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In the midst of nation-wide call for the application of a medicalization approach to the current heroin crisis in rural America, thousands of immigrants continue to be deported on criminal grounds due non-violent drug charges. Using Dominican deportees as a case study, this study explores the intersectional factors at play in this paradox, documenting some of the most severe risk outcomes derived from the War on Drugs, as applied to non-citizens of color. This paper is part of a larger ethnographic study conducted from 2009 to 2016 in Santo Domingo, involving quantitative (N= 130) and in-depth interviews (N= 62), (including a series of follow up interviews to a sub-group of twelve participants). Research findings illustrate (1) patterns of social exclusion and structural violence exercised against returned Dominicans upon arrival; (2) high rates of sexual abuse against female deportees; and (3) states of anomie and subsequent risk-seeking behaviors among deportees, such as heroin and crack misuse.