Barriers to addiction prevention and treatment in communities with organized crime: the perspective of health providers

Abstract

Introduction. The presence of organized crime may encourage an increase in the supply of illicit substances, the incorporation of young people into crime, the promotion of substance-oriented lifestyles, and the use of violent tactics to control territories that generate insecurity and loss of social capital are generated. Objective. The purpose of this study is to determine the barriers related to the presence of organized crime for the prevention and treatment of addictions from the perspective of health staff. Method. Based on a grounded theory study, eight semi-structured focused interviews were conducted with the staff of a primary addiction care center. In the interviews, the characteristics of the center, type of services, user profiles, the most successful treatments and barriers to care were explored, emphasizing those related to the presence of organized crime in the community. The data obtained were subjected to a thematic analysis with the help of MAXQDA software version 12. Results. Thematic analysis shows that criminal organizations determine which substances are used, encourage distribution within educational contexts, establish control processes in communities, limit preventive actions and treatments, and promote lifestyles associated with consumption, which especially affect vulnerable young people at the familial, social, and economic level. Discussion and conclusion. Membership of organized crime is also linked to substance use, so those affected seek treatment in spaces where there are insufficient safety conditions and health providers to create personal strategies for their protection. The article concludes that addiction prevention implies the recovery of communities and educational spaces by state institutions, while care requires better safety conditions for users and health staff.