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Female drug users on the rise in N-E: UN study

12.1 per cent of females involved in substance abuse in Meghalaya are addicted to drugs, says report

From CK Nayak

New Delhi: Use of banned drugs in the North East region which is perilously close to the infamous Golden Triangle – Asia’s main opium producing area – has made headlines very often. But the spine chilling cases of women drug users in the region including in Meghalaya have come to light through a recent UN study.
The study – Women Who Use Drugs in Northeast India – noted: “A household survey in one found that 2.1 per cent of females were opium users” and that “a majority of them were introduced to opium by their husbands after marriage.”
A higher percentage of drug consumption was found prevalent amongst all female users in Manipur (28.2 per cent), Mizoram (17.4 per cent), Nagaland (14.9 per cent), Meghalaya (12.1 per cent), Assam (10.2 per cent) and Sikkim (9.8 per cent).
The study was commissioned by the United Nations Office on Drugs and Crime under its regional initiative ‘Prevention of transmission of HIV amongst drug users in SAARC Countries’.
This is the first comprehensive study of women who use drugs across all the eight states of the North East.
The study said: “substance use among women is associated with early initiation to sex, sexual abuse, greater number of sexual partners, exchange of money for sex, and infrequent use of condoms with sexual partners”. It noted that among more than half of the women drug users, the prime source of income was through selling drugs or sex.
Physical violence is common among women who use drugs, with nearly two-thirds of the participants having been hit with a fist or kicked or beaten, at least once or more.
The incidence of physical violence and abuse with a frequency of once or more by non-sex partners, sex partners, community/ neighbours, police and casual sex partners is 62 per cent, 54 per cent, 28 per cent, 27 per cent and 26 per cent, respectively.
Just more than a third of the women became pregnant during the time of drug use and of those who were pregnant, 40 per cent of the women cared for their last pregnancy.
A majority (59 per cent) of them continued to use drugs during pregnancy and only 28 per cent stopped drug use after their pregnancy. More than a third of the women report abortion, and nearly three-fourths of them experienced adverse consequences following abortion; more than half of the abortions occurred in non-medical settings.
In one case, one 40-year-old woman admitted that she used drugs in her rectum to get relief from intense pain and now it has become a habit with frequency of use increasing. “I had painful piles for a long time and a friend from the police suggested that I apply heroin powder through my anus to get relief,” she said adding ever since it has become a habit.
In another case a woman was forced by her husband to have sex with others that too in front of him for both money and drugs. “There was no way to inform my people and I was helpless,” she added.  Comparing the demographic characteristics of women who use drugs in high HIV prevalent (Manipur, Meghalaya, Mizoram and Nagaland) and low HIV prevalent states (Arunachal Pradesh, Assam, Sikkim and Tripura) the study said that women from the high HIV occurrence states were slightly older. More of them re-widowed/separated/divorced and a smaller proportion live with a partner/spouse, it said.
Concerns were raised regarding the fact that in low HIV burden states, a significant proportion (57 per cent) of women begins to inject drugs without transitioning from non-injecting. It also stated that women in these states “who use drugs exhibit greater frequency of paid sex as well as sex in exchange for drugs”.
The study found that women who use drugs are marginalized and, as a consequence of societal discrimination, this hidden population of women faces serious threats to their health, safety and wellbeing. The mean as well as median age of the participants is 27 years; 42 per cent have completed higher secondary to college level education.
The median age of initiation of tobacco, alcohol and other substances is 16, 17 and 20 years, respectively. Among nearly two-thirds of the women, the first drug used other than tobacco/ alcohol is an opioid- either proxyvon or heroin. A little more than a third of the women who use drugs admit to a pathological pattern of alcohol use, and concurrent use of cannabis is reported by 35 per cent.
Most (86 per cent) women users have a family member or friend using the same drug. Women who use drugs are sexually active, with only a fourth of them reporting no sex with a partner of the opposite sex during the prior six months. More than a third of the women have never used condoms with their primary sex partners during the prior six months.
In 38 per cent of the cases, the primary method of contraception with the primary partner is condoms. More than half of the women having sex with their casual sex partners use condoms about half the time to always during the last six months.
Among women with casual sex partners, 79 per cent have engaged in paid sexual acts, and a little more than a third of them obtain drugs in exchange for sex. A little more than half of the women who use drugs reported their current health status as fair to poor.
The proportion of women reporting a prior/current history of tuberculosis, mouth infections such as
Candida, Hepatitis and Malaria, is 11 per cent, 16 per cent and 20 per cent, respectively. As many as 60 per cent of the women have been tested positive for HIV.
40 per cent of women who use drugs have been treated for drug use disorder and a little more than a fifth of the women report current drug dependence treatment. Nearly a fourth of them express difficulty in accessing treatment for drug use disorder, the primary reasons being: expensive treatment, unfriendly treatment services, ineffective treatment and geographical distance.
More than a fifth of the women have been in jail/prison and more than half have been incarcerated more than once. Among those who have been incarcerated, a fourth has used drugs inside jail/prison and of these more than a third has injected drugs.
The study has been prefaced by former super cop and anti drug activist Kiran Bedi.

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