Social and Structural Challenges to Drug Cessation among Couples in Northern Mexico: Implications for Drug Treatment in Underserved Communities

Available drug treatment modalities may inadequately address social and structural contexts surrounding recovery efforts.

This mixed methods analysis drew on (1) surveys with female sex workers and their intimate male partners and (2) semi-structured interviews with a subsample of 41 couples (n=82 individuals, 123 total interviews) in Northern Mexico. Descriptive and content analyses examined drug cessation and treatment experiences.

Perceived need for drug treatment was high, yet only 35% had ever accessed services. Financial and institutional barriers (childcare needs, sex-segregated facilities) prevented partners from enrolling in residential programs together or simultaneously, leading to self-treatment attempts. Outpatient methadone was experienced more positively, yet financial constraints limited access and treatment duration. Relapse was common, particularly when one partner enrolled alone while the other continued using drugs.

Affordable, accessible, evidence-based drug treatment and recovery services that acknowledge social and structural contexts surrounding recovery are urgently needed for drug-involved couples.

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By: Bazzi AR1, Syvertsen JL2, Rolón ML3, Martinez G4, Rangel G5, Vera A3, Amaro H6, Ulibarri MD7, Hernandez DO8, Strathdee SA9.

• 1Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th floor, Boston, MA 02118, USA. Electronic address: abazzi@bu.edu.
• 2Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174W. 18th Avenue, Columbus OH 43210, USA.
• 3Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0507, USA; Facultad de Medicina, Universidad Xochicalco, Rampa Yumalinda 4850, Colonia Chapultepec Alamar C.P. 22540, Tijuana, Baja California, México.
• 4Federación Mexicana de Asociaciones Privadas, Plutarco Elías Calles No. 744 Norte, Col. Progresista, C.P. 32310, Ciudad Juárez, Chihuahua, México.
• 5Comisión de Salud Fronteriza México-Estados Unidos, Sección México, Paseo del Centenario #10851, Zona Río. C.P. 22010, Tijuana, Baja California, México; Secretaría de Salud, Homero 213, piso 19, Col. Chapultepec Morales, Delegación Miguel Hidalgo C.P. 11570, México, D.F.
• 6School of Social Work and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Montgomery Ross Fisher Building, Room 221 669W. 34th St., Los Angeles, CA 90089.
• 7Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0849, USA; California School of Professional Psychology, Alliant International University-San Diego, San Diego, CA.
• 8School of Medicine, University of California, Davis, 4610 X Street, Sacramento, CA 95817, USA.
• 9Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0507, USA  

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