Papers by Heidi Hoefinger
By Ross Aikins, Heidi Hoefinger, Honoria Guarino, Andrew Rosenblum, Stephen Magura, and Herman Jo... more By Ross Aikins, Heidi Hoefinger, Honoria Guarino, Andrew Rosenblum, Stephen Magura, and Herman Joseph (2015)
Journal of Addictive Diseases, Special Issue: Selected Drug Use Issues in the Early 21st Century; Apr-Sep; 34(2-3): 185-97, 2015
DOI: 10.1080/10550887.2015.1059118
This study piloted the feasibility of rapidly collecting both self-reports of drug use and saliva specimens for drug toxicology in field settings. The use of oral fluid collection devices to supplement self-reports is unproven in street settings and may pose challenges for field research. Sixty adults who identified as recent illicit drug users were recruited in public settings in New York City, asked to complete a brief drug screening inventory and provided saliva specimens. Descriptive findings are detailed along with critical best research practices and limitations that provide important directions for researchers looking to employ both toxicology and self-report in rapid field recruitment designs.
Rape Issue Not Properly Addressed - Letter to the Editor, Phnom Penh Post
Ripped from their homes in the United States, the Kingdom’s
returnees are determined to make the ... more Ripped from their homes in the United States, the Kingdom’s
returnees are determined to make the most of a raw deal.
Published in Southeast Asia Globe Magazine, September 2013, p 67-68.
Photography by Sam Jam
Published in Hysteria - A Collection of Feminisms, Issue 3: Abjection, 2014 (to be re-printed in ... more Published in Hysteria - A Collection of Feminisms, Issue 3: Abjection, 2014 (to be re-printed in the Tamil language special issue)
This paper examines the intersections of ethnicity, race, sexuality, sociality and urban space in... more This paper examines the intersections of ethnicity, race, sexuality, sociality and urban space in the LGBTQ ‘post-migrant’ clubbing scene in London. Relying on ethnographic research conducted in clubs catering to young LGBTQ clubbers who claim British-Asian, Middle Eastern, Mediterranean, and Arabic identification, I argue that clubbing is a specific and productive kinship practice and that the clubs themselves are contested spaces where familial and gendered expectations are resisted, while cultural forms are embraced. These clubs are safe spaces both for ‘coming out’ and ‘coming home’ and for constructing queer alternative kinships and families, as well as spaces in which competition, violence, jealousy, and discrimination co-exist. This paper is framed through the lens of intimate ethnography.
Sex, Love and Money in Cambodia: Professional Girlfriends and Transactional Relationships
Dealing with the complex and discomforting ‘grey ‘area where sex, love and money collide, this bo... more Dealing with the complex and discomforting ‘grey ‘area where sex, love and money collide, this book highlights the general materiality of everyday sex that takes place in all relationships. In doing so, it draws attention to and destigmatizes the transactional elements within many ‘normative’ partnerships – be they transnational, inter-ethnic or otherwise.
Focusing on Cambodia, and on a subculture of young women employed in the tourist bar scene referred to as ‘professional girlfriends’, the book shows that the resulting transnational relationships between Cambodian women and their foreign partners are complex and multi-layered. It argues that the sex-for-cash prostitution framework is no longer an appropriate model of analysis. Instead, a new vocabulary of ‘professional girlfriends’ and ‘transactional sex’ is used, with which the nuanced complexities of these transnational partnerships are analysed.
Interdisciplinary in nature, the book inspires new understandings of gender, power, sex, love, desire, political economy and materiality within everyday relationships around the globe. It is a useful contribution for students and scholars of Anthropology, Sociology, Southeast Asian Studies, Gender and Sexuality Studies, and Cultural Studies.
