Abstract

Introduction A number of reports have documented the negative consequences of current prohibitionist drug control policies on health, human rights and development, 1 and these are the subject of growing international attention. 2 The past thirty years has also seen a growing number of studies on women's participation in all levels of the drug trade. However, limited research currently exists on the particular impact of drug control on women. This briefing paper focuses on this gap. This briefing aims to highlight the effects of drug policy on women as producers, suppliers and consumers of drugs in order to inform and guide policy makers on practices that should be avoided, as well as highlight those policies which effectively incorporate and address women's needs. This briefing also features 'snapshots' from women and service providers working with women that are affected by drug policies. These snapshots explore the complex consequences that drug policies have on both individuals and services. Such snapshots also highlight examples of interventions that seek to address the negative consequences of drug control and provide positive support to women. Box 1. A qualifying note about gendered language This briefing paper focuses on how drug policies particularly affect women. Gender and sex are sometimes conflated in policy documents when discussing issues that relate differently to men and women. A person's sex is a biological construct, while a person's gender is a social construct. Gender is not a static, binary concept. Transgendered, two-spirited, transsexual, transitioning people, among others, may identify as the gender opposite of their sex, or may identify beyond the realm of either a 'man' or a 'woman'. For the conceptual purposes of this paper, 'women' refer to people who self-identify as such, regardless of their biological sex. 2 The international framework Security, development and human rights have been identified by the Charter of the United Nations (UN) as the key policy 'pillars' of global governance systems. 3 These pillars are enshrined in high level agreements as constituting the building blocks for international well-being and security. Women's rights are specifically protected in a number of key international documents, including the Convention on the Elimination of Discrimination Against Women (CEDAW) and the 1995 Beijing Declaration, which aims to promote peace, development and equality for all women. However, despite the increasing amount of information available on women's involvement in drug production, traffic and consumption, UN bodies have not generally explored the various roles played by women in the drug trade. 6 The international drug control system is based upon the 1961 Single Convention on Narcotic Drugs, the 1971 UN Convention on Psychotropic Substances and the 1988 Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances. For the past 50 years, the governments have pursued tough law enforcement and prohibition-based policies which have led to a number of negative impacts particularly on health and well-being. This is despite the recognition in the preamble to the 1961 Convention of the need to uphold the 'health and welfare of mankind'. The Commission on Narcotic Drugs (CND), the UN's drug control policy making body, describes drug dependence as an 'evil', 7 while the International Narcotics Control Board (INCB), the UN agency in charge of monitoring the implementation of the UN drug conventions, encourages governments to adopt a strict interpretation of the conventions that prioritises a strongly punitive approach. The INCB often offers guidance on the UN drug control conventions without due regard to other international health, development and human rights obligations. 8 Gender issues are no exception to this situation, and issues related to drugs and women have largely been ignored by UN drug control agencies and their policies. The situation has started to evolve over the past few years, with the CND starting to acknowledge the importance of women's rights in drug policy. In Resolution 55/5 "Promoting strategies and measures addressing specific needs of women in the context of comprehensive and integrated drug demand reduction programmes and strategies" 9 for example, the CND recognises CEDAW and the Beijing Declaration, and calls on UN member states to adopt drug control measures that respond to the needs of women. CND Resolution 52/1 "Promoting international cooperation in addressing the involvement of women and girls in drug trafficking, especially as couriers" 10 also highlights key issues related to women's involvement in the international drug trade. The resolution mentions the need for more evidence-based research on women's involvement in the drug trade, and urges more education to reduce women's participation in drug-related crime. 11 However, although this resolution is a step towards incorporating gender issues into the drug policy agenda, the focus remains exclusively on the harms of women's involvement in the drug trade, while ignoring the harms that can also be caused by drug control strategies on women. 12 The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), created in July 2010 by the UN General Assembly, stated explicitly that governments not only have the duty to pass laws that are aimed towards protecting women, but that the state should also take responsibility for laws that may have unintended consequences of harm. 13 It is therefore necessary to study women's involvement in the drug trade and analyse the effectiveness of drug control strategies and their consequences, both positive and negative. Such research will constitute the basis for a potential review of harmful policies to ensure that the rights of women are protected effectively by national policies. 