October 20th, 2016
Women’s health is an essential piece of harm reduction and drug-user health. Last week’s news that Vancouver is planning a supervised injection facility just for women is inspiring. But far too often, we lump services together and fail to see the importance of specific programming for women who use drugs.
Sadly, most people just don’t know much about the hidden experiences of drug-using women. But everyone has an opinion.
Women who use drugs are especially demonized—the “addicted mother” is a stereotype hated by virtually everyone. Yet due to power imbalances, sexual assault and other forms of abuse, gender-based stigma and, in some cases, physiological or biological susceptibility, women who use drugs are in many ways at an increased risk of disease and harm compared with men, and therefore need tailored help.
It is unacceptable that in many communities, no services exist that women can count on to guide and support them in their drug use, decision-making and living. To help shed light on the importance of gender-specific programs, I want to share a small piece of my life with you.
I have experienced three pregnancies in my life, and I was using drugs—different kinds, and in different ways—when I found out about each of them. Our society understands drug use as a one-way trajectory from gateway to chaotic or addictive use. That is not my story.
From the age of 13, drug use has been a part of my life, but the kind of drugs I use, the way I use them, and the rapidity of consumption is not at all a one-way path. Rather, it is usually related to: the pace at which my partner uses and the pace he accepts my use; housing stability; external stressors like court dates; the strength of my connection to my family, my community and my friends; and my overall mental health.
The reproductive decisions women often have to make have major repercussions. These decisions should not to be made lightly, or without a firm understanding of options and available resources.
But there was no group or service I felt like I could turn to for help. No one I could trust. None of my pregnancies were planned and none resembled what you might think of when you think of pregnancy. No balloons, family pictures, showers—instead, for me, pregnancy represented loss and hardship.
My first pregnancy occurred when I was 16. I was running with a group of Grateful Dead-following hippies. We smoked pot, drank alcohol, ate hallucinogens and occasionally dabbled in cocaine. After much pressure from my then-boyfriend’s mother, I made the decision to have an abortion. I was not able to cope with this decision, and was too embarrassed to talk to anyone. I moved out of my parents’ house the day I had the abortion and did not move back in.
And I handled the emotional turmoil the way I always handle difficult situations: with heavy and chaotic drug use. I began smoking crack, taking handfuls of prescription pills and drinking heavily. Having no support and no idea how to handle such a decision, I depended on the only real coping skill I had.
I went through over a year of destructive and chaotic drug use, sexual risk-taking and intense self-hatred. One thing that is consistent in my life is negative self-talk and an overwhelming belief that I am not good enough and never will be. Constant negative thinking and obsessive negative thoughts are one of the reasons I use drugs: Doing so, for me, reduces the unbearable negative noise.
Aged 21, I again became pregnant, this time with a biracial child (I am white). This did not go over well in my family here in Greensboro, North Carolina. At the time I smoked crack, drank alcohol and used prescription pain pills. When my family disowned me, I lost their emotional and financial help, and with all of the stress and my inability to cope, I quickly became homeless. Life was then stressful in ways I had never before dealt with.
For the first time in my life, I became a victim of physical abuse. The stress of our situation and my emotional turmoil was more than my husband could cope with. Being hit by the man I loved was beyond comprehension for me. I felt the world was against me. What was wrong with me?
I just remember wanting to die. Many women are abused for the first time in their lives when they are pregnant. And in many ways, pregnancy can be the most dangerous time in a woman’s life. Women with mental illness often use drugs to cope and they are also at increased risk for postpartum depression.
After having a baby, things became even more difficult. With the help of his family we were able to secure housing, but the abuse continued and I was not able to stop using. My husband’s use escalated and he began experiencing cocaine psychosis. He was extremely paranoid and often paced around the house with a shotgun, loaded and ready.
He thought I was the FBI working undercover. He would shut the electricity down and we would sit in silence for hours. He thought the TV was sending messages.
I was terrified. I worked and did all the housework, while he either went out to clubs and cheated on me or stayed home and interrogated me about the paranoid delusions he was having. I feared for my daughter’s safety and my own.
Then one evening, my husband reported a pain in his kidney and went to the hospital. He ended up having a rare form of cancer and he died very quickly. I had a terrible time dealing with my confused feelings over his death.
Five years later, my third pregnancy came as a complete surprise. I was on Depo-Provera (birth control), and I rarely had a period during this time in my life—a time when I continued to use drugs, but in a more normalized way.
I did not realize that many women who use opioids stop having their periods. No one really talks about this.