Cultural Studies, Jan 1, 2011
This paper explores the sexuality, subculture and solidarity of young women who work in the hospi... more This paper explores the sexuality, subculture and solidarity of young women who work in the hospitality and entertainment sectors in Cambodia. Specifically, the focus is on women described as ‘professional girlfriends’ and ‘bar girls’ employed in the hostess bar scene in the capital city of Phnom Penh. Professional girlfriends are young women who engage in a performance of intimacy within multiple sexual or non-sexual ‘transactional’ relationships with ‘western boyfriends’ in order to benefit materially and support their livelihoods. Because of their initial material motivations within the multiple partnerships and the strict cultural taboos surrounding sex and sexuality, professional girlfriends, and most other bar girls, are simultaneously stereotyped as ‘prostitutes’ and ‘broken women’ by general society, and as ‘victims’ by the development community. Despite their simultaneous stigmatization and victimization, however, these young women utilize bar girl subculture, alternative kinship systems, linguistic ability, consumption, intimacy and interpersonal partnerships in order to improve their social status, secure their futures and achieve a sense of enjoyment in their otherwise complicated lives. Homosocial friendship groups that emerge from subcultural networks and communal living work to provide support, social cohesion and care in the face of marginalization, structural constraints and gendered violence. ‘Hedonistic’ bar girl subculture also provides the space for young women to experiment with their sexualities and explore heteroflexibility. Through the lens of cultural studies, and via the practice of ‘intimate ethnography’, this paper also pays particular attention to the negotiation of intimacy and friendship between the respondents and researcher.
This paper highlights the political and ethical challenges of projects that combine research, adv... more This paper highlights the political and ethical challenges of projects that combine research, advocacy and pedagogy. These challenges are illustrated through the lens of the Global Girls: Autobiography and E-Literacy project, which took place in Phnom Penh, Cambodia in 2008. Within Phnom Penh, there is a population of young women who work in bars, with the aim of forming transactional relationships with foreign men. They barter physical and emotional intimacy and friendship in exchange for various material and emotional benefits. They utilize many skills in order to maintain these relationships, including spoken and written English proficiency, and computer skills such as emailing and communication technology. The goal of the Global Girls Project was to harness those same skills to create a collaborative action-based educational research project focused on autobiography. The aim was to assist the women in improving their spoken and written English skills, grammar, typing, word processing and Internet skills, and in writing about personal history, family, self, future ambitions and career goals. The project aimed to create a space where women could network with one another, participate in dialogue about their experiences and lives, engage in collective action and solidarity, and build cross-sector friendships. This paper describes the practical details of the project, including its outcomes and limitations, as well as highlights some of the debates around action-based research and advocacy in anthropology. It also addresses the ethical and theoretical implications of becoming involved in education in field research settings, as well as the role of education as an ethnographic research tool, and the ways it can enhance and challenge the relationship between the anthropologist, participants, and communities in the field.
Transnational Intimacies: Examples from Cambodia
"This chapter focuses on two examples of transnational intimacies in Cambodia. The first example ... more "This chapter focuses on two examples of transnational intimacies in Cambodia. The first example not only reveals, but depathologises the entrepreneurial ways that certain young women in Cambodia described as ‘professional girlfriends’ (PGs), employ intimacy as a tool in order to barter for their own material and emotional gain with ‘western boyfriends’. The second example presented is that between the researcher and researched. Through cultivation of the practice of ‘intimate ethnography’, the researcher attempts to break down power asymmetries and provide a more egalitarian method which both humanises the research process, and allows participants’ voices to disrupt global hegemonic truth-claims about their lives.
The works of the many pivotal authors on transactional sex (Hunter 2002), transnational partnerships (Constable 2003, Brennan 2004), intimacy and authenticity (Bernstein 2007), love, sexuality and migration (Law 2000, Derks 2008), and intersections of emotion and political economy (Hamilton 1997, Hochschild 2003, Zelizer 2005) provide the key theoretical frameworks necessary for critical analysis of this population of postcolonial women and their western partners. The research of feminist ethnographers (Patai 1991, Stacey 1991, Ong 1995, Skeggs 1995, Wolf 1996, Narayan 2003, Irwin 2006), and scholars interested in identity and intimate subjectivities of researchers (Newton 1993, Kulick & Wilson 1995) also prove useful for a critique of ‘intimate’ ethnography.
