Underground addiction care in Mexico — and its spread to the U.S.

Across Mexico, thousands of illegal rehab centers treat patients with drug addiction, often holding them against their will.

Now, these "anexos" — informal, underground treatment facilities — are here in the United States.

Today, On Point: Illegal addiction care in Mexico — and its spread to the U.S.

Angela Garcia, professor of anthropology at Stanford University. Author of "The Way That Leads Among the Lost: Life, Death and Hope in Mexico City’s Anexos."

Part I

MEGHNA CHAKRABARTI: When Americans think about Mexico and illegal drugs, the story often begins and ends with Mexico's key role in drug trafficking into the United States. Rarely do we think of how Mexicans themselves are suffering from the scourge of drug abuse. Though the data are hard to come by, and historically drug abuse in Mexico seems to have been at much lower rates than in the United States, the problem in Mexico is growing.

For example, a 2016 national survey found that 10% of Mexicans had reported having tried an illegal substance, up from 7% in 2011. Moreover, synthetic drugs. The same ones hurting and killing so many people in the United States, are up in Mexico, too. In 2016, 15% of users at government treatment centers sought help for meth addiction.

By 2021, that number had soared to 36%. With that rapid growth rate, just as it's difficult to pin down exactly the extent of Mexico's addiction problems, it's also hard to know exactly if there are enough of those government treatment centers that I just mentioned. But there is strong evidence that there are not enough, and not by a long shot.

Because in Mexico, a new kind of treatment center is rapidly growing. They're called anexos. They are informal and illegal, and families often send their loved ones there against the person's will. Our guest today has research indicating that there could be anywhere from 5,000 to 10,000 anexos in Mexico City alone.

Angela Garcia is an associate professor of anthropology at Stanford University, and her new book is "The Way That Leads Among the Lost: Life, Death and Hope in Mexico City’s Anexos." Professor Garcia, welcome to you.

ANGELA GARCIA: Thank you. Hello.

CHAKRABARTI: So first of all, tell us, what exactly is an anexos? How do they get created?

Who runs them?

GARCIA: An anexo, which literally translates to annex, is a space, usually one room that is intended to hold people with addiction problems, much like a rehab clinic in the United States, but these are very rather grim places. They're very small, they're very cramped. They're often located within tenement buildings. So they're often embedded in larger domestic sort of structures, and they're run by lay people who generally have graduated from anexos themselves, having been in them for many years, cycling through, much like the way people in the United States often cycle through rehab.

And so they're run by people who have gone through the process of being in an anexo. And who've graduated from being in what they call an anexo, or someone who is there to deal with their addiction problems. And then they graduate to become a counselor. And then eventually they may move on to start their own anexos as a padrino, which translates to Godfather and sponsor or a madrina, godmother.

So they're very hierarchical in structure. But the people that run anexos, they don't have professional training. They have the training of having been in anexos themselves, often for many years.

CHAKRABARTI: Okay. So you follow people in your book the way that leads amongst the lost and one of them in particular is a mother who you have a story about what she experienced right in the opening of the book.

Can you tell us about that story?

GARCIA: Yes, her story is like a lot of stories that I encountered while doing my research. She had arranged for her son who had drug problems and was also a low-level drug dealer in their neighborhood, which was a neighborhood, which suffers from a lot of intensifying criminal and neighborhood violence.

Hortensia, as she's named, was very worried about her son and it was her only child. She was very concerned about his safety as any mother would be. And so she arranged to have him kidnapped, abducted in a way that she didn't expect it to be quite as brutal as it was. Two men known as servers, as they're called, entered the apartment at a very early hour and beat her son, tied him up, slipped a bag over his head.

She was observing the whole event, realized that she had really asked for something to be done, but she hadn't asked for this kind of brutal treatment. And so she wanted to stop the men from doing this. And they basically said to her, back off. If you want this to work, you need to back off. And her son was abducted, taken away.

