This blog was written by our Financial Officer, Ross Paterson.
On Thursday 17th March, at the 65th UN Commission on Narcotic Drugs (CND), Youth RISE ran its very own side event, in collaboration with the Women’s Harm Reduction International Network (WHRIN) and co-sponsored by Students for Sensible Drug Policy (SSDP), featuring contributions from a number of our dedicated team. The event, titled ‘Young Women Who Use Drugs: Breaking the Silence’, was moderated by Youth RISE Project Manager Beatrix Vas and included fantastic contributions from several other key Youth RISE staff including Ruby Lawlor (International Communications Officer), Ailish Brennan (Executive Director), Carolina Ahumada (Project Manager), and Marialba Quesada (International Working Group member), as well as guest Rita Gatonye on behalf of WHRIN. The side event aimed to expand on the themes contained in Youth RISE’s joint position paper with WHRIN, developed by an intercontinental working group of young women with living or lived experience of drug use across 10 different countries (hyperlink). It looked to draw attention to the many ways in which young women in particular experience unique challenges in the drug policy space, how they often face discrimination on-the-ground in ways distinct from other groups, and how all too often these unique sets of challenges are overlooked by policy makers and service providers alike.
After a short introduction by Beatrix, Ruby was the first to deliver her piece. Ruby began by pointing out that at this year’s CND, there had been a number of side events about women who use drugs or women involved in the drug trade, but that none had an explicit focus on young women. She went onto introduce the joint position paper and highlighted the difficulty they had encountered from the outset due to a severe lack of data available on the experiences of YPWUD in academic literature, pointing out how this has led to a situation where age and gender-specific risks, barriers and rights violations are poorly understood by policy makers and service providers. She acknowledged that age restrictions and required parental consent for Opioid Substitution Therapy (OST) is an issue for all young PWUD, but that for women there is also the added challenge of access to sexual and reproductive (S&R) health treatment. Furthermore, Ruby explained, young women who have received prison sentences experience even more difficulty accessing harm reduction services both as a result of not just their criminal record, but also their age and gender as well. As a result, she argues that harm reduction services must have both a gender and age balance so YWUD can discuss their drug use confidently in a safe space. In addition, YWUD are often targets of sexual harassment and violence as a result of stigma, in many cases at the hands of law enforcement. She finished by mentioning a paper she is working on as part of Youth RISE’s Young People and Harm Reduction series with a specific focus on YWUD in the Global South around access to harm reduction services, with YWUD facing barriers as a result of things like funding for transport to and from services, and a lack of childcare support for young mothers.
Next up was Ailish to discuss the huge challenges faced by young trans women who use drugs. As a trans woman who uses drugs herself, she detailed many of the challenges she and others in the trans community experience. She explained how her trans identity and use of drugs are not distinct. On the one hand, drugs have allowed Ailish the freedom and space to explore her gender identity with peers who love and accept her. On the other, however, the intolerance directed towards the trans community from wider society has contributed to her increasingly harmful use of drugs as a means of self-medication. This has only been compounded by the trauma caused by her horrific experience of violent assault. Ailish noted that the experience of stigma and discrimination sadly manifests most acutely during interactions with healthcare professionals and law enforcement. In the case of the former, there is a lack of experience and understanding of transgender medical needs and she feels unable to disclose her use of drugs for fear of losing access to trans-specific healthcare. In the case of the latter, gender sensitivity is low and there is little sympathy for trans people as well as PWUD. She described the suggestion that she should call the police when being targeted by transphobic harassment or violence as “laughable”, given the poor track record of law enforcement in dealing with both trans people and PWUD. She acknowledged that, despite the many challenges she has to face, she is in a privileged position in comparison to many others insofar as she has a stable income and relatively affordable housing and healthcare, as well as the fact she is white and lives in a country where her gender identity and sexual orientation are not criminalised. She went on to note that, while the goal of ending stigma and discrimination against the trans community is beyond the scope of the CND, what is possible in this forum is the development of policies to improve access to gender-sensitive harm reduction services. Ending the criminalisation of PWUD and LGBT+ communities will improve the health of these communities. However, she explains that there is a general reluctance to push for policies which will allow her community to thrive.
