Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

Substance Abuse Treatment, Prevention, and Policy

Maria Elena Medina-Mora³  Steffanie A Strathdee¹  William A Vega²  Clara Fleiz³  Yinfei Kong²  Jorge Ameth Villatoro³  Erick G Guerrero² 

[1] School of Medicine, University of California, San Diego, CA, USA;School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089, USA;Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calz. México Xochimilco 101, Col. San Lorenzo Huipulco, México D.F. C.P. 14370

关键词: Drug dependence;    Mexico;    Gender;    Migrant status;    Barriers to treatment;   

Others  :  1139667
DOI  :  10.1186/1747-597X-9-30

 received in 2014-04-10, accepted in 2014-07-24,  发布年份 2014

【 摘 要 】

Background

We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender.

Methods

This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment.

Results

Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City.

Conclusions

Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico.

【 授权许可】

   
2014 Guerrero et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Villatoro J, Medina-Mora ME, Fleiz Bautista C, Moreno López M, Oliva Robles N, Bustos Gamiño M, Fregoso Ito D, Gutiérrez López ML, Amador Buenabad N: El consumo de drogas en México: resultados de la Encuesta Nacional de Adicciones, 2011. Salud Ment 2012, 35:447-457.
• [2]Brouwer KC, Case P, Ramos R, Magis-Rodríguez C, Bucardo J, Patterson TL, Strathdee SA: Trends in production, trafficking, and consumption of methamphetamine and cocaine in Mexico. Subs Use Misuse 2006, 41(5):707-727.
• [3]Comisión Nacional contra las Adicciones: Norma Oficial Mexicana NOM-028-SSA2-2009: Para la prevención, tratamiento y control de las adicciones. [http://salud.edomex.gob.mx/imca/doc/GUIA_NOM028.pdf webcite]
• [4]Guerrero EG, Villatoro JA, Kong Y, Vega WA, Medina-Mora ME: Mexicans’ illicit drug use in an era of drug reform: a national comparative analysis based on migration status. Int J Drug Pol 2014, 25:451-457.
• [5]Wagner KD, Pollini RA, Patterson TL, Lozada R, Ojeda VD, Brouwer KC, Vera A, Volkmann TA, Strathdee SA: Cross-border drug injection relationships among injection drug users in Tijuana, Mexico. Drug Alcohol Depend 2011, 113:236-241.
• [6]Borges G, Medina-Mora ME, Breslau J, Aguilar-Gaxiola S: The effect of migration to the United States on substance use disorders among returned Mexican migrants and families of migrants. Am J Public Health 2007, 97:1847-1851.
• [7]Wagner KD, Moynihan MJ, Strathdee SA, Cuevas-Mota J, Clark M, Zúñiga ML, Volkmann TA, Teshale E, Garfein RS: The social and environmental context of cross-border drug use in Mexico: findings from a mixed methods study of young injection drug users living in San Diego, CA. J Ethn Subst Abuse 2012, 11:362-378.
• [8]Borges G, Breslau J, Orozco R, Tancredi DJ, Anderson H, Aguilar-Gaxiola S, Medina Mora ME: A cross-national study on Mexico-US migration, substance use and substance use disorders. Drug Alcohol Depend 2011, 117:16-23.
• [9]Brouwer KC, Lozada R, Cornelius WA, Firestone Cruz M, Magis-Rodríguez C, de Nuncio ML Z, Strathdee SA: Deportation along the U.S.–Mexico border: its relation to drug use patterns and accessing care. J Immigr Minor Health 2009, 11:1-6.
• [10]Borges G, Medina-Mora ME, Orozco R, Fleiz C, Cherpitel C, Breslau J: The Mexican migration to the United States and substance use in northern Mexico. Addiction 2009, 104:603-611.
• [11]Robertson AM, Rangel MG, Lozada R, Vera A, Ojeda VD: Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico. Drug Alcohol Depend 2012, 120:142-148.
• [12]Zemore SE, Mulia N, Ye Y, Borges G, Greenfield TK: Gender, acculturation, and other barriers to alcohol treatment utilization among Latinos in three national alcohol surveys. J Subst Abuse Treat 2009, 13:446-456.
