Е. is a woman with first-hand experience in using different drugs for many years, although she is only addicted to opioids. She hasn’t been using drugs for a long time now and is treated from addiction with a methadone substation therapy. In the meantime, she has a job and takes care of her child as a single parent. The difficulty of expressing her feelings was quite obvious, particularly when being interviewed by a man, and yet she agreed to the conversation, happy for the opportunity to share her experiences as a woman who has used drugs. Е. sincerely hopes her testimony will help appeal to the competent institutions to increase the help offered to girls and women who use drugs, including those treated from drug dependence. Her experience, and from what she knows from other girls and women, confirms the need for introducing specific gender-oriented services for girls and women who use drugs and are treated from drug dependence.
Can you briefly tell us about your experience with drug use?
Well, I started when I was 13 or 14 years old, in my puberty. As a teenager I was a bit vulnerable to peer pressure, you know how it is, the surroundings always pressures you to do certain things. For instance, my friends used to smoke joints with their boyfriends, and, you know, when you are 14 you want to be cool. You want to be accepted, right? You’re too young, you can’t understand certain things. That’s how I started doing drugs. I started with marihuana, which then turned into clubbing with MDMA, ecstasy, speed, cocaine. There was a lot of cocaine where I used to live abroad. For a while I lived in a country where the rule was, do whatever you want, but never use heroin.” So, you can smoke grass or “do ecstasy, go clubbing, but heroin is dirty. There was a disturbing image about heroin. I knew people who used heroin, but I had this opinion of them, you know, that they were filthy. But, then there is that other phase, when these people use heroin in the same room with you, you know. You go to an after-party and everybody is smoking heroin off foil, and here I am, telling them not to do it, not to do heroin. But at the end I wanted to try it. I watched them doing it every day so I thought it must be nice. You know what goes through a child’s brain! I was 16 at the time. I was against it, against heroin. I told myself they were filthy junkies, in filthy houses. You know, like a totally negative suggestion. And yet, I tried it. And I realized why they took it. The feeling was surreal. The first time is amazing. And so I started doing it, not knowing about a little something called “crisis.” I knew about drugs, but nobody told me what it was, and when you hear the word crisis, you have no idea what it means. And then, when I turned 17 and 18, I had a problem. I was hooked on heroin. When I graduated from high school I was addicted to heroin.
Did someone in particular influenced you to start using drugs?
What was the role of men in your decision to start using drugs?
Well, whenever I tried a new drug, heroin for example, it was always with the help of a friend’s boyfriend. I don’t mean just one friend. Usually it happened with all my female friends. So, my access to drugs was always through a guy. Those days, in the 1990s, during the transition, if you wanted drugs, in 90% of the cases you had to find it from a man. Most drug dealers are men. There are some other aspects as well. For instance, you go to buy drugs, and the dealer is hanging out with his friends, and you are the only female in a room with six men. Of course, they might not hurt you, but, I can say that in that moment, when they’re dealing drugs to you, it’s as if you’re having a nervous breakdown and you can’t wait to get out from there. It’s scary. You never know what might happen to you. At the time I was 18 or 19, what did I know?! They might take my drugs, they might beat me or even rape me. Or even worse, they might kidnap me and force me to give sexual services. Those sorts of things have happened to other women.
What did drugs mean to you?
Well, I started for the sake of socializing and having fun. Of course, it also implied a certain identity. You know, like, this is me. “Look at me. I am doing drugs. This is part of my identity. I am breaking the stereotypes.” It is a way to rebel in puberty, and yes, a part of your identity. A sort of revolt against society. Because society creates stereotypes. I wanted to show everybody that I was fighting that stereotype, with all the characteristics of a “junkie”, an “addict”. Yes, against that. Against the system. “I do what I feel like,” that sort of outlook.
Is there a difference between men and women who use drugs?
Well, not that a woman can’t stand going through a physical crisis (abstinence), but a woman always has other options. For example, once you are an addict, you have to find money to buy drugs, you have to manage. A woman, if she is that desperate, knows she has other ways to get money or drugs. Many women who have problem with addiction don’t admit it, but I think some, if not all of them, must have at least once thought of selling their body to the dealers. They go to the dealer and say “I don’t have money, but I can offer something else.” Men don’t have that option, because very rarely the dealer wants a gay guy. Women are more exposed to that. Sex work is connected to drug addiction. There is more. Women are more vulnerable than men. For example, when a woman goes somewhere to buy drugs, she has to be ready for everything, she is more vulnerable to certain situations, where a man can fight, a woman has to suffer. And that’s how things are. Someone might take their drugs, or rob them, they might get raped, in some cases women are humiliated just for the fun of it. You never know what might happen.
There was a case when a woman went to buy drugs alone in a bad neighbourhood. She was kidnapped by four men. They forced her into a car and took her to the woods. They wanted to rape her. What could she do in a situation like that? If she fought them, they could beat her up and kill her. What could she do? She agreed to it. She thought they might kill her afterwards. I don’t think that a man has ever been in a situation like that. Guys think to themselves, “she is a junkie, she won’t report us to the police.” That type of situations usually lead to abuse of women addicts. The four men were sure she wouldn’t report them to the police because she was an addict. And so, addicts become easy targets. I get why they think so. Police don’t treat addicts like regular citizens. Police would ask questions, like what was she doing there? And this leads to another trauma. She would have to disclose what she went through. She was educated and well-informed and wasn’t sure that the police could find a way to provide the evidence. She knew they would blame her, you know, something along the line of `she was looking for it herself`. “You do drugs? You go to places like that? What were you doing there?” At the end you get nothing out of it but more stress? She just wanted to return home safely and cope with the trauma.
