Historical Trends in the Production and Consumption of Illicit Drugs in Mexico: Implications for the Prevention of Blood Borne Infections

Department of Psychiatry, School of Medicine, University of California-San Diego, San Diego, CA 92093, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 10/2005; 79(3):281-93. DOI: 10.1016/j.drugalcdep.2005.02.003
Source: PubMed


Mexico has cultivated opium poppy since before the 1900's and has been an important transit route for South American cocaine for decades. However, only recently has drug use, particularly injection drug use, been documented as an important problem. Heroin is the most common drug used by Mexican injection drug users (IDUs). Increased cultivation of opium poppy in some Mexican states, lower prices for black tar heroin and increased security at U.S.-Mexican border crossings may be contributing factors to heroin use, especially in border cities. Risky practices among IDUs, including needle sharing and shooting gallery attendance are common, whereas perceived risk for acquiring blood borne infections is low. Although reported AIDS cases attributed to IDU in Mexico have been low, data from sentinel populations, such as pregnant women in the Mexican-U.S. border city of Tijuana, suggest an increase in HIV prevalence associated with drug use. Given widespread risk behaviors and rising numbers of blood borne infections among IDUs in Mexican-U.S. border cities, there is an urgent need for increased disease surveillance and culturally appropriate interventions to prevent potential epidemics of blood borne infections. We review available literature on the history of opium production in Mexico, recent trends in drug use and its implications, and the Mexican response, with special emphasis on the border cities of Ciudad Juarez and Tijuana.

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Available from: Carlos Magis-Rodriguez
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    • "Several authors have reported on consumer satisfaction with treatment services provided[17,18,21,25,28,32]and instances of mistreatment at addiction treatment centers in Tijuana have also been covered by news media in recent years2223242535]. In particular, evidence suggests that physical abuse and violence have taken place at peer support-based centers, in some cases culminating in legal action against the programs252627. "

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    • "In Ciudad Juarez, heroin is the primary substance motivating treatment seeking (Instituto Nacional de Psiquiatría, 2011). Less information is available on the quality or accessibility of methadone or other medication-assisted treatment services in Ciudad Juárez, yet abundant media reports have highlighted incidents of violence within residential centers (Lacey, 2009) and only one public methadone clinic was operating during the study period (Bucardo et al., 2005). "
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    • "Heroin in this region is usually in the form of black tar, which is typically injected. On the contrary, white/brown powder, which is more prevalent in other regions , is more easily used through smoking and snorting (Bucardo et al., 2005). Methamphetamine has become a major drug of abuse in Tijuana (Brouwer et al., 2006; Case et al., 2008) and is closely associated with unprotected sex and increased risk of acquiring HIV and other sexually transmitted diseases (Drumright et al., 2006). "
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    ABSTRACT: Background: Although most people who inject drugs (PWID) in Tijuana, Mexico, primarily inject heroin, injection and non-injection use of methamphetamine and cocaine is common. We examined patterns of polydrug use among heroin injectors to inform prevention and treatment of drug use and its health and social consequences. Methods: Participants were PWID residing in Tijuana, aged ≥18 years who reported heroin injection in the past six months and were recruited through respondent-driven sampling (n = 1,025). Latent class analysis was conducted to assign individuals to classes on a probabilistic basis, using four indicators of past six-month polydrug and polyroute use: cocaine injecting, cocaine smoking or snorting, methamphetamine injecting, and methamphetamine smoking or snorting. Latent class membership was regressed onto covariates in a multinomial logistic regression. Results: Latent class analyses testing 1, 2, 3, and 4 classes were fit, with the 3-class solution fitting best. Class 1 was defined by predominantly heroin use (50.2%, n = 515); class 2 by methamphetamine and heroin use (43.7%, n = 448), and class 3 by methamphetamine, cocaine, and heroin use (6.0%, n = 62). Bivariate and multivariate analyses indicated a group of methamphetamine and cocaine users that exhibited higher-risk sexual practices and lower heroin injecting frequency, and a group of methamphetamine users who were younger and more likely to be female. Conclusions: Discrete subtypes of heroin PWID were identified based on methamphetamine and cocaine use patterns. These findings have identified subtypes of heroin injectors who require more tailored interventions to reduce the health and social harms of injecting drug use.
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