title: Sociopolitical contexts for addiction recovery: Anexos in U.S. Latino communities.
abstract: Anexos are community-based recovery houses that were created in Mexico to serve people struggling with addiction to alcohol and other drugs. Brought to the U.S. by Mexican migrants, anexos provide residential care to primarily male Latino migrants and immigrants who are unable or unwilling to access formal treatment. While some Mexican anexos have come under fire for coercion, confrontational treatment methods, and corporal punishment, little is known about treatment practices in U.S. anexos.
  
  
  
  We conducted a two-year ethnographic study of three anexos in urban Northern California. The study included over 150h of participant observation and semi-structured interviews with 42 residents, 3 directors, 2 assistant directors, and 3 former directors (N=50). Qualitative data were analyzed thematically using ATLAS.ti software.
  
  
  
  The anexos in our study differed in important ways from Mexican anexos described in the scientific literature. First, we found no evidence of corporal punishment or coercive internment. Second, the anexos were open, allowing residents to leave the premises for work and other approved activities. Third, the anexos were self-supported through residents' financial contributions. Fourth, collective decision-making processes observed in the California anexos more closely resembled sober living houses than their authoritarian counterparts in Mexico.
  
  
  
  Anexos may operate differently in the U.S. versus Mexico due to variations in sociopolitical context. This exploratory study suggests that anexos are addressing unmet need for addiction treatment in U.S. Latino immigrant and migrant communities. As a community-created, self-sustained, culturally appropriate recovery resource, anexos provide important insights into Latino migrants' and immigrants' experiences with substance abuse, help-seeking trajectories, and treatment needs.
authors: Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Ave, Suite 1200, Oakland, CA 94612, USA. Electronic address: apagano@prev.org.
authors: Anna
authors: A
authors: Pagano
authors: Department of Anthropology, G1 McElhaney Hall, Indiana University of Pennsylvania, Indiana, PA 15701, USA; Mid-Atlantic Addiction Research and Training Institute (MARTI), 107E Stright Hall, Indiana University of Pennsylvania, Indiana, PA 15701, USA.
authors: Victor
authors: V
authors: García
authors: Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Ave, Suite 1200, Oakland, CA 94612, USA.
authors: Carlos
authors: C
authors: Recarte
authors: Prevention Research Center, Pacific Institute for Research and Evaluation, 180 Grand Ave, Suite 1200, Oakland, CA 94612, USA.
authors: Juliet P
authors: JP
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D057229:Alcoholics / Q000523:psychology; D000437:Alcoholism / Q000191:economics / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D000884:Anthropology, Cultural; D002140:California / Q000453:epidemiology; D003068:Coercion; D055030:Drug Users / Q000523:psychology; D054242:Emigrants and Immigrants / Q000523:psychology; D005260:Female; D017048:Health Care Costs; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D007182:Income; D007407:Interviews as Topic; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011678:Punishment; D036301:Qualitative Research; D016320:Substance Abuse Treatment Centers / Q000191:economics; D019966:Substance-Related Disorders / Q000191:economics / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D014836:Volition; D055815:Young Adult
keywords: Addiction; Alcohol; Drug; Immigrants; Latinos; Recovery