3 Women's participation in the drug trade Women are engaged at all levels of the global drug trade. This section intends to analyse the diverse roles that women play in the illicit production, trafficking and consumption of controlled drugs. Women's involvement in drug production Women play an important role in poppy cultivation in drug producing countries such as Afghanistan, Pakistan, Myanmar and Lao PDR, 14 and in coca production in the Andean region. Opium and coca cultivation can offer women the chance to earn money, and at times assume the role of the primary financial supplier for their family. However, while cultivation of crops destined for the illicit drug market may provide a degree of independence for some women, it can also lead to more demanding workloads. Women are often expected to continue performing their traditional duties; many are still expected to remain in charge of livestock, grain processing, dairy production and the management of fruit and poultry. 16 Therefore, the power structures that tend to undermine women's social and economic role remain the same. However, available estimates show that women's participation in drug trafficking has increased significantly in recent years. 19 In Mexico, for example, the importance of women's roles in the trade continues to grow. The number of women imprisoned for federal crimes in the country has increased by 400 per cent since 2007, making the female prison population over 10,000. This spike has been partly attributed to the increased involvement of women in the drug trade. Women's involvement in drug trafficking 21 The main drivers for increased involvement of women in trafficking include economic hardship, an absence of well-paid job opportunities and the desire to provide adequate housing and education for their children. 22 Other possible reasons for the increase of women participating in drug trafficking include the reality that women sometimes play on traditional conceptions of femininity in order to avoid being suspected as participating in criminal activity. 24 Based on the current research available, only a small number of women reach a level of socio-economic independence through their involvement in the drug trade. In his study of the US-Mexico border, Campbell argues that of all the women involved in drug trafficking, it is the women at the highest level of drug organisations who manage to achieve a level of 'empowerment'. Enedina Arellano Felix, believed to run the Tijuana cartel, is the highest-profile female cartel leader in Mexico. 25 Sandra Ávila Beltrán, dubbed the 'Queen of the Pacific', was another high-profile 4 cartel leader who was arrested in 2007 for money laundering and drug trafficking. 26 Campbell's study reviews female drug lords, women engaged at the middle level, low-level drug couriers and women who have little involvement but maintain a connection to the trade through their relationships with men. While this study is temporarily and contextually specific, Campbell argues that it is applicable to women involved in drug smuggling 'cross culturally, despite differences in specific political and social conditions'. 28 While very few women reach this level of 'queen pin', the fact that they exist at all may mean that they may serve as symbols of female power for other women in the drug trade. 29 In this context, it is essential to distinguish between drug couriers (low-level individuals who usually transport drugs across the border out of poverty and economic necessity) and drug traffickers (individuals at the higher level of the trade chain, who have both organisational and economic power which allows them to make considerable profits out of the drug trade). Women are mostly involved as low-level drug couriers. They sometimes conceal drugs internally, 'in brassieres, in other clothing items, in faked pregnancies or surgically implanted in the buttocks'. 30 Single mothers sometimes become involved in transporting drugs across the border due to the feminisation of inequality and poverty. However, it is simultaneously a way for women involved in the drug trade to achieve a certain level of economic independence from a male partner. 31 In their analysis of fifteen different studies on women's involvement in the drug economy in various parts of the United States, researchers Maher and Hudson found that although the studies varied spatially, temporally and in terms of methods used, the majority demonstrated the hierarchical nature of the drug economy, with women holding subordinate or peripheral roles. 32 It is also important to consider people involved in drug trafficking in order to finance their drug Box 2. The linkages between drug dependence and drug dealing The snapshot below was written by a British woman who explains her experience of drug dealing and drug dependence. Her testimony illustrates how people can get caught up in different aspects of the drug trade. 'I sold drugs from around the age of 20, via boyfriends who were selling at the time, until the age of about 25. At the age of 22, I was smoking weed heavily and was approached by a local dealer who asked if I wished to 'tick' (receive the drugs upfront and pay for them once they had been sold) a large amount of weed. I readily agreed as I knew a lot of people who regularly smoked and this also meant that I would end up smoking for free. My 'business' started off relatively small and I was selling mainly to my friends and family members. I felt that this was quite safe as these people would often come and visit me anyway, so this would not arouse suspicion from my neighbours. However, the business rapidly escalated and over the next few years my house became extremely busy. However, being unemployed and socialising day in, day out with some of these people led me towards other drugs and I started to use cocaine. I was then approached by the dealer I was buying this from, who was impressed by the way in which I ran my weed business and offered to supply me with cocaine to sell. I quickly added this to my existing business. Unfortunately, my use of cocaine also quickly escalated due to there being a constant supply at my fingertips. […] In the end I was just selling drugs (from a variety of different people by this point) in order to fund my habit'. 