Journal of Immigrant and Minority Health

, Volume 19, Issue 5, pp 1196–1206 | Cite as

Relationships Between Integration and Drug Use Among Deported Migrants in Tijuana, Mexico

  • Danielle Horyniak
  • Miguel Pinedo
  • Jose Luis Burgos
  • Victoria D. Ojeda
Original Paper


Deported migrants face numerous challenges which may elevate their risk for drug use. We examined relationships between integration and drug use among deported migrants in Tijuana, Mexico. A cross-sectional survey conducted at a free health clinic included 255 deported Mexican-born migrants residing in Tijuana ≥6 months. Multivariable logistic regression examined associations between variables across four integration domains (public participation, social connections, macro-level facilitators and foundations) and recent (past 6-month) drug use. The prevalence of recent drug use was 46 %. Having sought work in Tijuana in the past 6 months, greater household affluence, lifetime history of incarceration in both US and Mexico, and lacking health insurance were independently associated with recent drug use. Policies that support access to employment, adequate housing and healthcare in Mexico, particularly for justice-involved deportees, may facilitate successful integration and reduce potential stressors that may contribute to drug use.


Migration Deportation Integration Illicit drug use Mexico 



The authors would like to thank the study participants for sharing their experiences with us, and our collaborators at PrevenCasa for their continued support. We acknowledge funding from the following sources: Australian Endeavour Awards (#4722_2015 - Horyniak), Australian National Health & Medical Research Council (Early Career Fellowship #1092077 - Horyniak), US National Institute on Alcohol Abuse and Alcoholism (T32AA007240 - Pinedo), US National Institute on Drug Abuse (K01DA025504 - Ojeda), US National Institute of Mental Health (K01MH095680 - Burgos), University of California GloCal Health Fellowship (Ojeda), and Center for US-Mexican Studies Fellowship (Ojeda). The funding bodies played no role in the study design, data analysis or preparation of the manuscript for publication.

Author Contributions

VO and JLB developed and implemented the overall study that produced the data. VO and DH conceptualised this manuscript. DH performed data analysis and drafted the manuscript. All authors commented and contributed text, and gave approval for the manuscript to be submitted.