And then eventually released into the anexo so that she had arranged for him to be basically a patient at, but she hadn't expected this degree of violence. And many of the mothers I spoke to who had arranged for their children to be taken to anexos, often also experienced this type of delivery. And the padrinos who I spoke to in anexos, I would ask them, why do you need to pick up people in this manner?

And they would say things like, "It works. The goal is to instill fear in them. So they're not sure where they're going to be taken." It's a practice that in many ways resembles practices that are employed by anexos, criminals, et cetera. So it resembles that in some form, but in fact what people who have been abducted find is that they're released into an anexo and not further violated or abused outside.

It's a very harrowing experience and women that have gone through this often wonder, Did I do the right thing?

CHAKRABARTI: You write in the book, I think, that you've also, in fact, you yourself have witnessed some of these kidnappings, for lack of a better word.

GARCIA: I have spent a lot of time observing anexos.

So I would spend the entire day just sitting around talking to people casually. And one afternoon, I was ready for a day of observation in one anexo. So the first one that I started to study. And in came two men carrying what I thought was a rug and they put the rug down, or what I thought was a rug, and they began to unfurl it. And inside was revealed a young woman who had been also abducted and she was released from the rug and I was deeply disturbed by this. Because she was clearly in distress, and I went to talk to the padrino, shortly after, she was released into the anexo.

And I said, again, why this terrible act of violence? And the answer was often, it works, it makes people afraid. Then they come here, and they realize they're okay. And they begin to appreciate. That much more the fact that they're alive and haven't been killed or kidnapped and taken somewhere unknown to them.

So this young woman is someone that I followed for several months. And she was like many teenagers, young, would like to party, did drugs, but never identified herself as a drug addict, but rather as someone who just did drugs as she would put it, everyone else, but that was enough to lead you to bring her into the anexo.

Not just because her parents were concerned about her drug use, but because they were concerned about her safety. Because at the time, many women around Ceci's age were being kidnapped and abused, and sometimes disappeared. And so this was one way of disappearing her into the anexo, was one way her family felt that they would keep her safe.

CHAKRABARTI: Okay. I'd like to come back to periods throughout the rest of the show to hear more about what you learned about Ceci and the mother you also mentioned who had sent her son to the anexos. But I think it helps, to the anexo, I should say. Anexos being the plural.

I think it helps to get a little bit more background about why so many of these facilities have been opening across Mexico. Because I mentioned earlier that there are government treatment facilities in Mexico. Is it just that those treatment facilities are overcrowded? Are they also financially out of reach of many Mexicans?

Why are they not serving this growing population of people and their families who were seeking help?

GARCIA: Both of the factors that you described are one of the reasons why there's so many anexos. There aren't enough treatment services. The ones that are available are often state run and are known to be in abysmal conditions.

A lot of the money that goes to Mexico's mental health care system actually goes to its psychiatric hospitals, which are infamous for being spaces of abuse. So there aren't enough facilities. There aren't enough treatment programs. There are a lot of private programs for people who can afford them.

But the majority of Mexicans are people who work in the informal sector. They're poor. They're the working poor and they can't afford, those clinics are out of reach financially. So anexos really emerged as a response to this lack of professional treatment, lack of resources. And they really stem from communities that are trying to take care of their own, and they build on a long tradition of mutual aid support networks where you see, essentially, poor people creating their own networks of care and assistance. And in many ways, and anexos can be seen in that light as a form of mutual care, mutual aid. And they really began to proliferate not only with the increase in drug use but also with the intensification of violence.

In Mexico, and so that became my primary lens, which was, why are these proliferating in these neighborhoods right now? Why in 2011, when I began this research, were there 10 people in anexos? And then in 2018, there were more than 50. So what happened? And I was really interested in tracking both the proliferation and then the increase in the population of people who were in anexos.

CHAKRABARTI: From your book, I learned that in terms of the government treatment centers, I think there was in Mexico City, there's something like 65 or thereabouts government treatment centers. But then as you've revealed in your research, there could be anywhere from 5 to 10,000 anexos in Mexico City as well.

So clearly, there's an urgent need there that's not quite being met. To put it lightly, by those government centers.