Do women who use drugs have some kind of protection mechanisms in such situations?
Female dealers. I am serious, I am not joking. When you hear about a female dealer, you feel safer. You know that no one would attack you if you go to her. But then, if you go to such places, I don’t think there is a way to defend yourself.
Also, it is better when you have a partner to watch your back. But on the other hand, you expose yourself to him and his gang.
What other problems do women who use drugs encounter?
Women become pregnant. When a woman is a drug user, then it’s an entirely different world, and Macedonia is still not ready for that. I mean, institutions have no idea how to deal with it. As all women, I would also like to have a family, but I am an addict. Discrimination has nasty effects. It makes you feel terrible, you could suffer through serious depression, clinical depression; the discrimination. “Who let you have a baby?” the gynaecologist would say, for example. They advise you to leave your baby in front of the gates of a monastery. You know, God forbid someone would sit next to you, take you by the hand and explain what to expect. You go to the gynaecologist, he sees the mark F11 in your health care card and has no information to offer but plenty of negative comments and suggestions where you can leave your baby. They don’t even ask whether you want to keep it or not, whether you want to give birth or not. They just make presumptions on their own. During the nine months of pregnancy this woman will be discriminated against daily.
Giving birth is another story. When you go to the hospital you have to tell them you’re on methadone therapy, or some other therapy, and since you’re in a hospital you have to tell the truth, just in case. There is discrimination during delivery as well. For example, everybody avoids touching you. They hold the baby as if it’s a stray dog. You have no rights. They isolate you from the other mothers. They isolate you with the baby to a completely different floor, alone in a room. And you suffer from postnatal depression. And nurses take care of the healthy mothers, not you. It is very difficult to deal with such psychological state…, particularly with the hormones. On top of that there are people’s expectations that you must have a family. You are already suffering from stress and then you are faced with discrimination in the hospital, from the administration, the nurses, the obstetricians, everybody. You have a problem and you are in a very difficult position. Very difficult!
All my friends who have children and are addicted to methadone have had the same experience. Not in the same hospital, in different hospitals and yet they had the same experience. A friend of mine told me a while ago that she was also told to leave her child in a monastery and run away. A nurse said to me “It would be the best for the baby, it will have a better life…”, and she didn’t even know me, she didn’t know that I had a job, she was just guessing. “Leave it,” she said, “at the stairs of a monastery, it is better for the baby. A nice family will then adopt it.” So, immediately she told me that my husband and I were not a good family.
I didn’t receive any support when I gave birth. And my situation was quite specific. I expected more extra attention. I expected there to be some…, but no, “here is your baby, here is you file, goodbye!”. Things are very difficult for a new mother, but an addict mother… I am lucky to have people to help me a lot, friends, family. I had support. I had a network of support with people who understood me and gave me space when I was emotional. Whenever I asked for advice, I got it. Thank goodness I had someone to talk to. I blamed myself. Mothers need psychological help with that as well, but no one offers it.
You often mentioned opioid addiction. Can you explain how opioid addiction treatment for women functions?
Just as treatment for men, but I think the approach for women should be much different because women are in a different position than men. There are mothers, new mothers. A lot of women suffer from depression caused by addiction. They offer you some help, but not different help. There is a difference between men and women. A huge difference.
In your opinion, do women who use drugs need different social and health services than men who use drugs? From any institution?
I think it’s good to have the support of a psychologist and to have a support group… You know, a group of women who have gone through the same thing, with a professional leading them while they talk about their problems. Something like Narcotics Anonimus, but only for women, because the problems they face are specific. I don’t think men can talk about how they were raped. They can’t talk about it because it has never happened to them. I think these group meetings are very important. There is a lack of such facilities. You can’t isolate yourself and be lonely when you’re a woman, a mother and an addict. You can’t. It will certainly lead to depression. I mean, there must be an institution that could take care of that in some way.
Also, if your partner is an addict as well and he physically abuses you, you can’t just go to the social services since you’re afraid they might take your children because you’re doing drugs. I had such a situation, and when my husband hurt me for the third time I reported him to the police and they came. The social services called me, saying a child was concerned in this case, but when I went to their office it turned out they just wanted me to confirm the statement I gave to the police. The social services have shelters, but you have to be in a pretty desperate state to be taken there. They also explained some laws to me… it turns out he had to hit me again for them to take action. “Wait a minute, you’re going to wait for the next attack to take action, and there had been already three? And what would that action be? Who are you people and what is your job?” So I was send to HOPS to talk with a psychologists and I said to myself, “Look at this, they don’t even have their own people!”. Neither the social services, nor the police offered protection.
There is a women’s group for exchanging information in HOPS. I think it’s important, to share your stories, situations, incidents. It helps psychologically and you can also find out something new, something you didn’t know before. HOPS has helped me personally a lot. They helped me get my citizenship, they took me to the hospital, and to the family centre where I was able to tell them what was happening to me. But I don’t think a lot of women know about HOPS. I was surprised when they covered my expenses, for example, for the electronic health card. I didn’t know that HOPS does that in cases when somebody can’t afford it. I didn’t want to go to the social services for that. I didn’t know what they might think. They would have judged me. They might have not told me straightforward but I would have read it in their eyes, I would have noticed. I knew that no one in HOPS would judge me, I knew they would understand.
The state needs to provide easier access to free psychological and psychiatric serviced, for men and women, but especially for women. There should be test centres for sexually transmitted diseases. And it should be specifically made for women, for women who might have been raped or who are sex workers.
Interviewer: Vanja Dimitrievski