CINCINNATI -- Patti Hogan knows a heroin baggie when she sees it.
She leads a weekly community charge to take back the streets of her East Price Hill neighborhood, a community of about 2 square miles and 15,000 people looking out over the industrial Mill Creek Valley and, beyond that, the high-rises of downtown Cincinnati.
Hogan and her friends see the baggies enough to know what they look like. The heroin epidemic has hit East Price Hill hard, as well as other West Side neighborhoods like West Price Hill and Westwood. Before heroin, Hogan said, the problem was crack.
From July to October, four neighborhoods on the city's West Side -- East and West Price Hill, Westwood and South Fairmount -- made up more than a quarter of all heroin overdoses citywide.
Hogan and her friends don't know who's bringing in the drugs, and what makes their West Side neighborhoods so attractive for drug abuse.
"They've taken kilos out of here," Hogan said, as she and her group walked near Glenway and Rosemont avenues one day last month. "To me that's big."
According to the Drug Enforcement Administration, Hogan is likely cleaning up after drugs trafficked from Mexico, and probably from the Sinaloa cartel run by the notorious drug lord known as "El Chapo" Guzman. Guzman has had dealers killed for turning on him; last year, he escaped a Mexican prison through a tunnel and eventually was arrested again.
Tim Reagan, resident agent in charge of the DEA Cincinnati office, said El Chapo's cartel gets carfentanil, a powerful synthetic opioid, from China. The cartel cuts heroin with carfentanil before sending it to the United States for distribution in places like Hogan's West Side neighborhood. Drugs trafficked through Cincinnati also end up in areas across Northern Kentucky and southern Indiana.
"I'm a little shocked by that, because I keep asking questions, and that's really the first time I've heard that this is cartel-driven," Hogan said.
Although the cartel makes its money on the streets, Reagan explained it's similar to any Fortune 500 company: Guzman is the CEO, with a board of directors responsible for various aspects of the business.
"Some of these people are some of the best counter-surveillance people that we've ever dealt with," Reagan said. "They will drive around the city, around 275 four or five times before they decide to do a deal."
The interstate highway system also makes it easier for dealers to move around. Hogan's East Price Hill neighborhood is accessible from Interstate 75 via the Sixth Street Expressway; Reagan said quick access like that makes arrests tough.
"There's a ton of different reasons (it's hard to find dealers). Technology kills us," he said. Dealers change their cell phones the way most people change clothes. And lately, Reagan said, they're also changing cars and apartments frequently, all aimed at leaving no trace.
In the past five years, federal agents have arrested several suspected cartel dealers in Franklin and Montgomery counties, north of Cincinnati. In late September, Acting U.S. Attorney Benjamin Glassman announced the nation's first indictment for distributing carfentanil. Glassman said the investigation found a couple had been dealing heroin laced with carfentanil out of an apartment in Cincinnati's Carthage neighborhood, a community that also saw a high number of overdoses in the past few months. It also has convenient interstate access and is just 10 miles from Hogan's neighborhood.
The couple Reagan said, was "definitely working for a cartel. They definitely got their dope from someone else, who's definitely getting it from a Mexican source of supply."
While Reagan and other investigators work to track down more dealers, Hogan and her group have a plan beyond cleaning up: They walk down the street together, trying to inspire neighbors to take care of the community.
They also hope it sends a message to people selling drugs: "Stay the hell out of here! We don't want you here," Hogan said. "They all talk about a neighborhood's moral voice. Well, this is the moral voice of this neighborhood."