Mexico City Develops Standards for Treating Female Substance Abusers

MEXICO CITY, MEXICO – Surrounded by pink walls, she admits that this is not her first time in rehab.

Méndez, who asked that only her last name be used, was addicted to alcohol, marijuana and inhalants, known in Mexico by the slang word “activo.”

“I didn’t like the smell of activo, it disgusted me, but I did like the sensation. I would hallucinate, and I wouldn’t feel sad anymore,” she says. “At the beginning, I thought that I did drugs to coexist. But you realize that it is also to fill a void and the pain.”

At 24 years old, this is Méndez’s second stay in a substance abuse rehabilitation facility.

But unlike last time, she sought out a treatment facility for women, a rare find in Mexico’s capital city.

She says she’s abused alcohol since she was 14, and started drugs at 17.

Méndez lowers her voice as she looks down, and says it is difficult to admit having been a drug addict. She thought she was in control, she says, that she could stop whenever she wanted to. But by the time she realized how desperate her situation was, she felt there was no turning back.

When she finally got the strength to go into rehab the first time, she didn’t realize how challenging the environment would be for a woman.

Her first rehabilitation center, which she declined to name for fear of retribution, was coed. Female residents were forbidden to socialize, share cigarettes or even speak to the men, she says.

If residents were caught mingling with the opposite sex they were punished, she says. During her stay, she says some women had their hair cut off, and men would have their heads shaved, if they were caught.

Méndez says she was uncomfortable at the center because of the mistreatment by the staff. What’s more, she says, the clinical treatment she received was generic and didn’t address her needs.

She left after six weeks.

Today, she is completing a rehabilitaiton program at Fundación Jóvenes Tlatilco, one of six female-only rehabilitation facilities in Mexico City, according to the government agency charged with monitoring the facility.

In Mexico City, government officials and advocates agree that women face greater stigma for addiction than men, and they also have fewer treatment options. There are 338 rehabilitation facilities in the Federal District, which has a population of 8.8 million people, according to 2010 census data. But just six of those centers are reserved for women. For the last two years, the local government has been working to standardize and regulate new treatment norms for women here. The new guidelines are expected to be released in April 2016.

Those guidelines will be the first-ever for specialized care for women, says Dr. Gustavo Castillo Ramírez, director of treatment and rehabilitation at the government-run Institute for the Care and Prevention of Addictions (IAPA), and they’ll be piloted in women’s treatment centers.

IAPA regulates standards and policies within Mexico City’s substance abuse rehabilitation centers. It does not manage the centers or provide financing, Castillo Ramírez says.

Of the 338 rehabilitation centers in Mexico City, 107 were registered with IAPA as of October, according to IAPA data provided by José Alejandro Juárez Gamero, head of IAPA’s social communication department. Of those, 87 are inpatient and the remaining 20 are outpatient clinics used for addiction emergencies. Centers are not required to register with IAPA.

Through a series of pilot programs and surveys, the IAPA determined that there was a significant lack of resources for women seeking treatment, Castillo Ramírez says. IAPA research also highlighted psychological differences between men and women, which sparked interest in creating separate guidelines.

Castillo Ramírez says the IAPA has been working on these new guidelines since 2013, but could not say exactly what the guidelines hope to regulate or establish. However, leaders of some of the six centers working with IAPA say the guidelines aim to include gender-specific therapeutic methods, empowerment tools and leadership training, they say.

Castillo Ramírez says women with addiction issues suffer a higher risk of stigmatization in the community.

Advocates working directly with women in rehabilitiation facilities say women do face increased obstacles to get into and stay in treatment. Coed facilities don’t address those issues, the advocates say.

Antonio Segura González founded Fundación Jóvenes Tlatilco 18 years ago, after recovering from his own addictions, he says. Initially, the center only had men, but then started to accept women as well. At the time, the center only worked with the Alcoholics Anonymous program.

But in 2006, Segura González says he realized that womens’ drug use was being ignored at the center. He separated the single center into two to avoid the risks presented by a facility with both men and women.

He says IAPA has trained staff and provided them courses about women’s basic necessities and treatment plans that respect women’s rights.

“Almost always, rehabilitation is aimed at men,” Segura González says.

Olga Badillo González agrees.

She opened the Crisol Amor y Esperanza rehabilitation center after working at another coed facility. She says she opened her own center after seeing first-hand the need to support women and provide them with specific care.

When women were included in the same therapy activities as men in mixed centers, for example, she says, women often felt uncomfortable sharing personal details.

“This limits rehabilitation,” Badillo González says. “We noticed that the girls, when they are treated in different ways, they have a rehabilitation that is much more health conscious and structured.”

Badillo González says her center, as one of the six centers piloting treatment programs for women,  has received training and support from IAPA.

Cecilia Pérez Rodríguez, 26, is the director of La Perla Mexicana, another of the six centers working with IAPA.

She says the center is researching the best ways to offer treatment to women in a society that stigmatizes women addicts, she says.

Women face major social stigmatization when it comes to drug abuse and treatment, says Mónica Martínez Arroyo, a professor at the University of the Incarnate Word’s campus in Mexico City. Even going to a rehab center is stigmatized becuase women who seek treaktment are judged for abandoning their social roles and obligations as wives and mothers, she says.

Martínez Arroyo is working on an investigation with Stanford University in California that focuses on treatment for drug addicts who come from conditions of poverty.

She says it’s risky to place men and women in the same centers because of a likelihood of physical or sexual abuse. There is a coersive effect at play when women are in centers, she says.

So far, there is anecdotal evidence that women-only centers work.

Méndez recently graduated from Fundación Jóvenes Tlatilco. She says she feels she now has the tools she needs to stay clean.

 

Natalia Aldana, GPJ, translated this article from Spanish.