Keywords: professional girlfriends, transactional sex, transnational relationships, intimate ethnography, Cambodia
"
Negotiating Intimacy: Transactional Sex and Relationships Among Cambodian Professional Girlfriends
This research focuses on the transactional nature of sexual and non-sexual relationships between ... more This research focuses on the transactional nature of sexual and non-sexual relationships between certain young women in Cambodia described as ‘professional girlfriends’, and their ‘western boyfriends’. In this case, the term ‘transactional’ refers to the initial material motivation behind their interactions. While the majority of women are employed as bartenders or waitresses in tourist areas of Phnom Penh, outside observers tend to erroneously label them as ‘prostitutes’ or ‘broken women’ because of the gift-based nature of the intimate exchanges. Ethnographic evidence demonstrates, however, that they make up a diverse and nuanced group of individuals who engage in relationships more complex than simply ‘sex-for-cash’ exchanges, and often seek marriage and love in addition to material comforts. Though they do not view themselves as ‘prostitutes’, the distinction of the term ‘professional’ is used to emphasize that 1) they do rely on the formation of these relationships as a means of livelihood and their motivations are initially materially-based; 2) they engage in multiple overlapping transactional relationships, usually unbeknownst to their other partners; 3) there is a performance of intimacy, whereby the professed feelings of love and dedication lie somewhere on a continuum between genuine and feigned, and where the term ‘love’ itself carries multiple meanings.
The research further reveals not only the stereotypes, contradictions, and structural constraints experienced by these young women, but also their entrepreneurialism, determination and creativity. Despite trauma related to recent political past, sexual violence, stigma, depression and self-harming, they use tools of global feminine youth culture, consumption, linguistic ability, ‘bar girl’ subculture, and interpersonal relationships to make socioeconomic advancements and find enjoyment in their lives. The practice of 'intimate ethnography' also illuminates the negotiation of intimacy and friendship between the participants and researcher, as well as the general materiality and exchange of everyday sex and relationships around the globe.
Women’s Studies International Forum. , issue 38, p 147-149. , 2013
There has been an increasing amount of academic literature (of varying quality) written on sex, s... more There has been an increasing amount of academic literature (of varying quality) written on sex, sex work and sexual trafficking. However, Doezema's Sex Slaves and Discourse Masters (2010) and Ditmore, Levy and Willman's edited collection Sex Work Matters (2010) are two stand-out contributions.
Prescription Drug Use and Diversion: An Assessment of Practices and Perceptions
Prescription drug diversion is a growing yet understudied problem (Inciardi et al., 2009). This ... more Prescription drug diversion is a growing yet understudied problem (Inciardi et al., 2009). This paper delineates usage and diversion patterns in a large sample of individuals in three areas where diversion is suspected to be a heightened problem. According to the Drug Abuse Warning Network (DAWN), the National Institute on Drug Abuse’s Community Epidemiology Work Group, the Monitoring the Future (MTF) survey, and the National Survey on Drug Use and Health (NSDUH), the prevalence of prescription medication abuse (e.g., opioids, sedatives, and stimulants) in the United states has been rising for decades, representing a significant public health problem (Inciardi et al., 2009). Most commonly abused prescription drugs are scheduled by the DEA as controlled substances with a high potential for abuse (US Dept. of Justice, 2008; Perrine, 1996). This means that the diversion—or the buying, selling, trading, or redistributing—of controlled medications is a felony offense.
Diversion can occur in a variety of ways within health industry channels including doctor shopping by visiting multiple physicians to obtain multiple prescriptions, illegal prescriptions made by doctors or pharmacists for their financial gain, theft or forgery of prescriptions, or theft from pharmaceutical manufacturers or pharmacies (Gilson, Ryan, Joranson, & Dahl, 2004; Inciardi et al., 2006). Additionally, diversion can entail the redistribution of medication outside of the healthcare sphere, means of which include theft, purchasing or acquiring medications from family or friends, trading drugs or medications, purchasing prescription drugs from street-level dealers, smuggling pills from abroad, or purchasing medications from online pharmacies or other web advertisements (Inciardi, Surratt, Kurtz, & Cicero, 2007).
This presentation will highlight usage and diversion patterns of prescription drugs, as well as the perceptions individuals have regarding the health, safety and legal implications of their prescription drug use and diversion. Four classes of prescription drugs will be assessed: opioids, sedatives/tranquilizers, stimulants, and sexual enhancement/erectile dysfunction medications. These classes of medication were chosen based on existing literature regarding prescription drugs where diversion was a concern (Arria, Garnier-Dykstra, Caldeira,Vincent, O’Grady, 2011; Hernandez & Nelson, 2010; SAMHSA, 2010).
