Facts, not fear: Inside Mexico's pioneering drug harm reduction programs

MEXICO CITY (AP) — Under warm strobe lights and pulsing house beats, a recent festival in Mexico City offered more than music, food and booze. Amidst the usual festival fare, a booth provided free, anonymous drug testing.

The initiative, known as “Checa tu Sustancia” (Check Your Substance), is one of several recent efforts by Mexican civil society to reduce risk among people taking drugs. Spearheaded by the Instituto RIA, a Mexico-based drug policy research and advocacy organization, it aims to address drug use from a public health and social justice perspective, rather than a security one.

In a well-lit corner of the festival, members of the Instituto RIA used reagents and laboratory porcelain plates to test substances that some of the partygoers planned to use and recorded the data. Their analysis uses color changes to indicate what’s in the drug: It can reveal the presence of adulterants but not their exact proportion.

They also offered test strips that can detect the presence of fentanyl and nasal sprays of naloxone, a medication designed to rapidly reverse opioid overdose.

Also available were informational flyers detailing the effects of various psychoactive substances and what to do to reduce the risks associated with using them, including simple but critical measures like staying hydrated and eating well.

While some partygoers seemed wary of the initiative, others approached it with curiosity.

“(There is) amazement, but also a little bit of fear, because there is a whole context of criminalization,” said social psychology student Jessica Reyes Moreno, 27, a volunteer with Checa tu Sustancia.

When unexpected substances are detected, users receive detailed information on what they are, about their risks, potential interactions with other substances and dosage adjustments, empowering them to make informed choices.

When people understand that the focus is not on prohibiting but on offering information and safe, non-judgmental spaces where they can be heard, trust is built, said Reyes Moreno.

"I think it’s information we should have. Because (drug use) is taboo, and if we're uninformed, we can overdose,” said a 34-year-old Mexican partygoer, who requested anonymity due to his use of illicit substances.

He said he feels there isn't enough information about illegal drugs in Mexico, and when there is, it's either confusing or all stigma. "It’s just ‘Don’t do it,’ but there’s no such thing as ‘If you do it, take this precaution.’”

The “don’t do it” approach sees abstinence as the solution. In contrast, harm reduction, as defined by Harm Reduction International, aims to minimize the negative health, social and legal effects of substance use by working with people without judgment or requiring them to stop using drugs.

The approach focuses more on people — and their communities— than on the substance.

“We never say, ‘you shouldn’t consume this,’” said Zara Snapp, a political scientist and director of the Instituto RIA. “The best way to reduce your risks is not to consume at all. But if you have made the decision to consume, we want you to have as much information as possible so you can take care of yourself.”

The prohibitionist, hardline approach of the war on drugs in Mexico has led to the perception of the user as someone who is necessarily associated with drug trafficking or criminal activities.

Earlier this year, Mexico President Claudia Sheinbaum unveiled her government’s latest anti-drug campaign, “Stay away from drugs. Fentanyl kills,” which centers on the synthetic opioid responsible in its deadliest year for more than 70,000 overdose deaths each year in the U.S. — now down to an estimated 52,000 deaths a year.

Aimed at young Mexicans, the campaign frames drug use as a public health issue, but some of the videos and glowing neon billboards show scenarios in which death and loneliness (drug use) are contrasted with life and family (not using drugs). They read, “Choose to be happy.”

“It’s not that if I use drugs I won’t be happy, or if I stop using drugs I’ll be happy,” said Lilia Pacheco, operational director of PrevenCasa A.C., a Tijuana-based organization that runs harm-reduction initiatives for opioid users, mostly deportees from the United States who report that they started using in that country.

“How can we say that to someone who is using because they are cold, hungry or in withdrawal?” she said.

Mexico's health department did not immediately respond to inquiries regarding concerns that its latest campaign stigmatizes drug use.

Dr. Carlos Magis, a professor at Mexico’s National Autonomous University’s medical school and member of a working group on opioids, said that stigma poses serious challenges. He cited examples of health workers refusing treatment without abstinence, limited access to naloxone or the scarcity of public methadone clinics.

A recent report by the Mexican Observatory of Mental Health and Drug Use, found that between 2013 and 2024, 5,901 people in Mexico were treated for emergencies related to opioid use, with it trending up.

