Deported, homeless, and into the canal: Environmental structural violence in the binational Tijuana River

Calderón-Villarreal, Alhelí; Terry, Brendan; Friedman, Joseph; Olachea, Sara Alejandra Gonzalez; Rivera, Alfonso Chavez; López, Margarita Díaz; Bufanda, Lilia Pacheco; Martinez, Carlos; Ponce, Stephanie Elizabeth Medina; Adame, Rebeca Cazares; Bochm, Paola Fernanda Rochin; Kayser, Georgia; Strathdee, Steffanie A.; Meléndez, Gabriela Muñoz; Holmes, Seth M.; Bojórquez, Ietza; Huertos, Marc Los; Bourgois, Philippe

doi:10.1016/j.socscimed.2022.115044

Cited by 22 publications

(25 citation statements)

References 44 publications

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“…Ethnographic data were collected as part of a wider study investigating shifting risk environments of PWUD in Mexico. Sampling dynamics and methodology have been described extensively elsewhere [1][2][3][4] .…”

Section: Ethnographic Methodsmentioning

confidence: 99%

“…Our ethnographic team has conducted longitudinal research focused on illicit drug markets in Northern Mexico since 2018 [1][2][3][4] . In 2021-2022, study participants-especially those who were US citizens that frequently visited in or stayed in Mexico to consume illicit drugs-began describing new, unusually potent medications, sold ostensibly as controlled substances, from pharmacies that cater to US tourists.…”

Section: Introductionmentioning

confidence: 99%

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Fentanyl, Heroin, and Methamphetamine-Based Counterfeit Pills Sold at Tourist-Oriented Pharmacies in Mexico: An Ethnographic and Drug Checking Study

Friedman

Godvin

Molina

et al. 2023

Preprint

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Background Our ethnographic team has conducted longitudinal research focused on illicit drug markets in Northern Mexico since 2018. In 2021-2022, study participants described the arrival of new, unusually potent tablets sold as ostensibly controlled substances, without a prescription, directly from pharmacies that cater to US tourists. Concurrently, fentanyl- and methamphetamine-based counterfeit prescription drugs have driven escalating overdose death rates in the US, however their presence in Mexico has not been assessed. Aims To characterize the availability of counterfeit and authentic controlled substances at pharmacies in Northern Mexico available to English-speaking tourists without a prescription. Methods We employed an iterative, exploratory, mixed methods design. Longitudinal ethnographic data were used to characterize tourist-oriented micro-neighborhoods and guide the selection of n=40 pharmacies in n=4 cities in Northern Mexico. In each pharmacy, samples of 'oxycodone', 'Xanax', and 'Adderall' were sought as single pills, during English-language encounters, after which detailed ethnographic accounts were recorded. We employed immunoassay-based testing strips to check each pill for the presence of fentanyls, benzodiazepines, amphetamines, and methamphetamines. We used Fourier-Transform Infrared Spectroscopy to further characterize drug contents. Results Of 40 pharmacies, these controlled substances could be obtained in any form with no prescription at 68.3% and as single pills at 46.3%. Counterfeit pills were obtained at n=11 (26.8%) of pharmacies. Of n=45 samples sold as one-off controlled substances, n=20 were counterfeit including 9 of 11 (81.8%) of samples sold as 'Adderall' that contained methamphetamine, and 8 of 27 (29.6%) of samples sold as 'Oxycodone' that contained fentanyl, and n=3 'Oxycodone' samples containing heroin. Pharmacies providing counterfeit drugs were uniformly located in tourist-serving micro-neighborhoods, and generally featured English-language advertisements for erectile dysfunction medications and 'painkillers'. Pharmacy employees occasionally expressed concern about overdose risk and provided harm reduction guidance. Discussion The availability of fentanyl-, heroin-, and methamphetamine-based counterfeit medications in Northern Mexico represents a public health risk, and occurs in the context of 1) the normalization of medical tourism as a response to rising unaffordability of healthcare in the US, 2) plummeting rates of opioid prescription in the US, affecting both chronic pain patients and the availability of legitimate pharmaceuticals on the unregulated market, 3) the rise of fentanyl-based counterfeit opioids as a key driver of the fourth, and deadliest-to-date, wave of the opioid crisis. It is not possible to distinguish counterfeit medications based on appearance, because identically-appearing authentic and counterfeit versions are often sold in close geographic proximity. Nevertheless, US tourist drug consumers may be more trusting of controlled substances purchased directly from pharmacies. Due to Mexico's limited opioid overdose surveillance infrastructure, the current death rate from these substances remains unknown.

