GUAYAQUIL (Ecuador) — Shaking and delirious, "Rina" ambles half-dressed beside a dump in Ecuador's port city of Guayaquil.

She is under the psychotropic effects of "H," a cheap and addictive drug that is ravaging the poorest sectors of Ecuadoran society.

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H: The heroin derivative ravaging Ecuador's poor

Psychiatrist Julieta Sagnay (right) talks to "Rina", a patient with addiction problems, at the Bicentenario hospital in Guayaquil, Ecuador, on Jan 6, 2023.

GUAYAQUIL (Ecuador) — Shaking and delirious, "Rina" ambles half-dressed beside a dump in Ecuador's port city of Guayaquil.

She is under the psychotropic effects of "H," a cheap and addictive drug that is ravaging the poorest sectors of Ecuadoran society.

The scene was captured on video on New Year's Eve and relayed to the municipal health centre, which came to her aid.

"When I consume (the drug) I hear voices," the 24-year-old, who is using a pseudonym, told AFP.

For the second time in less than a year she is following a drug rehabilitation program.

In her desperation, she stole and even worked as a prostitute to buy H, a heroin-based white powder that can be snorted or smoked and is sold for US$1 (S$1.30) a gram.

It is much cheaper and much more toxic than cocaine, which goes for US$3 to US$5.

H is cut with all sorts of toxic materials that can harm humans.

"We have found lime, cement, ether, rat poison and even ketamine, an analgesic used on horses," in the white powder, said psychiatrist Julieta Sagnay, from the Guayaquil-based Neuroscience Institute, an NGO that supports drug addicts.

Guayaquil, a city of almost three million people, has become a hub of drug trafficking and addiction.

Officials say 162kg of H were seized in 2022.

Dr Sagnay, an expert with more than 30 years of experience treating addicts, says the number of patients she treats for H use is increasing every day.