Part II

CHAKRABARTI:Professor Garcia, before you take us further into the kind of treatment that people receive in an anexo.

I'm just wondering if you could tell us what got you interested in pursuing this research and really uncovering these informal and illegal treatment centers.

GARCIA: I come from a family that has long suffered from addiction problems. So addiction has always been something that I've thought about that.

I've experienced up close. And so it's always been something that has affected me in ways that are more than just scholarly or intellectual. And my first book, actually, I work on, I described a heroin epidemic in northern New Mexico, which is where I am from. And during that work, where I was during my research, I worked in a detox clinic in the region, which was the only clinic in the area tending to the needs of detoxing heroin users.

And that experience of working with drug users, helping them to essentially kick their habit, to recover, to get through the worst of withdrawals, really got me interested in sort of the experience of addicts themselves. And what it is like to be in a treatment center that is in itself struggling to stay alive. And the way that the struggles of a particular neighborhood clinic made recovery that much more difficult for the people that found themselves inside of it.

I went to Mexico actually hoping to escape the theme of drugs and addiction. The theme that has in so many ways run my life, I went to Mexico City, hoping to begin a sort of a new project on a theme of a mega development that was going to be taking place in a part of Mexico City.

And it was interested in architecture and health and all of these different things. I was trying to get away from the topic of drugs because it exhausted me at this point. But when I got there, I found quite unexpectedly this world of anexos, and I was immediately drawn into them as I often am.

And anything that concerns addiction. And I realized, this is a world where that exists. That is proliferating. And that so few people really know about. People on the ground know about them, but there was nothing that I could find in scholarly journals. There was very little I could find in the media, other than representations of anexos as being clandestine, hellish spaces where people were deprived of their human rights.

But I began to then realize that narrative about anexos was insufficient. And it just was the narrative of, so many addicts have a very sort of superficial narrative of, what their life is like, what their struggles are like, et cetera. So I knew there was pieces of the story that were being, the few pieces of the few stories about anexos, I knew they were insufficient, and I wanted to go in and understand more fully. What these spaces were, how they worked, who was in them, why were they in them? The questions just kept emerging for me. And I found this to be really an unexpected space from which to try to understand not only addiction in Mexico, but violence in Mexico.

CHAKRABARTI: So I definitely want to come back to that because the two things are so intimately linked, but if we could now, Professor Garcia, I keep thinking of the story you told of Ceci, who arrived, kidnapped, rolled up in a rug. What happens to someone like that on day one, once they arrive at the anexo?

GARCIA: On day one, Ceci sat against a wall and cried the entire afternoon, and I spent the afternoon seated beside her not talking, but just trying to lend some moral support. She actually didn't really appreciate my presence that much, but she was really hardened and obviously very distraught.

But what happened that day specifically was Ceci was allowed to sit where she was for the day. The anexados assembled and did what they called a study hour, which was actually reading passages from the Bible. So Ceci was around for that, then there was a mealtime, Ceci was around for that, and eventually it was nighttime, bedtime.

And Ceci took her place on the floor next to all of the other anexados to typically sleep on thick blankets. And she took her place on her thick blanket. And then in the morning woke up at 5 a.m. The day starts with exercise, then moves to a very simple breakfast. It's very regimented.

There's a very tight schedule that people follow. And Ceci just got folded into the lot and just started following the schedule like everybody else. But it did take her a few days to stop crying and to settle down and recognize where she was. She had been there before. People knew her.

When she arrived, so there were already relationships that she had with folks there, including with the counselors and the padrino. So she wasn't unfamiliar with the space. She just didn't think she would ever end up back in it. And she did. I'm so fascinated by this, what you said about how regimented they are, right?

Because you reveal in the book, it's to a degree where even people who were there, there's a lot of focus on how they're holding their bodies, if they're holding their bodies correctly. And the tight scheduling, as you said, there's no medication given, as far as I could tell from your book, but there's a lot of time spent in meetings.

