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The Syndemics of Removal: Trauma and Substance Abuse

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Outside Justice

Abstract

This is a mixed-methods study conducted among heroin-using deportees in the Dominican capital of Santo Domingo, from 2008 to 2010. The study illustrates how forced mobility in transnational groups can lead to sudden changes in cultural environment, which promote risk-seeking attitudes, such as substance abuse, in the absence of structural checks and balances on high-risk behavior. In this study I adapt Merrill Singer’s Syndemics model to illustrate how social isolation, mental health issues, and substance abuse are synergistic forces that aggravate the deportee’s risk for serious health conditions. Data were gathered through a combination of (a) participant observation (inside shooting galleries, private homes, and public spaces); (b) life-histories, open-ended (N = 12); and (c) semi-structured interviews (N = 120). Risk factors that may encourage risk seeking behavior and substance abuse are the lack of positive social networks, lack of financial means of subsistence, lack of adequate health care services, and institutional and structural stigmatization. Additionally, deportation-related trauma heightens the returnee’s likelihood to suffer from mental health conditions.

Why the hell was I doing drugs for? You feel isolated, you feel rejected. You feel helpless, hopeless… You have nothing. You don’t have a job. You don’t have papers, really, because you have to start getting your birth certificate, the cedula (The “cedula” is the national identification card, which is required for most basic social services, as well as for legal employment), this or that… It’s like a shock to your system.

(Gloria, 44. Personal interview; March 19, 2010)

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Notes

  1. 1.

    These numbers are consistent with the comprehensive report by Human Rights Watch “Forced Apart” (2007), in which only 14 % of all offenses involved violence against persons for years 1996 through 2007. See full report at http://www.hrw.org/reports/2009/04/15/forced-apart-numbers-0.

  2. 2.

    http://www.ice.gov/news/releases/1010/101008washingtondc.htm.

  3. 3.

    All names have been changed for confidentiality purposes. I conducted all the interviews, prepared all interview transcriptions (both in Spanish and English), and when possible, asked the participants to read my field notes for fact checking. I triangulated personal narratives, interviewing some of the participants’ peers and relatives, if available.

  4. 4.

    http://www.justice.gov/ndic/pubs38/38661/drugImpact.htm. Accessed March 4, 2012.

  5. 5.

    Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011.

  6. 6.

    Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior. Source: AIDS Behavior 2009 Apr;13(2): 207–16.

  7. 7.

    Carlos Decena’s book, Tacit Subjects, explores how ethnic minority homosexuals live their lives as both visible and invisible. I use this concept to highlight the deportee’s double rendering as visible (when it comes to being blamed for all criminal activity that occurs in the DR), and invisible (denied of both agency and basic rights, as if they were not recognized as part of the larger population).

  8. 8.

    Approximately 31,000 of the more than 1.4 million persons serving on active duty (1.5 % of the total) are noncitizens. Each year, 8,000 more noncitizens become service-members—See Preston (2009), at A1; and Timmons and Stock (2009).

  9. 9.

    See also Young (1999) and Brotherton and Barrios (2011) on systems of exclusion.

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Correspondence to Yolanda C. Martín Ph.D. .

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Martín, Y.C. (2013). The Syndemics of Removal: Trauma and Substance Abuse. In: Brotherton, D., Stageman, D., Leyro, S. (eds) Outside Justice. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6648-2_5

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