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A Dispatch from the War on Women Who Use Drugs

In the global war on drugs women have become the invisible casualties.


Representatives of the International Network of People who Use Drugs (INPUD)

Being imprisoned for sex work after testing positive for HIV, an increased likelihood of domestic violence, the removal of children, and a heightened risk of contracting blood-borne viruses: these are some the hardships faced by women who use drugs around the globe. The silence created by the stigma surrounding their drug use, coupled with a lack of adequate programs designed to service their needs, renders these women invisible casualties of the war on drugs.

At the recent International AIDS Conference in Melbourne, a group of drug activist women came together to for Women Drugs Users: Our Voices, Our Lives, Our Health, a seminar discussing the difficulties encountered by women who use drugs in their own countries. In August, to help improve the lives of female drug users, the United Nations Office on Drugs and Crime (UNODC), UN Women and the International Network of People who Use Drugs (INPUD) released a joint policy brief, calling for gender equality in the field of harm reduction. The key outtake: there is much to be done.


A victim of domestic violence in Tanzania

In Tanzania domestic violence is rife and widely accepted, with statistics from a 2010 report showing that 39 percent of women surveyed between the ages of 15 to 49 had experienced it. But the situation is much worse for women who use drugs. In a recent, yet unpublished Pangaea study, 93 percent of women drug users who were not on an opioid substitution program reported experiencing domestic violence.

Susan Masanja, founder and coordinator of Real Activist Community Tanzania, spoke about the situation at the International AIDS Conference. Masanja is a long-term drug user who’s experienced domestic violence and undertaken the drawn-out court process to receive a protection order. She said when women do report an incidence of violence to police, their drug use is often used as a reason to dismiss their claims.

Masanja also explained that because of the stigma that comes with drug use, many of these women find it difficult to gain employment and turn to sex work. They then face being arrested and at times forced by police to have sex in return for their release. Although there is no accurate data available, Masanja believes that most women who use drugs in her country have hepatitis C, while around 80 percent are living with HIV.


Susan Masanja.

“There needs to be more harm reduction services, first of all, and sexual reproduction and health rights. Lots of women have sex without any protection. You need education about family planning,” explained Masanja. In regards to domestic violence, she said: “There needs to be more advocacy networks… because in our culture and tradition it's OK for a woman to be beaten by a man.”

Due to the issues being confronted by these women and others like them, the UNODC joint policy brief entitled Women who inject Drugs and HIV was released last month. It outlines that most harm reduction programs are geared towards men, so changes need to be made to these services addressing the specific needs of women. In order to have gender equality in harm reduction, it is essential that women who use drugs are involved in the development and implementation of these programs.

Monica Beg, chief of the HIV/AIDS section at UNODC, told VICE that women who use drugs face unique challenges because of physiological factors, such as pregnancy and that they are more likely to acquire HIV than male drug users. “This requires a wide range of tailored services for women who use drugs beyond standard harm reduction services,” she said. “To move forward and quicken the pace of the response we will need commitment and we will need champions starting from senior policy makers to programme managers… to say straight and loud that accessing gender responsive harm reduction services is not a privilege—it is a right.”

In 2012, the Greek health minister Andreas Loverdos instated Provision 39A, allowing Greek authorities to carry out the forced HIV testing of hundreds of women in Athens. The move, which was condemned by human rights groups around the world, led to the imprisonment of 31 female drug users. They were accused of being sex workers and—because they were living with HIV—causing serious bodily harm to their clients.

Chairwoman of the Greek Drug and Substitute Users Union, Efi Kokkini, described this incident as “one of the most terrible human rights violations in Greek history.” At the seminar, she explained that these women had their names and photos revealed to the media and some remained in prison for up to ten months. It was subsequently found that only one of the women was actually a sex worker.

Kokkini, who injected drugs for many years, is now on the methadone program. She thinks that women who use drugs and sex workers need to mobilise and claim their human rights. “Drug use would not be demonized if a safe environment was available to drug users, if the war on drugs, prohibition and criminalisation stopped today and harm reduction practices were established to heal the wounds this war has caused,” she said.

Nyah Harwood, a PhD candidate at the Centre for Social Research in Health at the University of New South Wales, spoke at the seminar about trans women who use drugs. She said trans women have never been assigned an epidemiological category, so when research is carried out and in harm reduction programs, they are often overlooked. Although there is little data available regarding trans women who use drugs and HIV rates, she stated that the rates are extremely high. Harwood pointed to a 1992 study in Rome cited by Viviane Namaste, which found that 100 percent of trans women who use drugs were living with HIV, when they’d lived within that same environment for a period of four years.

According to Harwood, when harm reduction programs are being developed by governments, the most vulnerable people in the community should be consulted, those being: indigenous people, trans people of colour, sex workers and injecting drug users. “The things that destroy people's lives are the laws that we have around drugs and drug use,” she said. “The laws that we have at the moment criminalise people. They stigmatise people who use drugs and therefore people don't want to go and get tested for blood-borne viruses. They don't want to get treatment and everything to do with drug use is done in the dark trying to hide away from the authorities.”

Jude Byrne, chair of INPUD, said that because of the societal standards placed upon women, often women who use drugs don’t speak about their experiences or utilise services and “hide because they're children will be taken off them.”

Byrne was on the committee that helped write the UNODC joint brief. She sees the brief as an important statement, as it is coming out of an office that is renowned for its prohibitionist stance. “For them to come out and say that women who use drugs are struggling and put a paper out on that indicates that even they get it,” she said. “Even the top organisation globally that supports prohibition is saying that women are really suffering, on what on the one hand we're supporting, but on the other hand we see is not helping.”

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