Following Ailish’s powerful contribution, next up was Rita to discuss S&R healthcare and rights in the context of YWUD in Kenya. She explained how S&R services are poor in Kenya generally, but for YWUD, the situation is even worse. Drug use in the country is largely seen as “problematic”, and the social climate there criminalises PWUD. Thus, access to these services for YWUD is impeded by a huge amount of stigma. Furthermore, harm reduction services in the country are age restricted, meaning people under the age of 18 may not access these services without a guardian present. However, the obvious problem with this is the inevitable reluctance of young people to disclose their drug use to their parents due to stigma, meaning that in most cases they are unable to access services at all. She explained that violence against YWUD is a huge issue in Africa more widely, including sexual violence and rape. When these YWUD become pregnant, doctors have an exaggerated focus on the patient’s drug use which in turn discourages women to engage with services in the first place. She described how, in Kenya, sexuality and drug use are “about as taboo as they come”, with little (if any) access to harm reduction information available to YWUD such as how certain drugs may affect fertility. Furthermore, Rita explains how YWUD in much of Africa are completely unaware that S&R rights are actual rights, and argues that education about S&R rights for YWUD can help to prevent recreational drug use from becoming problematic. In this way, S&R health should be taken seriously as a minimum requirement in harm reduction service provision.
From Kenya to Costa Rica, next up was Marialba to turn our attention to the situation for YWUD in Latin America. Systemic violence against women on the continent is a huge problem, and unfortunately there is a distinct lack of data and a great deal of misinformation around women who use drugs. Gender-based killings, access to justice, and sexual violence are some of the main problems reported by women in Latin America, with race and ethnicity playing an important role. Marialba notes that there is a correlation between violence against women and their decision to use drugs, and unfortunately prosecution efforts tend to be directed most often towards the least responsible actors in the drug trafficking chain, such as poor women and children, small scale dealers, women used as couriers, and young PWUD. This is reflected in prison data from a range of Latin American countries, where the vast majority of women are incarcerated for non-violent drug-related offences – often as a result of poverty, lack of opportunity, and male coercion and violence. This is the case for 48% of female prisoners in Bolivia, 65% in Argentina and Costa Rica, 68% in Chile, and 80% in Colombia, Ecuador and Mexico respectively. Marialba concluded by asking whether a lack of information can be considered a form of violence against women who use drugs, pointing out that the lack of data available around YWUD was indeed one of the primary motivations behind the Youth RISE and WHRIN joint position paper published in 2021.
Finally, it was Carolina’s turn to speak about access to harm reduction services and how these can be tailored for YWUD. Carolina began by highlighting that women are the most likely group to make use of harm reduction services where they are available and the least likely to take drugs that are known to be adulterated or of unknown purity and quality. In this way, we can see how harm reduction measures like drug testing can be extremely effective for YWUD. However, she explains that most harm reduction programmes are not designed to respond effectively to the needs of young women as they are under- represented in research on drug use. This leads to the specific needs of YWUD going unrecognised or not being well understood by medical professionals, policy makers and service providers. For instance, there is little information disseminated on things like interactions between certain drugs and birth control medication or how drug use may impact periods. Women have been shown to respond well to programmes that are women-centred and peer-led, and so it is vital that the staffing structure of harm reduction services reflects this fact. This is especially important in order for women to feel safe talking about sexual harassment or violence where drug use is often used as a means to justify, normalise
or minimise violence against women. Carolina makes further recommendations for poster campaigns in places like bar and nightclub bathrooms featuring anti-harassment messages and information on consent. She then concluded by citing the key recommendations of the position paper, which can be found here.
Despite its targeted focus, the side event was incredibly wide-ranging in scope and approached the topic of YWUD from a multitude of different angles and localised experiences. As a young man who uses drugs, I was acutely aware throughout the duration of the event that I have never, and will never, experience any of the challenges discussed. As a male, I will never have to overcome barriers to access services, never have to deal with the added stigma reserved exclusively for women who use drugs, and I benefit from over-representation in research data on drug use. All of the challenges addressed during this event are structural in nature and reflect the male-dominated, patriarchal society in which we live. As such, the systemic nature of these challenges make them inherently difficult to overcome. But starting a dialogue about these issues in influential spaces like the CND, raising awareness of the multitude of failures at every level – from research to policy and practice – can only be a positive first step on the long journey to a truly inclusive and compassionate drug policy environment which accounts for the specific needs of young women and the context surrounding their involvement with drugs in the first place. Change
in this regard will no doubt be frustratingly incremental, and many states are likely to resist any form of progress. But this fact only goes to further demonstrate the vital importance of the conversations generated by events like this one, which offer hope for YWUD around the world whose specific needs are so often side-lined in drug policy considerations.