Salud Mental

Attitudes towards safe consumption sites among police and people with lived experience in Tijuana, Mexico: initial report from the field


Jaime Arredondo-Sánchez Lira
Clara Fleiz-Bautista
Pieter Baker
Jorge A. Villatoro-Velázquez
Mario Domínguez-García
Leo Beletsky


Introduction. Mexico northern border has high levels of heroin use. For more than 10 years, the country has implemented several harm reduction interventions to reduce the risks associated with drug use. New strategies such as Safe Consumption Sites (SCS) must be considered as a next step to service vulnerable populations and increase their health outcomes.

Objective. This report seeks to measure and compare attitudes on a potential SCS intervention in Tijuana among police and people with lived experience (PLE) in heroin use in the city.

Method. Two parallel studies on police practices and everyday experiences of heroin users in Tijuana were able to ask similar questions about attitudes toward SCS and its implementation in the city. They conducted quantitative interviews with 771 active police officers and 200 PLE while in rehabilitation services.

Results. Both groups showed a high personal support for SCS of nearly 82% and a perceived implementation success around 80%. Officers reported 58.9% peer support for SCS while PLE 79%. Around 76% of both groups agreed that a SCS would help to improve their personal health. Finally, 86.2% of the officers would refer people to a SCS while 62.5% of PLE would use the service.

Discussion and conclusions. The strong positive attitudes from police officers and PLE towards SCS in the city of Tijuana reported in both studies indicate the possibility of a successful implementation of a SCS. This intervention would represent an innovative way to protect PLE from police harassment and victimization, helping reduce HIV and HCV risk behaviors while improving community health.
Harm reduction, safe consumption site, drug policy, heroin, Mexico


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Arredondo, J., Beletsky, L., Baker, P., Abramovitz, D., Artamonova, I., Clairgue, E., ... Cepeda, J. (2019). Interactive versus video-based training of police to communicate syringe legality to people who inject drugs: The SHIELD Study, Mexico, 2015-2016. American Journal of Public Health, 109(6), 921-926. doi: 10.2105/AJPH.2019.305030

Arredondo, J., Strathdee, S. A., Cepeda, J., Abramovitz, D., Artamonova, I., Clairgue, E., ... Beletsky, L. (2017). Measuring improvement in knowledge of drug policy reforms following a police education program in Tijuana, Mexico. Harm Reduction Journal, 14(1), 72. doi: 10.1186/s12954-017-0198-2

Bayoumi, A. M. & Zaric, G. S. (2008). The cost-effectiveness of Vancouver’s supervised injection facility. Canadian Medical Association Journal, 179(11), 1143-1151. doi: 10.1503/cmaj.080808

Beletsky, L., Baker, P., Arredondo, J., Emuka, A., Goodman-Meza, D., Medina-Mora, M. E., ... Magis-Rodriguez, C. (2018). The global health and equity imperative for safe consumption facilities. The Lancet, 392(10147), 553-554. doi: 10.1016/S0140-6736(18)31469-7

Beletsky, L., Macalino, G. E., & Burris, S. (2005). Attitudes of police officers towards syringe access, occupational needle-sticks, and drug use: A qualitative study of one city police department in the United States. International Journal of Drug Policy, 16(4), 267-274. doi: 10.1016/j.drugpo.2005.01.009

Bucardo, J., Brouwer, K. C., Magis-Rodríguez, C., Ramos, R., Fraga, M., Perez, S. G., ... Strathdee, S. A. (2005). Historical trends in the production and consumption of illicit drugs in Mexico: Implications for the prevention of blood borne infections. Drug and Alcohol Dependence, 79(3), 281-293. doi: 10.1016/j.drugalcdep.2005.02.003

Centro Nacional para la Prevención y Control del VIH/SIDA. (2008). Manual para la prevención del VIH/SIDA en usuarios de drogas inyectadas. ISBN 970-721-139-3

Cepeda, J. A., Strathdee, S. A., Arredondo, J., Mittal, M. L., Rocha, T., Morales, M., ... Beletsky, L. (2017). Assessing police officers’ attitudes and legal knowledge on behaviors that impact HIV transmission among people who inject drugs. International Journal of Drug Policy, 50, 56-63. doi: 10.1016/j.drugpo.2017.09.009

