KUALA LUMPUR, March 5 — In one of the first ever reports looking into the issue of female drug users in the country, it has been found that treatment services for drug addiction and harm reduction are not geared towards addressing their needs.
The policy brief on women who use drugs in Malaysia, “Everything on My Own”, carried out by the Malaysian AIDS Council (MAC) and funded by the European Union also found that the fairer sex also face increased stigma from parties such as service providers, their own families and friends, compared to their male counterparts.
It will be launched today in conjunction with the International Women’s Day on Sunday.
Malay Mail, in highlighting drug use among children, reported of two boys, aged seven, were sniffing glue while there were 1,416 students aged between 13 and 19 who used drugs.
The report found that women drug abusers often have their children taken away from them either by the Welfare Department or extended family members.
MAC European Union Asia Action and CAHR Projects policy manager Fifa Rahman said women face significant emotional trauma when their children are taken away.
International literature showed that children undergoing a sudden and traumatic separation have increased tendencies to exhibit antisocial tendencies and find it difficult to bond with new carers.
“Taking drugs doesn’t mean she is a bad mother. Taking drugs means she’s a normal person struggling with addiction, she loves and cares for her children just as a regular person does. There’s a misconception that women who use drugs are bad because they are so nice, just regular people.” said Fifa, who carried out the study with Sarah Iqbal, policy officer from the same division.
“Loss of parental rights is traumatic, whether by the state authorities or by extended family. Many have their children located to different states. When their children are forcibly removed, we add on the risk of depression to the list of troubles faced by women who use drugs.”
Such experiences, she said, left the women more vulnerable and likely to “fall back” on drugs.
Fifa said drug treatment centres did not cater for women, adding that the centres did not have services like sexual and reproductive health, domestic violence counselling, and parenting workshops.
She cited that services are currently male-centric.
“Respondents in our study state that male drug users are given better activities such as motivational camps while the women prefer to learn skills such as cooking and sewing,” she said.
“Women are allowed to join these camps with the men, but they feel like the males are looking down on them and this makes them shy.”
Gaps in services
Fifa said most do not go for gynaecological check-ups because they did not understand the importance of it.
“Some of them think that going to a gynae simply means the doctor is going to check them and confirm they have a vagina,” she said.
“Health literacy is low.”
Fifa, however, said the report was not representative of all women who use drugs, many of whom use functionally and have normal jobs.
These women were sourced from MAC outreach workers, and as such come from lower socioeconomic strata and use drugs problematically.
“They come from the lower socioeconomic strata,” she said.
“But there are many women who use drugs functionally and have regular jobs.”
The study, conducted between September 2013 and February this year, found clear gaps in services currently provided.
There were three focus group discussions comprising nine respondents in Penang, and five respondents each in Kelantan and the Klang Valley. Nineteen in-depth interviews were done in the Klang Valley, Kelantan, Penang and Johor.
“Services are often provided to one individual to address one or two needs rather than a cluster of needs,” the report said.
“For example, a person may receive sterile needles and syringes, and encouragement to attend free anonymous HIV testing, but may not receive referrals to assistance in regard to children, welfare assistance, mental health services, or sexual reproductive health checkups, among others.”
The report added that research in other countries showed that women who use drugs face increased risk of HIV transmission, higher levels of stigma compared to their male counterparts, higher levels of intimate partner violence and mental illness.
What they need
Among the recommendations made were women should have counselling services integrated within drug treatment centres (including assistance to domestic violence and non-judgmental positive thinking services), sexual and reproductive health services and strengthening inter-agency collaboration.
The report also found that a majority of respondents had dropped out of school with no further follow-up from school authorities or state social services.
“Further research should be conducted about the follow-up process and intervention for school dropouts,” it said, adding that recommendations from such research should be compatible with the Convention on the Rights of the Child.
Universiti Malaya’s Centre of Excellence for Research in AIDS director Prof Dr Adeeba Kamarulzaman said the “real” problem of female drug users were under recognised as they were more hidden than the males.
“They are also more stigmatised. And they are forgotten because people don’t expect women to use drugs. Women also tend to have self-stigmatisation,” she said.
She said that services such as harm reduction needed to be more women-friendly including sexual and reproductive health.
“The Kajang prison, which have women prisoners, hardly have specific women services,” she said, adding that the current scenario of the lack of services for female drug users was happening in other countries.
“But women have a higher risk of getting HIV. They might be sharing needles and their risk of getting infected through sexual transmission is also higher.”