This study used a web-based recruitment and survey administration. Participants were alerted to the study through advertisements placed on social networking websites and online bulletin boards (e.g., Craigslist). Research staff employed time space sampling procedures to randomly select the time and site for each study advertisement. The study recruited participants from three geographic locations in the Eastern United States where diversion is thought to be especially high (NY, Washington DC, South Florida) who are at least 18 years of age.
The results from this study will indicate the magnitude of prescription drug use and diversion across Eastern United States. Policy implications regarding the processes of diversion patterns will also be discussed.
Self-Reported Alcohol/Substance Use and Depression Among Deported Cambodian-American Refugees: A Qualitative Perspective
Deported Cambodian-American refugees (also referred to as ‘returnees’) make up a small but growin... more Deported Cambodian-American refugees (also referred to as ‘returnees’) make up a small but growing population in Cambodia, yet little to no data exists about their alcohol/substance use and experiences of depression. This paper provides a qualitative perspective on their changing alcohol or substance use behaviours both prior to and after their deportation from the United States to Cambodia, with particular attention paid to self-reported initiation, transition, and escalation patterns of use, as well as to self-reported depression.
The Cambodian-Americans who are the focus of this research were born in Cambodian prisons and labor camps, or Thai refugee camps during, the Khmer Rouge Era (1975-1979) and came to the USA as children with their families as political refugees. Ethnographic research with this population, as well as one academic report published by the Walter Leitner International Human Rights Clinic at Fordham Law School (Leitner Center 2010) has revealed that violence, social exclusion, discrimination, family fracture and financial hardships had led many of these refugees to become involved in illegal activities, which ultimately resulted in incarceration in the US. In 1996 Congress passed the Illegal Immigration Reform and Immigrant Responsibility Act (IIRAIRA), which stipulates that any non-citizen living in the United States can be deported if convicted of an aggravated felony. After indeterminate stays in immigration prison, these Cambodian-American refugees have eventually been deported in shackles to Cambodia —a country that many had never stepped foot in. The law is retroactive, meaning that many had also already completed their prison and parole sentences and were removed up to 13 years after leaving prison. Arriving in an unknown land, with few remaining family members, scant cultural understanding, and limited Khmer language skills, they experience continued stigma, social exclusion and hardship.
Oral history interviews and longitudinal ethnographic research were conducted with a sample of twelve alcohol and substance using returnees (10 male, 2 female) living in the capital city of Phnom Penh. Grounded theory and content analysis of interview transcriptions and ethnographic data identified major themes in the participants’ experiences. These themes include 1) self-reported initiation of certain substances after arrival, including alcohol, marijuana, methamphetamines, and heroin; 2) self-reported transition of drug use after deportation (ie from crack or marijuana to methamphetamines); 3) self-reported escalation of alcohol and substance use after deportation (including marijuana and methamphetamines); 4) initiation, transition and escalation of use was related to various social, economic, cultural, and environmental stressors experienced by participants; 5) and many participants experienced self-reported depression related to these stressors (as well as to the alcohol and substance use).
This paper argues that intervention, programming, and binational cooperation is needed to address some of the major stressors (such as discrimination, stigma, unemployment, lack of financial, housing and mental health support) so that post-deportation initiation, transition and escalation of alcohol and substance use can be mitigated, and depression can be addressed. The paper ends with a description of the self-organization activities that some of the participants are engaging in, with the hopes of eventually setting up their own drop-in center, which would provide peer-to-peer counselling. The author argues this could lead to potential future participatory action research opportunities with this highly stigmatized population.
