Side Event: Young Women Who Use Drugs – Breaking the Silence

Organized by the Youth RISE (Resource, Information, Support, Education) Limited with the support of the Women and Harm Reduction International Network

This side event is inspired by the ‘Young Women and Drug Use’ position paper by YouthRISE and WHRIN: https://youthrise.org/resources/young-women-and-drug-use-position-paper/

Six young women who use drugs (YWWUD) from around the world discuss the shared and nuanced challenges faced by YWWUD and our recommendations to mitigate these challenges. Co-sponsored by the Women and Harm Reduction International Network (WHRIN), Students for Sensible Drug Policy (SSDP), and the Norwegian Delegation.

 

Moderator: Beatrix Vas, Youth RISE and UNITE – Global Parliamentarians Network

This event is organised by YouthRISE, SSDP International, WHRIN and Norway.. This side event is inspired by the ‘Young Women and Drug Use’ position paper by YouthRISE and WHRIN: https://youthrise.org/resources/young-women-and-drug-use-position-paper/ by young women who use drugs. People in Ukraine are at increased risk, we are very concerned about our friends in Ukraine, Russia and Belarus – their access to critical health services and OST is jeopardised that the moment. EHRA are running a crowd funding campaign at the moment – we will share details in the chat. Today is about women who use drugs, whose needs are rarely addressed in forums like the CND. Our whole panel is made up of young women who use drugs.

Ruby Lawlor, Youth RISE and Uganda Harm Reduction Network.

Delighted to see so many people here to break the silence. This year at CND there are a number of side events on women, but nothing else on young women specifically. This is why we came together with WHRIN to establish the paper. We came together as young women who use drugs and those working in harm reduction provision. We met challenges in identifying the issues in lack of data on women who use drugs – this can be felt all around the world. Policy makers and service providers are not aware of issues related to gender and respective factors. I am a woman who used drugs who has lived in the Global North and the Global South. I work at the only harm reduction service for women in Uganda. We experience specific barriers that are not recognised by policy makers. The minimum age of consent is met with discrepancy. Young women involved in drug trade are heavily impacted when imprisoned. Young women who use drugs can receive life altering criminal sentences due to their ago. Stigma and discrimination is worse for young women. Most women who use drugs who use drugs start at a young age and are at risk of overdose. Harm reduction services must have a gender and age balance. Young women who use drugs often experience harassment. I’m writing a paper for the young people special edition of HRJ about challenges faced by young people in global south. Young women who use drugs cannot be expected to pay to travel to services with no support for children.

Ailish Brennan, Youth RISE Executive Director

Thank you Trixi and thank you to everyone for joining our side-event today. Before I start I would just like to extend my love and solidarity to our friends and colleagues in Ukraine, and in particular the trans* and drug using communities in Ukraine. The situation for my community, trans* women, in Ukraine and at the border crossings is extremely worrying. We need to see action from all parties, to ensure the safe passage of key population groups out of Ukraine and all war zones, while ensuring we maintain their access to healthcare and other essential services. While the situation for my community in Ukraine is much more critical than the issues I will discuss today, the root causes of stigma, discrimination and transphobic policies are the same.

As Trixi mentioned I am a young transgender woman who uses drugs. These two components of my identity, being trans and using drugs, are not distinct from one another and interact with each other in a multitude of ways. My trans identity is inherently connected to my drug use and impacts why I use drugs, when I use drugs, and where I use drugs. Drug use has provided me with freedom and space to explore my gender identity, and people who use drugs were among the first to embrace me and accept me as a trans woman. In this way drug use and the drug using community provided me with something general society often could not – love and acceptance.

It is this lack of acceptance from wider society that further impacts my drug use, in negative and harmful ways. The trauma of being attacked in the street has led to an increase in the amount of drugs I use by way of self-medication. It has led me to use drugs more on my own, isolating myself from my community and the support and solidarity that comes with that, an issue which was further exacerbated by the pandemic. It has led to me engaging in more unsafe drug using habits, consuming more drugs and engaging in polydrug use, as well as avoiding what few services are available to meet my needs as both a trans woman and a young person who uses drugs.