Now, you had mentioned the Bible before. And in your research, you write about how in these meetings, it's often like people giving testimony for hours and hours. How much is religion actually a foundation to this or woven into the kind of treatment that one would get at anexo?

GARCIA: Religion is definitely woven into this. And I would say this is a form, these are mostly Catholic communities. They're not Pentecostal, they're Catholic. And they're deeply Catholic in many ways. You walk into one of these spaces, there's a cross, there are bibles, there are rosaries, et cetera.

And there's a podium where people, the anexados are forced to go and give what is called testimony. But what is also another, anexos that I studied, often called confessions, and they're forced to do this for hours every day. And this is the primary activity and one anexado will go up.

They'll be forced to speak for sometimes 3, 4 hours or more, then they take their seat. And another anexado goes up, they tell their story. And that rhythm of testimony is really what maintains the anexo throughout the day, you just hear testimony after testimony, and the stories that I began recording were real stories of loss.

They were stories of having been a witness to violence, having been a perpetrator of violence, but also a victim of violence. So the stories that the anexados told, and many of them were quite young, in their twenties and sometimes teenagers, but not always. Often, they were older in their fifties and sometimes even sixties and seventies.

They would weave in elements of their own life into these stories of addiction and violence. And so I began to be able to paint a sort of broader picture, not only of the individual, but what life was like for them outside of the anexo.

CHAKRABARTI: We'll come back to that because, again, the violence part of this is so important.

But, as I hear you describe the testimonies and the fact that no medication is given, that it seems like there's some kind of 12 step inflected methodology going on here. These are all things that I imagine a lot of listeners might think, roll their eyes or be concerned at, because they're probably wondering where's the evidence base for it.

But I'm actually wondering the opposite. Given the importance of Catholicism, as you said, in particular to the places where these anexos are, to the families that feel they have no other resort or no other option, other [than] to the send their loved ones to them. Is it possible that through religion and through the ways of being in Catholicism, that perhaps there's some kind of at least powerful touch point for the people who are being treated there.

GARCIA: Absolutely. And it's, for me, that the powerful touch point wasn't just about religion, or what emerges through certain kind of ritual practices, which were often quite beautiful, even though, anexos were forced to do them.

That wasn't so different as what it was like for me when I was going to Catholic school. At one point, I was forced to do certain rituals as well. But these are coercive practices, even if they are infused with a kind of Catholic sensibility. Nevertheless, they are, the anexados are forced to do certain kinds of religious practices.

But what I felt like a lot of these practices, whether it was reading from the Bible, whether it was sitting on your knees for hours and having to pray or be silent, there was a desire to change the inner workings of the self, for anexados to become very aware of their own bodies, very aware of physical pain, because a lot of the people who enter into these spaces have experienced lifetimes of pain, but have felt that they've actually become numb to the pain itself.

And so one of the sort of philosophies is to bring pain back into the body, into the minds of the people who have been experiencing it, often for much of their lives. And so when one is going through this experience of pain, whether that's through the body or through testimony, how it emerges, it's something that is witnessed.

And I think it's the element of witnessing that, is so crucial to an anexo. Because so many people experience pain alone, and in this context, you experience it in front of your peers, with your peers, and there's a kind of community that emerges from this shared pain. But how do you draw the line between the potential healing impact of either experiencing or expressing pain and the witnessing thereof, and abuse.

GARCIA: That is the line that has always captured my attention. It's always fascinated me, and it fascinated me when I worked in a detox clinic in the United States, all of the patients there were court appointed. So in a sense, they too were coerced into treatment. And I often wondered, does being coerced into treatment work or does there have to be a degree of self-decision?

I want to be here. And in this context, what works in anexo isn't just that you cannot use. There's no alcohol. There are no drugs, that I ever witnessed. But it's also a matter of being with others, being with others, being forced to participate in the same kind of daily activity.

Yes, these were coercive spaces. There was often things that certainly I believe were abusive forms of psychological and physical abuse. But there was also some, and that existed, I don't want to downplay that did not exist, but it existed alongside the development of friendships, of community, sometimes of romances, and of people beginning to imagine a different kind of life for themselves.