Shackles, full circle: An ethnography of methamphetamine addiction among Cambodian-American refugee deportees in Phnom Penh
Through use of recorded oral histories and ‘intimate’ ethnography, this paper maps the journeys o... more Through use of recorded oral histories and ‘intimate’ ethnography, this paper maps the journeys of a certain group of Cambodian-American refugees, from their birth in ‘shackles’ in Khmer Rouge prison camps and Thai refugee camps, to their arrival in the US as child-asylum seekers, and later indoctrination into drug and gang culture as adolescents. From there, the paper follows their trajectory of teen methamphetamine and crack-cocaine use and sales, to eventual imprisonment and deportation back to Cambodia in literal shackles. The article concludes with a description of their contemporary metaphorical incarceration in the form of methamphetamine addiction and societal stigmatization, and illustrates the creative ways they are coping with these complexities (e.g. by working in a harm reduction NGO for drug users) and contesting other binaries such as good/bad, foreign/local, deviant/non-deviant, Cambodian/American through the construction of hybrid and multiplex subjectivities (Rosaldo 1989), double consciousness (Gilroy 1993)and community solidarity. Though there have been some journalistic depictions of this population, there has been little sociological/anthropological analyses of this population to date.
A Different Look at Sex Work and Structural Violence in Post-Conflict Cambodia
Within the global debate, sex and entertainment work are often considered acts of violence agains... more Within the global debate, sex and entertainment work are often considered acts of violence against women particularly among abolitionist radical feminists (Farley, Dworkin). Women employed in these sectors in postcolonial, post-conflict societies are particularly portrayed as helpless victims that could never possibly ‘choose’ this lifestyle or profession, and should instead be ‘saved’ by good intentioned ‘white saviors’ whom operate within a veritable neo-colonial rescue industry (Agustin 2007). A decade of longitudinal ethnographic research on the sex and entertainment sectors in Cambodia has revealed instead, however, that many young women not only consent to, but actively seek out both commercial and transactional sexual exchanges with both local Khmer and foreign men in order to take control of their lives and make socio-economic advancements in a sea of gendered and structural constraints. This perspective of self-empowerment through sex work is by no means an attempt to ignore or deny the vast structural violence that women in Cambodia must grapple with on a regular basis. But as this research reveals, their decisions to leave home, engage in commercial sex, and/or seek out materially beneficial relationships with men oftentimes constitute an endeavour to escape even more deeply violating situations and social conditions. The paper argues that rather than trying to impress a moral agenda in discussions around sex work in Cambodia, which focus relentless attention on the victimization and oppression of ‘prostituted women’, the sexual exchanges in question should, perhaps, be viewed through more of a historically and culturally contingent perspective, with attention paid to rapid economic industrialization, gender roles, working conditions, land disputes, political agendas and the historical legacy of the last 60 years.
Studies in Gender and Sexuality (Special Edition on Gender in Cambodia) , 2014
Since the fall of the Khmer Rouge in the 1990s, global capitalism and tourism have reshaped Cambo... more Since the fall of the Khmer Rouge in the 1990s, global capitalism and tourism have reshaped Cambodia’s cultural, sexual and economic landscapes. Complex interpersonal relationships have resulted from the intermingling of cultures, capital, desires, histories and imaginations that takes place within the country’s transnational spaces. One particularly prolific site for the formation of these postcolonial partnerships is within the western-oriented hostess bar scene in Phnom Penh. The data presented here has been taken from the author’s larger longitudinal ethnographic study on the hostess bar scene in Cambodia. The main method employed was ‘intimate ethnography’, and data was taken from formal ethnographic research and interviews conducted with 86 young women employed in the entertainment sectors in Phnom Penh, and 102 ‘western’ male tourists or expatriates living or passing through Cambodia during various fieldsite visits between the period of 2005-2010. The evidence reveals that motivations to engage in these relationships are racialized and gendered, and influenced by global imagination, personal aspirations, and global media. For women, the cultural constructs of ‘patronage’ and ‘bridewealth’ are particularly influential. For western men, these motivations have been categorized into four typologies which include ‘unattached holiday sex’, ‘hero syndrome’, ‘conventional domestic order’, and ‘true love’.
Although these transnational relationships often present overlaps rather than dissimilarities with more normative/non-remunerative relationships in terms of the entanglement of intimacy and political economy, the relationships in this study are inevitably fraught due to the specific ways that gender, race, culture and power are played out in uneven terrains. The article, thus, ends with highlighting some of the psycho-behavioral consequences that result from cultural misunderstandings and failed expectations, which include depression, alcohol/substance use, intimate partner violence, self-harming and suicide—the last two of which being issues that have received little to no attention in Cambodia.