This stigma and discrimination from wider society is often manifested when dealing with public health and law enforcement professionals. Healthcare professionals are often unsuited to meet my needs as a trans woman, lacking knowledge of our experiences and medical needs, as well as often disregarding the information I do provide them with. I am unable to disclose my drug use to them for fear of losing access to essential trans-specific healthcare such as hormone replacement treatment and surgeries.

My experiences with law enforcement have been far from positive too. Gender sensitivity among law enforcement is usually quite low and they demonstrate little sympathy towards trans people and people who use drugs. This combined with the gender marker in my passport delineates that I would likely go to a male prison if arrested, the results of which would be catastrophic for my well-being.

When I am the victim of transphobic harassment or assault, it is often suggested that I should call the police. This is an almost laughable suggestion. The idea that I as a trans woman who uses drugs, or even just a person with either of those two identities, would be safer in the presence of a police officer is very far from the reality I have faced, and the track record of law enforcement.

Despite all of this, I can consider myself to be quite privileged. I am lucky enough to have a stable income and relatively affordable housing and healthcare. I am in a position to speak with you all here today and act as a voice for my community, many of whom are not so privileged as me. I am white and I live in a country where my gender identity or sexual orientation are not criminalized. I am thankful that the gender marker on my passport being different to my gender identity does not have any significant impact on my daily life. The same cannot be said for my community in many parts of the world.

My community, from me sitting here today, to the trans* people we now see in popular media or even sitting in parliaments around the world, all the way to the trans* women trapped inside a warzone or facing violence on a daily basis around the world. We need to see a society free of stigma and discrimination, a goal which is unattainable through the scope of the work of the Commission we are all attending today.

However, within the scope of the Commission, and within the scope of the policymakers attending this Commission, there are avenues for positive change. We know that easily accessible and gender-sensitive harm reduction services have a positive impact on the health and well-being of my community. Similarly, we know that policies which allow trans* people autonomy over their bodies and access to life-saving trans-related healthcare are extremely effective in improving the health and well-being of my community. We know that if we end the criminalization of people who use drugs and the LGBTQ+ community, this will improve the health and well-being of these communities.

Despite the evidence towards these policies, governments and policymakers who dictate our lives are reluctant to offer us even the slightest of change. In many countries, we are even seeing positive steps being undone in this regard, to the massive detriment of my community. We can see the evidence, in particular in relation to the global target to End AIDS by 2030, that these policies are effective. However there remains a reluctance, at least in part because some people simply do not want to allow my community to thrive. I will end by paraphrasing a well-known trans activist Marsha P. Johnson in saying that there is no pride for some of us, without liberation for all of us, and that includes the most marginalized communities of both trans* women, and people who use drugs. Thank you.

Rita Gatonye, Women In Response to HIV/AIDS and Drug Addiction, VOCAL Kenya, SSDP Kenya Chapter

I am a woman who uses drugs in Kenya and my use has been largely problematic. People bury their heads in the sand when it comes to gender and drugs. There is a lack of awareness and access to services. My country has a high rate of teen pregnancies.

Mariabla Quesada, Latin America for a Sensible Drug Policy, Youth RISE LatinX.

Systemic violence against women who use drugs

Concept of systemic violence against women in general. Challenges of Latin American women: Gender based killings, access to justice, sexual violence. Women in our region continue to face serious challenges when it comes to having their fundamental rights fully respected.

It’s important to emphasise that factors such as race and ethnicity play a preponderant role in the experiences of violence and discrimination in the lives of Latin American women. Now we can talk about the correlation between violence against women and our decisions to use drugs.

