Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
Departamento de Psiquiatría y Salud Mental, Escuela de Medicina, Universidad Autónoma de México, Ciudad de México, Mexico; Centro Global de Investigación en Salud Mental, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
Arch Med Res. 2019 Nov;50(8):527-534. doi: 10.1016/j.arcmed.2019.12.013. Epub 2020 Feb 5.
Heroin production for external markets and low rates of use in Mexico have had a long history. A recent shift toward an increase in use and related problems calls for the evaluation of treatment needs in order to draw recommendations for policies.
The objectives were to identify predictors of choice of treatment and barriers to care among persons that had been with no treatment. The study included a convenience sample of 600 face-to-face interviews of people 18 years of age and older and a rapid HIV and HCV tests in three cities on Mexico's Northern Border: Ciudad Juárez, San Luis Río Colorado and Tijuana. The choice of treatment (methadone, other pubic or private treatments with no experience with methadone maintenance and only self-help or religious care), was analyzed though a multiple logistic multimodal regression analysis. Informed consents to be interviewed and for HIC and HIV were signed by interviewers.
The majority of persons interviewed were males (89.7%) with an average age of 40. Having emigrated to the United States and a greater length of heroin use predicted seeking methadone treatment versus public or private treatment or informal care. The most important barriers to care were lack of information and stigma. HIC, HIV and other infectious and chronic diseases including depression were often unattended.
There is a need to reform treatment policies in order to cover this w emerging and demanding problem.
墨西哥长期以来一直有向外部市场生产海洛因和低使用率的历史。最近，使用量的增加以及相关问题的出现，需要对治疗需求进行评估，以便为政策制定提出建议。
本研究旨在确定那些从未接受过治疗的人选择治疗和接受治疗障碍的预测因素。该研究包括在墨西哥北部边境的三个城市：华雷斯城、圣路易斯里奥科罗拉多和提华纳，对 600 名 18 岁及以上的人群进行了方便样本的面对面访谈，并进行了快速 HIV 和 HCV 检测。通过多变量逻辑多元回归分析来分析治疗的选择（美沙酮、其他公共或私人治疗，但无美沙酮维持治疗经验，只有自助或宗教护理）。访谈者签署了知情同意书，同意接受访谈和进行 HIC 和 HIV 检测。
接受访谈的大多数人是男性（89.7%），平均年龄为 40 岁。移民到美国和更长时间的海洛因使用预测了寻求美沙酮治疗，而不是公共或私人治疗或非正式护理。接受治疗的最大障碍是缺乏信息和耻辱感。HIC、HIV 及其他传染病和慢性疾病，包括抑郁症，往往得不到治疗。
需要改革治疗政策，以应对这一新兴且要求很高的问题。
