On International Overdose Awareness Day 2018, the Women and Harm Reduction International Network (WHRIN) calls attention to the gender specific needs of women who use drugs (WUD) and the need for urgent responses to address the ever rising death toll for accidental overdose.

Women who inject opioids face unique challenges in accessing lifesaving information, support to develop personal strategies to prevent overdose and the tools to effectively manage overdose. Where harm reduction services exist, they are generally established without a gender lens and cater best for the male majority of their clients. This means the services lack relevance and accessibility for WUD, particularly those with children and those who have been subject to intimate partner violence. WUD with children, especially single mothers, are often reluctant to attend drug services for fear of being identified as a drug user and losing child custody. As a result of this fear, women may inject secretly and alone, compounding the risk of fatal outcomes. Fortunately, some jurisdictions are starting to respond to these short comings by developing gender sensitive services (see for example, Insite the women only safe injecting facility in Vancouver). However, these examples are exceptional and in no way proportionate to the scale of need nor the rising death rates.

To put the death toll on a downward trajectory, it is vital that women who inject opioids be meaningfully engaged in planning and delivering life saving services. Peer to peer naloxone distribution and administration programs must become a feature of all harm reduction services and other organisations engaging with WUD. In addition, services should make all efforts to reach WUD with a low threshold. Women-sensitive harm reduction services must be redoubled.

On Overdose Awareness Day, WHRIN grieves for the women who have lost their lives to this war on drug users. The losses are harder to bear given the preventability and injustice surrounding this deplorable failure of prohibition. The damaging ideology surrounding the war of drugs is killing people by acting as a core barrier to preventing accidental overdose and must end.