The possibility of starting one's own anexados as being, there was also the sort of entrepreneurial spirit that was often generated through one's being an anexado. Although they think, okay, I want to become a counselor. Okay. I want to become a padrino. And that actually mirrors very closely to who becomes a drug counselor in this country, they are often recovering drug users themselves and so it in many ways mirrors some of the kind of resource-poor clinics that I've witnessed and worked in the United States.

CHAKRABARTI: I guess the big question is, do they work though, right? Because in the United States, as you well know, over the past several decades, there's been this kind of evolution in thinking about substance abuse, right?

Moving towards a model where it's considered a disorder on a public health issue, and by virtue of it being a disorder, perhaps sometimes people suffering from substance abuse need medication or long-term treatment or whatnot. But tough love isn't necessarily so much favored anymore by people who advise on substance abuse issues.

Because the belief is that's not as effective as other ways of doing it. How much have you been able to judge or gauge if the treatment received in an anexo works?

GARCIA: One of the things that I found, and this was what was really surprising to me, is that a lot of people that are in anexos don't identify as having a problem with addiction.

They're not, a lot of them young people. Yes, I use drugs. And they were described to me that the types of drugs they would use or people who have problems with alcohol would describe that. But often, the problem and this became increasingly apparent to me over time. The problem was really violence.

CHAKRABARTI: Yes.

GARCIA: And in the sense that anexos remove people from neighborhoods that are very insecure. And put them in a space that is also very insecure, but nevertheless, where they are held, mothers in particular, saw them as working. They worked because they knew where their kids were. They knew they were eating.

They knew they had a place to sleep. They knew they wouldn't get out and be able to roam at their own peril. And for mothers, they worked because it gave them a little bit of peace of mind. So it depends on what are we asking, whether it works to stop people from using drugs.

Certainly, in the short term, it does when you're there, you're not using. But it also works for them, for the people that are outside. For the mother, in particular, the mothers who can rest a little bit easier, knowing that their kid is in such a place, even though they know the risks of what that might mean to be in this place, because they know what goes on.

CHAKRABARTI: But then also both of these benefits though, in terms of peace of mind for family and temporary sobriety, they're time limited, right? Do the people go back to the very same neighborhoods that are so infected with violence? Or do they end up falling back into substance abuse again? They are limited, and basically people stay in there as long as someone is paying for them to stay in there.

So it's a small, relatively small monthly fee compared to what another addiction treatment center would be. And women in particular, they're often left with a burden of taking care of addicted kids. And they themselves then have to work that much harder to keep their kids in anexos, in order to meet the monthly fee.

So they're taking on additional work to keep them in and a lot of women would say to me, I would not be taking on this work if I did not believe something good were happening because I work All the time. I wouldn't want to work even more.

Part III

CHAKRABARTI: Professor Garcia, just for a moment, I hope you don't mind, but I want to apply a much more skeptical filter here to some of my questions.

Because while I don't deny that these anexos are mushrooming across Mexico, because there's a vast unmet need, due both to drugs and violence, associated with the drug war that you've talked about several times. I have to wonder, you say they don't cost very much, but I'm curious about how much they cost.

Who's running them? Is there some kind of organized network that started the anexos and is growing them? Is it possible to see this as a mother, especially, as you're saying, getting bilked by folks offering them a bit of hope but maybe not much long-term peace regarding the ways drugs and violence have affected their families?

Is there an underlying organization here that we need to talk about?

GARCIA: Yeah, I bet that's certainly something that I was very concerned and interested in when I started this work. And it's important to note that a lot of these anexos are situated within apartment complexes.

So a lot of the people that find themselves in the anexo, may be from that apartment complex where people have lived their entire lives. Sometimes generations of people have lived in their entire lives. And so these places are often known to the people within the building.

They're known to be almost, it's a combination of a kind of both a sort of tough love detox clinic, AA space and shelter. The anexo is a kind of a fusion of all of these different kinds of activities, different kinds of needs.

