucial, and that he’d have to act fast.
Ocon isn’t the only deported veteran who told me that stepping off the immigration bus was one of the most terrifying moments of his life.
“The cartels are waiting for you,” one told me. “They know you’re desperate. They know you’ve spent time in prison. So you’ve got a small window of time to get out of town and get where you’re going. Because if they pick you up, there’s three ways it can go. They’ll either kill you, recruit you, or kidnap you and hold you for ransom.”
Ocon managed to squeeze on to the first bus bound for Juárez. Not all of the deportees were so lucky.
On the morning before the official ribbon-cutting ceremony for the opening of The Bunker in Juárez, three rows of neatly stacked papers sit atop a plastic table in Lopez’s backyard. These are the first of many forms that will need to be filled out as the deported veterans begin the process of trying to secure medical benefits, pensions, and, ultimately, permission to return to the United States. For now, Lopez’s home is serving as the local headquarters for the operation. Lopez settled here in 2004 after serving nine years in a Texas prison for the crime of possessing “five hundred grams or more” of cocaine, according to court documents.
“We need to be together and be a group,” he says as he folds pamphlets that will be given to guests at tomorrow’s ceremony. His hands move slowly, as if underwater. “We need to fight for our rights. That’s the only way we’re going to get it done.”
Lopez’s family immigrated to Wichita Falls, a small town in north Texas, when he was a teenager, and he was drafted into the U.S. military in 1967 at the age of 23. According to his military records, Lopez served with the Army’s 15th Transportation Battalion for a year in Vietnam, from 1968 to 1969. He hardly spoke English. “I done everything,” he says. “Sometimes I did rescue missions in the helicopters. Sometimes I was a driver. Sometimes I went with the infantry. Whatever they tell me to do.” He thought his honorable discharge from the Army made him a U.S. citizen until he found out he was being deported back to Mexico. Because he didn’t have money to fight his case, ICE agents took Lopez straight from prison to Juárez, the nearest border town.
Lopez left behind five children in Texas, all U.S. citizens. Some of them he hasn’t seen in more than 20 years, and he doesn’t know how many grandchildren he has. “I want to get back so I can find my family,” he says. “I want to see them and hug them.” The walls of his house are decorated with pictures he’s painted, of birds, of desert landscapes, of the Virgin Mary. He’s talented enough to make a meager living as a painter, but art is also his therapy. There’s no VA facility in Mexico; no monthly disability checks in the mail. He tells me he’s still haunted by his experiences in Vietnam.
One of the two bedrooms in Lopez’s house has been converted into a shelter with bunk beds and cots for vets down on their luck. Before The Bunker in Tijuana was moved to a building donated by the city, Barajas ran a similar shelter out of his apartment. This is one of the more vital services the organization provides. Few deported veterans are able to find jobs when they arrive in Mexico. Some, like Marine Corps veteran Mike Evans, didn’t even speak Spanish when they stepped off the immigration bus.
Which helps explain why I confuse Evans for a volunteer from the States when he strolls into the Bunker. “What’s up, man,” he says, pulling me in for a bro hug. “Mike.”
Ocon introduces Evans as his neighbor. They first met several days ago on the street, by chance. Evans was stunned to discover that there were other U.S. military veterans living in Juárez. For the past eight years, he thought it was just him. “You guys have plans tonight?” he says. “I’m DJing at La Bodeguita. Come by. It’s gonna be sick.”
Sporting a shirt too small for his musclebound torso and a generous amount of hair gel, Evans, 39, looks, acts, and sounds like a cast member on the “Jersey Shore,” albeit with a slight Southern accent. There’s an explanation for this: He was adopted by an American university professor and spent his childhood in Columbia, South Carolina. Which makes him a citizen, right? Nope. Not in 1984. Instead, Evans, who had the rare privilege of choosing his own first name when he was 6 years old, was granted resident status through amnesty. “Later, when I applied for citizenship,” he says, “it fucked me.”
