With the substantive failings of the drug war, conversations about obviously existing drug use have gained tentative traction in recent years. And yet, female drug use remains a relative unknown.

Patriarchy is deeply woven into drug policy, advocacy, treatment, research and reform. Consigned to corners of Twitter and the footnote of studies on male use, female drug use is a sanctified taboo. And drug use and abuse are seen through the male gaze. We know very little about the pharmacological effects of some psychoactive substances on women. Do women react differently to drugs? Does problematic use manifest in different ways? Are services suitable to female needs? We aren’t really sure. All of the trials have been conducted on men; all of the research on male use.

A recent collection, The Impact of Global Drug Policy on Women: Shifting the Needle, edited by Julia Buxton, Gia Margo and Lona Burger is seeking to change that. Addressing the lack of space for conversations about female use within both the women’s movement and drug-centric forums, the book looks to integrate the long dismissed gender dynamic and emphasise an under-appreciated reality: women are very much actors in the drug world and very much impacted by drug policy.

Providing a space for not only academic research, but the voices of women impacted by the collision of patriarchy and drug policy, the book takes the reader across the world, tracing patterns of injustice across both the Global North and the Global South. ‘We tend to model our whole understanding of drug use and drug culture around the Global North and it’s inadequate’ said Julia. ‘Drug policy is global drug policy. Whether it be Russia, Lithuania, Kenya, Chile or the US, the harm is universal.’

As expected, the vast majority topics touched upon in the book make for a frankly miserable read. From Ghana to Scotland, women are facing exclusion and stigmatisation. Patriarchy, like racism is written into the drug war. Women are treated differently by doctors and the criminal justice system, and many struggle to access support services. An article in the book details the ‘punitive, stigmatising multi-structural social systems’ that affect pregnant women who use drugs, erecting barriers to life-altering and even, life-saving services. The article in based on a series of interviews in New York, but the implication is global. Beset with very real fears about losing their children, women who use drugs problematically are often unable to access the help they need. Even for those able to circumnavigate the obstacles, the spaces they enter are hardly suitable. Clinics for middle aged men with problematic alcohol use are hardly appropriate for women with substance abuse issues.

This stance against the marginalisation of female voices in the drug world is more timely than ever. Recent statistics published by the ONS indicate that female drug induced deaths are rising rapidly. 2019 saw a 26.5% increase in female deaths from cocaine in England and Wales. Such trends are, at least in part, a consequence of the persistence of prohibition. Yet, as Julia emphasises, they may also be indicative of a final recognition of the need for a more through investigation of female substance use. Owing to gender norms, ‘coroners have traditionally tended to focus on female co-morbidities’, negating the possibility drug use as a potential cause of death. While the statistics are far from a cause for celebration, they may be demonstrative of a step in the right direction.

For all the woe, the book makes clear that conversations about female use need not be negative in their entirety. Akin to a breaking of chains in the context of current conversations about female drug use, a chapter on the politics of pleasure emphasises that the female experience cannot be pushed squarely into either the medical or criminogenic framework. ‘What we wanted to do was show that there is this alternative stream of argument around women and drugs and pleasure’. With the rise of female autonomy, ‘more women are using drugs for sexual and personal pleasure than ever before’. Yet, you would be forgiven for assuming otherwise. For-pleasure female substance use is neglected to the point of in-existence.

Without wanting to bash liberal feminism too virulently, the second wave has a lot to answer for that. Painting female substance use as a form of patriarchal anesthetisation and a barrier to consciousness, the whitewashed second wave refused to contend that women could use drugs experimentally. In fairness, tranquillisation was the hallmark of female substance use in the 1960s and 1970’s, but such is no longer the case. And yet, as Julia told me, the notion that drugs are a form of conscious-dampening ‘enslavement’ persists.

Far from embracing the notion that women can use drugs unproblematically, broad swathes of mainstream feminism refuse to contend with female drug use at all. “Liberal feminism has a real real issue with the notion of women’s drug use. The movement had been so reluctant to engage on this because they have been so focused on getting an equal voice at the table”

Notwithstanding the fact that drugs can factor into female enslavement, the failure to engage is, in part, linked to the infantilisation of women as potential victims. “There is this idea that it is best to pretend women aren’t using drugs because it might be putting them in danger”. Of course, the danger is often very real, and there is a valid concern that an acknowledgement may embolden the victim blaming stick, but to deny that female drug use exists is hardly the solution. An acknowledgment of the autonomy women exercise with regards to substance use is perhaps the first step in eradicating some of the dangers that we’d rather not think about.

Enter Narcofeminsim. Challenging the erasure of female substance use, Narcofeminism is a burgeoning intersectional movement seeking to create a space for womxn (transgender and non-binary women included, as denoted by use of the term womxn) who use drugs.

Formally launched on international women’s day 2019, the movement is rooted in a recognition that the drug war is suffused with sexism; and that criminalisation negatively affects womxn of colour, youth and womxn in poor communities differently from men. It also points a middle finger to past exclusion.

As Judy Chang, director of INUPD contended: ‘We’re no longer willing to be marginalised by a movement that we hold claim to, where our bodies are deemed impure or our behaviour unnatural or immoral. What, after all, could be more patriarchal than telling a woman what to do with/put in her body?’

But it isn’t only liberal feminism that has something to answer for. Also implicated in the erasure of the female experience are advocacy organisations. Like the dominant anti-drug paradigm that it stands against, the drug policy reform movement is unknowingly saturated with patriarchy. And the gender blind approach is so prevalent that female drug use and abuse rarely gets a mention.

Questions about a un-patriarchal post drug world must therefore wait. For Julia and those that contributed to the collection, the immediate concern is getting drug policy reform community to engage with the gendered aspect of the problem. The book goes a significant way to achieving that. Demonstrating the homogeneity of injustice touching women right across the world, it is a welcome reminder that the gender dynamic matters.

This piece was written by Lola Brittain, Research Officer at Volteface. Tweets @LolaBrittain

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