PrevenCasa reduces harm not by asking users to stop using, but by showing that their lives matter by providing them with safe injection equipment, showers, toiletries and social events like Friday movie nights.

“These interventions improve quality of life, unlike a sign that says ‘fentanyl kills you,’" said Pacheco. “The right to health should be universal.”

Both Pacheco and Snapp emphasized that collective care is at the heart of harm reduction efforts. Whether practiced in the facilities of organizations working on the border or at electronic music festivals, the goal is to break down social isolation and fear in concrete ways.

“This is a service that will save lives...it’s very forward-thinking,” said a 43-year-old man, who requested anonymity because he is a user of illicit substances, after members of Instituto RIA tested his ecstasy at a recent festival.

He said that drug testing kits are available in the United States, where he’s from, but that in his experience so far, it’s something people mostly do on their own or behind closed doors.

The visibility and organization of Checa tu Sustancia was a surprise to him.

“I feel good that I’m not doing anything wrong. I’m just here to have fun, but now with peace of mind,” he said with a smile. He then rejoined his friends and disappeared into the dancing crowd.

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A government billboard warns against the use of drugs, noting that they may contain fentanyl, and offers a hotline to call for help in Mexico City, late Thursday, March 13, 2025. (AP Photo/Eduardo Verdugo)

A man shows his ecstasy pills and paper stub from the Check your Substance booth that offers free drug testing and where people can confirm their drug does not contain adulterants or fentanyl, during a three-day electronic music festival in Mexico City, Friday, Jan. 30, 2025. (AP Photo/Aurea Del Rosario)

Test strips for psychoactive substances that can detect adulterants or fentanyl, sit at the Check Your Substance booth that offers free drug testing for attendees of a three-day electronic music festival in Mexico City, late Friday, Jan. 30, 2025. (AP Photo/Aurea Del Rosario)

A volunteer analyzes the reagents in psychoactive substances belonging to a festival-goer at the Check Your Substance booth which offers free drug testing, and where people can confirm their drug does not contain adulterants or fentanyl, during a three-day electronic music festival in Mexico City, late Saturday, Jan. 31, 2025. (AP Photo/Aurea Del Rosario)

A reagents color chart for psychoactive substance testing is used at the Check Your Substance booth that offers free drug testing, and where people can confirm their drug does not contain adulterants or fentanyl, during a three-day electronic music festival in Mexico City, late Friday, Jan. 30, 2025. (AP Photo/Aurea Del Rosario)

A container of cocaine belonging to a festival-goer sits at the Check Your Substance booth that offers free drug testing, and where people can confirm their drug does not contain adulterants or fentanyl, during a three-day electronic music festival in Mexico City, early Saturday, Jan. 31, 2025. (AP Photo/Aurea Del Rosario)

A sample of the synthetic drug MDMA is tested at the Check Your Substance booth that offers free drug testing, where people can confirm their drug does not contain adulterants or fentanyl, during a three-day electronic music festival in Mexico City, late Saturday, Jan. 31, 2025. (AP Photo/Aurea Del Rosario)

A man waits for his drug's lab results at the Check Your Substance booth that offers free drug testing, where people can confirm their drug does not contain adulterants or fentanyl, at a three-day electronic music festival in Mexico City, late Friday, Jan. 30, 2025. (AP Photo/Aurea Del Rosario)

The Trump administration has transferred hundreds of immigrants to El Salvador even as a federal judge issued an order temporarily barring the deportations under an 18th century wartime declaration targeting Venezuelan gang members, officials said Sunday. Flights were in the air at the time of the ruling.

U.S. District Judge James E. Boasberg issued an order Saturday blocking the deportations but lawyers told him there were already two planes with migrants in the air — one headed for El Salvador, the other for Honduras. Boasberg verbally ordered the planes be turned around, but they apparently were not and he did not include the directive in his written order.

“Oopsie…Too late,” Salvadoran President Nayib Bukele, a Trump ally who agreed to house about 300 migrants for a year at a cost of $6 million in his country’s prisons, wrote on the social media site X above an article about Boasberg’s ruling. That post was recirculated by White House communications director Steven Cheung.

