Women who use drugs and access to treatment in Mexico: Between violence and stigma

This article, consisting of two parts, was originally posted, in Spanish, on the Animal Político website (Part 1 / Part 2). We are grateful to Karen Torres (IDPC volunteer) for the Spanish-to-English translation below.

'Well, I am a person who has relapsed several times, I have been in different rehabilitation centres, I have been in different street situations […]. More than anything, I would like to help, to support people, because sometimes we are harshly labelled as ‘addicts’ or as ‘consumers’ and, not to try to justify myself but, we all have our stories and reasons'.

And this is how our interview begins with Tamara, a 23-year-old woman admitted to a private residential treatment centre in Baja California. Her testimony is part of the more than 40 voices collected for an investigation carried out by EQUIS Justicia para Mujeres (EQUIS Justice for Women) focused on adolescents and women who use drugs who are in treatment centres or in jail.

Through this research, we seek to investigate the conditions of detention of people who use drugs. Moreover, we are particularly interested in knowing, from the narratives of the women themselves, what their relationship with drugs has been, what substances they have used and how they talk about drugs in relation to their life stories.

In line with what is reported regionally and internationally, in Mexico women consume significantly less than men and experience lower rates of dependence. They also face greater social, structural and cultural barriers to access treatment, as well as greater stigma.

As Lesly, who was admitted to a public treatment centre in Chiapas, points out: 'A man who uses drugs is seens as a ‘user’. A woman who uses drugs is deemed a ‘user’ and a ‘whore’'. Therefore, women are subject to a double penalty: on top of the marginalisation, stigmatisation and criminalisation to which all people who use drugs are subjected, women also experience the moral condemnation of having transgressed the gender axioms that frame the ideal of a ‘good woman.’

Life stories traversed by violence

The women interviewed have, for the most part, been victims of sexual abuse on multiple occasions. Violence against children, coupled with gender violence against women and girls, manifests in the home and in the community and is deployed by grandparents, cousins, uncles - in short, close relatives of whom no one suspects.

Tamara herself, whom we cite at the beginning of this article, was abused for years by her cousins, every Sunday, after Mass.

Rape by a family member means that children do not talk about what happens or, if they do, no one believes them. This is the case of Diana, also admitted to a treatment centre on the northern border, who at the age of sixteen was raped by her maternal grandfather. When she told her mother, she didn't believe her. Diana ended up being deprived of freedom in a prison for minors in the United States for two years for having stabbed her grandfather to death.

In the stories collected in prisons and treatment centres, symmetries appear: sexual violence; drug use starting in the family setting or through a partner and, among the youngest, with friends; alcohol as the first drug and the beginning of substance use; as well as the development of dependence, since adolescence. In their narratives, drugs appear as an element of support/coping mechanism serving different purposes: to forget the experience of abuse, to deal with violence, to feel pleasure.

Bruno, a teenager whom we interviewed in Chiapas, to approach the experiences of young men and adolescents, was a victim of abuse by his grandfather since childhood. He smoked crystals and when he was under the effect of the drug, he imagined going for walks with his grandfather, playing with him, having the childhood he could only dream of. When we interviewed him, he was two days away from release. To the question 'What do you feel when you think about your departure?', he replied: 'I fear that I will be live the same way again'. That answer was shared by the other three young men we interviewed with Bruno.

Drugs are part of a search for solutions and an aid to try to address difficult situations and not, as people with substance dependence are usually represented, as means to brush off or abdicate on extremely difficult and painful situations. In fact, at the beginning of women's narratives, drugs are not important per se, rather they act as a pivot to deal with the rest. At some point the relationship changes and everything starts to revolve around substances. At that time of high vulnerability and cumulative exclusion, treatment centres become crucial.

The huge problem of treatment centres in Mexico

Mexico does not have enough public treatment centres. Most outpatient and residential centres are private, religious, and based on a mutual aid scheme. All the people interviewed who have been in private treatment centres report having witnessed or suffered physical, verbal, psychological and even sexual abuse.

This is the case of Yolanda; whose first pregnancy was the result of a rape by an operator of a treatment centre. In several cases, women were picked up by trucks and taken to the centres by force: Basically, a kidnapping operated by the so-called ‘Celestial Patrol.’

