“Somebody Is Gonna Be Hurt”: Involuntary Drug Treatment in Mexico

ABSTRACT

Involuntary drug treatment (IDT) is ineffective in decreasing drug use, yet it is a common practice. In Mexico, there are not enough professional residential drug treatment programs, and both voluntary and involuntary drug treatment is often provided by non-evidence based, non-professional programs. We studied the experiences of people who inject drugs (PWID) in Tijuana who were taken involuntarily to drug centers under the auspices of a federally funded police operation. We provide insight into how the health, wellbeing, human rights, dignity, and security of PWID ought to be at the center of international drug policies included in universal health care systems.

SPANISH ABSTRACT

El tratamiento de drogas involuntario es una práctica común a pesar de no ser efectivo. En México no hay suficientes programas residenciales profesionales para el tratamiento por consumo de drogas y, ya sea tanto voluntario como involuntario, lo proveen centros no-profesionales que no están basados en la evidencia. Analizamos las experiencias de las personas que se inyectan drogas (PID) que fueron llevadas involuntariamente a centros de tratamiento bajo un operativo policiaco en Tijuana. La salud, el bienestar, los derechos humanos, la dignidad y la seguridad de las PID deben ser elementos centrales de las políticas de drogas internacionales y de los sistemas universales de salud.

KEYWORDS:

• Mexico
• disciplinary power
• human rights
• involuntary drug treatment
• people who inject drugs

PALABRAS CLAVE:

• Mexico
• poder disciplinario
• derechos humanos
• tratamiento de drogas involuntario
• personas que se inyectan drogas

Acknowledgments

The authors gratefully acknowledge the contributions of Susana Leal, Kenya Lazos, Gerardo Díaz, Socorro Martínez, Efraín Ríos, and Armando Ríos. We also want to thank María Luisa Zúñiga, Mario Morales and Andy Guise for their feedback. The Human Research Protections Program of the University of California, San Diego, USA and Universidad Xochicalco, Tijuana, Baja California, Mexico approved the study protocols.

Notes

1. We chose to call them drug centers rather than drug treatment centers because they do not provide evidence-based treatment.

2. The real name is Tijuana Mejora/Improving Tijuana. This is the name that the community, including the police, uses.

3. People who used drugs that enter the drug centers as interns but that are now recovered and volunteer their service to the center.

Additional information

Funding

This research was funded by NIDA R37 DA019829. CR was supported by UC-MEXUS/CONACyT scholarship 209407/313533, UC MEXUS Dissertation Grant DI 15-42, Fogarty International Center D43TW008633, and a CIHR Postdoctoral fellowship. The funding sources were not involved in the study design, data collection, analysis, interpretation or decision to submit if for publication; National Institute on Drug Abuse [R37 DA019829]; Fogarty International Center [D43TW008633]; Consejo Nacional de Ciencia y Tecnología [209407]; University of California Institute for Mexico and the United States [DI 15-42].

Notes on contributors

Claudia Rafful

Claudia Rafful is an assistant professor at Universidad Nacional Autónoma de Mexico, Mexico.

María Elena Medina-Mora

María Elena Medina-Mora is researcher at Instituto Nacional de Psiquiatría Ramón de la Fuente, Mexico City, Mexico.

Patricia González-Zúñiga

Patricia González-Zúñiga is director of the parent study.

Janis H. Jenkins

Janis H. Jenkins is professor at the Departments of Anthropology and Psychiatry at UCSD.

M. Gudelia Rangel

M. Gudelia Rangel is the Executive Secretary of the US-Mexico Border Health Commission.

Steffanie A. Strathdee

Steffanie A. Strathdee is associate Dean of Global Health Sciences at UCSD, and Principal Investigator of El Cuete IV.

Peter J. Davidson

Peter J. Davidson is associate professor at UCSD.