Mexico
A middle-income country that rebuilt its opioid prescribing system on an electronic platform, which tests whether a monitoring system can widen access rather than restrict it.
9 domains reviewed · 7 high-confidence · 5 dated estimates · 9 material gaps
WHO region: Americas. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 0 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 10
- Newest source 2026
Lessons from Mexico
- A prescribing platform can be built to widen access. Mexico paired electronic tracking with a higher per-prescriber cap and faster issue, and dispensing rose. This is the counterpoint to the Saudi experience: a narcotics register can be designed for prescriber ease, not only control.95
- Easier mechanics did not close gaps between richer and poorer states. Targeted measures for lower-resource districts are still needed.95
- The insurance scheme that carried opioid coverage was abolished within five years. Palliative financing should not depend on a single scheme that a new administration can close.95,97
- Clinicians can expect patients to combine prayer and traditional remedies with clinic care and can ask about both openly.524
- Relying on a single domestic methadone producer left treatment exposed to supply shocks, so alternative medicines such as buprenorphine add resilience.738,739
- Electronic opioid prescribing can widen access, and monitoring dispensing by region shows whether poorer areas are being left behind.95
Palliative care
Is morphine available in Mexico?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 36 percentSOURCE-CHECKED · 2013 DATA
Opioid need for palliative care met, Mexico, 201395
Last checked 2026-09-24.
For 2010 to 2013, as cited from the Lancet Commission on Palliative Care and Pain Relief.
Cite this figure: - 26.30 prescriptions per 10,000 peopleSOURCE-CHECKED · 2019 DATA
National opioid dispensing rate, Mexico, 201995
Last checked 2026-09-24.
Over the whole period from mid-2015 to late 2019.
Cite this figure: - 13 percentMODELED ESTIMATE · 2019
Average quarterly change in opioid dispensing after the reform, Mexico, 201995
Last checked 2026-09-24.
95 percent confidence interval 6.8 to 19.6. Joinpoint regression.
Cite this figure:
Before 2015 Mexico ranked last among OECD members for opioid availability. Dispensing rose after the reform but remained low by international comparison.95
What is consumption on a morphine-equivalent basis after 2019?
Help answer it:Search PubMedHow does Mexico regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
- 200 prescriptionsSOURCE-CHECKED · 2015 DATA
Prescription limit per provider after the 2015 reform, Mexico, 201595
Last checked 2026-09-24.
Raised from 50.
Cite this figure:
In 2015, after pressure from civil society and palliative care groups, the federal regulator moved opioid prescribing onto an electronic system for issuing prescriptions and tracking dispensing, added a QR code to each prescription, shortened the wait, and raised the per-provider prescription limit.95
Which gazetted instrument carries the 2015 reform, and has it changed since?
Help answer it:Search PubMedWho can prescribe morphine in Mexico?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
Since 2015, providers obtain opioid prescriptions through a federal electronic system, and each prescription carries a QR code that encrypts the prescriber's personal data. The limit on prescriptions per provider rose from 50 to 200.95
Which professions may legally prescribe group 1 opioids in Mexico, and must prescribers hold a specific COFEPRIS registration?
Help answer it:Search PubMedHow does palliative care reach patients in Mexico?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 1.88 rate ratioMODELED ESTIMATE · 2019
Dispensing rate, higher against lower socioeconomic status states, Mexico, 201995
Last checked 2026-09-24.
95 percent confidence interval 1.33 to 2.58, after controlling for estimated need.
Cite this figure:
Dispensing was markedly higher in states of higher socioeconomic status, even after controlling for need.95
How many palliative services exist, and how are they spread across states and public subsystems?
Help answer it:Search PubMedWho pays for palliative care in Mexico?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
Seguro Popular added opioid coverage around the time of the reform. It was closed in 2020 and replaced, with disruption to coverage that followed.95,97
Is opioid coverage for palliative use continued under the successor public scheme?
Help answer it:Search PubMedHow are palliative care clinicians trained in Mexico?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
Palliative medicine is recognised as a medical specialty. General physicians still lack universal training in palliative care and pain management.96,95
How does Mexico prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
After Mexico introduced regulatory changes and an electronic prescribing system in 2015, opioid dispensing rose by an average of 13% per quarter, and wealthier states dispensed more than poorer states. In 2023 the closure of the main methadone production facility interrupted supply nationwide, and methadone treatment among Tijuana clinic patients fell from 36% to 13%. A WHO indicator assessment still finds limited access to essential palliative medicines.95,738,740
Has buprenorphine been authorized for opioid use disorder, and is naloxone available to communities outside pilot programs?
Help answer it:Search PubMedHow do children get palliative care in Mexico?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Of 37,444 child deaths in Mexico in 2021, 10,677 were from conditions with serious health-related suffering, and no state had early or advanced pediatric palliative care integration. Professionals rate lack of awareness and commitment, lack of support and legal factors as the most severe barriers.741,742
How many children are reached by pediatric palliative services, and which oral opioid formulations for children are available?
Help answer it:Search PubMedHospice care in Mexico
How the hospice model works here, who can use it, who pays and who it reaches. Covered 0 of 4.
What does hospice care look like in Mexico?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
Does any peer-reviewed source describe hospice services inside Mexico as distinct from hospital palliative care units? PubMed hospice studies mentioning Mexico mostly concern Mexican Americans in the United States.
Help answer it:Search PubMedWho can get hospice care in Mexico?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
What admission criteria apply to Mexican hospice-type services, if they exist?