Evans served four years in the Marine Corps and was discharged honorably in 2000 without citizenship. “I just got so frustrated with the process, I stopped trying,” he says. In 2005, after a period “of fucking off and getting into trouble in El Paso,” he completed and filed all the naturalization paperwork and was approved. Two weeks before he was scheduled to take the Oath of United States Allegiance, Evans was named as an accomplice by a drug dealer who’d been arrested for selling ecstasy several years before. There was evidence. Evans was sent to prison for four years. In 2009, while in the midst of fighting his case, he was abruptly deported. His sister rushed to the immigration detention center and arrived just in time to give him an English-Spanish dictionary before he got on the bus.
At the height of the turf wars between the Sinaloa and Juárez drug cartels, Juárez was just as kinetic as anything American troops have faced in Iraq and Afghanistan. The battles waged daily in the city’s streets featured all of the familiar tools of carnage: sniper rifles, grenades, car bombs, machine-gun fire. Gunmen would slice through weddings and birthday parties just to send a message or mark turf. Many mornings revealed headless and mutilated bodies strung from bridges and light posts. Twenty-six hundred people were murdered in the city the year Evans arrived, barely enough money in his pockets for a tiny room downtown, which he furnished with an air mattress and two milk crates (one for a chair, the other for a table). In 2010, Juárez ranked as the murder capital of the world. That same year, El Paso, which sits just beyond a narrow sliver of the Rio Grande — walking distance, if you have an American passport or a visa — boasted the lowest crime rate of all major cities in the United States. Evans could see El Paso from his window.
The turf wars have subsided, but the cartels still exert varying degrees of control over nearly every facet of the city. Extortion is rampant. People are still wary of hanging out in groups. Most of the bars and clubs remain off-limits to “civilians” after dark. There’s still no shortage of violence — Mexico is currently second only to Syria on the list of world’s deadliest conflict zones — but the killings in Juárez have become more focused, less indiscriminate. One former cartel member, a U.S. Army veteran, tells me the war now is over what drugs are being sold. The Sinaloa cartel recently introduced crystal meth into the local market, triggering retaliation from the more “old school” factions that see the highly addictive drug as disruptive.
“Meth is not a good business model,” says the veteran, whom I’ll call John (he asked not to be named). “If you get someone hooked on coke, you’ll have a customer for life. But with meth, they’ll probably be dead in five years. So now they’re going after the meth heads, shooting up the places they hang out to send a message.”
“I had to agree right away, because if you don’t, they’re going to beat you up or probably kill you. Period.”
John had served with the 3rd Infantry Division in Ramadi with a colleague of mine, who put us in touch. We meet for dinner in Juárez one night. When I ask him if he’s ever seen other U.S. military veterans working for the cartels, he tells me the same thing Camacho did: He had, and that some of them — “White guys, black guys, Mexicans” — commuted in from the other side of the border. John, a U.S. citizen, used to be one of those guys. He lives in El Paso. “After I got out of the Army, I started coming to Juárez on the weekends to party, do coke,” he says. “And I just got sucked into that life. It was dark.” He recalls an internal feud that nearly resulted in his execution, late night convoys through the desert, and the brutal beating he was forced to undergo before being allowed to leave the cartel. I ask him how long it’s been since he quit. He pauses to do the math. “Six months,” he says. “November.”
Most of the deported veterans I meet in Juárez refuse to speak on the record about the cartels for fear of being labeled a “snitch,” but many have stories that go something like this: Someone they had met in prison or in an immigration detention center looked them up after they’d arrived in Juárez and asked if they’d like to put their military experience to work for a cartel. A few, like Camacho, weren’t given a choice. Interestingly, their specific military backgrounds — whether they had been, say, an infantryman or an admin clerk — were irrelevant. It was the fact that they had been trained by the U.S. military that made them appealing as potential recruits. That and the assumption that they were desperate.
“I was approached one time by a guy, since he knew that I’d been in the military, to purchase weapons for the mafia,” Juan Salazar, a 50-year-old former Army medic, tells me, volunteering that he had been deported in the 90s after getting busted with 50 pounds of marijuana in Texas. “I definitely denied, because once I had made a mistake and got deported, I realized that I had failed to protect the country from all enemies foreign and domestic. I still feel that is my duty even if I’m here. Because all of my friends and family are still over there. It’s still my duty to defend them.”