Secretary of State Marco Rubio, who negotiated an earlier deal with Bukele to house migrants, posted on the site: “We sent over 250 alien enemy members of Tren de Aragua which El Salvador has agreed to hold in their very good jails at a fair price that will also save our taxpayer dollars.”

The migrants were deported after Trump’s declaration of the Alien Enemies Act of 1798, which has been used only three times in U.S. history.

The law, invoked during World Wars I and II and the War of 1812, requires a president to declare the United States is at war, giving him extraordinary powers to detain or remove foreigners who otherwise would have protections under immigration or criminal laws. It was last used to justify the detention of Japanese-American civilians during World War II.

The ACLU, which filed the lawsuit that led to Boasberg's temporary restraining order on deportations, said it was asking the government whether the removals to El Salvador were in defiance of the court.

"This morning, we asked the government to assure the Court that its order was not violated and are waiting to hear, as well as trying to do our own investigation,” ACLU’s lead lawyer, Lee Gelernt, said in a statement Sunday.

A Justice Department spokesperson on Sunday referred back to an earlier statement from Attorney General Pam Bondi blasting Boasberg’s ruling and didn’t immediately answer questions about whether the administration ignored the court’s order.

Venezuela’s government in a statement Sunday rejected the use of Trump’s declaration of the law, characterizing it as evocative of “the darkest episodes in human history, from slavery to the horror of the Nazi concentration camps.”

Tren de Aragua originated in an infamously lawless prison in the central state of Aragua and accompanied an exodus of millions of Venezuelans, the overwhelming majority of whom were seeking better living conditions after their nation’s economy came undone last decade. Trump seized on the gang during his campaign to paint misleading pictures of communities that he contended were “taken over” by what were actually a handful of lawbreakers.

The Trump administration has not identified the migrants deported, provided any evidence they are in fact members of Tren de Aragua or that they committed any crimes in the U.S,. It did also send two top members of the Salvadoran MS-13 gang to El Salvador who had been arrested in the United States.

Video released by El Salvador’s government Sunday showed men exiting airplanes into an airport tarmac lined by officers in riot gear. The men, who had with their hands and ankles shackled, struggled to walk as officers pushed their heads down to have them bend down at the waist.

The video also showed the men being transported to prison in a large convoy of buses guarded by police and military vehicles and at least one helicopter. The men were shown kneeling on the ground as their heads were shaved before they changed into the prison’s all-white uniform – knee-length shorts, T-shirt, socks and rubber clogs – and placed in cells.

The migrants were taken to the notorious CECOT facility, the centerpiece of Bukele's push to pacify his once violence-wracked country through tough police measures and limits on basic rights

The Trump administration said the president actually signed the proclamation contending Tren de Aragua was invading the United States Friday night but didn't announce it until Saturday afternoon. Immigration lawyers said that, late Friday, they noticed Venezuelans who otherwise couldn't be deported under immigration law being moved to Texas for deportation flights. They began to file lawsuits to halt the transfers.

“Basically any Venezuelan citizen in the US may be removed on pretext of belonging to Tren de Aragua, with no chance at defense,” Adam Isacson of the Washington Office for Latin America, a human rights group, warned on X.

The litigation that led to the hold on deportations was filed on behalf of five Venezuelans held in Texas who lawyers said were concerned they'd be falsely accused of being members of the gang. Once the act is invoked, they warned, Trump could simply declare anyone a Tren de Aragua member and remove them from the country.

Boasberg barred those Venezuelans' deportations Saturday morning when the suit was filed, but only broadened it to all people in federal custody who could be targeted by the act after his afternoon hearing. He noted that the law has never before been used outside of a congressionally-declared war and that plaintiffs may successfully argue Trump exceeded his legal authority in invoking it.

The bar on deportations stands for up to 14 days and the migrants will remain in federal custody during that time. Boasberg has scheduled a hearing Friday to hear additional arguments in the case.

He said he had to act because the migrants whose deportations may actually violate the constitution deserved a chance to have their pleas heard in court.

“Once they’re out of the country," Boasberg said, "there’s little I could do."

Associated Press writer Regina Garcia Cano in Caracas, Venezuela contributed to this report.

FILE - Republican presidential nominee former President Donald Trump speaks along the southern border with Mexico, on Aug. 22, 2024, in Sierra Vista, Ariz. (AP Photo/Evan Vucci, File)