Disentangling Patterns of Drug Use Among a Street Recruited Sample of Latino Day Laborers in Baltimore

Despite the estimated 11.2 million unauthorized immigrants that live in the U.S., there is an absence of a well-defined understanding of this population’s drug use. Studies suggest that Latino immigrant day laborers (LIDLs), many of whom are undocumented, are at heightened risk of drug use given their distinct social, situational and contextual circumstances. The health risk behaviors of this population in new settlement cities or cities without an established Latino immigrant population is relatively unknown as the bulk of the research has been set in traditional settlements (California and Texas). For LIDLs who migrate to new immigrant settlement cities, exposure to risk factors may be even higher due to lack of family and an established Latino community. The emphasis of this study is on how the context of a new immigrant settlement as well as individual and migration factors impact the drug use patterns of three groups of LIDLs: pre-migration drug initiators (current drug users who initiated use before migration), post-migration drug initiators (current drug users who initiated use in the U.S.) and non-drug users (no drug use in the last year).

Methods:  This ethnographic study utilized an adaptive sampling methodology with elements of field intensive outreach, Rapid Assessment for Response and Evaluation (RARE), and targeted snowball sampling. Respondents were street recruited from identified day labor sites. In-depth interviews were conducted with 77 LIDLs (n=52 current users, n=25 non-drug users) in Baltimore. The interview data was the main source for interpretation and analysis regarding participants’ experiences with drug use and associated risk behaviors. Field notes and participants’ characteristics were triangulated into analysis of the interview data to develop a comprehensive understanding of the context of drug use among LIDLs. Analysis was guided by Social Ecology theory and used NVivo to elucidate the culmination of individual, migration and new settlement community factors as they relate to drug use.  

Results: Baltimore is characterized by high levels of drug use and open air drug markets. Increased accessibility to drugs, marginalization and lack of social support (e.g., family) led to drug use initiation. A key-turning point for engagement in drug use for the first time post-migration included a traumatic event (death of a loved one or separation). Post-migration drug use initiators trended to escalate into harder drug use when compared to pre-migration drug use initiators. Non-drug users’ settlement experience was distinct compared to drug users as this group tended to have stronger familial connections both in the United States and in their country of origin.

Discussion.  This study’s focus on drug use patterns of LIDLs within a new immigrant settlement destination elucidates previously unknown patterns of drug use and potential predictors (such as family relations, labor market experiences, social support networks) that can inform future research and theory. Findings regarding drug practices may challenge traditional modes of treatment and shift clinical practice paradigms by indicating important points for prevention and intervention.