Latin American women face structural violence that has increased and intensified. Cruelty against women has increased, and further vulnerabilities are identified. Prosecution efforts have ended up concentration on the least responsible actors in the chain, including young women who use drugs. There are domino effects for people associate with legal markets. “Beyond its rhetoric, prohibition is not put into practice in a coherent way […]”

A high percentage of women prisoners in Latin America are serving sentences for non-violent drug-related offenses, which in most cases are a direct result of poverty or lack of other opportunities who have suffered violence from their partners or other men. Globally more than 500,000 women who use drugs are imprisoned and awaiting trials. Women who commit crimes even if they are non-violent are seen as if a man did the same action.

In Bolivia, the IACHR state that 48% of Bolivian women in prison are deprived of their liberty for drug-related crimes. Living conditions of Indigenous populations are not good. In Ecuador, 80% of women are charges with drug-related crimes. In Mexico, the same. 92% of those committed those crimes without weapons or violence. 65% of the 780 Costa Rican women are convicted right now.

Can lack of information be a form of violence against women who use drugs? Yes – noting the comments made earlier on lack of research in this area.

Caroina Ahumada, Youth RISE, and PAF! from Intercambios Asociación Civil.

Good morning/afternoon everyone. It’s a pleasure to be here with these amazing young women.

I’m gonna speak today about the importance of harm reduction services for young people who use drugs and what we can do as service providers to tailor our programs for young women. I have been working at a harm reduction project for young people in lightlife in Argentina for the past 5 years and became its full time coordinator last year.

Young women are among the most likely to make use of harm reduction services whenever they are available, and are also the most willing to discard or opt out of taking substances that prove to be adulterated or of unknown purity and quality. Drug checking is accordingly a very effective harm reduction approach for young women who use drugs in nightlife and festival contexts. It is highly recommended to provide /drug sample/pill- testing services in such contexts to help young women make more informed choices about their substance use.

As we claimed in the position paper last year, while harm-reduction has proven effective in improving health goals among people who use drugs, current programmes are generally not designed to respond to the needs of young women or the specific legal challenges and ethical concerns in working with them. This is mainly because young women are underrepresented in health research on drug use, which leads to their specific needs going unrecognized or not being well understood by medical professionals, service providers and policymakers. For example, what happens when women use drugs and take birth control pills or how drug use may impact on our periods. Even though this gap is not well documented, young women and adolescent girls interact with drugs in multiple contexts, and face all of the same risks and challenges that adults who use drugs, only exacerbated by age and gender-related factors. Research and clinical experience has shown that women and girls respond well to programmes that are women-centred and feature meaningful involvement of women who use drugs, while in populations of young people there is evidence of the greater efficiency of programmes that are peer-led or involve peer support.

It is also imperative that the staffing structure of harm reduction services strive for a gender and age balance, as young women may feel better able to discuss their drug use with their peer young women. This is especially important in instances when young women report experiencing sexual harassment and violence in contexts as women’s drug use is often used to justify, minimize or normalize the violence they face. An effective action for interventions in nightlife is for example, putting posters in bathrooms with anti harassment messages and consent.

Finally, I’m going to read recommendations we put up in our position paper:

  • End the criminalisation of drug use
  • Institute strengths-based client-led support programmes for young women who use drugs in need to replace punitive approaches to drug use
  • Remove policies and laws related on age restrictions that affect access to harm reduction services and commodities, SRH and health care
  • Remove parental consent requirements on health care services, including SRH services, and establish effective confidentiality guarantees
  • Promote gender equality and gender transformative programmes in harm reduction
  • Increase the use of alternatives to imprisonment (in line with the Bangkok Rules)
  • Expand provision of youth friendly, gender sensitive harm reduction services for women who use drugs (incorporating comprehensive SRHR, GBV and counselling services attuned to the needs of young women)
  • Ensure the capacity of harm reduction staff and other healthcare workers to provide youth and gender friendly services
  • Support community-based organizations that are inclusive of young women who use drugs
  • Support youth-led organizations to produce advocacy and action research highlighting the needs, priorities, and voices of young women who use drugs
  • Create frameworks for acknowledging young women under-18 who use drugs and are involved in the sex industry to recognise and protect their rights and needs
  • Support widespread drug testing to enable safer use

 

 

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