‘I'm Back In Withdrawal’: Methadone Shortage Is Hitting Opioid Users Hard in Mexico

MEXICO CITY— Gibran Salazar, 35, started injecting heroin when he was 18 years old. Then, he got into a methadone program in Mexico City 2016 that helped him get a job and start a family. But when Mexico’s methadone supply started drying up at the end of last year, Salazar started falling back into his old habits. 

“I’m back in withdrawal. I’ve got stomach aches, panic attacks. I’m desperate. I feel terrible,” he told VICE World News by phone in a conversation punctuated by sniffs and sneezes. He’s also gone back to shooting up occasionally, he said, to offset the body aches and withdrawal pains.

Salazar is one of thousands of heroin and fentanyl users around the country who are at increasing risk of regression as well as overdose as Mexico experiences an unprecedented methadone shortage. 

In recent months, many former opioid users have gone back to their old habits and overdoses have increased, according to the harm reduction community.

“Things are really bad, since the shortages started months ago,” said Alfonso Chávez, who works at the harm reduction center Prevencasa in Tijuana, on Mexico’s border with the U.S, where Mexico’s heroin and fentanyl use is most severe. 

“People who had stopped using street fentanyl and started on methadone have now gone back to using, and their lives are at risk.”

“The lack of methadone has sparked a serious health problem for people who had their habits under control via treatment with that medication,” said in a letter signed by more than 30 harm reduction organizations and dozens of people who work in that area, that was send to Mexico’s President Andrés Manuel López Obrador on April 25.

“[Border harm reduction organizations] have detected … that there is a growth in fentanyl use and that is causing a spike in overdose deaths, especially in the last three months,” said the letter. 

Mexico has so far been spared the opioid crisis ravaging the United States. But the consumption of heroin and fentanyl—and opioid-induced overdoses—across the country has grown in recent years, especially in border cities such as Tijuana, Mexicali and Ciudad Juarez. Mexico’s cartels are now the largest supplier of illicit fentanyl to opioid users in the United States, and some of that supply is leaking into the Mexican consumption market as it is trafficked north to Americans. 

Methadone is a medicine widely used to treat opioid addiction, and helps wean people off heroin and fentanyl. Its production and importation is tightly controlled. But the need for methadone programs in Mexico that help users manage their lives has arguably never been greater as heroin and fentanyl use has grown. 

The causes of the current methadone shortage are varied, according to observers. One factor is the closure of a major production laboratory in Mexico called Psicofarma by the Mexican government sanitation agency known by its initials COFEPRIS in recent months due to “irregularities.” It is yet to reopen.

“Psicofarma is the most important [producer of methadone], but it’s not the only one,” said health policy analyst Xavier Tello. 

“The shortage of all opioids in Mexico is because of the enormous quantity of regulatory bureaucracy and importation problems,” he added. Other specialists consulted by VICE World News also said that importation requirements have created a bottleneck, with nothing coming in until matters are resolved. 

COFEPRIS failed to respond to questions about the methadone shortage before this story was published. The government’s anti-addition agency, known by its initials CONADIC, told VICE World News that it was working with other parts of the government and Psicofarma to resolve the shortage. 

The government of President López Obrador has shown little support for the harm reduction efforts of non-profits around the country, cutting public funding to them when he took office in 2018, despite growing evidence at the time that heroin and fentanyl overdoses were spiking, and the use of methamphetamine had risen exponentially. 

“The mental health of patients in methadone clinics has been affected by the shortage. Now their addiction is not the only disorder that needs attention, but now the trauma (that grows greater day by day), the stress, the panic attacks, the anxiety, the lack of sleep etc,” said the letter to President López Obrador from the harm reduction community. 

How long it will be before the flow of methadone into and around Mexico begins again is unknown. Methadone users like Salazar, who said he was close to getting off methadone before the shortages started, hope that help is in sight.

“I have two options,” Salazar told VICE World News. “One is to wait until the withdrawal symptoms pass—but it’s already been ages. Or else I can start using heroin again like I was before.