# Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2023 · $147,370

## Abstract

In April 2023, Mexico’s federal government closed the country’s only methadone manufacturing plant following
concerns about quality control. In Mexican-U.S. border cities, such as Tijuana, where the prevalence of opioid
use disorder (OUD) is among the country’s highest, the city’s four methadone clinics are turning new clients
away, and for existing clients are limiting doses or not dosing altogether. Although there are no accurate
estimates of the number of persons with OUD in Mexico, there were ~1000 adults receiving methadone in
Tijuana alone at the time of the plant closure. Few empirical studies have been conducted on the impact of
methadone dispensing interruptions but these have focused almost entirely on methadone prescribers, rather
than people with OUD and have only examined short-term effects. We propose to leverage our existing cohort
infrastructure in Tijuana to meet these Aims: 1) To qualitatively explore the experiences of adults in Tijuana
receiving methadone for the treatment of OUD following the closure of Mexico’s only methadone
manufacturing plant. 2) To prospectively characterize the impact of the closure of Mexico’s only methadone
manufacturing plant on rates of drug use relapse, overdose (OD), suicidality, anxiety, depression and mortality
among adults with OUD in Tijuana. Specifically, we will compare PWUD who have had their methadone
treatment interrupted vs. those who have not and those who have never or not recently received methadone
treatment. 3) To estimate the number of ODs and deaths caused by the closure of Mexico’s only methadone
manufacturing plant among PWUD in Tijuana over the first month and first year after the closure using dynamic
modeling. We hypothesize that PWUD with methadone treatment interruptions will have higher rates of drug
relapse, OD, depression, anxiety, suicidality and death. We will re-open recruitment in the parent study to
enroll 200 PWUD in Tijuana who were recently receiving methadone treatment, and compare outcomes to the
existing cohort (N=250 for a total of N=450). Participants will undergo quantitative interviews every 6 months
over 18 months. A subset will be purposively sampled for prospective qualitative interviews. Dynamic modeling
will be used to estimate the impact of treatment interruptions on rates of overdose and mortality, and micro-
and macro-level interventions that may be undertaken to ameliorate the crisis. Findings will be used to inform
policymakers at the municipal, state and federal level in Mexico, as well the US and international agencies.

## Key facts

- **NIH application ID:** 10833944
- **Project number:** 3R01DA049644-04S2
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** STEFFANIE A. STRATHDEE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $147,370
- **Award type:** 3
- **Project period:** 2020-04-01 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10833944

## Citation

> US National Institutes of Health, RePORTER application 10833944, Ethno-epidemiology of HCV, HIV and Overdose associated with Drug Markets and Drug Tourism (3R01DA049644-04S2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10833944. Licensed CC0.

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