Launch of Annual report of INCB ,Special Focus on Women and Drug at UNODC, N Delhi

The launch of Annual Report of the International Narcotics Control Board, Thursday 2 March 2017 is attached.

Women and drugs
1. There is growing awareness of the importance of
appropriately incorporating a gender perspective into
drug-related policies and programmes. The Political
Declarations of 19983 and 20094 incorporate gender considerations,
and both the General Assembly5 and the
Commission on Narcotic Drugs6 have given increasing
attention to this aspect over the past 10 years. In addition,
the General Assembly, in its resolution on the 2030
Agenda for Sustainable Development,7 underlined the
critical importance of gender equality and the empowerment
of women. In the outcome document of the thirtieth
special session of the General Assembly, entitled “Our
joint commitment to effectively addressing and countering
the world drug problem”,8 Member States are encouraged
to address the specific needs of women in the context
of drug policy. The Commission on Narcotic Drugs, the
main policymaking body of the United Nations system
for drug-related matters, has adopted a number of resolutions
with regard to the situation of women as it relates
to the world drug problem. To contribute to the advancement
of gender-sensitive policies to address this issue, the
Commission has highlighted the specific needs of women,
most recently at its fifty-ninth session, held in March
2016, when it adopted its resolution 59/5, entitled
3 Political Declaration adopted by the General Assembly at its twentieth
special session, devoted to countering the world drug problem
(General Assembly resolution S-20/2, annex).
4 Political Declaration and Plan of Action on International Cooperation
towards an Integrated and Balanced Strategy to Counter the World
Drug Problem (see Official Records of the Economic and Social Council,
2009, Supplement No. 8 (E/2009/28), chap. I, sect. C).
5 General Assembly resolutions 58/138, 61/143, 63/241 and 70/182.
6 Commission on Narcotic Drugs resolutions 52/1, 55/5 and 59/5.
7 General Assembly resolution 70/1.
8 General Assembly resolution S-30/1, annex.
“Mainstreaming a gender perspective in drug-related
and programmes”.
2. Recognizing the importance of gender-responsiveness,
the International Narcotics Control Board (INCB) has
devoted the first chapter of the present annual report to
the topic of women and drugs. However, owing to the
multifaceted nature of this subject, it cannot be dealt with
in an exhaustive manner in only one chapter. Moreover,
data on women drug users are sparse, further complicating
analysis. For those reasons, the present chapter is limited
to some salient aspects: drug-related harms, special
populations, prevention and treatment, and rehabilitation
for drug dependence.
3. Drug-dependent women may face many difficulties:
they can experience high levels of stigmatization; they can
be ostracized by their family or community; they may be
subjected to violence from partners or family members;
and they may turn to, or be coerced into, sex work to
support their drug use or that of their partner. In addition,
they lack access to gender-sensitive treatment for
drug dependence. The limited data available at the global
level show that women drug users are increasing in number
among youth and prison populations. Few countries
provide adequate levels of drug-dependency treatment to
women, and virtually all countries need to expand
sensitive treatment if they are to achieve the highest
attainable standard of health for women.
4. Criminal justice data indicate that an increasing
number of women are arrested for drug-related crimes.
The incarceration of women involved in drug-related
offences may have a catastrophic effect on their children,
particularly if they are the primary caregivers. Afemale prisoners have very high levels of drug dependence
but rarely have access to treatment and rehabilitation
A. Prevalence and patterns of drug
5. Women and girls comprise one third of people who
use drugs globally. In 2010, the global estimated number
of women dependent on amphetamines was 6.3 million;
women dependent on opioids numbered 4.7 million; and
women dependent on cocaine numbered 2.1 million.
Women had a high prevalence of amphetamine dependence
(0.31 per cent) in South-East Asia and Oceania, of
opioid dependence (0.25 per cent) in Oceania, and of
cocaine dependence (0.22 per cent) in North America
and Latin America. Also in 2010, an estimated 3.8 million
women injected drugs globally, corresponding to
0.11 per cent of the world female population.9 Drug-use
patterns among women reflect differences in opportunities
to use drugs, which are a result of the influence of
their social or cultural environment.
6. Generally, women start using drugs later than men
do, and their use is strongly influenced by partners who
also use drugs. However, once women start abusing
drugs, their rate of consumption of cannabis, opioids and
cocaine progresses more rapidly than among men, and
they tend to develop a substance use disorder more
quickly than men do. In the case of methamphetamines,
women begin using them at an earlier age than men, and
they are more likely to have a methamphetamine use disorder
than men. Compared with men, women who use
heroin are younger, likely to use smaller amounts and for
a shorter time, are less likely to inject the drug and are