Conference Organization by Heidi Hoefinger
Panel: „Leisure Practices of Queer Post-Migrants/ Black People/ People of Color and Urban Space“
ERC Conference: „New Post-Migrant Socialities. Rethinking Urban Leisure Practices in the Context ... more ERC Conference: „New Post-Migrant Socialities. Rethinking Urban Leisure Practices in the Context of Diversity and Dominance“, Goethe University Frankfurt, January 2013
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Papers by Heidi Hoefinger
Journal of Addictive Diseases, Special Issue: Selected Drug Use Issues in the Early 21st Century; Apr-Sep; 34(2-3): 185-97, 2015
DOI: 10.1080/10550887.2015.1059118
This study piloted the feasibility of rapidly collecting both self-reports of drug use and saliva specimens for drug toxicology in field settings. The use of oral fluid collection devices to supplement self-reports is unproven in street settings and may pose challenges for field research. Sixty adults who identified as recent illicit drug users were recruited in public settings in New York City, asked to complete a brief drug screening inventory and provided saliva specimens. Descriptive findings are detailed along with critical best research practices and limitations that provide important directions for researchers looking to employ both toxicology and self-report in rapid field recruitment designs.
Article found here:
http://www.phnompenhpost.com/analysis-and-op-ed/rape-issue-not-properly-addressed
returnees are determined to make the most of a raw deal.
Published in Southeast Asia Globe Magazine, September 2013, p 67-68.
Photography by Sam Jam
Focusing on Cambodia, and on a subculture of young women employed in the tourist bar scene referred to as ‘professional girlfriends’, the book shows that the resulting transnational relationships between Cambodian women and their foreign partners are complex and multi-layered. It argues that the sex-for-cash prostitution framework is no longer an appropriate model of analysis. Instead, a new vocabulary of ‘professional girlfriends’ and ‘transactional sex’ is used, with which the nuanced complexities of these transnational partnerships are analysed.
Interdisciplinary in nature, the book inspires new understandings of gender, power, sex, love, desire, political economy and materiality within everyday relationships around the globe. It is a useful contribution for students and scholars of Anthropology, Sociology, Southeast Asian Studies, Gender and Sexuality Studies, and Cultural Studies.
The works of the many pivotal authors on transactional sex (Hunter 2002), transnational partnerships (Constable 2003, Brennan 2004), intimacy and authenticity (Bernstein 2007), love, sexuality and migration (Law 2000, Derks 2008), and intersections of emotion and political economy (Hamilton 1997, Hochschild 2003, Zelizer 2005) provide the key theoretical frameworks necessary for critical analysis of this population of postcolonial women and their western partners. The research of feminist ethnographers (Patai 1991, Stacey 1991, Ong 1995, Skeggs 1995, Wolf 1996, Narayan 2003, Irwin 2006), and scholars interested in identity and intimate subjectivities of researchers (Newton 1993, Kulick & Wilson 1995) also prove useful for a critique of ‘intimate’ ethnography.
Keywords: professional girlfriends, transactional sex, transnational relationships, intimate ethnography, Cambodia
"
The research further reveals not only the stereotypes, contradictions, and structural constraints experienced by these young women, but also their entrepreneurialism, determination and creativity. Despite trauma related to recent political past, sexual violence, stigma, depression and self-harming, they use tools of global feminine youth culture, consumption, linguistic ability, ‘bar girl’ subculture, and interpersonal relationships to make socioeconomic advancements and find enjoyment in their lives. The practice of 'intimate ethnography' also illuminates the negotiation of intimacy and friendship between the participants and researcher, as well as the general materiality and exchange of everyday sex and relationships around the globe.
Diversion can occur in a variety of ways within health industry channels including doctor shopping by visiting multiple physicians to obtain multiple prescriptions, illegal prescriptions made by doctors or pharmacists for their financial gain, theft or forgery of prescriptions, or theft from pharmaceutical manufacturers or pharmacies (Gilson, Ryan, Joranson, & Dahl, 2004; Inciardi et al., 2006). Additionally, diversion can entail the redistribution of medication outside of the healthcare sphere, means of which include theft, purchasing or acquiring medications from family or friends, trading drugs or medications, purchasing prescription drugs from street-level dealers, smuggling pills from abroad, or purchasing medications from online pharmacies or other web advertisements (Inciardi, Surratt, Kurtz, & Cicero, 2007).
