Structural violence and the need for compassionate use of methadone in Mexico
Abstract Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective of this study was to describe the heroin and methadon...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-12955-x |
| _version_ | 1819025868998049792 |
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| author | Martha Romero-Mendoza Ingris Peláez-Ballestas Ariagor Manuel Almanza-Avendaño Emilia Figueroa |
| author_facet | Martha Romero-Mendoza Ingris Peláez-Ballestas Ariagor Manuel Almanza-Avendaño Emilia Figueroa |
| author_sort | Martha Romero-Mendoza |
| collection | DOAJ |
| description | Abstract Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective of this study was to describe the heroin and methadone use of intravenous heroin users of both sexes who have been in jail, to offer evidence for the formulation of health policy. Methods This study used an ethnographic approach, with open-ended interviews carried out from 2014 to the present. Heroin users of both sexes attending a private methadone clinic in Mexico City were invited to participate. The sample was non-probabilistic. All interviews were audiotaped and transcribed, and narratives were analyzed using thematic analysis. Results Participants in this study were 33 users of heroin, two of them women, who had been in prison. They ranged in age from 33 to 62 years, had used heroin for a period of 13–30 years, and were from three states: Michoacan, Oaxaca, and Mexico City. Three principal categories of analysis were structured: 1. Pilgrimage for help (dynamics of the drama of suffering, pain, and time through health care spaces); 2) methadone use as self-care; and 3) accessibility to methadone treatment. The impossibility of access to methadone treatment is a condition which motivates users in their journey. The dynamics of methadone use are interpreted as a form of self-care and care to avoid substance use. Reducing the psychological, physical, and harmful effects of the substance allows them to perform daily activities. The inability to access treatment leads to a significant effect on users who experience structural violence. Conclusion Compassionate methadone treatment and holistic attention should be considered as a way to meet patients’ needs and mitigate their suffering, based on public health policy that allows for human rights-based care. |
| first_indexed | 2024-12-21T05:17:32Z |
| format | Article |
| id | doaj.art-b47bb760e5fa4a04bb2a2ca1914c64b7 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-21T05:17:32Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-b47bb760e5fa4a04bb2a2ca1914c64b72022-12-21T19:14:53ZengBMCBMC Public Health1471-24582022-03-0122111510.1186/s12889-022-12955-xStructural violence and the need for compassionate use of methadone in MexicoMartha Romero-Mendoza0Ingris Peláez-Ballestas1Ariagor Manuel Almanza-Avendaño2Emilia Figueroa3Instituto Nacional de Psiquiatría Ramón de La Fuente MuñizHospital General de México Dr. Eduardo LiceagaFacultad de Ciencias Humanas, Universidad Autónoma de Baja CaliforniaClínica Integral de Tratamiento Contra Las AdiccionesAbstract Background Epidemiological data from Mexico have documented an increase in heroin use in the last decade. However, there is no comprehensive care strategy for heroin users, especially those who have been accused of a crime. The objective of this study was to describe the heroin and methadone use of intravenous heroin users of both sexes who have been in jail, to offer evidence for the formulation of health policy. Methods This study used an ethnographic approach, with open-ended interviews carried out from 2014 to the present. Heroin users of both sexes attending a private methadone clinic in Mexico City were invited to participate. The sample was non-probabilistic. All interviews were audiotaped and transcribed, and narratives were analyzed using thematic analysis. Results Participants in this study were 33 users of heroin, two of them women, who had been in prison. They ranged in age from 33 to 62 years, had used heroin for a period of 13–30 years, and were from three states: Michoacan, Oaxaca, and Mexico City. Three principal categories of analysis were structured: 1. Pilgrimage for help (dynamics of the drama of suffering, pain, and time through health care spaces); 2) methadone use as self-care; and 3) accessibility to methadone treatment. The impossibility of access to methadone treatment is a condition which motivates users in their journey. The dynamics of methadone use are interpreted as a form of self-care and care to avoid substance use. Reducing the psychological, physical, and harmful effects of the substance allows them to perform daily activities. The inability to access treatment leads to a significant effect on users who experience structural violence. Conclusion Compassionate methadone treatment and holistic attention should be considered as a way to meet patients’ needs and mitigate their suffering, based on public health policy that allows for human rights-based care.https://doi.org/10.1186/s12889-022-12955-xStructural violenceMethadonePilgrimageSelf-careTreatment barriersMexico |
| spellingShingle | Martha Romero-Mendoza Ingris Peláez-Ballestas Ariagor Manuel Almanza-Avendaño Emilia Figueroa Structural violence and the need for compassionate use of methadone in Mexico BMC Public Health Structural violence Methadone Pilgrimage Self-care Treatment barriers Mexico |
| title | Structural violence and the need for compassionate use of methadone in Mexico |
| title_full | Structural violence and the need for compassionate use of methadone in Mexico |
| title_fullStr | Structural violence and the need for compassionate use of methadone in Mexico |
| title_full_unstemmed | Structural violence and the need for compassionate use of methadone in Mexico |
| title_short | Structural violence and the need for compassionate use of methadone in Mexico |
| title_sort | structural violence and the need for compassionate use of methadone in mexico |
| topic | Structural violence Methadone Pilgrimage Self-care Treatment barriers Mexico |
| url | https://doi.org/10.1186/s12889-022-12955-x |
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