5 dependence. As is the case with poverty, drug dependence should also be considered as a mitigating factor in the imposition of penalties against drug traffickers, and include a health component, such as the possibility to attend evidence-based drug dependence treatment programmes. The snapshot below exemplifies the linkages between trafficking and drug dependence. Women's involvement in drug consumption While precise data on the number of women who use drugs is rarely available, it is estimated that women represent 40 per cent of people who use drugs in some parts of Europe and the United States, 20 per cent in Eastern Europe, Central Asia and Latin American, and between 17 and 40 per cent in certain provinces in China and 10 per cent in other parts of Asia. 34 It should be noted that most women who use drugs consume these substances occasionally, and/or without problems. Therefore, many women who use drugs do not experience some of the problems that will be discussed below. Those that are most affected by drug dependence, drug-related harms and the negative consequences of drug control (see next section of the briefing) are usually women who use drugs in difficult socio-economic '"Drugs saved me from suicide", said my female friend from Russia, as we sat in a cafe at the Vienna Conference on AIDS. I am also one of those women who began using drugs to get rid of the emotional pain of rape. Since then, 26 years have passed. During that time I endured more pain and humiliation following calls for help at the hospital. I was always interested in the question: "When doctors offer a new method of treatment for drug addiction why is nobody watching what happens to a person afterwards?" It is harassment and humiliation, legitimised by one stereotype: she's a "drug addict". In 1995, I did a "clean blood" procedure, so-called "Hemosorption". A three day course costs the same as two months' average salaries in Ukraine. Three days later, I was discharged from the intensive care unit with clean blood and in abstinence from drugs. The pain ripped through my body, and a desire to inject drugs tore through my brain. I found drugs very quickly, and received the first result of 'treatment' -an overdose. That night in the hospital ward; tied to a bed with sheets, coming off of the anaesthesia after an unplanned operation. I was in a lot of pain after surgery, and from withdrawal. My whole body was twisted. Waiting for my husband, he will bring heroin. The doctors and nurses, of course, immediately guessed that I was an addict. I asked them to give me pain medication, begging. They replied: "Be patient. You are to blame"'. 6 environments, living in situations of poverty and are at the margins of society. Women experience more negative consequences from drug use than their male counterparts. 35 Although many women use drugs without experiencing any problems, many other women use drugs in environments of economic deprivation, and their use is often impacted by class and gender inequalities. 36 In addition, although drug use is generally stigmatised, women's use carries a double stigma, as it is usually seen as contravening the natural roles of women in society as 'mothers, the anchors of their families, and caretakers'. 37 The stigma of drug use is also compounded with gender discrimination (see Box 3). Women are also reportedly more likely to provide sex in exchange for housing, protection, drugs and/or sustenance. They also tend to experience violence from sexual partners and may have difficulty insisting that male sexual partners use condoms, making them more vulnerable to HIV and other sexually transmitted infections (STIs). 39 Researchers have underlined the need for further research in this area. 41 Women tend to share injecting equipment more frequently than men. Further, when injecting with men, women are more likely to be 'last on the needle', which has attendant implications concerning the risk of transmission of HIV and other blood-borne viruses from the use INWUD is a global network that represents women who use drugs in international agencies and with those that undertake international development work. It collaborates with other agencies to 'voice' the issues affecting women who use drugs. As well, INWUD provides women with a safe space (through a list serve) where they can share ideas and challenges they face when seeking support and promote women who use drugs as equal partners and contributors in all aspects of drugs theory and practice, including drug policy, drug law reform and harm reduction development. INWUD also conducts advocacy activities in order to impact on policy and practice. WHRIN is a global platform that aims to reduce the harms associated with drug use by women and to develop an enabling environment for the implementation and expansion of harm reduction resources for women. It also seeks to facilitate access to high-quality resources, including educational materials, to assist women who use drugs and the people who work with them to improve access to gender-sensitive harm reduction services. Finally, WHRIN advocates for national, regional and international bodies to adopt and implement policies and programmes that promote and support harm reduction interventions that are adapted to the needs of women and girls. 42