This presentation will highlight usage and diversion patterns of prescription drugs, as well as the perceptions individuals have regarding the health, safety and legal implications of their prescription drug use and diversion. Four classes of prescription drugs will be assessed: opioids, sedatives/tranquilizers, stimulants, and sexual enhancement/erectile dysfunction medications. These classes of medication were chosen based on existing literature regarding prescription drugs where diversion was a concern (Arria, Garnier-Dykstra, Caldeira,Vincent, O’Grady, 2011; Hernandez & Nelson, 2010; SAMHSA, 2010).
This study used a web-based recruitment and survey administration. Participants were alerted to the study through advertisements placed on social networking websites and online bulletin boards (e.g., Craigslist). Research staff employed time space sampling procedures to randomly select the time and site for each study advertisement. The study recruited participants from three geographic locations in the Eastern United States where diversion is thought to be especially high (NY, Washington DC, South Florida) who are at least 18 years of age.
The results from this study will indicate the magnitude of prescription drug use and diversion across Eastern United States. Policy implications regarding the processes of diversion patterns will also be discussed.
The Cambodian-Americans who are the focus of this research were born in Cambodian prisons and labor camps, or Thai refugee camps during, the Khmer Rouge Era (1975-1979) and came to the USA as children with their families as political refugees. Ethnographic research with this population, as well as one academic report published by the Walter Leitner International Human Rights Clinic at Fordham Law School (Leitner Center 2010) has revealed that violence, social exclusion, discrimination, family fracture and financial hardships had led many of these refugees to become involved in illegal activities, which ultimately resulted in incarceration in the US. In 1996 Congress passed the Illegal Immigration Reform and Immigrant Responsibility Act (IIRAIRA), which stipulates that any non-citizen living in the United States can be deported if convicted of an aggravated felony. After indeterminate stays in immigration prison, these Cambodian-American refugees have eventually been deported in shackles to Cambodia —a country that many had never stepped foot in. The law is retroactive, meaning that many had also already completed their prison and parole sentences and were removed up to 13 years after leaving prison. Arriving in an unknown land, with few remaining family members, scant cultural understanding, and limited Khmer language skills, they experience continued stigma, social exclusion and hardship.
Oral history interviews and longitudinal ethnographic research were conducted with a sample of twelve alcohol and substance using returnees (10 male, 2 female) living in the capital city of Phnom Penh. Grounded theory and content analysis of interview transcriptions and ethnographic data identified major themes in the participants’ experiences. These themes include 1) self-reported initiation of certain substances after arrival, including alcohol, marijuana, methamphetamines, and heroin; 2) self-reported transition of drug use after deportation (ie from crack or marijuana to methamphetamines); 3) self-reported escalation of alcohol and substance use after deportation (including marijuana and methamphetamines); 4) initiation, transition and escalation of use was related to various social, economic, cultural, and environmental stressors experienced by participants; 5) and many participants experienced self-reported depression related to these stressors (as well as to the alcohol and substance use).
This paper argues that intervention, programming, and binational cooperation is needed to address some of the major stressors (such as discrimination, stigma, unemployment, lack of financial, housing and mental health support) so that post-deportation initiation, transition and escalation of alcohol and substance use can be mitigated, and depression can be addressed. The paper ends with a description of the self-organization activities that some of the participants are engaging in, with the hopes of eventually setting up their own drop-in center, which would provide peer-to-peer counselling. The author argues this could lead to potential future participatory action research opportunities with this highly stigmatized population.
Although these transnational relationships often present overlaps rather than dissimilarities with more normative/non-remunerative relationships in terms of the entanglement of intimacy and political economy, the relationships in this study are inevitably fraught due to the specific ways that gender, race, culture and power are played out in uneven terrains. The article, thus, ends with highlighting some of the psycho-behavioral consequences that result from cultural misunderstandings and failed expectations, which include depression, alcohol/substance use, intimate partner violence, self-harming and suicide—the last two of which being issues that have received little to no attention in Cambodia.
Conference Organization by Heidi Hoefinger