In a rehabilitation center in Ciudad Juárez, a man we will call Santiago, in order to protect his identity, faced the biggest challenge of his life: to decide between abandoning treatment or turning himself in after three months of internment.
Translated by Jesús Ronquillo / Circuito Frontera
“Boss, either you get me out or I’ll endure the three months and forget you had a son,” he told his mother on the day of his arrival.
The environment inside the annex was hostile, but over time he discovered that there he could unburden himself without filters, scream, curse and face his own reality without fear of being judged.
However, not all the experiences in the “annexes” that exist in the city are the same, since on this border, only 39 rehabilitation centers operate with a state permit, but it is estimated that more than 120 operate clandestinely, without supervision or guarantees for the patients.
This was made known to Circuito Frontera by Lizeth Gutiérrez Pérea, head of the State Commission for Attention to Addictions, who said that the regulated spaces also include three Community Mental Health and Addiction Centers, better known as CECOSAMA.
He explained that many of these centers do not have state permits, which puts the safety and treatment of patients at risk.
In addition, some operate under the guise of religious associations or shelters, thus evading official regulation.
It is worth noting that the state of Chihuahua ranks fifth in the nation in drug use among young people, according to the National Addictions Survey.
Santiago said that during the first 15 days he was admitted to the rehabilitation center, no one was allowed to visit him.
It was the time when he had to adapt to the discipline of the place, where he soon took on responsibilities as head guard.
“I had to get up a little earlier, but they treated me well,” she confesses. His days were divided between running meetings and taking care of the pharmacy, a drastic change for someone used to the freedom of the street.
She says the rules were strict: Food was served without salt or sugar, and they called it “spiritual broth.” “You have to value the salt, the taste, the food,” they were told.
For Santiago, this was a shock to the life he knew. In the prison he could buy whatever he wanted, but in the annex there were no options: obedience and deprivation, so he had to learn to follow rules and accept the conditions imposed on him as part of his rehabilitation.
On weekends, visitors would bring roasted chickens for the inmates. El Benji, Santiago’s friend, would order them from everyone he could and end up with a table full.
“Bring me a chicken,” he begged once, and Santiago agreed, unaware that others had already done the same. For many, that day was a respite from the monotony and a reminder of the outside world.
In time, Santiago understood that his time in the annex was an opportunity. “If I fall again, I know it’s up to me,” he reflects.
Drawings made by Santiago during his stay at the center / Photo: Francisco Servín
He says he does not want to return, except as a visitor, because he has seen many relapse and be forcibly hospitalized, but he knows that his destiny is in his own hands and that every decision counts on the road to recovery.
Now, away from those substances, he understands that his real challenge was not just to detox, but to rebuild himself from the inside out.
Scholarships for rehabilitation
In light of this situation, the state government offers scholarships for those who cannot afford to pay for treatment to enter rehabilitation centers.
Despite these efforts, the lack of supervision in irregular centers has led to serious incidents.
A recent example occurred in Granjas de Chapultepec, where a riot in a clandestine annex left 28 people escaped and others detained after synthetic drugs were found inside the facility.
The official warned that the centers must have a medical area and specialized personnel, since some centers only offer spiritual sessions, which can be complementary, but do not replace comprehensive treatment.
Consumption and care in the centers
According to the World Drug Report 2024, cannabis is the most consumed substance globally, with 228 million users, followed by opioids and amphetamines. In Ciudad Juarez, the trend is similar, with marijuana, amphetamines and alcohol being the most commonly consumed drugs.
CECOSAMAs offer free and specialized treatment to people with addiction problems. In addition, there are 34 regulated residential facilities in Ciudad Juarez and two more in Casas Grandes, with a capacity to care for between 600 and 700 people.
However, the consumption of legal substances also represents a challenge. Dr. Lizeth Gutiérrez pointed out that alcohol is one of the least attended addictions because its consumption is normalized in society.
In addition to illicit substances, there are other addictions such as compulsive gambling, sex and work, which require psychological and medical attention. These problems are less visible, but affect the quality of life of those who suffer from them.
Dr. Gutiérrez explained that addictions should be treated as chronic diseases. “It is like diabetes: it can be controlled, but there is no cure. Forty percent of the treatment is psychotherapy and the remaining 60% is the patient’s effort to stay in recovery,” she said.
Stigmatization and challenges
Despite advances in addiction care, stigma remains an obstacle to the rehabilitation and social reintegration of consumers.
In Ciudad Juarez, arrests are still reported for simple possession and personal consumption, which reflects a punitive policy rather than a public health approach.
Stigma towards people with addictions is largely due to negative social perceptions.
“Drinking coffee is consuming a stimulant substance, but it is not stigmatized. In contrast, the use of other substances generates rejection,” Gutiérrez explained.
Sociologist Erving Goffman, in his book Social Stigma Theory, points out that historically, societies have discriminated against specific groups based on race, religion or physical conditions.
Currently, this discrimination is reflected in the criminalization of substance users.
In the workplace, many companies conduct drug tests to detect substance use.
According to Roberto Arturo Flores, manager of Global Health Care, the most common tests detect cannabis, cocaine, amphetamines, benzodiazepines, methamphetamines and opioids.
The impact of drug use at work can be significant, the Global Health Care manager noted.
“A person with addiction is 60% more at risk of suffering an accident at work and 70% more likely to suffer injuries. In addition, their productivity is reduced by up to 40%,” Flores explained.
However, these tests do not always distinguish between occasional consumption and a state of intoxication.
“The effects of some drugs can last up to 10 days in the body, which can g added.
Despite these challenges, public policies should prioritize the health and social reintegration of consumers, said Dr. Gutiérrez Perea.
She pointed out the need for the State Commission for Attention to Addictions (CEAADIC) to implement protocols based on scientific evidence, avoiding approaches based solely on religious beliefs.
“The objective is not to impose a doctrine, but to guarantee adequate treatment,” she concluded.