more likely to be influenced by drug-using sexual partners.
Often, someone else, typically their partner, will
administer a woman’s first injection of drugs.
7. Women in high-income countries have a higher level
of drug use than women in low- and middle-income
countries. In terms of abuse of all drugs, the gap between
women and men is narrower among the youth population
than among the adult population. Women also constitute
a large proportion of those abusing prescription
9 Harvey A. Whiteford and others, “Global burden of disease attributable
to mental and substance use disorders: findings from the Global
Burden of Disease Study 2010”, The Lancet, vol. 382, No. 9904 (2013), pp.
drugs. The Pompidou Group of the Council of Europe
reported that the use of prescription drugs by women
increases according to age group, peaking among women
in their thirties. Although data are limited, both Germany
and Serbia reported that fatal overdoses owing to prescription
drug abuse were more common among women
than among men.10 Studies show that women are more
likely to use prescription drugs, such as narcotic analgesics
and tranquillizers (e.g., benzodiazepines), for nonmedical
purposes.11 This is compounded by the greater
vulnerability of women to depression, anxiety, trauma
and victimization compared with men. Women report
using drugs to cope with stressful situations in their lives,
and there is evidence that women are significantly more
likely than men to be prescribed narcotics and anti-anxiety
8. The prevalence of illicit drug use, drug abuse by
injection and drug dependence is consistently higher
among women who have sex with women. Among
transgender women, drug abuse, including by injection,
is also common, ranging from approximately 30 per cent
in the United States of America, to 42 per cent in Australia
and up to 50 per cent in Portugal and Spain. However, a
study carried out in 2004 in Pakistan found that fewer
than 2 per cent of transgender women had injected drugs
in the previous year.
C. Drug-related harm
1. HIV infection, overdose and other
negative health consequences
16. Studies of drug abuse and its related harms often do
not specifically consider women, in turn limiting the
accurate assessment of how various issues affect women
who use drugs. Furthermore, most research is undertaken
in high-income countries, thus limiting the global understanding
of the situation. Nevertheless, a reasonable
amount of data on HIV among women has been generated,
providing some indication of the problem, given the
link between injecting drug use and the risk of HIV infection.
HIV prevalence among female drug users can range
vastly, from low levels in several countries to over 50 per
cent in some others, such as Estonia and the Philippines.
In the United Republic of Tanzania, 72 per cent of women
who abuse heroin by injection are HIV positive, compared
with 45 per cent of men. In Senegal, HIV prevalence
among women who abuse drugs by injection is
three times higher than among men.
17. Overall, even in generalized epidemics in sub-Saharan
Africa, female sex workers are 12 times more
likely to be HIV positive than the general female population.
Similarly, in other environments with medium or
19 India, Ministry of Social Justice and Empowerment, and UNODC,
Regional Office for South Asia, “Women and drug abuse: the problem in
India—highlights of the report” (New Delhi, 2002).
high prevalence of HIV, or generalized HIV epidemics,
the likelihood of HIV infection was found to be high.20
Female prisoners also have higher rates of HIV infection
compared with both the general population and male
18. Women who inject drugs frequently report sharing
needles, giving reasons such as being unaware of the risks,
being unable to obtain needles from pharmacies and
being afraid of being caught by police. Some women
report that they share needles with their partner as a sign
of love or trust. Poor injecting techniques cause vein injuries
with severe complications. Women injecting drugs
face problems such as fatigue, weight loss, withdrawal
pain, depression and suicidal tendencies; many also have
sexually transmitted infections and hepatitis. For these
women, access to health care is mainly hindered by the
stigma attached to women who abuse drugs by
19. In 2012, more than 15,000 women died from drug
overdoses in the United States. Between 1999 and 2010,
the number of deaths related to the use of prescription
opioid painkillers among women in the United States
increased by a factor of 5, while the rate for men increased
by a factor of 3.6. A review of mortality data in the United
Kingdom of Great Britain and Northern Ireland from
2007 to 2008 revealed larger increases in overdoses (of
all substances) among women than among men (17 per
cent for women and 8 per cent for men). In particular,
there was an 8 per cent increase in the number of deaths
of women from heroin/morphine overdose and a 20 per
cent increase in the number of deaths of women from
cocaine overdose during that period.22
2. Mental illness
20. The dual occurrence of substance use disorder and
mental illness is difficult to diagnose and treat and is
more common in women than men. If women who suffer
from this dual occurrence are not treated they will
have poorer clinical outcomes than women with a single
disorder. In Europe, co-morbid major depression is more
frequent in women with substance use disorders.

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