Des Jarlais, D. C. (1995). Harm reduction ‒ a framework for incorporating science into drug policy. American Journal of Public Health, 85(1): 10-12. doi: 10.2105/ajph.85.1.10

Fleiz-Bautista, C., Domínguez-García, M., Villatoro-Velázquez, J. A., Vázquez-Quiroz, F., Zafra-Mora, E., Sánchez-Ramos, R., ... Medina-Mora, M. E. (2019). Cuqueando la Chiva: Contextos del consumo de heroína en la frontera norte de México. Ciudad de México, México: INPRFM. ISBN: 978-607-98474-0-1

Goodman-Meza, D., Medina-Mora, M. E., Magis-Rodríguez, C., Landovitz, R. J., Shoptaw, S., & Werb, D. (2019). Where is the opioid use epidemic in Mexico? A cautionary tale for policymakers south of the US–Mexico border. American Journal of Public Health, 109(1), 73-82. doi: 10.2105/AJPH.2018.304767

Güereña-Burgueño, F., Benenson, A. S., & Sepúlveda-Amor, J. (1991). HIV-1 prevalence in selected Tijuana sub-populations. American Journal of Public Health, 81(5), 623-625. doi: 10.2105/AJPH.81.5.623

Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz & Centro Nacional para la Prevención y Control del VIH/SIDA [CENSIDA]. (2008). Guía para el uso de metadona en usuarios adultos con VIH dependientes de la heroína intravenosa. Secretaría de Salud. ISBN: 978-607-460-533-4

Irwin, A., Jozaghi, E., Bluthenthal, R. N., & Kral, A. H. (2017). A cost-benefit analysis of a potential supervised injection facility in San Francisco, California, USA. Journal of Drug Issues, 47(2), 164-184. doi: 10.1177/0022042616679829

Kerr, T., Wood, E., Montaner, J., & Tyndall, M. (2009). Findings from the evaluation of Vancouver’s pilot medically supervised safer injection facility—Insite (UHRI Report). Vancouver, BC: BC Centre for Excellence in HIV/AIDS. Addiction and Urban Health Research Initiative. p 2-3.

MSIC Evaluation Committee. (2003). Final report of the evaluation of the Sydney Medically Supervised Injecting Centre. MSIC Evaluation Committee. Revised from:

Pinkham, S., Myers, B., & Stoicescu, C. (2012). Developing effective harm reduction services for women who inject drugs. In: The global state of harm reduction. London: Report, Harm Reduction International. p 125-136. ISBN 978-0-9566116-6-6

Rhodes, T. (2009). Risk environments and drug harms: a social science for harm reduction approach. International Journal on Drug Policy, 20(3), 193-201. doi: 10.1016/j.drugpo.2008.10.003

Robertson, A. M., Garfein, R. S., Wagner, K. D., Mehta, S. R., Magis-Rodriguez, C., Cuevas-Mota, J., ... Strathdee, S. A. (2014). Evaluating the impact of Mexico’s drug policy reforms on people who inject drugs in Tijuana, B.C., Mexico, and San Diego, CA, United States: a binational mixed methods research agenda. Harm Reduction Journal, 11(1), 4. doi: 10.1186/1477-7517-11-4

Salmon, A. M., Dwyer, R., Jauncey, M., van Beek, I., Topp, L., & Maher, L. (2009). Injecting-related injury and disease among clients of a supervised injecting facility. Drug and alcohol dependence, 101(1-2), 132-136. doi: 10.1016/j.drugalcdep.2008.12.002

Strathdee, S. A., Arredondo, J., Rocha, T., Abramovitz, D., Rolon, M. L., Patiño Mandujano, E., ... Beletsky, L. (2015). A police education programme to integrate occupational safety and HIV prevention: protocol for a modified stepped-wedge study design with parallel prospective cohorts to assess behavioural outcomes. BMJ Open, 5(8), e008958. doi: 10.1136/bmjopen-2015-008958

Villatoro, J., Medina-Mora, M. E., Fleiz Bautista, C., Moreno López, M., Oliva Robles, N., Bustos Gamiño, M., ... Amador Buenabad, N. (2012). El consumo de drogas en México: Resultados de la Encuesta Nacional de Adicciones, 2011. Salud Mental, 35(6), 447-457.