If Ontario really wants to fight the opioid crisis, it needs targeted solutions for women

OPINION: Women who use opioids are more likely than men to experience sexual and physical trauma, writes Lauren McKeon. But the province’s drug strategy does little to address the challenges they face
By Lauren McKeon - Published on November 15, 2018
a tray of drugs
The Tories have stated that they will continue to fund the province’s supervised-injection and overdose-prevention sites. (Jonathan Hayward/CP)

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The Progressive Conservative government recently announced that it would continue to fund the province’s supervised-injection and overdose-prevention sites. Some were surprised by the move: Doug Ford, after all, once said that he was “dead against” such sites — so much so that he put the opening of three overdose prevention sites on hold this summer, pending a review of Ontario’s drug strategy. Thankfully, the government seems to have drawn the same conclusion as many health experts: these sites save lives. But the good news came with caveats. A lot of them.

The 18 sites that received funding before the review will have to reapply to receive more. And the government has not only refused to fund pop-up services, such as tents: it has prohibited them. That’s an especially troubling move, considering the government has also capped the number of sites at 21. Almost 4,000 people in Canada died from opioid overdoses last year — the number is expected to rise in 2018. Why would the government limit its ability to address the crisis?

Arguably, we need more sites, not fewer. But we also need the means to respond more creatively, and with greater flexibility, to the growing crisis: for example, we should be able to target different populations — women, transgender, non-binary people — according to their needs. The opioid crisis affects men and women differently [PDF], but much of the larger conversation centres around men. That makes sense, to an extent: opioid-related overdoses and deaths are higher among men, and they’re also increasing at a higher rate for men than for women. But women who use opioids are more likely than men to experience sexual and physical trauma. They’re also more likely to report being dependent on opioids, particularly to manage physical and emotional pain.

Some women using drugs are also homeless or under-housed. Of the homeless women surveyed in Toronto’s 2007 Street Health Report [PDF], one in five reported having been raped in the past year and 55 per cent reported having been raped more than once. More than one-third reported having been sexually harassed in the past year. Just under 40 per cent had been physically assaulted. Women, then, can face layered and interconnected traumas.

Grim statistics such as these are partly what prompted the opening of SisterSpace, Canada’s first women’s-only overdose prevention site last year. Located in Vancouver’s Downtown Eastside, it grew directly out of concerns that women may put themselves in unsafe situations to use drugs safely. “They often have to sit in co-ed spaces with men who have raped them or men who they owe money to or men who mean to cause them harm, and so they forgo services all together,” Janice Abbott, CEO of the Atira Women's Resource Society, one of the partners for the site, told media when the space launched. “Women have told us that they’ll be sitting in a room and be called whores and skanks.” No wonder many of them choose, instead, to use in isolation — thereby greatly reducing the chance that another person will be able to administer life-saving naloxone in the case of overdose.

If Ontario truly wants to help fight the opioid crisis, it needs to make room for innovative, targeted solutions, such as SisterSpace — and it can’t do that if it’s primarily concerned with limiting resources and increasing funding hurdles. Additional rehabilitation resources are a good thing, but they shouldn’t create barriers for access to urgent services. If the government is going to meaningfully combat the crisis, it must offer solutions without casting moral judgments — must ditch its outdated ideas about who does, and who doesn’t, deserve help.

Lauren McKeon is the digital editor of The Walrus. She's the author of F-Bomb: Dispatches from the War on Feminism, published by Goose Lane Editions.

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