And again, they're situated typically within a domestic sphere. And women are bringing food to keep people eating. Sometimes they'll wash the laundry in exchange for help with a child that is, you know, struggling with addiction problems. But most people will pay a monthly fee of anywhere between typically around $30 to $50 a month.

To keep a child or a spouse, a loved one, in one of these spaces, and it's not like you just drop them off. And then you never, you don't engage with them anymore. Although that was certainly the experience of a few anexados who I met, but for the most part, there are visiting hours once a week.

And if you're in good standing, you're able to go sit in the communal courtyard with a family member and talk and then you are led back into the anexo. So, they are in some ways, carceral spaces, but again they're situated within neighborhoods, they are situated within apartment complexes, in full view of families who are conducting their daily lives. People know that apartment is an anexo. And they know that if they need help, they could send someone there. And if they themselves are at risk. And this is something I saw too, for example, a woman who was suffering from domestic violence and everyone knew.

So the padrino went, took her husband out, threw him into the anexo for a few days, just to cool things off at home, and then he would go back. And the padrino would check in on the woman to make sure she was okay. So they serve a lot of different purposes. Addiction is but one of them. And but it's a big one.

Because the problem of addiction is worsening in Mexico. Many of the drugs that are meant for the consumption in the U.S. are finding their way into domestic markets and so addiction is definitely a concern, but there are other --

CHAKRABARTI: I guess to put it more bluntly, did you find any evidence or feel any need for concern that people were profiteering off the suffering of others?

GARCIA: That was definitely a worry that I had, and I was at one party once in one of these buildings where there were apartment buildings where there was an anexo, and a woman said to me, Oh, have you met the padrinos of the anexo that's in our building? I said, no, I hadn't.

And she said, just look for the guy who has the fanciest clothes on. Indicating, people are making some money here. And that is always a concern. And it was one that I carried with me and still do. Because I'm still in contact with a number of people in an anexo who are in them and who run them. But these are mostly loose networks of people that were in AA for decades. And anexos actually emerged from an offshoot of AA that was very popular in Mexico City. So that AA really is the roots of these spaces. And so there are networks of anexos. There are certain anexos that have a particular kind of philosophy that is one of service.

There's another stream of anexos where the philosophy is one more of like physical discipline. And so there are different sort of philosophies at work. The ones that I followed were the ones that generally saw themselves more closely aligned with AA. And were what you might call anexos light.

They were certainly not as overtly violent as others that I was told about. I personally wanted to stay out of those spaces for concerns of my own safety and also the safety of others. But so the ones that I went to were, again, I just want to emphasize, the connection of these spaces to a broader neighborhood environment. They're not hidden. They're not. In the sense that they've often been described as being quote unquote underground. They're illegal, but they're not underground. Everyone knows they exist, and they know they might be two doors down, in the other apartment just down the hallway, for example.

CHAKRABARTI: So I want to get back then to how you've mentioned oftentimes that the scale of the problem that the anexos are springing up to try and meet would not have been so large were it not for the rising violence in Mexico due to, heavily in part due to the drug trade, right? To the gangs, the narco traffickers, the cartels, many of the stories that we hear in the United States about how Mexicans are suffering from the drug trade have to do with kidnappings and murders, right?

Would you say that this, what we're discussing, in terms of neighborhood violence, addiction, families just being constantly afraid, young people having their lives derailed, that's another major part of the cost of the drug trade between Mexico and the United States that just isn't often that much discussed.

GARCIA: Yeah, and another aspect of anexos is that many of the people in them are actually suffering from mental health issues. And if we think about what the war, what wars do to people's mental health. I saw people in there that might be classified as having PTSD, or terrible problems with anxiety, depression.

In addition to dealing with addiction, there were people there that were really suffering from mental health disorders who didn't identify as having a drug problem at all. And oftentimes family members who couldn't deal with the gravity of the sort of emotional and mental health problems that their relatives were facing would turn to anexos as well, for support.