• [13]Massey DS, Pren KA: Origins of the new Latino underclass. Race Soc Probl 2012, 4:5-17.
• [14]Guerrero EG, Marsh JC, Khachikian T, Amaro H, Vega WA: Disparities in Latino substance use, service use, and treatment: implications for culturally and evidence-based interventions under health care reform. Drug Alcohol Depend 2013, 3:805-813.
• [15]Price RH: What We Know and What We Actually Do: Prevalence of Best Practices in Substance Abuse Treatment. In Treating Drug Abusers Effectively. Edited by Egertson JA, Fox DM, Leshner AI. Cambridge, MA: Blackwell; 1997:125-155.
• [16]Karageorge K: Reasons for Seeking Treatment among Male and Female Clients in NTIES. Fairfax, VA: Caliber Associates; 2002.
• [17]Alvarez J, Jason LA, Olson BD, Ferrari JR, Davis MI: Substance abuse prevalence and treatment among Latinos and Latinas. J Ethn Subst Abuse 2007, 6:115-141.
• [18]Blume SB: Chemical dependency in women: important issues. Am J Drug Alcohol Abuse 1990, 16:297-307.
• [19]Marsh JC, Miller NA: Female clients in substance abuse treatment. Int J Addict 1985, 20:995-1019.
• [20]Rolon ML, Syvertsen JL, Robertson AM, Rangel MG, Martinez G, Ulibarri MD, Servin A, Strathdee SA: The influence of having children on HIV-related risk behaviors of female sex workers and their intimate male partners in two Mexico-US border cities. J Trop Pediatr 2013, 59:214-219.
• [21]Marsh JC, D’Aunno TA, Smith BD: Increasing access and providing social services to improve drug abuse treatment for women with children. Addiction 2000, 95:1237-1247.
• [22]Syvertsen J, Pollini RA, Lozada R, Vera A, Rangel G, Strathdee SA: Managing la malilla: exploring drug treatment experiences among injection drug users in Tijuana, Mexico, and their implications for drug law reform. Int J Drug Policy 2010, 21:459-465.
• [23]Amaro H, Dai J, Arévalo S, Acevedo A, Matsumoto A, Nieves R, Prado G: Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment. J Urban Health 2007, 84:508-522.
• [24]Ojeda VD, Strathdee SA, Lozada R, Rusch MLA, Fraga M, Orozovich P, Magis-Rodriguez C, De La Torre A, Amaro H, Cornelius W, Patterson TL: Associations between migrant status and sexually transmitted infections among female sex workers in Tijuana, Mexico. Sex Transm Infect 2009, 85:420-426.
• [25]Garcia V: Meeting a binational research challenge: substance abuse among transnational Mexican farmworkers in the United States. J Rural Health 2007, 23(Suppl):61-67.
• [26]Colten ME, Marsh JC: A Sex-Roles Perspective on Drug and Alcohol Use by Women. In Sex Roles and Psychopathology. Edited by Widom CS. New York: Springer; 1984:219-248.
• [27]Oetting ER, Beauvais F: Adolescent drug use: findings of national and local surveys. J Consult Clin Psychol 1990, 58:385-394.
• [28]American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC: American Psychiatric Association; 2000. text revision
• [29]Stata 12 help for nberg procedure [www.stata.com/help.cgi?nbreg webcite]
• [30]Cameron AC, Trivedi PK: Microeconometrics Using Stata. College Station, TX: Stata Press; 2009.
• [31]Xiang L, Lee AH, Yau KKW, McLachlan GJ: A score test for overdispersion in zero-inflated poisson mixed regression model. Stat Med 2007, 26:1608-1622.
• [32]Alvarez J, Olson BD, Jason LA, Davis MI, Ferrari JR: Heterogeneity among Latinas and Latinos entering substance abuse treatment: findings from a national database. J Subst Abuse Treat 2004, 26:277-284.
• [33]Guerrero EG, Cepeda A, Duan L, Kim T: Disparities in completion of substance abuse treatment among Latino subgroups in Los Angeles County, CA. Addict Behav 2012, 37:1162-1166.
• [34]Encuesta Nacional de Adicciones 2002 [http://www.inegi.gob.mx/prod_serv/contenidos/espanol/bvinegi/productos/continuas/sociales/salud/2004/ena02.pdf webcite]