BACKGROUND: In August 2009, Mexico reformed its drug laws and decriminalized small quantities of drugs for personal use; offenders caught three times will be mandated to enter drug treatment. However, little is known about the quality or effectiveness of drug treatment programs in Mexico. We examined injection drug users' (IDUs) experiences in drug treatment in Tijuana, Mexico, with the goal of informing program planning and policy. METHODS: We examined qualitative and quantitative data from Proyecto El Cuete, a multi-phased research study on HIV risk among IDUs in Tijuana. Phase I consisted of 20 in-depth interviews and Phase II employed respondent-driven sampling to recruit 222 IDUs for a quantitative survey. We also reviewed national drug policy documents, surveillance data, and media reports to situate drug users' experiences within the broader sociopolitical context. RESULTS: Participants in the qualitative study were 50% male with a mean age of 32; most injected heroin (85.0%) and methamphetamine (60.0%). The quantitative sample was 91.4% male with a mean age of 35; 98.2% injected heroin and 83.7% injected heroin and methamphetamine together. The majority of participants reported receiving treatment: residential treatment was most common, followed by methadone; other types of services were infrequently reported. Participants' perceptions of program acceptability and effectiveness were mixed. Mistreatment emerged as a theme in the qualitative interviews and was reported by 21.6% of Phase II participants, primarily physical (72.0%) and verbal (52.0%) abuse. CONCLUSIONS: Our results point to the need for political, economic, and social investment in the drug treatment system before offenders are sentenced to treatment under the revised national drug law. Resources are needed to strengthen program quality and ensure accountability. The public health impact of the new legislation that attempts to bring drug treatment to the forefront of national drug policy should be systematically evaluated.
BACKGROUND: In August 2009, Mexico reformed its drug laws and decriminalized small quantities of drugs for personal use; offenders caught three times will be mandated to enter drug treatment. However, little is known about the quality or effectiveness of drug treatment programs in Mexico. We examined injection drug users' (IDUs) experiences in drug treatment in Tijuana, Mexico, with the goal of informing program planning and policy. METHODS: We examined qualitative and quantitative data from Proyecto El Cuete, a multi-phased research study on HIV risk among IDUs in Tijuana. Phase I consisted of 20 in-depth interviews and Phase II employed respondent-driven sampling to recruit 222 IDUs for a quantitative survey. We also reviewed national drug policy documents, surveillance data, and media reports to situate drug users' experiences within the broader sociopolitical context. RESULTS:Participants in the qualitative study were 50% male with a mean age of 32; most injected heroin (85.0%) and methamphetamine (60.0%). The quantitative sample was 91.4% male with a mean age of 35; 98.2% injected heroin and 83.7% injected heroin and methamphetamine together. The majority of participants reported receiving treatment: residential treatment was most common, followed by methadone; other types of services were infrequently reported. Participants' perceptions of program acceptability and effectiveness were mixed. Mistreatment emerged as a theme in the qualitative interviews and was reported by 21.6% of Phase II participants, primarily physical (72.0%) and verbal (52.0%) abuse. CONCLUSIONS: Our results point to the need for political, economic, and social investment in the drug treatment system before offenders are sentenced to treatment under the revised national drug law. Resources are needed to strengthen program quality and ensure accountability. The public health impact of the new legislation that attempts to bring drug treatment to the forefront of national drug policy should be systematically evaluated.
Authors: Jesus Bucardo; Kimberly C Brouwer; Carlos Magis-Rodríguez; Rebeca Ramos; Miguel Fraga; Saida G Perez; Thomas L Patterson; Steffanie A Strathdee Journal: Drug Alcohol Depend Date: 2005-04-01 Impact factor: 4.492
Authors: Steffanie A Strathdee; Carlos Magis-Rodriguez; Vickie M Mays; Richard Jimenez; Thomas L Patterson Journal: Ann Epidemiol Date: 2012-06 Impact factor: 3.797
Authors: Victoria D Ojeda; José Luis Burgos; Sarah P Hiller; Remedios Lozada; Gudelia Rangel; Alicia Vera; Irina Artamonova; Carlos Magis-Rodriguez Journal: J Immigr Minor Health Date: 2012-02
Authors: Shira M Goldenberg; Gudelia Rangel; Alicia Vera; Thomas L Patterson; Daniela Abramovitz; Jay G Silverman; Anita Raj; Steffanie A Strathdee Journal: AIDS Behav Date: 2012-05
Authors: Angela M Robertson; Jennifer L Syvertsen; Hortensia Amaro; Gustavo Martinez; M Gudelia Rangel; Thomas L Patterson; Steffanie A Strathdee Journal: J Sex Res Date: 2013-05-09
Authors: Angela R Bazzi; Jennifer L Syvertsen; María Luisa Rolón; Gustavo Martinez; Gudelia Rangel; Alicia Vera; Hortensia Amaro; Monica D Ulibarri; Daniel O Hernandez; Steffanie A Strathdee Journal: J Subst Abuse Treat Date: 2015-09-21
Authors: Erick G Guerrero; Jorge Ameth Villatoro; Yinfei Kong; Marycarmen Bustos Gamiño; William A Vega; Maria Elena Medina Mora Journal: Int J Drug Policy Date: 2014-04-18
Authors: Angela Robertson Bazzi; Gudelia Rangel; Gustavo Martinez; Monica D Ulibarri; Jennifer L Syvertsen; Samuel A Bazzi; Scott Roesch; Heather A Pines; Steffanie A Strathdee Journal: Am J Epidemiol Date: 2015-03-13 Impact factor: 4.897
Authors: Andrea M Lopez; Philippe Bourgois; Lynn D Wenger; Jennifer Lorvick; Alexis N Martinez; Alex H Kral Journal: Int J Drug Policy Date: 2013-01-09