The places also help people who identified as having PTSD or anxiety, or what is sometimes called more broadly in Mexico, some form of neuroses. That's a term that's still very much in use there. And they really, they become a lens, I think, from which to see a whole host of problems, drug violence, addiction, mental illness, and also just the needs of women, needing support with their loved ones.

Women often needing a break from their loved ones who are suffering from these problems. So they serve a host of things and they become microcosms from which to really begin to understand all of the issues that are confronting these sort of low income, marginalized communities.

Who don't have access to professional health resources.

CHAKRABARTI: So we're headed towards unfortunately, the last several minutes of the show, Professor Garcia. I've got a couple more questions for you. And first of all, I'd just love for you to tell us or describe to us what happened to --

GARCIA: She got out.

And she, I went once, her family owns a small stationary shop in this working-class neighborhood where the anexo was located and she went back and she's working with her mother in the stationary shop. But it's not, it's a rocky road for her. And her mother told me without doubt, if Ceci again, feels like she's again at risk, her mother is going to send her back to the very place where she had been released from, and back into the care of her family.

Last I knew, she was back at work with her mom in their little stationary shop and was doing fairly well. Did the anexo help? I think it did to a certain extent. It helped her family. She developed strong friendships with some of the people that were there. She was off the streets.

She was forced to kick her use of drugs, but whether or not Ceci will be out long term is something that is unknown to me and my job as an anthropologist. Is to try to continue to follow these people to get a sense of, what happens to them, once they're released.

So I understand that you have found a couple anexos in the Bay Area?

GARCIA: Yes.

CHAKRABARTI: Can you tell me a little bit about that?

GARCIA: Yeah. Many. I came to understand that there were anexos in the U.S. when I would be interviewing anexados in Mexico City and they would say, Oh, my first time in an anexo was in El Paso or in L.A. or in Redwood City. And so I became interested in what got these things exist in the U.S. I got a team of researchers together, and we began charting them in the Bay Area and found 23 of them without a lot of digging.

Once you find one. You ask, Hey, are there any others? And then they say, yes, there's one here.

And then, you're just led, there's just a network. And the anexo, and there are many, and I describe in the book one anexo in Oakland, California that is run by and for women. And the women there were all undocumented. Many of them suffered from mental health problems. Some from addiction problems, as well.

But the anexo in Oakland for women. Was really in some ways served not just as a detox space, but a space of refuge. And the women that, I would listen to their testimonies there. The kinds of concerns that they described were very different. They were worried about loved ones back home who were living in war torn towns and Michoacan, Guerrero, all over throughout Mexico, they were worried about being deported. They were worried about being able to feed their children, so the kinds of anxieties and concerns that anexados in this country have, are, to a certain degree, rather different from the ones that I encountered in Mexico City.

CHAKRABARTI: So I guess finally while the anexos are there, because, as I've mentioned several times, clearly, they're serving a very urgent need. Ultimately, we would love to live in a world where the need wasn't so great, right? And given the complexity of the illegal drug trade, of the relationship between that and violence, of failed policies over many decades in the United States and Mexico about the cycle of violence and illegal drugs that continues to ramp up.

I'm wondering, based on your research and what you've observed, is there anything specific that you would like to see changed that perhaps would then maybe ease the need for so many anexos in Mexico?

GARCIA: Ultimately, I would like to see real different form of drug policy, one that prioritizes addiction treatment and not punishment and I think that is something that would benefit Mexico as well.

But the anexos, I think that their proliferation, both in Mexico and in the U.S, speaks to broad questions of violence. What is the United States' role in the intensification of violence in Mexico? That's one of the things that the book really tries to point out. These places exist in part because of our own policies and because of our own hunger and thirst and need for drugs.

So there needs to be a kind of binational discussion. And there are the, obviously there's binational discussion, but one that takes into account the needs of people who are suffering from addiction in Mexico as well. And of a form of policy and a form of analysis. And reckoning that sees addiction not just a problem with drugs per se, but a problem that is composed of so many different elements.