And things had been going pretty well for me: I had re-enrolled in school; my drug use had stabilized; my family relationships were growing more positive.
This time, once I found out, I was already five months pregnant and had had no idea. As soon as I told my family, I was disowned again. Since I was already five months pregnant, I had no choices about what to do.
I totally lost it. Meanwhile the father of the child became increasingly abusive and difficult. (After I was physically abused by my husband, I spent the next 10 years with abusive men; it became a pattern for me. I seemed to somehow unconsciously pick abusive partners.)
Upon finding out we were having a baby, he immediately began selling drugs so we would have money to pay for the baby. I dropped out of school because there was no way to finish, and I ended up giving birth about a month early.
I have never felt so crazy in my life. This pregnancy ended with postpartum psychosis and my inability to care for myself or either of my children.
I left the man and the child.
Broken, alone and confused, I spun into the arms of the most abusive and by far the sickest man I have had in my life.
Women who use drugs are often influenced by their drug-using partners. My past boyfriends introduced me to drugs, and I was very dependent upon the men I was with to show me how to use and what to use. I always depended on the men I was with to make my shots, inject me and help me get high.
But the man I was with next was different. He sold drugs but did not use them. He was truly dangerous. He was addicted to power and money. I worked for him and sold cocaine for him.
After I realized how dangerous he really was, I tried to quit. I begged to leave. I even paid him large amounts of money so that I could stop working for him. He would take the money and agree to leave me alone, but the next day he would come barging into wherever I was, and he would beat me, humiliate me and rape me.
Like so many women who use drugs, I did not consider the police as an option for help. You can’t call the police if you are a criminal, and if you are working for a criminal you never call or threaten to call the police.
Rape, abuse and terror were my life. By this point, any semblance of self-respect I had was gone. I was completely stuck. I could not leave him because I was so addicted and completely financially dependent on him. I drove his car, lived in his house, and sold his drugs. He was how I survived. This was what he liked. He wanted me to need him to the extent that he had complete power over me.
The pain of my life exacerbated my drug use. Now I felt like I was using combinations of heroin and cocaine just to survive. I had a terrible time hitting my veins; like many women, I have very small veins. I did not know how to protect myself from hepatitis C, or overdose. I regularly let other people make my shots and inject me because I had such a hard time doing it myself.
Too many women have men inject them and fix their shots. They report there is a certain intimacy to having your man inject you. But we need services to help women learn how to take care of themselves and their own health—this is so important.
Looking back, I’m lucky to be alive. By 28, I had hepatitis C and a MRSA staph infection in my blood. I could barely walk. My legs had huge abscesses on them and my arms were blistered with track-marks.
I showed up in an emergency room, ashamed and terrified, and said, “Please help me.” Doing so didn’t mean that things went happily ever after, but it did wind up being a good move.
This is just a snapshot of my life. One woman, one experience.
There were so many times and places where, had there been the right kind of help available, I would have benefited from it. Had anyone been willing to listen or counsel me about safer use or shared harm reduction strategies and techniques,it could have changed everything. We must stop believing that there is nothing we can do for people until they stop using. This is simply not true. There are so many places we can intervene. We need pragmatic,solutions that accept the reality that not all people are able or willing to be 100-percent abstinent.
Women who want help for substance use issues are often too afraid to look for help—and when they do feel they can reach out, there is often very little to reach out for. There are not many drug treatment centers or support groups where child care services are available, for example. And the treatment centers that are available for both mother and child are almost always faith-based, with a 12-step component—not necessarily helpful for many women. I have never seen one that allows mothers to be on medication-assisted treatment.
Women are afraid of people knowing about their struggles with drugs—and we have reason to be.
Read more from The Influence:
It is not safe to tell anyone you are a mother who uses drugs. Child Protective Services is notorious for being overly aggressive and disagreeable to women who are caught up in the system because of drug use. I have never heard a CPS-involved woman report that it felt like she had a team working to improve her and her child’s life; many report CPS involvement as feeling like punishment.
The hurdles and dangers placed in front of women drug users are so severe that many simply give up and give in. We have to stop punishing women and start providing services—harm reduction, treatment and other forms of support—that are built around what we know about the specific difficulties and barriers that women face.
Louise Vincent is the national director of the Urban Survivors Union, an advocacy and support organization of people who use drugs, and the founder of the North Carolina chapter. She and her work have previously been profiled on The Influence in an article by Kat Bawden: “‘Light That Fire’—How Drug User Unions Fight for Better Laws and Self-Defined Recovery.” You can follow her on Twitter: @WeezieBeale.