Spread of Heroin Taxes Tijuana Clinics

Miguel Gutierrez shivers outside the cluster of ramshackle houses until the iron gate guarding the compound slowly opens.

His cocoa-colored eyes ooze tears. He mumbles an apology because his hands are trembling. The 22-year-old heroin addict is led to a detoxification room that he will share with other addicts.

“Tonight and tomorrow night will be his most difficult,” says Jose Luis Avalos Lopez, director of this branch of the Center for the Integration and Recuperation for Alcoholics and Drug Addicts, known by its Spanish acronym CIRAD.

“He will hurt, but he will survive.”

As a veil of fog rolls over the city, Gutierrez breaks into a sweat. He vomits, then sleeps fitfully through a stream of nightmares.

Gutierrez has checked himself into one of Tijuana’s 31 ad hoc, unregulated drug addiction centers that have opened since 1994--almost one a month--in this city known more for its vices than its healing powers.

The sparsely furnished compounds, founded and operated by former addicts, are responding to the rising use of heroin and methamphetamine.

As Gutierrez sits on the edge of a lower bunk that evening, he accidentally thumps his shaved head on the bedpost. He does it again. And again, apologizing to a visitor. This time he winces and leans back.

Moments later, he returns to a discussion about heroin and its easy availability on the streets of Tijuana.

“It broke me,” he says.

The men who share the detox room with Gutierrez agree. Of the five huddled under nubby blankets, four were addicted to heroin. The fifth was on methamphetamine, a cheap speed cooked up in the remote deserts of Southern California.

“There was never the demand for heroin like there is now,” says Luis de la Torre, a 32-year-old addict sitting across from Gutierrez in the cramped room, their knees almost touching.

U.S. Drug Enforcement Administration officials and addicts in Tijuana say methamphetamine and heroin exploded onto the border region’s illegal drug market in late 1994 and early 1995, just as Mexico was experiencing a financial crisis and the peso was devalued.

Drug smugglers were paid for their services with narcotics they hoped to sell for more-valuable U.S. dollars. Instead, many began consuming the drugs they had “earned” for smuggling loads across the border, becoming hooked.

Soon they were begging traffickers to let them perform any type of service--male prostitution, robbery or smuggling--to earn more hits.

A DEA official, who requested anonymity, confirmed that in late 1994 and early 1995, Mexican drug traffickers began to deal heavily in methamphetamine and heroin.

“Traditionally, Mexican traffickers were involved in marijuana and cocaine. They had established routes,” the official said. “But about 1994-1995, they realized they could make it overnight and get it on the street the next day for a minimum investment.”

With $500 in glassware and chemicals, Mexican traffickers could produce a batch of crystal meth that would sell for $50,000 on the street, the official said.

Avalos dismisses economic factors as contributing to drug addiction.

“Those men that carry drugs are addicted,” he says. “They are addicts already, and they go to the [Mexican] Mafia looking for work. They know they will be paid in drugs.”

Maria Antonieta Olvera Najera, a psychologist with Mexico’s Health Department, says Tijuana’s non-regulated rehab centers are more successful than the city’s two government-run clinics.

“If the government programs were effective, there wouldn’t be these new centers,” Olvera says.

Of Tijuana’s 1.7 million residents, its heroin-addict population has swelled to 25,000, an increase of about 45% since late 1993, says Olvera, who leads two commissions on drug addiction. In addition, there are about 10,000 regular methamphetamine users in the city.

Within CIRAD’s white and purple walls, there is no doctor on the staff. Gilberto Soriano, a recovering alcoholic, operates the “pharmacy,” a closet-size room stuffed to the ceiling with antibiotics and alcohol-free cough syrup donated by the Red Cross.

If the expiration date has passed, he administers a bit more to compensate. He also treats the addicts’ cyst-filled veins and infected needle punctures.

For more difficult cases, he refers to a surgical reference book he picked up in California.

“If I have doubts, I speak with my friend who is a doctor,” says Soriano, a soft-spoken man who lived in Los Angeles for several years before returning to his native Mexico.

Olvera cites three elements of success within the alternative treatment centers: They are free, voluntary and run by former addicts.

“These centers work with a person-to-person program,” she says. “Many Americans come here for treatment because the U.S. centers are too expensive.”

Federico Garxiola, a 28-year-old construction worker from Brawley, Calif., was a recent patient at CIRAD. He says U.S. rehabilitation centers are ineffective.

“They’re too weak,” says the former heroin addict. “They spoil you.”

CIRAD residents have a 3-in-4 chance of returning to drugs after they leave the gated compound, Avalos says. It is a conservative estimate, gathered anecdotally. A survey in the early 1990s indicated that success rates in U.S. clinics or at the government-regulated clinics ranged from 35% to 60%. But that was before the demand for heroin and methamphetamine reached epidemic proportions in the border region.

As Mexico struggles with its growing drug problem along the border, so does the United States. An agent who specializes in heroin intelligence for the DEA says U.S. emergency rooms are treating three times as many heroin-related traumas as they did five years ago.

He says it is no coincidence that the purity of Mexican heroin has tripled in the same period. Mexican drug traffickers are trying to compete with the high-quality heroin coming out of South America and East Asia, the official says.

South American and Asian heroin remains twice as pure as Mexican black tar or brown powder, but users in the western United States are loyal to the Mexican drug, DEA statistics indicate.

Counselors at U.S. drug treatment centers say they are seeing a growing number of heroin emergencies at their doors.

“There is a resurgence of heroin addicts,” says Dwayne Durant, director of the Volunteers of America Detox Center in San Diego. “The population is younger, more manipulative and more aggressive, and more addicted to their substance.”

Many addicts who have been through a California program head to Mexican rehabilitation centers where they will be whipped into shape by tougher--but not necessarily more effective--programs, Durant says.

Many government-regulated centers in Mexico and the United States require patients to stay for three days to two weeks. But CIRAD enforces a 90-day confinement period.

Perched on the compound’s walls on a recent day, five recovering addicts sat in large wooden chairs in round-the-clock shifts to make sure no one scrambled over the brick walls to escape. New arrivals are the greatest flight risk, Avalos says.

After a week in CIRAD’s detox room, new patients move to clean, sparse rooms jammed with several bunk beds. The men spend most of their waking hours in the meeting room, where they have four daily group-therapy sessions.

After 90 days, the patients are allowed to return to the outside world. But many choose to live inside the compound, commuting to work each morning and donating their salaries to the center.

A heroin addict for 23 years, Avalos was defensive about criticism that the centers are not monitored or regulated. He hasn’t returned to drugs since he arrived at CIRAD three years ago, and he says he owes his life to the program.

“We are not experts, not doctors, not psychiatrists,” Avalos says. “But we have lived inside the addiction.”

Over in the detox room, Gutierrez braces himself for another long night. He asks for another blanket. Contrary to what Avalos says, the second and third nights are more difficult than the first, he whispers.

With no appetite and little energy, Gutierrez explains that he has been here before. Last spring, he lived inside CIRAD for three months and 14 days. Then the young husband and father stepped back onto the streets of Tijuana clean and sober.

It lasted four days.