Cesar Orihuela, 33, echoes a similar sentiment in his truck as we drive through downtown Juárez en route to La Bodeguita for Evans’ DJ show. “Yeah, I’ve been approached,” he says, his eyes fixed on the road. There’s a giant tattoo of an American flag on his forearm. He continues: “But doing that is like turning your back on your country. Nobody put a gun to your head and told you to join the military. Then after you make a mistake and you get sent to Mexico, once you get here, doing something like that is like siding with the enemy. It’s just something you don’t do. Personally, I don’t like it here.”
Orihuela’s family moved to El Paso from Juárez when he was 8. He was an all-star pitcher in high school — with a 96 mph fastball — but he put aside his dreams of going pro to join the Air Force in 2002, “because of what happened on 9/11.” He deployed to Pakistan in support of Operation Enduring Freedom early on in the war. Later, I come across a 2004 story about Orihuela published in Airman Magazine, which compares him to a “juggler in a circus,” juggling military service, college, and baseball. The article explains that Orihuela had made it to the last round of tryouts for the Chicago White Sox the year before. It also notes that he had just applied for U.S. citizenship.
Orihuela was deported three years ago. “I got an assault charge,” he says. “My brother had just been killed by a gang on this side of the border, and I had anger issues. The police over here wouldn’t help us. It destroyed my whole family. That’s when my sister got in trouble, too.” He tells me he was arrested for beating up a member of the gang outside a bar in El Paso; however, Task & Purpose found court documents listing the aggravated felony conviction that resulted in his deportation as a sexual assault. Orihuela served three years in prison, and was still fighting his case when they put him on an immigration bus and drove him to Juárez. In 2014, his appeal of the sexual assault conviction was denied by the U.S. Court of Appeals Fifth Circuit in Texas.
Now, Orihuela works as a barber. A few of the guys he served with in the Air Force occasionally visit from Texas for a haircut, but otherwise he’s on his own. The barbershop is located downtown, on gang turf. He says he hands over 30% of his wages in extortion payments, and that he has to cover up his American flag tattoo when he works — not because he’s afraid of being targeted as a tourist, but because stars are the symbol of a rival crew. “The older people in the neighborhood know it’s a U.S. flag, and assume I’m probably just visiting from Texas or whatever,” he says. “But the younger kids, man, that’s who you’ve got be worried about. They don’t think like that. They just react.”
Close your eyes and imagine a bar in Juárez. Now, imagine the opposite: this is La Bodeguita. Tucked into a shopping center on the edge of one of the city’s more affluent neighborhoods, the bar draws a decidedly hipster crowd. It’s packed when we arrive just before sundown. Evans is manning the turntables — tongue out, one hand on his headphones, the other tinkering with a techno version of Ed Sheeran’s “Shape of You.” His eyes light up when we walk through the door, a group of U.S. military veterans. Just a few days ago he thought he was the only one. Barajas is sporting his old red beret from the 82nd Airborne. A Vietnam War service ribbon sits front and center on Lopez’s hat. Everyone, including Ocon, is wearing the Deported Veterans Support House t-shirt, which is emblazoned with a small American flag. It’s clear the other patrons don’t know what to make of this strange militia.
Evans selects his last song and jogs over to the bar. There are bro hugs all around. Beers and tequila shots are ordered. Everyone seems to dig the music. It’s a house mashup of Edwin Starr’s “War.” The chorus lands like a karate chop: War, huh, yeah / What is it good for / Absolutely nothing. I seem to be the only person who notices the irony. “I told you this place was sick,” Evans says, throwing an arm over my shoulder. It dawns on me that I’d never even bothered to ask him if he even wanted to return to the States, so I do now. “When I first got here, it felt like a life sentence. But this” — he nods towards the crowd — “this is my home. I had to fight really, really hard to be happy here. You just don’t let that kind of happiness go.”