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Section: Ethnographic Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fentanyl, Heroin, and Methamphetamine-Based Counterfeit Pills Sold at Tourist-Oriented Pharmacies in Mexico: An Ethnographic and Drug Checking Study

Friedman

Godvin

Molina

et al. 2023

Preprint

Self Cite

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“…Our data were collected during the early stages of the COVID-19 pandemic and because of that, our findings have implications for service provision during future infectious disease outbreaks. However, given the fact that administrative burdens disproportionately impact the poor (Herd & Moynihan 2020) and people experiencing homelessness (Robinson 2022), and given the ample research conducted prior to the COVID-19 pandemic showing challenges unhoused people encounter when interacting with bureaucracies (some examples include Calderón-Villarreal, et al 2022;Flanigan & Welsh, 2021;Herring 2021;Hoffman & Coffey 2008;Robinson 2022;Thompson et al 2020; Welsh JHHSA Vol 45 ssue 3 & Abdel-Samad, 2018), we expect our findings also are relevant outside the context of infectious disease outbreaks.…”

mentioning

confidence: 86%

Psychological Costs and Administrative Burdens Produce Systemic Service Avoidance among People Experiencing Homelessness

Hoang¹,

Felner²,

Flanigan³

et al. 2022

Journal of Health and Human Services Administration

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How do people experiencing homelessness make decisions about accepting or avoiding social services and health care? The study presented here seeks to answer this question by drawing on remotely-gathered surveys (n=244) and in-depth interviews (n=57) with unhoused people during the first wave of the COVID-19 pandemic. In this paper, we explore service-seeking behaviors and processes to understand how to best support people experiencing homelessness during current and future public health disasters. We find that homelessness services systems are often fragmented, increasing administrative burdens such as learning costs (Herd & Moynihan 2018, 2020) and driving unhoused people away from seeking the support they actually need. Four organizing themes centered on temporary housing, health care and medical racism, precarious employment, and self-preservation became apparent within the broader systems challenges. Findings provide insight into the survival strategies of people experiencing homelessness, including how and why people avoid services. Findings point to systems-level recommendations for better aligning homelessness-serving systems with the actual needs of unhoused people themselves. Lastly, the research approach described here offers lessons learned regarding doing social science research with people experiencing homelessness during public health disasters.

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“…Fourth, unhoused people are disproportionately exposed to environmental hazards, such as toxic chemicals, waterborne diseases, pollution, unsafe water, and unclean sanitation facilities (Calderón‐Villarreal et al, 2022; DeMyers et al, 2017; Goodling, 2020; Uddin et al, 2016; Vickery, 2018). People may build shelter in hazardous or toxic environments like brownfields, riverbanks, road embankments, and railroad tracks (Goodling, 2020).…”

Section: Key Definitions and Insightsmentioning

confidence: 99%

“…In addition to the widespread closures of public water facilities and toilets (Lowe, 2018), normal human functions are increasingly policed and criminalized in public spaces (Avelar Portillo, 2021; Calderón‐Villarreal et al, 2022; Herring, 2019; Herring et al, 2020; Meehan, 2013; Speer, 2016). For example, in 2017, the Los Angeles Police Department issued parking citations to LavaMae, an organization that provides mobile showers and restrooms to unhoused communities in Skid Row, a 50‐block neighborhood in downtown Los Angeles (LACAN, 2017).…”

Section: Disciplining Water and Spacementioning

confidence: 99%

Homelessness and water insecurity in the Global North: Trapped in the dwelling paradox

Meehan,

Beresford,

Amador Cid

et al. 2023

WIREs Water

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In this article, we introduce the "dwelling paradox" to explore how the state actively produces water insecurity for people experiencing homelessness in the Global North. We explain that the dwelling paradox is (1) produced by a modernist ideology of public service delivery that privileges water provision through private infrastructural connections in the home; (2) is reproduced by the welfarewarfare state, which has increasingly weaponized public water facilities and criminalized body functions in public space; and (3) is actively contested by some houseless communities, who challenge hegemonic ideals of the "home"-and its water infrastructure-as a private, atomized space. In advancing a relational and spatial understanding of water insecurity, we use the dwelling paradox to illustrate how unhoused people are caught in a space of institutional entrapment that is forged by state power and amplified by anti-homeless legislation. Such spaces of entrapment make it extremely difficult for unhoused people to achieve a safe, healthy, and thriving life-the basis of the human rights to water and sanitation.

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Deported, homeless, and into the canal: Environmental structural violence in the binational Tijuana River

Cited by 22 publications

References 44 publications

Fentanyl, Heroin, and Methamphetamine-Based Counterfeit Pills Sold at Tourist-Oriented Pharmacies in Mexico: An Ethnographic and Drug Checking Study

Fentanyl, Heroin, and Methamphetamine-Based Counterfeit Pills Sold at Tourist-Oriented Pharmacies in Mexico: An Ethnographic and Drug Checking Study

Psychological Costs and Administrative Burdens Produce Systemic Service Avoidance among People Experiencing Homelessness

Homelessness and water insecurity in the Global North: Trapped in the dwelling paradox

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