Life can be particularly challenging for girls living with addiction in Serbia. Read the call from our Serbian partner organisations, for a gender-sensitive approach to helping substance users.
There once was a girl who lived with her mum and dad. The girl started to use marijuana and alcohol, and developed anorexia. Shortly after her initiation into drug use, she began using heroin. At the age of 19, she entered drug addiction treatment, and recovered. Her mum had AIDS and rejected any kind of psychological help and support. A year passed, and the girl was in successful abstinence. She was at home, looking at old family pictures. She found an old photo of her dad with a needle and syringe in his vein, and wearing the familiar facial expression of a heroin high. Some years later, the girl was still struggling with anorexia, her mother's disease, and her knowledge about her fathers’ past. The girl relapsed. She became a sex worker. While she was working on the street, her pimp cut her long hair and she was beaten numerous times. At the age of 22, she got tested for HCV and HIV. A few days before the results were due, she found her peace of mind. When she saw the test results, she just said, “I am HCV positive” and lit a cigarette. While the smoke was disappearing on the wind, she looked as if her peace of mind was completely gone. After that day, she left the city. She was very beautiful, smart, with a childlike shy smile.
There are many girls who are alcohol or drug users. They use drugs and alcohol with their friends, but they also use drugs and alcohol alone, hiding from everyone. They walk through the town, searching for drugs in pharmacies, smiling and acting tough in order to hide that they have failed. Failed at being princesses, good girls, successful and beautiful according to society's norms. Failed, in a famous test that says, “Addiction diseases are not for women!”. In order to avoid thinking about the factors that could lead to addiction, the main focus tends to be on the question, "What can be done about it?"
There are numerous weaknesses in all countries, as well as in Serbia, which ensure that stories like this one have a similar end. From the description above, peace of mind is important, because it shows how an individual can completely lose the strength to influence and direct their life. With problems accessing help within the health and social system, carrying the burden of stigma and prejudices, especially related to women and alcohol or drug addiction, there are numerous young women who give up their life. The principal factor involved in facing addiction, is facing the prejudices. When it comes to HIV or HCV, the situation is similar. There is no psychological support for women with children, and there is no special help for kids with HIV- and HCV-positive parents in Serbia. These women often walk in the shadows, alone with their worries and difficulties.
In comparison to men, women are less likely to initiate treatment. Official data show that the ratio between women and men in alcohol use is 1:3, with a tendency to parity in urban areas. At adolescence, this gender difference is almost nonexistent. Data show that women have an 80% success-rate in drug addiction treatment, but that 81.7 % of clients in harm reduction programs in Serbia in 2011 were male. In Serbia, women aren't often seen in drop-in centres, they rarely visit, and they often send someone else to pick up injecting equipment for them. Their model of drug use is mainly home-based.
When it comes to opiate addiction, 62.5% women initiate and develop addiction within an emotionally close relationship, mainly with their partners. Levels of sexual (21.9 %) and physical abuse (40.6%) are high, as well as levels of depression (56.3 %) and anxiety (84.4%). Data show that women with an addiction are less likely to cause a car accident or to be involved in criminal activity, but they are more likely to be victims of such behavior
Through internalisation of responsibility for obtaining drugs, as well as fear of experiencing psychological, physical and sexual violence, women who are in a relationship with IDU partners, often make a “choice” to borrow money or to initiate sexual work. Men are the dominant figures in the drugs black market, so the woman has to enter a territory outside her comfort zone. She pays, by selling her body, by living in deprivation of her basic needs – doubly dependent, both on men and on drugs.
There are specific outreach programs for women who are commercial sex workers. They attend to women's reproductive health and STD prevention, distribute condoms and provide psychological support. But their main target group is women who are sex workers, not women who use drugs in general. Needle and syringe programs aren't gender-sensitive. There is no crucial bridge that connects women with institutions which do run gender-sensitive programs of any kind. Prevention work in Serbia has also failed to communicate the message that women have no congenital immunity to addiction diseases, and that they need to be treated – at any level of prevention, harm reduction or treatment – differently from men. If we imagine a world with a structure that cares about gender differences and addiction, and cares for kids whose mothers are HIV- or HCV-positive, provides support allowing HIV- or HCV-positive women to remain productive members of society, and teaches women how drugs affect their body differently – the stories told above would have a different perspective.
There was once a couple; they were both injecting drug users, both in their late forties. He fell ill and was dying. There was nothing that could be done for him. She was sitting beside him and talking about the old times, travelling, love, jokes they made, dinners they had. At one point she said that she was sorry she had never felt what it was like to be a mother.
The need for a gender-sensitive approach is biologically defined, by the different effect of alcohol and drugs on the female body; the need for a gender-sensitive approach is psychologically defined, by the tendency, among drug using women, to of low levels of self-esteem and high levels of guilt and depression; and the need for a gender-sensitive approach is also socially defined by high levels of stigma and prejudice directed at women with alcohol or drug addiction. In the sentence, “She is HIV-positive and she is a drug addict”, before the labels 'HIV-positive' and 'drug addict' stands “SHE” and that is what should be the guideline to respect her particular needs, and shape the ways to keep her safe.
Prejudices do not achieve prevention. Prejudices do not cure. Prejudices do not make society’s problems disappear. Prejudices are the malign tumour blocking the exit from addiction.
Andjelka Jelčić, Re Generation