  1. 1.
    Fozdar F, Hartley L. Civic and ethno belonging among recent refugees to Australia. J Refug Stud. 2014;27(1):126–44.CrossRefGoogle Scholar
  2. 2.
    Wille J. Agency and belonging: Southern Sudanese Former Refugees’ reflections on life in Australia. Aust Rev Afr Stud. 2011;32(2):80–100.Google Scholar
  3. 3.
    Valtonen K. From the margin to the mainstream: conceptualizing refugee settlement processes. J Refug Stud. 2004;17(1):70–96.CrossRefGoogle Scholar
  4. 4.
    Ruben R, Van Houte M, Davids T. What determines the embeddedness of forced-return migrants? Rethinking the role of pre- and post-return assistance. Int Migr Rev. 2009;43(4):908–37.CrossRefGoogle Scholar
  5. 5.
    Ager A, Strang A. Understanding integration: a conceptual framework. J Refug Stud. 2008;21(2):166–91.CrossRefGoogle Scholar
  6. 6.
    Castañeda H, Holmes SM, Madrigal DS, Young MED, Beyeler N, Quesada J. Immigration as a social determinant of health. Annu Rev Public Health. 2015;36(1):375–92.CrossRefPubMedGoogle Scholar
  7. 7.
    Davies AA, Borland RM, Blake C, West HE. The dynamics of health and return migration. PLoS Med. 2011;8(6):e1001046.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Viruell-Fuentes EA, Miranda PY, Abdulrahim S. More than culture: structural racism, intersectionality theory, and immigrant health. Soc Sci Med. 2012;75(12):2099–106.CrossRefPubMedGoogle Scholar
  9. 9.
    Gil-González D, Carrasco-Portiño M, Vives-Cases C, Agudelo-Suárez AA, Castejón Bolea R, Ronda-Pérez E. Is health a right for all? An umbrella review of the barriers to health care access faced by migrants. Ethn Health. 2014;20(5):523–41.CrossRefPubMedGoogle Scholar
  10. 10.
    US Department of Homeland Security. 2013 Yearbook of immigration statistics. Washington, DC: US Department of Homeland Security; 2014.Google Scholar
  11. 11.
    Forced Apart (By the numbers). Non-citizens deported mostly for nonviolent offenses. New York: Human Rights Watch; 2009.Google Scholar
  12. 12.
    Hagan J, Eschbach K, Rodriguez N. U.S. deportation policy, family separation, and circular migration. Int Migr Rev. 2008;42(1):64–88.CrossRefGoogle Scholar
  13. 13.
    Wheatley C. Push back: U.S. deportation policy and the reincorporation of involuntary return migrants in Mexico. Lat Am. 2011;55(4):35–60.Google Scholar
  14. 14.
    Anderson J. “Tagged as a criminal”: narratives of deportation and return migration in a Mexico City call center. Lat Stud. 2015;13(1):8–27.CrossRefGoogle Scholar
  15. 15.
    Goldenberg S, Strathdee S, Gallardo M, Patterson TL. “People here are alone, using drugs, selling their body”: deportation and HIV vulnerability among clients of female sex workers in Tijuana. Field Actions Science Reports. 2010; Special Issue 2.Google Scholar
  16. 16.
    Boehm DA. US-Mexico mixed migration in an age of deportation: an inquiry into the transnational circulation of violence. Refug Surv Q. 2011;30(1):1–21.CrossRefGoogle Scholar
  17. 17.
    Bojorquez I, Aguilera RM, Ramirez J, Cerecero D, Mejia S. Common mental disorders at the time of deportation: a survey at the Mexico-United States border. J Immigr Minor Health. 2014. doi: 10.1007/s10903-014-0083-y.Google Scholar
  18. 18.
    Fernández-Niño JA, Ramírez-Valdés CJ, Cerecero-Garcia D, Bojorquez-Chapela I. Deported Mexican migrants: health status and access to care. Rev Saude Publica. 2014;48(3):478–85.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Degenhardt L, Whiteford HA, Ferrari AJ, et al. Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. Lancet. 2013;382(9904):1564–74.CrossRefPubMedGoogle Scholar
  20. 20.
    U.S. Department of Homeland Security. ICE enforcement and removal operations report: fiscal year 2014. U.S. Department of Homeland Security; 2014.Google Scholar
  21. 21.
    Masferrer C, Roberts BR. Going back home? changing demography and geography of Mexican return migration. Popul Res Pol Rev. 2012;31:465–96.CrossRefGoogle Scholar
  22. 22.
    Rhodes T. The ‘risk environment’: a framework for understanding and reducing drug-related harm. Int J Drug Policy. 2002;13:85–94.CrossRefGoogle Scholar
  23. 23.
    Brouwer KC, Case P, Ramos R, et al. Trends in the production and trafficking and consumption of methamphetamine and cocaine in Mexico. Subst Use Misuse. 2006;41:707–27.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Bucardo J, Brouwer KC, Magis-Rodriguez C, et al. Historical trends in the production and consumption of illicit drugs in Mexico: implications for the prevention of blood borne infections. Drug Alcohol Depend. 2005;79:281–93.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Instituto Nacional de Salud Pública. Encuesta Nacional de Adicciones 2008. Cuernavaca: Instituto Nacional de Salud Pública; 2008.Google Scholar