What the study found
● The median age for starting illicit drug use was 18. The youngest was a nine-year-old, who sniffed glue. There was a girl, aged 10, who used heroin
● There were 15 respondents who said they had financially difficult childhoods, while 14 dropped out of school, most commonly either at Form 3 or Form 4, and one had never attend school
● Most respondents married below the age of 20. Some had multiple marriages
● About half of the respondents reported experiencing some kind of violence either during childhood or with male partners
● Drugs used include methamphetamine and heroin. There was also polydrug use. There were three injecting drug users while 36 “chased” either heroin or syabu
● Some respondents also reported either having an older family member who used drugs. Others reported currently having or had a male partner who used drugs
Note: National Anti-Drugs Agency statistics found 668 female drug users in 2013. Previously, it was 580 (2010), 490 (2011) and 439 (2012).
The veil shrouding female drug users is slowly being lifted to show that their problems and needs differ from male counterparts. Non-governmental organisations are saying that the numbers could be higher than the official ones as the women remain hidden.
Malay Mail interviewed two women who were willing to share their experiences.
Suzy, 22, Klang Valley
“I started smoking when I was about 13 or 14. Then I experimented with ganja to see if ‘it was OK’. After that, it was syabu. I was on syabu for a long time until it didn’t have much effect on me anymore. That’s when I started trying heroin. Now, I take both.
I prefer heroin because it calms me down. All my problems go away. My head clears. Syabu causes me to hallucinate. When I sit in my room after taking it, I can hear voices outside. People talking. But no such thing is happening.
I can’t hold down a job and most times, I work one month here, another month there. I quit school when I was in Form 2. I feel I can’t do anything right. My family always has something to say about what I’m doing. Nothing is good enough.
Now, we are about to be thrown out of our house and have nowhere to go. It seems like my mother, siblings and I are going to be living on the streets. Only one of my siblings is working. My mother can’t work because she’s got all kinds of illnesses like diabetes and high blood pressure.
But I can’t afford to leave home now because I am afraid my fiance won’t be able to find me after I’m kicked out of this house. We have been engaged for about a year and a half.
His mother doesn’t like me as much. He uses drugs, too. We can’t get married because there’s never enough money. He’s trying to get me to quit because he says it’s different when women use drugs. For men, at least they can still work. For women? What can they do? He asks me if I am going to sell my body if I don’t have money.
I did sell my body when I was about 15 or 16. I didn’t have a pimp. I was an independent. The price would be agreed upon between the client and I. It was to pay for drugs and that was all that mattered.
Nowadays, the number of times I ‘take a hit’ depends on how I feel. How long I can go without drugs. My friends and I normally share the drugs. We normally do it in secluded places.
Sometimes, I inject myself. Sometimes, I ‘chase’. It depends whether I am rushing for time. I have tried cutting back because I am afraid if people know that I am ‘on’. So, I have to be careful. I have thought of quitting but maybe the time hasn’t come yet.”
Noor, 30, Kelantan
“I haven’t seen or spoken to my children since I was sent to jail in 2011. I was released at the end of 2012. They are staying with my mother-in-law or husband’s cousin. I have three kids.
I was caught five times before but could always pay the fine. The sixth time, I didn’t have money so I went to jail.
Now, I am married to my fourth husband and I can’t stand being alone because I start to think about them (her children). Wherever he goes, I go. Of course, I want my children back but I’m not making enough money to take care of them.
Plus, it’s difficult to see my kids. My in-laws won’t give them back to me.
Right now, my husband and I have a vegetable farm. We make about RM100 a day and I have been on methadone for the past three to four months.
I used to buy it but now I get it for free ever since I found out that I could get it for free. I started on pil kuda when I was a teenager. My friends were taking it. I got married when I was 16 but we divorced a few months later. It was sort-off an arranged marriage.
I stopped schooling when I was 15.
Many people in my village were on pil kuda. My second husband was a dealer and I used to help him sell the drugs. My third husband was both a user and a dealer. My second and third husbands were friends.
I was married to my second husband for five years. He used to beat me. The worst was when he slammed my head against the wall. My face was so bruised I couldn’t go to work. But I didn’t leave because we already had children.
I started on heroin after my second divorce. It helped me get over my disappointment. My husbands would not let me do drugs.
The people around here know I used drugs but it’s not a big deal because there are many people, especially men, who are or used to be on drugs.”