The chapter first describes those who learned to use drugs in Cuba and those who learned after immigration to or birth in the United States and then identifies principal factors influencing drug use, focuses on the relationships among these factors and the process of becoming a Cuban drug user, and discusses occurrences in Cubantown that have modified some of the patterns identified in the original study. Old-time drug users did not change their drug consumption behavior appreciably after arrival in the United States, but the epidemic period and post-epidemic users learned drug use after exile, and their learning process was directly or indirectly related to the exile experience. Factors influencing drug use include immigration, gangs, family environment, street inculcation, acculturation, and other institutional influences.