“It Ruined My Life”: The Effects of the War on Drugs on People Who Inject Drugs in Rural Puerto Rico

Kirk Dombrowski, the principle investigator of the REACH Lab, recently published a research paper on how the War on Drugs is affecting people who inject drugs in rural Puerto Rico. This paper was published in the International Journal of Drug Policy.

The War on Drugs has raised the incarceration rates of racial minorities for non-violent drug- related crimes, profoundly stigmatized drug users, and redirected resources from drug prevention and treatment to militarizing federal and local law enforcement. Yet, while some states consider shifting their punitive approach on drug use to one based on drug treatment and rehabilitation, nothing suggests that these policy shifts are being replicated in Puerto Rico.

This paper utilized data from 360 PWID residing in four rural towns in the mountainous area of central Puerto Rico. Initially, 315 PWIDs were recruited using respondent-driven sampling (RDS) and collected data about risk practices and conducted HIV and HCV testing. During the second phase, 34 micro-ethnographic assays were conducted, in which 34 participants were randomly recruited from the first phase and included their ego networks in this phase. This ethnographic inquiry produced significant data regarding the effects of the war on drugs on the local drug trade, drug availability, and injectors’ social networks.

Findings suggest that repressive policing has been ineffective in preventing drug distribution and use among those in our study. This type of law enforcement approach has resulted in the disproportionate incarceration of poor drug users in rural Puerto Rico, mainly for nonviolent drug-related crimes. In addition, incarceration exposes PWID to a form of  cruel and unusual punishment: having to quit heroin “cold turkey” while the prison environment presents its own HIV/HCV risks. In turn, the war on drugs not only diverts resources from treatment but also shapes treatment ideologies, punishing non-compliant patients.

This research paper concluded that shifting the emphasis from repression to treatment and rehabilitation is likely to have a positive impact on the health and overall quality of life of PWID and their communities.


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