Puerto Rican officials have found that relocating injecting drug users to the United States is a convenient form of drug treatment and preferable to the expansion of services on the island. This study investigates the socio-psychological forces that shape and maintain this current migration and its consequences.

Participant observation data provides a basic understanding of this relocation while thematic and narrative analysis of interview data reveals specific dynamics of stigmatization, the impact of drug treatment on the state-side, and intricacies about this population's drug use, migration patterns, and treatment experiences. A life-history narrative analysis demonstrates that an understanding of the impact of relocation requires a deeply contextualized and life-course perspective.

Stigmatization and marginalization dynamics on the island foster and maintain the systematic relocation of drug users to the United States. These dynamics are based on and sustained by specific moral evaluations of drug users. Participants' treatment narratives reveal that different drug treatment paradigms have different scopes of justice. Treatment paradigms differ in where practitioners set the psychological boundaries for inclusion into or exclusion from their predefined moral community. In many instances, the relocation in geographical boundaries marks a shift in psychological boundaries of justice. Participants find the harm reduction treatment approach, more frequently employed on the state-side, offers them access to more broadly defined moral and service communities than do abstinence-based treatment programs prevalent in Puerto Rico.

A relocation from Puerto Rico to the state-side for treatment begins with a story featuring New York alleys and the relocation of a child from New York to the island-colony. A life-history approach exposes a man's life-long contention with structural limitations and human possibilities. The concept of contending with allows an intimate depiction of the complex ways a life is impacted when relocated and an individual's continuous negotiation of the intersections of service delivery, public policy, blurred state-lines, lack of resources, and a colonial version of the American dream. Theoretical implications and policy recommendations are discussed.