The syndemics of removal: Trauma and substance abuse

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.