A qualitative exploration of the downstream impact of a sustained disruption to the methadone supply in Mexico: effects on the mental, financial, and social health of patients with opioid use disorder in Tijuana

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-07-11 DOI:10.1016/j.lana.2025.101176

Annick Bórquez , Jesse Lloyd Goldshear , Sheryl Muñoz-Mina , Arturo Tornez , Alicia Harvey Vera , María Elena Medina Mora , Gudelia Rangel , Steffanie A. Strathdee

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引用次数: 0

Abstract

Background

Medications for opioid use disorder (MOUD) are considered the gold standard long-term treatment for opioid use disorder (OUD) as they have a range of health and psycho-social benefits. Sudden reduction or interruptions in MOUD can have both immediate and long-term consequences for patients. We sought to qualitatively examine the impact of the prolonged closure of Mexico’s main methadone production facility (Psicofarma) in 2023 on MOUD patients in Tijuana, Mexico.

Methods

We conducted semi-structured qualitative interviews with 20 MOUD patients in Tijuana, Mexico, from May to August 2023. We transcribed interviews and translated them from Spanish to English for analysis. Our analysis followed a thematic and narrative approach, and code congruency was found by consensus. Analytic and narrative memos provided the foundation for the ultimate findings.

Findings

The closure of Psicofarma resulted in a sudden stoppage in MOUD for participants. While some were provided with a benzodiazepine alternative and/or psychotherapy by their clinics, most were completely cut off from medical support. Participants reported returning to the illicit market for solutions to both withdrawal and drug cravings. Increased spending on the illicit market drained participant finances and strained employment and familial relationships.

Interpretation

The sudden interruption of MOUD treatment had varied yet predictable effects on our participants. These results demonstrate the need to ensure adequate methadone supply for people with OUD in Mexico and to offer other alternative therapies such as low-threshold buprenorphine.

Funding

Support for this study was provided by NIDA (R01DA049644-S4, T32DA023356 and DP2DA049295).

查看原文本刊更多论文

对墨西哥美沙酮供应持续中断的下游影响的定性探索：对蒂华纳阿片类药物使用障碍患者的精神、经济和社会健康的影响

阿片类药物使用障碍（mod）药物被认为是阿片类药物使用障碍（OUD）的金标准长期治疗，因为它们具有一系列的健康和心理社会益处。突然减少或中断对患者有直接和长期的影响。我们试图对2023年墨西哥主要美沙酮生产设施（Psicofarma）长期关闭对墨西哥蒂华纳（Tijuana）的mod患者的影响进行定性研究。方法于2023年5月至8月对墨西哥提华纳20例mod患者进行半结构化定性访谈。我们将采访记录下来，并将其从西班牙语翻译成英语进行分析。我们的分析遵循主题和叙事方法，并通过共识发现代码一致性。分析性和叙述性的备忘录为最终的发现提供了基础。Psicofarma的关闭导致参与者的mod突然停止。虽然诊所向一些人提供苯二氮卓类药物替代品和/或心理治疗，但大多数人完全无法获得医疗支持。与会者报告说，他们回到非法市场寻求戒断和渴望毒品的解决办法。在非法市场上增加的支出耗尽了参与者的资金，并导致就业和家庭关系紧张。突然中断mod治疗对我们的参与者有不同但可预测的影响。这些结果表明，需要确保墨西哥OUD患者有足够的美沙酮供应，并提供其他替代疗法，如低阈值丁丙诺啡。本研究由NIDA （R01DA049644-S4， T32DA023356和DP2DA049295）提供资金支持。

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.