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In Puyo, central Ecuador, a youth studies at one of the few government facilities helping drug users. The murdered Ecuadorian presidential candidate Fernando Villavicencio was threatened by drug cartels for speaking out against organised crime. Ecuador has become a hub for the global drug trade, and addiction rates are soaring across the country. Share on Facebook Share on Twitter. Teenage drug users play games and sports to improve social and behavioural skills. The Puyo centre has 42 beds with separate wings to treat boys and men. Some of the teenagers, many from Indigenous communities, have been placed there by court order. Many joined gangs to escape violent families and found that cocaine, marijuana and pills were easy to come by. Adults at the centre receive job training to help them reintegrate into the workforce. Art is used to help them express their emotions and communicate more effectively. A therapy session at the centre. Patients receive regular group therapy and one-to-one sessions with a psychologist. Family members are encouraged to attend. One patient is a deputy headteacher who is on his fourth stay. He travels hundreds of miles to stay at the centre but does not want to be named because the school where he teaches is unaware of his drug problem. About half of all patients relapse within 30 days of leaving a treatment centre, and more than three-quarters relapse within the first year. This might be their only meal of the day. Bermeo, a psychiatrist, hands out information leaflets to drug users in Guayaquil. As well as food, Bermeo offers advice on where they can get help and how to reduce risks. Some street drugs have been found to contain rat poison, cement or quicklime. Bermeo believes people need to be taught from an early age how to resist the pressure to take drugs. Use in adolescents between 10 and 12 is experimental, so preventive activities must be carried out. Patients often volunteer to enter this clinic or are brought here by family. I wanted to lose weight because I had a complex … I started to use drugs to lose weight. Victor is a bricklayer in the capital, Quito. He is the seventh of eight siblings brought up in a violent home. His father was an alcoholic and an older brother died from a drug overdose. My earnings were enough for my bus fare to school. At 12, I started using cocaine paste base. She says Victor has run away from rehab centres. They treated him but then he ran away. Marco — pictured at home with his wife, Rosa, and daughter, Karina — started using drugs at seven. His mother died when he was eight and he was abandoned by his father. He lived on the streets until he was 25, and in was charged with drugs possession. Group exercise time at the Cetad centre, which opened two years ago and has since provided free medical and psychological help to more than 51, women in Guayaquil. Most women come from dysfunctional families, she says. Rizzo treats a patient at the Cetad centre. It touches me a lot. Topics Global development. Ecuador Americas Drugs Drugs trade. More galleries. Most popular.

Cocaine, cartels, and corruption: The crisis in Ecuador, explained

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At Guayaquil, Ecuador's biggest port and export hub, drug gangs and the coast guard play a cat-and-mouse game, vying for supremacy of the river among the many hidden inlets and tangles of mangrove. One officer says that some of the drug traffickers are so adept at scaling ships and covertly planting drugs on them that they are like 'spidermen. Excluding oil, 80 percent of Ecuador's exports pass through here, including key products such as bananas and shrimp. According to Alvarez, Ecuador has become the main cocaine distributor in the world, with most of the drugs originating in neighbors Colombia and Peru -- the world's top producers of cocaine. To the right of them is a forest of mangroves shielding shrimp farms. To the left, miserable poverty-stricken neighborhoods in which gangs rule with an iron fist. And in the middle of the water lane, a massive container ship about six stories high -- the perfect vessel for a hidden drug stash. On the one hand, they have to look out for speed boats, semi-submersibles also known as 'narco subs' and even submarines now employed by ever-wealthier drug traffickers along the nearly mile channel that connects Guayaquil to the open sea. It is a very, very complicated task to control all this,' one officer told AFP on condition of anonymity for fear of being targeted. Another threat is criminals who bring drugs from ashore in canoes or small boats, use ropes or ladders to clamber up the sides of tankers and container ships bound for the United States or Europe, and hide the contraband there. The intruders, some of whom pose as fishermen, usually act under the cover of darkness, sometimes with the complicity of the crew, according to the coast guard. According to Alvarez, the gangs often follow the vessels carrying their illicit goods, and 'do not hesitate to open fire' if they spot anyone on their tail. They adapt constantly' -- also trying to buy off members of the security forces. The gangs are in cahoots with three major transnational traffickers: Mexico's Sinaloa and Jalisco New Generation cartels -- which are behind the influx of fentanyl into the U. The same patrols are also tasked with securing the waterway to the protected Galapagos archipelago from illegal Chinese and Spanish fishing fleets. And while the task is sometimes overwhelming, the state of emergency declared last week to put down a violent gang uprising 'has changed things in our favor,' said Alvarez. Once a bastion of peace, Ecuador has recently been plunged into crisis after years of expansion by transnational cartels. The latest violence was triggered by the escape from Guayaquil prison just over a week ago of one of the country's most powerful narcotics gang bosses. The government declared a state of emergency and countrywide curfew, infuriating gangsters who declared war against civilians and security forces, launching several deadly attacks and taking dozens of hostages. Most have since been freed. By Sunday, Ecuador's security forces said they had taken control of several prisons back from gangs and reported more than 1, arrests, 27 escaped inmates recaptured and eight gangsters, whom the government describes as 'terrorists,' killed. For year, much of the violence has concentrated in prisons , where clashes between inmates have left more than dead, many beheaded or burnt alive, since February Last week, hundreds of soldiers patrolled near-deserted streets in Ecuador's capital after the government and drug mafias declared war on each other, leaving residents gripped with fear. The small South American country has been plunged into crisis after years of growing control by transnational cartels who use its ports to ship cocaine to the U. President Daniel Noboa, 36, gave orders last week to 'neutralize' criminal gangs after gunmen stormed and opened fire in a TV studio and bandits threatened random executions of civilians and security forces. Less than two months after taking office, he declared the country in a state of 'internal armed conflict. More from CBS News. Many Cubans still waiting for power to return after days of blackout. Thousands of migrants leave southern Mexico for the U. North Carolina communities devastated by Helene determined to stay. Trump says he'd hire a year-old CEO. There aren't many of them. Chrome Safari Continue. Be the first to know. Get browser notifications for breaking news, live events, and exclusive reporting.

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