  26. 26.
    Guerrero EG, Villatoro JA, Kong Y, Gamino MB, Vega WA, Mora ME. Mexicans’ use of illicit drugs in an era of drug reform: national comparative analysis by migrant status. Int J Drug Policy. 2014;25(3):451–7.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Borges G, Breslau J, Orozco R, et al. A cross-national study on Mexico-US migration, substance use and substance use disorders. Drug Alcohol Depend. 2011;117(1):16–23.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Borges G, Medina-Mora ME, Orozco R, Fleiz C, Cherpitel C, Breslau J. The Mexican migration to the United States and substance use in northern Mexico. Addiction. 2009;104(4):603–11.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Borges G, Medina-Mora ME, Breslau J, Aguilar-Gaxiola S. The effect of migration to the United States on substance use disorders among returned Mexican migrants and families of migrants. Am J Public Health. 2007;97(10):1847–51.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Zhang X, Martinez-Donate AP, Nobles J, Hovell MF, Rangel MG, Rhoads NM. Substance use across different phases of the migration process: a survey of mexican migrants flows. J Immigr Minor Health. 2015. doi: 10.1007/s10903-014-0109-5.PubMedCentralGoogle Scholar
  31. 31.
    Rangel MG, Martinez-Donate AP, Hovell MF, et al. A two-way road: rates of HIV infection and behavioral risk factors among deported Mexican labor migrants. AIDS Behav. 2012;16(6):1630–40.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Robertson AM, Rangel MG, Lozada R, Vera A, Ojeda VD. Male injection drug users try new drugs following U.S. deportation to Tijuana, Mexico. Drug Alcohol Depend. 2012;120(1–3):142–8.CrossRefPubMedGoogle Scholar
  33. 33.
    Ojeda VD, Robertson AM, Hiller SP, et al. A qualitative view of drug use behaviors of Mexican male injection drug users deported from the United States. J Urban Health. 2011;88(1):104–17.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Martin YC. The syndemics of removal: trauma and substance abuse. In: Brotherton DC, Stageman DL, Leyro SP, editors. Outside justice: immigration and the criminalizing impact of changing policy and practice. New York: Springer; 2013.Google Scholar
  35. 35.
    Brotherton DC, Barrios L. Displacement and stigma: the social-psychological crisis of the deportee. Crime Media Cult. 2009;5(1):29–55.CrossRefGoogle Scholar
  36. 36.
    Link BG, Phelan JC. Conceptualizing Stigma. Annu Rev Sociol. 2001;27:363–85.CrossRefGoogle Scholar
  37. 37.
    Pinedo M, Burgos JL, Ojeda VD. A critical review of social and structural conditions that influence HIV risk among Mexican deportees. Microbes Infect. 2014;16(5):379–90.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Schuster L, Majidi N. Deportation stigma and re-migration. J Ethn Migr Stud. 2015;41(4):635–52.CrossRefGoogle Scholar
  39. 39.
    Fitzgerald J, Curtis KA, Corliss CL. Anxious publics: worries about crime and immigration. Comp Political Stud. 2012;45(4):477–506.CrossRefGoogle Scholar
  40. 40.
    Collins J, Reid C. Minority youth, crime, conflict, and belonging in Australia. Int Migr Integr. 2009;10(4):377–91.CrossRefGoogle Scholar
  41. 41.
    Simon RJ, Sikich KW. Public attitudes toward immigrants and immigration policies across seven nations. Int Migr Rev. 2007;41(4):956–62.CrossRefGoogle Scholar
  42. 42.
    Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health inequalities. Am J Public Health. 2013;103(5):813–21.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Link BG, Phelan JC. Stigma and its public health implications. Lancet. 2006;367(9509):528–9.CrossRefPubMedGoogle Scholar
  44. 44.
    Ojeda VD, Eppstein A, Lozada R, et al. Establishing a binational student-run free-clinic in Tijuana, Mexico: a model for US-Mexico border states. J Immigr Minor Health. 2014;16(3):546–8.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Instituto Nacional de Estadistica y Geografia. Censo de poblacion y vivienda 2010 Aguascalientes, Ags. 2010.
  46. 46.
    Ferraiolo N, Pinedo MM, J., Burgos JL, Vargas-Ojeda AC, Rodriguez M, Ojeda VD. Depressive symptoms among patients at a clinic in the Red Light District of Tijuana, Mexico. Int J Cult Ment Health. 2016. doi: 10.1080/17542863.2016.1144776 (in press).PubMedPubMedCentralGoogle Scholar
  47. 47.
    Adams J. Marked difference: tattooing and its association with deviance in the United States. Deviant Behavior. 2009;30(3):266–92.CrossRefGoogle Scholar