In addition to the dubious legitimacy and legality of most private centres - often becoming illegal prisons where inmates live indefinitely incarcerated - women who use drugs suffer further stigma. For example, we find that in some mixed centres, dress codes are stricter for women than for men. In the case of a girl who one day wore tights, the centre raised a report with a line that said: '[...by dressing like that] You are asking to be raped.' The young woman had been a victim of rape since she was three years old. In another centre they told us that men can go outside to do tasks or to get goods in kind or in money for the centre. Women, on the other hand, can never go out.

These are just some of the topics developed in the interviews. The findings and proposals derived from the cases collected will be part of a document that EQUIS will present at the beginning of the following year and that will be shared in this space over the coming months.

Part 2

— ’Before, I was a happy girl ... happy ...’ Alejandra said.
— Were you hurt? - I asked.

Ale turns her eyes into the past, and the story of hell begins.

She was thirteen when she walked to school, in a rural town in a state of Mexico that, for her safety, we will not mention. Two men she already knew approached her and began to hit her with a stick on her ankles, pushing her to a vacant lot, where they beat her and raped her for hours. Before letting her go, they told her to stay quiet or they would do the same to her sisters.

Days later, the same men kidnapped her and kept her locked up for three days, marked by blows and more rape. Ale reports that in the room where they had her tied up, there were some boys her age. When her kidnappers raped her, they would tell them: 'This is how you treat women.'

Ale is currently deprived of liberty in a women's social reintegration centre for the crime of robbery with violence. Between the rape and her current detention, Ale experienced drug dependence, worked as a sex worker and was deprived of liberty due to homicide.

She is one of the almost 50 women who generously agreed to speak with us. Her testimony is part of an investigation by Equis, Justicia para Mujeres (Equis, Justice for Women), which will be published next year, focusing on adolescents and women who use drugs who are detained in public and private drug dependence treatment centres and in reintegration centres. As we mentioned in the first part of this series, this document will aim both to share their narratives, and to make visible the intersection between gender norms and access to treatment.

Every life story collected in these months is unique. One after another, adolescents and women - mostly young people - with whom we spoke, had the strength to share with us stories they had never shared with anyone else. Within said uniqueness, patterns are discernible, namely regarding the intersection between gender norms, violence against women and punitive drug policies.

In roughly 90% of cases, when asked how they started using drugs, most begin by reporting sexual violence in their childhood (from ages three to eleven), by stepparents, grandparents, uncles and other men in their close social circles. Usually, when they share what happened with their mothers or other relatives, they do not believe them or accuse them of being the instigators of sexual violence.

Two predominant scenarios ensue: Fleeing from home and living on the streets, or starting a relationship with an adult or adolescent man. Gina, a 23-year-old woman with a career as a hitman for almost a decade, says: ‘I felt safer on the streets than with my family.’

When the only option to escape violence, neglect and abuse is a relationship in adolescence, the consequences are almost always teenage pregnancies and more violence. Sexual violence against children is replaced by gender violence against girls and women. There are multiple perpetrators: Boyfriends, husbands, fellow people who use drugs, dealers, police officers and staff of rehabilitation treatment centres.

Women who use drugs are victims of multiple forms of violence: i) domestic violence, in the private, family or couple sphere; ii) violence in childhood; iii) specific violence in drug use circles, mainly of a sexual nature; iv) violence linked to sex work/prostitution; v) violence experienced by women victims of human trafficking; vi) institutional violence.

Adding to the gendered violence experienced by women who use drugs, women who use psychoactive substances in their childhood or adolescence are also subject to the penalties of punitive drug policies. In our next article, we will talk specifically about gender-based violence in drug treatment centres, based on the right to health approach.

As noted by a group of women deprived of liberty with whom we talked, mostly prosecuted for multiple homicides and related activities, no one denounces, persecutes or repairs the violence that women were victims of during their childhood. No one asks and no one believes them.

Criminal organisations find them in their adolescence and ‘fashions them [to their benefit]’: Young women with a form of military training, who coldly kill one victim after another, until they feel nothing. They evolve into single mothers who find a space of equality and empowerment in their work as hitwomen, as well as a source of income that allows them to keep their daughters and sons cared for. Women deprived of liberty who face sentences of more than one hundred years and who state, in their lucid and unappealable analysis: ‘the State only stops us, hits us or kills us’.

Women who use drugs and who are detained in prisons or treatment centres are completely invisible and stigmatised; they live in a circle of violence, systematic and widespread, that needs to be stopped. If we want to eradicate violence against all women and girls, it is necessary to listen to them and incorporate their experiences and their voices in the debates and policies that affect them.

* Corina Giacomello is a consultant for Equis – Justicia para las Mujeres.