Checking Your Substances in Mexico
By Zara Snapp, director of Instituto RIA (Mexico)
The situation in Mexico complicates the implementation of drug policies and harm reduction measures. Engaging in political advocacy and providing services to substance users is a task that organizations have had to undertake cautiously. The reality of substance adulteration in illegal markets, including the danger of fentanyl, underscores the urgency and need for health services that allow for substance composition analysis. The insecurity surrounding these markets poses a risk both for those who purchase substances and for those involved in harm reduction initiatives.
The regulatory framework for substance analysis services in Mexico is established through various official standards and federal laws. The Mexican Constitution, in Article 4, provides the legal basis for the regulation of “addictions” at the national level. Additionally, the Official Mexican Standard NOM-028-SSA2-2009, published by the National Human Rights Commission, establishes guidelines for the prevention, treatment, and control of addictions. This standard details procedures for the care of people with dependency issues, including referral to specialized care facilities and the preparation of referral sheets for clinical follow-up. However, the NOM focuses almost exclusively on the population of people who inject drugs, in relation to the prevention of HIV transmission. We need a regulatory framework that recognizes the current reality and provides tools and protections that shield the work of civil society organizations.
In recent years, we have seen a slight increase in the availability of harm reduction programs in Mexico, always self-managed and coming from civil society collectives and organizations, due to our proximity to the overdose crisis in the United States and Canada and government campaigns in Mexico that promote fear about market adulteration and consumption risks. For these reasons, after a transition process, Instituto RIA launched the substance analysis service Checa tu Sustancia (Check Your Substance, CTS).
Driven by a multidisciplinary team of volunteers, our main focus is harm reduction, community health, and pleasure management for users of psychoactive substances in Mexico. We offer comprehensive, anonymous, and free care for people who use drugs, through the distribution of informational materials and open conversations. If a person wishes to analyze their substance, we apply a brief questionnaire, perform a chemical analysis of the substances, and deliver the results along with specialized counseling for the individual and their group of friends.
With the drug checking service and other interventions, we seek to generate well-being for adults who decide to use psychoactive substances in various contexts.
During the first months of operation, we have received very positive feedback from the user community, especially from the LGBTQ+ community with whom we have connected to be present at their parties and social spaces. Between February and May, we conducted 6 interventions where we analyzed 481 samples of psychoactive substances and impacted more than 800 people, in addition to distributing thousands of informational materials.
In Mexico, due to our geographical position and the dynamics of illegal markets, we have a high production of methamphetamine, which is why it is often the most used substance for adulteration. In our first intervention in February, 38 MDMA samples had been completely substituted with another substance: 35 with methamphetamine, 2 with 2C-B, and 1 with cocaine and methamphetamine. We recognize and are concerned about the increase in methamphetamine consumption in the country as data indicates it is the substance that leads the greatest number of people to seek treatment, with 46.2% of all cases, followed by alcohol with 24.6%.
The most analyzed substance, reflecting regional data from analysis services, is MDMA, accounting for 57% of the samples analyzed in Checa tu Sustancia. Of the 273 MDMA samples analyzed, 198 contained only the expected substance, while 75 of the samples contained an additional adulterant or had been completely substituted.
Fentanyl is the substance that causes the most fear in the country. On the US border, the heroin market is almost completely replaced by fentanyl, and opioid users live at risk of overdose without safe access to naloxone and substitution treatment. Community organizations working in the border region provide health services, including substance analysis, with no government support.
Government campaigns make people think that most illegal substances might contain fentanyl. We have identified that the demand for substance analysis services has increased to address this fear. Although we require a larger volume of data and samples for analysis, so far we have not found fentanyl in the metropolitan area of Mexico City.
Sometimes in Mexico, it feels like those of us working in drug policy or harm reduction are very exposed. There is no state guarantee of access to services for users or support to continue providing the service. We do not issue alerts about psychoactive substances because we do not want to provoke confrontations with non-state actors, a risk we cannot take as we lack the funds to ensure the continuity of services. This means that every step achieved is a victory behind which lies a great self-managed effort.
We write this text in the days following the presidential elections, where Claudia Sheinbaum won, and Clara Brugada was elected as head of the government of Mexico City, in addition to state and local elections throughout the country. It is important to note that while there may be criticisms of various implemented policies, both candidates supported different initiatives during their previous terms. As the former head of government, Claudia Sheinbaum investigated and sought ways to improve access to cannabis for adult use in the city. Clara Brugada, as mayor of Iztapalapa, implemented a series of very important initiatives called Utopías, where there are playgrounds for children, dentists, psycho-emotional support, cultural and artistic spaces, and the Colibrí Centers. These Centers are a new way of addressing psychoactive substance use, providing support services, therapy sessions, and pharmacological interventions, all within a harm reduction approach, without the users necessarily contemplating the cessation of use. It was a very innovative initiative in the Mexican context with great results that allowed substance users on the outskirts of Mexico City to have a free support option with trained and specialized personnel.
At Instituto RIA and Checa tu Sustancia, we recognize all that has been achieved and also all that remains to be built. In the drug checking service, our objectives are clear: to expand the range of strategies and services to promote comprehensive harm reduction policies; to produce knowledge about the composition of drugs in the illegal market and their impacts on public health, and to share objective information about psychoactive substances and the human rights of users of psychoactive substances.
Zara Snapp is the director of Instituto RIA, a Mexican organization that conducts research and advocacy on drug policy and implements harm reduction and pleasure management interventions. She is a political scientist from the University of Colorado at Denver, and holds a Masters in Public Policy from Harvard University, where she was a full fellow. Zara is the author of the Dictionary of Drugs, an international advisor to Acción Técnica Social (Colombia), a board member of YouthRISE and a member of LANPUD.
