Attitudes and Perspectives of Service Providers on Persons Who Use Stimulants in Northern and Central Mexico.

Substance use & addiction journal Pub Date : 2025-07-01 Epub Date: 2025-01-28 DOI:10.1177/29767342241311665
Claudia Rafful, Leonardo Jiménez-Rivagorza, Daniela Peralta, María Elena Medina-Mora, Andrés Mota
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Abstract

Background: Methamphetamine and other stimulant use are increasing across Mexico while treatment options and public funding remain scarce for substance use treatment. This study examined the attitudes and perspectives of service providers who work with persons who use stimulants in Mexico.

Methods: Semistructured qualitative interviews were conducted with 20 service providers in diverse cities in the northern and central regions of Mexico, from healthcare centers and harm reduction community-based organizations (CBOs). All interviews were audio-recorded, transcribed, and de-identified. We conducted a thematic analysis to identify and compare common themes and patterns among participants, including portrayal of persons who use stimulants, dynamics of use, attitudes toward persons who use stimulants, and treatment availability and effectiveness.

Results: First, service providers considered that persons who use stimulants have more complex backgrounds than others who use other substances. Second, although most providers mentioned trauma, pain, and the risk environment, CBO providers also stressed the importance of accounting for hedonism for understanding stimulant use trajectories. Third, treatment options are based on the type of services the institutions provide, usually constrained to guidelines for any substance use. In a few cases, cocaine treatment guidelines are used regardless of the type of stimulant used. Fourth, although health care services are abstinence-based, providers acknowledge the effectiveness of harm reduction approaches. In contrast, CBOs provide person-centered options.

Conclusions: Overall, although service providers are aware of the increase in stimulant use, stigmatizing attitudes are prominent among some of them. However, providers in CBOs were more sensitized to their communities' specific needs. Public policy recommendations include training to eliminate institutional stigmatization, the importance of first-person language, harm reduction effectiveness, and implementing community-based interventions to improve stimulant use-related services.

服务提供者对墨西哥北部和中部使用兴奋剂者的态度和观点。
背景:在墨西哥,甲基苯丙胺和其他兴奋剂的使用正在增加,而药物使用治疗的治疗方案和公共资金仍然缺乏。本研究调查了在墨西哥与使用兴奋剂的人打交道的服务提供者的态度和观点。方法:对墨西哥北部和中部地区不同城市的20名服务提供者进行半结构化定性访谈,这些服务提供者来自卫生保健中心和减少危害社区组织(cbo)。所有的采访都被录音、转录并去识别。我们进行了主题分析,以确定和比较参与者之间的共同主题和模式,包括使用兴奋剂的人的写照,使用的动态,对使用兴奋剂的人的态度,以及治疗的可用性和有效性。结果:首先,服务提供者认为使用兴奋剂的人比使用其他物质的人具有更复杂的背景。其次,尽管大多数提供者提到了创伤、疼痛和风险环境,CBO提供者也强调了解释享乐主义对理解兴奋剂使用轨迹的重要性。第三,治疗方案取决于机构提供的服务类型,通常受限于任何药物使用指南。在少数情况下,不管使用何种兴奋剂,都使用可卡因治疗指南。第四,尽管卫生保健服务以禁欲为基础,但提供者承认减少伤害方法的有效性。相比之下,cbo提供以人为本的选择。结论:总体而言,尽管服务提供者意识到兴奋剂使用的增加,但其中一些人的污名化态度很突出。然而,社区卫生组织的提供者对其社区的具体需求更为敏感。公共政策建议包括消除机构污名化的培训、第一人称语言的重要性、减少伤害的有效性以及实施基于社区的干预措施以改善与兴奋剂使用有关的服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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