  48. 48.
    Lane DC. Tat’s all folks: an analysis of tattoo literature. Sociol Compass. 2014;8(4):398–410.CrossRefGoogle Scholar
  49. 49.
    Jennings WG, Fox BH, Farrington DP. Inked into crime? An examination of the causal relationship between tattoos and life-course offending among males from the cambridge study in delinquent development. J Crim Justice. 2014;42(1):77–84.CrossRefGoogle Scholar
  50. 50.
    García V, González L. Labor migration, drug trafficking organizations, and drug use: major challenges for transnational communities in Mexico. Urban Anthropol Stud Cult Syst World Econ Dev. 2009;38(2–4):303–44.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Degenhardt L, Mathers B, Guarinieri M, et al. Meth/amphetamine use and associated HIV: implications for global policy and public health. Int J Drug Policy. 2010;21(5):347–58.CrossRefPubMedGoogle Scholar
  52. 52.
    Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379:55–70.CrossRefPubMedGoogle Scholar
  53. 53.
    Martinez-Donate AP, Hovell MF, Rangel MG, et al. Migrants in transit: the importance of monitoring HIV risk among migrant flows at the Mexico-US border. Am J Public Health. 2015;105(3):497–509.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Strathdee SA, Magis-Rodriguez C, Mays VM, Jimenez R, Patterson TL. The emerging HIV epidemic on the Mexico-U.S. border: an international case study characterizing the role of epidemiology in surveillance and response. Ann Epidemiol. 2012;22(6):426–38.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005;61(5):1026–44.CrossRefPubMedGoogle Scholar
  56. 56.
    Gutierrez JP, Garcia-Saiso S, Dolci GF, Hernandez Avila M. Effective access to health care in Mexico. BMC Health Serv Res. 2014;14:186.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Horyniak D, Higgs P, Cogger S, Dietze P, Bofu T. Heavy alcohol consumption among marginalised African refugee young people in Melbourne, Australia: motivations for drinking, experiences of alcohol-related problems and strategies for managing drinking. Ethn Health. 2015;21(3):284–99.CrossRefPubMedGoogle Scholar
  58. 58.
    Posselt M, Procter N, Galletly C, Crespigny C, de Crespigny C. Aetiology of coexisting mental health and alcohol and other drug disorders: perspectives of refugee youth and service providers. Aust Psychol. 2015;50(2):130–40.CrossRefGoogle Scholar
  59. 59.
    Logran importantes acuerdos para migrantes en Congreso Nacional de Migración en Tijuana [Important achievements for migrants at the Migration Congress in Tijuana]. San Diego Red [Internet]. 2015.
  60. 60.
    Blanco C, Morcillo C, Alegría M, et al. Acculturation and drug use disorders among Hispanics in the U.S. J Psychiatr Res. 2013;47(2):226–32.CrossRefPubMedGoogle Scholar
  61. 61.
    Carter-Pokras O, Zambrana RE, Yankelvich G, Estrada M, Castillo-Salgado C, Ortega AN. Health status of Mexican-origin persons: do proxy measures of acculturation advance our understanding of health disparities? J Immigr Minor Health. 2008;10(6):475–88.CrossRefPubMedGoogle Scholar
  62. 62.
    Antecol H, Bedard K. Unhealthy assimilation: why do immigrants converge to American health status levels? Demography. 2006;43(2):337–60.CrossRefPubMedGoogle Scholar
  63. 63.
    Government of Mexico. Programa de Repatriación [Repatriation Programs] [28/07/2016]. Available from:
  64. 64.
    Government of Mexico. Procidimiento de Repatriación al Interior de México (PRIM) [Repatriation procedures to the interior of Mexico].
  65. 65.
    Instituto para la Seguridad y la Democracia (Insyde). Diagnóstico del Instituto Nacional de Migración: Hacia un Sistema de Rendición de Cuentas en pro de los Derechos de las Personas Migrantes en México [Assessment of the National Institute of Migration: Towards a System of Accountability for the Rights of Migrants in Mexico] 2013 [27/09/2016]. Available from:
  66. 66.
    Rhodes T. Risk environments and drug harms: a social science for harm reduction approach. Int J Drug Policy. 2009;20(3):193–201.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Danielle Horyniak
    • 1
    • 2
    • 3
  • Miguel Pinedo
    • 4
  • Jose Luis Burgos
    • 1
  • Victoria D. Ojeda
    • 1
  1. 1.Division of Global Public Health, School of MedicineUniversity of California San DiegoLa JollaUSA
  2. 2.Centre for Population HealthBurnet InstituteMelbourneAustralia
  3. 3.School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
  4. 4.Alcohol Research GroupUniversity of California BerkeleyEmeryvilleUSA

Personalised recommendations