Mexico's powerful drug cartels have been operating drug rehabilitation clinics, turning some into bloody killing fields and forcing recovering addicts into their ranks of hit men and smugglers.
At least two of the country's six major drug cartels have used treatment facilities to further their trade, top Mexican law enforcement officials told The Associated Press in exclusive interviews. One group even opened its own centers where they brainwashed addicts during rehabilitation, offering them an ultimatum once they kicked their habits: work for us or we'll kill you.
Here, just across the border from El Paso, Texas, 41 people have been killed in massacres at rehab clinics over the past year and a half — massacres prompted not only by recruitment efforts within the clinics, but also by more common reasons like failure to pay for drugs or betrayal of a dealer.
"The rehabilitation centers are an extension of the battlefield," said Edgardo Buscaglia, a leading Mexican drug expert. "There are no refuges anymore."
The phenomenon highlights the government's failure to address the social ills that have grown from Mexico's burgeoning drug trade, he said. While the government has gone after the cartels using the police and military, they have done little to regulate private treatment facilities that have proliferated as cocaine use doubled nationwide over the last six years.
In Ciudad Juarez, a city of 1.3 million with an estimated 100,000 addicts, many of the clinics are unlicensed, run out of dilapidated homes by former addicts — making them easy targets for traffickers to infiltrate.
Victor Valencia, the former public safety secretary for Chihuahua state who resigned Sunday and is expected to run for mayor of Ciudad Juarez, blamed the attacks on the Sinaloa cartel. He told AP that cartel members checked themselves into the unlicensed clinics posing as patients. They eventually gained control by co-opting or running off the workers by threatening to kill them.
Sinaloa members sought by police or by the rival Juarez gang would check into the clinics, so they could hide out, Valencia said. The cartel also used the centers to lure in addicts, then tell them they had to work as drug dealers or be killed.
Recovering addicts, even from licensed clinics, often sell candy, cigarettes and gum at Juarez intersections to raise money for struggling rehabilitation centers. Cartels have seized the opportunity and use addicts to peddle drugs as well.
Lorenzo Macarena, a heroin addict, was a patient at a clinic where state investigators later found members of the Sinaloa cartel working.
Macerena was homeless, weighed 80 pounds and had an insatiable habit when another homeless man gave him the address of what he believed to be a legitimate clinic.
It was a dingy cinderblock home in a rough neighborhood but the workers offered prayer sessions and inspirational messages along with counseling sessions to help him deal with his craving for another shot of heroin.
But his detox also included beatings. Food was a daily ration of bread and water.
And there was something else that made 46-year-old Macarena uneasy: The staff and many of the other addicts were unfriendly. He found it strange that many of the patients were from the border city of Mexicali — nearly 1,000 miles west of Ciudad Juarez, and in the territory of the Sinaloa cartel.
Desperate to overcome his 25-year addiction, he stayed, but as the weeks dragged on he began to suspect the gang's presence and left. Later, his suspicions were confirmed.
In August 2008, assailants wielding assault rifles burst into a pastor's sermon at the clinic. The gunmen yelled out the names of the victims before shooting 13 of them, eight of whom died.
More clinic attacks followed in 2009. In June, gunmen killed five men at another rehabilitation center in Ciudad Juarez, while 50 patients scrambled over a back fence to escape. In September, 18 addicts were lined up against a wall at another facility and mowed down by gunfire. Two weeks later, nine men and a woman were slain at yet another clinic in a poor neighborhood.
In the Pacific coast state of Michoacan, the La Familia cartel created and ran its own clinics in more than half a dozen communities, Mexico's Public Safety Secretary Genaro Garcia Luna told the AP.
Its Gratitude Refuge clinics lured drug users using religious programs, he said. Once off drugs, patients were given an ultimatum: Work as a trafficker or be killed — and plenty were gunned down in case anyone doubted the threats.
Rafael Cedeno, a reputed La Familia recruiter arrested in April, oversaw the clinics in the rural mountains dotted with marijuana fields, Garcia Luna said. In many places, the Gratitude clinics were the only option for addicts.
The patients were taken to retreats, where they prayed and received lessons in morality. But as they progressed in their treatment, the retreats turned into brainwashing sessions for future smugglers.
"They would tell them that, in the name of God, you have to kill," said Garcia Luna, who read a manual by Cedeno detailing his recruitment strategies. "And those who did, did not feel guilty because they felt their actions were on behalf of a superior being, that they had done something divine when they killed a young person for not moving a drug shipment or for stealing a load or payment."
Cedeno allegedly trained more than 9,000 recruits for the cartel in 2008, Garcia Luna said, although it is not known how many of those came from the clinics.
La Familia preferred to recruit addicts because it was easy to convince them they owed the gang their lives, Garcia Luna said. He also noted the name, which means "the family" in Spanish, appealed to those who felt lost in a society just beginning to wrestle with a drug-using population.
Those who resisted were executed at the retreats, Garcia Luna said. He did not have figures on how many were killed since unlike in Ciudad Juarez, the cartel did not stage attacks on the centers.
Drug experts say cartel-infiltrated clinics are not widespread, but the tactic shows the need for a national anti-drug program, especially in battleground cities like Ciudad Juarez, that would address treatment and prevention.
Macarena has since found help at the Center for Liberation from Drug Addiction, a registered treatment center.
But he shudders to think what could have become of him: "You arrive to these places already suffering, only to suffer more or end up worse."
© Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.