Department of Anthropology, University of South Florida, USA.
Int J Drug Policy. 2010 Nov;21(6):459-65. doi: 10.1016/j.drugpo.2010.06.006. Epub 2010 Aug 25.
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.
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.
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.
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.
2009 年 8 月，墨西哥对其毒品法进行了改革，将个人使用的少量毒品合法化；三次被捕的罪犯将被强制接受戒毒治疗。然而，关于墨西哥戒毒治疗计划的质量或效果知之甚少。我们考察了墨西哥提华纳注射吸毒者（IDU）接受戒毒治疗的经历，旨在为戒毒治疗计划和政策提供信息。
我们分析了“El Cuete 项目”的定性和定量数据，该项目是一项在提华纳对 IDU 进行 HIV 风险研究的多阶段研究。第一阶段包括 20 次深入访谈，第二阶段采用受访者驱动抽样法招募了 222 名 IDU 进行定量调查。我们还审查了国家毒品政策文件、监测数据和媒体报道，将吸毒者的经历置于更广泛的社会政治背景下。
定性研究的参与者中 50%为男性，平均年龄为 32 岁；大多数人注射海洛因（85.0%）和冰毒（60.0%）。定量样本中 91.4%为男性，平均年龄为 35 岁；98.2%的人注射海洛因，83.7%的人同时注射海洛因和冰毒。大多数参与者表示接受过治疗：住院治疗最常见，其次是美沙酮；其他类型的服务很少被报道。参与者对戒毒治疗计划的接受度和效果的看法褒贬不一。虐待问题在定性访谈中是一个主题，在第二阶段的参与者中有 21.6%报告了这一问题，主要是身体（72.0%）和言语（52.0%）虐待。
我们的研究结果表明，在修订后的国家毒品法将罪犯强制送医治疗之前，需要在政治、经济和社会方面对戒毒治疗系统进行投资。需要资源来加强计划的质量并确保问责制。新立法试图将戒毒治疗作为国家毒品政策的重点，应该对其公共卫生影响进行系统评估。
