At Counselling Online, we know recovery is different for everyone. Access to culturally appropriate care can play a critical role in an individual’s rehabilitation. How does Australia’s model fare in comparison to other countries and their cultures? One of our alcohol and other drug counsellors considers Australia’s model of rehabilitation with the approach of her homeland, Mexico.

Attitudes towards alcohol and other drugs

Mexico is known around the world for its local exports, including tequila from Jalisco and mezcal from Oaxaca. In recent years, Mexico’s drug and alcohol culture has been in the headlines — from the deadly drug war and cartel violence, to the controversial drug lord Joaquin ‘El Chapo’ Guzman and popular television shows like Queen of the South.

Yet the drinking culture in Mexico has similarities with Australia. In both countries, alcohol is a socially acceptable drug and social pressure can be a factor in how much people drink. Put simply, to many Mexicans, it would be considered an act of treason to turn down a shot of tequila on Independence Day. This sentiment will be all too familiar for Australians.

In terms of illicit drugs, after marijuana, cocaine is the second most prevalent illicit drug in my homeland, as opposed to crystal meth (ICE) in the land down under. This means that both Mexicans and Australians have experience with a range of usage types across the spectrum of addictive substances — from recreational or occasional use to problematic, daily use.

Accessing support

Addiction affects individuals, families and communities in the same way everywhere. Peer support groups, such as Alcoholics Anonymous and Narcotics Anonymous, have been the most popular form of treatment in both nations for decades. Similarly, in rural or remote areas of both countries, there are fewer services and/or treatment options available for people to access.

The circumstances surrounding accessibility and quality of treatment differs greatly between Mexico and Australia. While both nations have adopted a harm minimisation philosophy, this strategy is supported in Australia by its federal government.

In both countries, there are helplines for people affected by addiction to alcohol and other drugs. Additionally, individuals can access private treatment centres. In Mexico, this type of support takes place either on home soil or in the neighbouring United States — however, private treatment is a luxury that the majority of the population cannot afford.

Steps towards harm minimisation

Each nation has implemented different strategies in an effort to minimise harm. In 2009, Mexico partially decriminalised the possession of small quantities of drugs for personal use. Instead of incarceration, mandatory referrals are made to drug rehabilitation centres. However, a major barrier to the successful implementation of a harm minimisation approach in Mexico is the presence of drug cartels and their increasing violence.

At present, Mexico is revising a law to legalise the recreational use of cannabis. (The legal use of cannabis for medicinal purposes was approved in 2017.) If passed, the bill would allow users to legally smoke marijuana and request a permit to grow a small number of cannabis plants at home. However, it is yet to be seen if this measure will help reduce the cartel's power.

Australia has been successful in opening two safe injecting rooms in Melbourne and Sydney. Furthermore, throughout the country various drug diversion services operate — like the Drug Diversion Appointment Line — offering first time offenders, found with non-trafficable amounts of an illicit substance, the option to be referred to health services for assessment and treatment, rather than to engage with the justice system.

The advent of Drug Courts also provides offenders, whose dependence on alcohol or drugs contributes to their offending, the opportunity to engage with treatment options as part of their justice outcomes.

Challenges to maintaining recovery

After 2009, in response to decriminalisation laws, cartels responded with violence towards drug rehabilitation centres in cities such as Tijuana, becoming one of the major barriers to accessing addiction treatment. Around the same time, coercive residential addiction treatment centres or ‘anexos’, which are run and used by low-income communities, opened in Mexico City and proliferated in rural areas.

Unfortunately, Mexico is not just a transit country for drugs into the United States, it has become a market itself. There are not enough residential treatment programs and involuntary drug treatment programs have proven ineffective to decrease drug use. To compound this issue, both voluntary and involuntary drug treatments often provide non-evidence based and non-professional programs.

Observing from a Mexican lens, it has been incredible to witness Australia’s alcohol and other drugs treatment system. Though it is not without its flaws, like waitlists to access a detox unit, there are still many service options available to the general population with an overall outstanding quality in both public and private sectors. It has been an absolute honour to be part of this sector. I can only wish that people in my country may one day have access to a similar level of quality treatment.