Help answer it:Search PubMedWho pays for hospice care in Mexico?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Who pays for hospice-type care in Mexico: IMSS, ISSSTE, IMSS-Bienestar, charities or families?
Help answer it:Search PubMedHow many people reach hospice in Mexico?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
How many people in Mexico use hospice before death? The national aging survey did not ask, citing little long-term care capacity.
Help answer it:Search PubMedWhat fills the gap in Mexico
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
- Faith communities
Catholic patients and caregivers in Mexico City described prayer and faith in God as a main way of coping with suffering; one caregiver said prayer is stronger than medicine. The study drew on 68 participants from social security clinics.524
Single-site evidence- Traditional and complementary healers
Some patients and caregivers described traditional remedies such as purifications by healers and shamans, holy water, and herbs for pain relief. Others were cautious about using remedies without reliable information.524
Single-site evidence- Substitute and informal pain relief
When social security pharmacies were out of stock, patients bought prescribed medicines themselves, at one thousand to two thousand pesos per medicine, and some borrowed money. National opioid stock covers less than one-third of need, and wealthier states have far more access than poorer ones.524
Mixed scope
Sources cited here
- 95Goodman-Meza D, Friedman J, Kalmin MM, Aguilar-Posada E, Seamans MJ, Velazquez-Moreno S, et al.
Geographical and socioeconomic disparities in opioid access in Mexico, 2015-19: a retrospective analysis of surveillance data. Lancet Public Health 2021;6(2):e88-e96. DOI 10.1016/S2468-2667(20)30260-7. National dispensing surveillance data from the federal health regulator, 2015 to 2019. Describes the 2015 reform: an electronic system for obtaining prescriptions and tracking dispensing, a QR code on prescriptions, a shorter wait, and a higher per-provider prescription limit; Seguro Popular adding opioid coverage; dispensing rates and their disparities by state socioeconomic status.
- 97Knaul FM, Arreola-Ornelas H, Touchton M, McDonald T, Blofield M, Avila Burgos L, et al.
Setbacks in the quest for universal health coverage in Mexico: polarised politics, policy upheaval, and pandemic disruption. Lancet 2023;402(10403):731-746. DOI 10.1016/S0140-6736(23)00777-8. Abstract read. Closure of Seguro Popular in 2020 and the disruption that followed.
- 96Pastrana T, De Lima L, Stoltenberg M, Peters H.
Palliative medicine specialization in Latin America: a comparative analysis. Journal of Pain and Symptom Management 2021;62(5):960-967. DOI 10.1016/j.jpainsymman.2021.04.014. Abstract read. Mexico is among the Latin American countries reporting palliative medicine as a medical specialty.
- 738Goldshear JL, Harvey-Vera A, Rangel G, et al.
Methadone treatment and associated health and social outcomes after a national manufacturing closure in Mexico: a longitudinal observational cohort study in Tijuana. Lancet Reg Health Am 2026;62:101577. Longitudinal cohort of 200 methadone clinic patients in Tijuana, Mexico, after the 2023 closure of the main national methadone production facility. One city; NIDA funded. Abstract read.
- 740Ramos-Guerrero JA, Zuniga-Villanueva G, Dorsey-Rivera B, et al.
Assessing Palliative Care Development in Mexico Through the WHO Actionable Indicators Model. J Pain Symptom Manage 2025;70(2):160-169.e1. Assessment of Mexico's palliative care development using WHO actionable indicators; finds regression, limited access to essential medicines and no national palliative care plan or authority. Authors active in regional palliative care advocacy. Abstract read.
- 524Doubova SV, Bhadelia A, Pérez-Moran D, et al.
Dimensions of suffering and the need for palliative care: experiences and expectations of patients living with cancer and diabetes and their caregivers in Mexico - a qualitative study. BMJ Open 2023;13(12):e075691. Qualitative telephone interviews with 68 patients and caregivers from IMSS clinics in Mexico City on suffering and coping. Full text read.
- 741Ramos-Guerrero JA, Correa-Morales JE, Sánchez-Cárdenas MA, et al.
Comparing the Need and Development of Pediatric Palliative Care in Mexico: A Geographical Analysis. J Pain Symptom Manage 2024;68(4):382-391.e3. Geographic analysis of Mexican national mortality data (2021) estimating pediatric palliative need and state-level development using six indicators including opioid access. Abstract read.
- 742Grüneberg ES, Ramos-Guerrero J, Pastrana T
Challenges in the Provision of Pediatric Palliative Care in Mexico: A Cross-Sectional Web-Based Survey. J Palliat Care 2021;39(1):58-67. Web-based survey of 70 health professionals in 15 Mexican states on barriers to pediatric palliative care. Convenience and snowball sample. Abstract read.
- 739Bórquez A, Goldshear JL, Muñoz-Mina S, et al.
A qualitative exploration of the downstream impact of a sustained disruption to the methadone supply in Mexico: effects on the mental, financial, and social health of patients with opioid use disorder in Tijuana. Lancet Reg Health Am 2025;49:101176. Qualitative interviews with 20 patients in Tijuana, Mexico, on the 2023 methadone supply disruption. One city, small sample. Abstract read.
- 523Dannenberg A, Cohen J, Deliens L, et al.
Place of Death of People With Cancer in 12 Latin American Countries: A Population Study Using National Death Registers. Cancer Med 2025;14(12):e70996. Population study of 491,929 cancer deaths in 12 Latin American countries using death certificates (2016 to 2018). Full text read.