On the morning of April 22, the Bunker is a hive of activity. The ribbon-cutting ceremony is scheduled to begin at noon. Local reporters make their rounds, pulling the deported veterans aside one at a time for interviews. A pack of bikers in black leather jackets covered in military patches roll in from New Mexico. Three volunteers, all veterans and employees of a VA facility in Arizona, pull up with a carload of bottled water, hygiene kits, and sleeping bags, which they unload into the living room. Several women tend to a spread of chicken and rice. Ice-cold Fantas are distributed. Everyone is intensely focused on their tasks, as if worried that the months of preparation that went into this day could be completely undone by one wrong move.
By this point, I’ve come to realize that the members of this group are bound not just by their military service but also by a desire to prove to themselves, their families, and the country they served that they’ve learned from their mistakes. That’s the point of this whole operation. Until jobs and security are restored to Mexico, nothing, not even a giant wall, will keep droves of Mexicans from crossing the border illegally. That option has always been available to these men, too. But they’re done breaking the law. If and when they return to the States, it will be not as criminals, but as U.S. military veterans who embody the qualities, good and bad, implied by that distinction. Or at least that’s the hope. “I’ll wait eight years, nine years, 10 years,” Ocon tells me.
Ocon’s mother, nephew, and sister arrive from Las Cruces just before the ceremony begins. His daughter refused to come. It’s been 12 years since he’s seen her.
“They keep in contact a lot, but she has a really negative opinion of Mexico,” says Ocon’s sister, Claudia Ocon. “She’s afraid that she’d come down here and not make it out alive.”
Claudia, a behavioral health treatment coordinator for children in foster care, gets emotional talking about her brother’s situation. She talks about growing up poor, one of five siblings raised by a single mother, and describes Ocon’s decision to join the Army as an attempt to make a better life for himself. It’s clear that she looks up to her older brother. “It’s heartbreaking to see him living in these conditions,” she says, her eyes glassing over. “You have this man who served his country, who went to the Middle East, and now he sleeps on a couch in a house that didn’t even have running water when he showed up.”
A row of news cameras focus on Barajas, adorned in his signature red beret and old dress blues, as he addresses the small crowd that’s gathered in the courtyard. He points to a folded American flag that he brought from Tijuana for the ceremony. “Until the last man comes home, this flag will not leave this place,” he says, pausing to fight back tears. “Thank you for being here.” To his side, Ocon and Lopez stand rigid like soldiers in formation. A table behind them displays photos of the guys from their days in uniform. There’s also a shrine to all of the deported veterans who have died or gone missing “in exile.” Barajas’ wife says a prayer, in both Spanish and English. Then Barajas presents the folded flag to Lopez and Ocon and the men exchange slow salutes, just as they would if they were conducting a military funeral.
When I got out of the Army, I promised myself that I wouldn’t be one of those veterans who always talks about their military service like it was the best time of their life. Which meant that whatever I did next had to be an upgrade. The day I left Fort Campbell for good, I packed all of my old uniforms, medals, and souvenirs from overseas into a box and haven’t opened it since.
In the back of my mind, I’ve always known that being able to do that was a luxury. Not everyone can just do a few years in the military and then ride their honorable discharge to a more comfortable life. Not everyone comes home to a safe and loving community, as I did. Sometimes they go home to the opposite, or nothing. Old habits resume. Bad influences resurface. Brothers get arrested. Brothers die. Citizenship paperwork gets neglected. I finished my bachelor’s degree on the Post-9/11 GI Bill and it’s been more than a decade since I’ve been in handcuffs, but I’m no more of a veteran than those guys. All of us served the same nation, one that proudly supports the people who defend it with their lives. But as a society we also recognize that those people aren’t perfect. They fuck up. And when they do, they go to prison like everyone else. Unless they have a green card. In that case, we’ve decided prison isn’t enough. Why?
Orihuela takes his lunch break and the three of us walk to the edge of the Rio Grande. Barajas and several other deported veterans are there waiting for us. Each of us pays four pesos to get through the turnstiles and onto the bridge, which arcs high over the empty river. At the top, we pause for a minute to take photos at the line separating Mexico and the United States, and then proceed down toward Texas. The bridge terminates at a set of doors that only I c
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