The Pastoral Clinic: Addiction and Dispossession along the Rio Grande

Garcia challenges the accepted narrative of an individual with drug addiction as someone who exists in isolation. Contemporary stereotypes about these individuals center on the lone heroin user who is estranged from family and friends. Throughout her research, Garcia uncovers the interconnected and intimate ways in which heroin becomes a binding agent for the community. Both drug use and recovery are bound within familial ties, and it is common for intergenerational drug use to take place. Garcia proposes that heroin addiction is part of the ties of kinship and finds cultural and communal roots.

Additionally, she unravels the conventional idea that only men experience addiction. The two mother-daughter pairs she describes in this chapter reveal how drug addiction is interwoven with relationship and contextual factors: “By presenting intergenerational addiction as part of the biological, social, and affective mix that is kinship, I show how heroin works through, and provides endurance for, ties of blood and property, of inheritance” (114). Bernadette and Eugenia’s story is a powerful example of how addiction ties people together. Despite Bernadette’s difficult upbringing, she feels close to her mother and worries about her. She asks about her often and sends help when she can. The story of Lisa and Michelle also contributes to how familial ties impact heroin use. Garcia learns from staff at the clinic that family members often return to heroin use to cope with a loved one’s death. However, Garcia asserts that heroin is also used to immortalize and honor the dead. Law enforcement officers inform Garcia that many arrests take place at cemeteries, where family members use drugs at their loved one’s gravesites. The researcher proposes that while drug use has devastating effects, it also binds people together in their melancholy, solidifying a never-ending cycle. For example, Lisa describes the sense of relief she felt when she and Bernadette began using the drug together. Rather than feeling alone in her addiction, Lisa now had a partner in grief.

Like Alma in the previous chapter, Bernadette and Eugenia experience the effects of land loss. Eugenia’s father, Eugenio, was the first in his family to not inherit the land that belonged to his ancestors. While he did his best to keep his family’s farm alive, the loss of ancestral lands forced Eugenio to seek work elsewhere. This serves as an example that while loss is shared from person to person, it is also a part of an inheritance, passed down. The women in this chapter embody this ancestry, with each mother passing her grief and addiction to her daughter.

While their identities as “addicts” are forged by their familial relationships, the women in the chapter are also defined by the external structures that command them. The privatization of prisons adds to Garcia’s argument within the theme of The Institutional Shaping of Identity. The corrections officer who provides Garcia with a tour of her prison is excited about the incentive programs offered there. Garcia notes that these incentives are tied to religious conversion, another example of how institutional structures can strip people of their histories and cultures. The women in prison are often placed in solitary confinement, and their participation in the religious aspects of the prison provides them with community. Additionally, access to education is not made available to those who do not convert. This highlights the way coercion in prison systems erases people’s communities and culture, which can exacerbate feelings of alienation and melancholy. Central to Garcia’s Critique of Conventional Approaches to Addiction Treatment is the way that the decentralization of addiction care and a failure to account for the contexts that inform drug use leads to further disenfranchisement and recidivism. The New Mexico Women’s Correctional Facility is the largest employer in the region, showing an intrinsic relationship between New Mexico’s economy and drug use. The institution's private nature adds to prisoners' vulnerability by forcing them to either convert or suffer the consequences.