Pourquoi les politiques actuelles en matière de drogues sont-elles inefficaces envers les femmes, les travailleuses du sexe, les mères et les personnes de diverses identités de genre ?

The Australian Government reopened the Inquiry into the Health Impacts of Alcohol and Other Drugs use in Australia. The inquiry started in the previous session of parliament, was cut short of finishing due to the Federal Election in May 2025. AIVL’s submission to the previous inquiry is carried over to the current inquiry. 

AIVL in collaboration with Scarlet Alliance et our member organisations provided supplementary evidence responding to the issues paper. Our latest submission shows that Australia’s current approach to drugs is failing women, sex workers, mothers, and gender-diverse people who use drugs—and making us less safe. Below is a summary of the key issues outlined in the submission.  

1. Gender and ‘narcofeminism’ 

How people experience drugs, violence, and the healthcare system depends heavily on their gender. Men are more likely to access AOD services such as needle and syringe programs; we know men encounter stigma, judgment, and structural barriers when engaging with these services. At the same time, women and gender-diverse people often experience heightened forms of punishment, surveillance, stigma, and control when interacting with systems and service providers, reflecting the gendered dynamics that shape access and treatment within AOD responses. In addition, women, gender diverse people, and sex workers who use drugs have been excluded from mainstream feminist organisations and campaigns.  

We introduce ‘narcofeminism’ as a framework that recognises the harms of drug policy (like criminalisation, removal of children, and violence) as core feminist issues. We invited the Inquiry Committee to consider the lived-living experiences of all women who use drugs and that there are many positive reasons for use – for safety, connection, pleasure, And for those among us who want to change the relationship we have to our drug use, services need to consider the gender aspects of our experiences. 

2. Women who use drugs: trapped between violence and a system that blames them 

Women who use drugs are two to five times more likely to experience sexual, domestic, or family violence. But when women seek support, they’re often turned away from housing, health, and sexual and family violence services. 

The issues paper’s focus on alcohol as a main cause of violence misses the point. Evidence shows alcohol is often an excuse or an enabler, not the root cause. The real drivers are gendered power imbalances and control. Women who fight back or who use drugs are often seen as ‘unworthy victims,’ allowing violence to continue. 

3. Mothers and pregnant people: punished, not supported 

Mothers who use drugs live in fear. Asking for support can mean having their children removed. This forces them to use drugs in riskier ways (e.g. alone) and avoid healthcare. These barriers may mean mothers don’t access opiate agonist maintenance and treatment programs (pharmacotherapy). Services must be family-friendly and non-punitive to support positive health outcomes and keep families together. 

4. Young women and gender-diverse people: navigating risk and pleasure 

For young people, drug use isn’t just about risk—it’s about connection, pleasure, and exploring identity. But men’s harassment and violence in social spaces shape our every move. Young women and gender diverse people’s harm reduction strategies focus on managing men’s behaviour, not just being mindful of our own drug use. Services and safety campaigns need to be designed with us, not for us. 

5.Sex workers who use drugs: compounded stigma 

Sex workers who use drugs face a ‘double stigma.’ We are often excluded from both mainstream health and social services. Sex workers need peer-led, specialised support that recognises our unique needs, not stereotypes that blame us or question our choices.  

6. Sexualised drug use: it’s not just a ‘gay, bi+, queer thing’ 

Using drugs to enhance sex (‘chemsex’) is often portrayed as only affecting people from gay, bi+ and queer communities. But new data shows it’s just as common among non-GBQ Australians. Public health information needs to include everyone and focus on pleasure, consent, and practical safety. Health promotion about sexually transmissible infections (STI) is most effective when it is peer-led. Health system responses could be informed by values and preferences of people who use drugs for sex. We must centre peer-led research at all times. 

7. Dental care: a right, not a luxury 

People who use drugs may have dental problems because care is too expensive, dentists often judge them, and the system is too hard to navigate. When state or territory governments fund dental services for people in our communities, there have been high levels of service use. Good dental health is good for our overall health and quality of life. We need affordable, respectful dental care for all, included in Medicare. 

8. Learning from COVID-19: peers are central to public health responses 

The pandemic hit people who use drugs especially hard. Services closed, policing increased, and health risks soared. Some positive changes—like easier access to medication—were made but were later rolled back. In planning for future pandemics and climate-related disasters like floods and bushfires, our communities must be at the table, helping to plan a response that doesn’t leave us behind. 

The bottom line: a call for humanity and rights 

Australia’s punitive, one-size-fits-all drug policies are causing harm. We need a shift to harm reduction, peer-led services, and human rights. While the inquiry may result in recommendations for reform that are subject to government adoption, the upcoming refresh of the National Drug Strategy may be well placed to listen to and reflect the experts: people with lived-living experience. 

Our submission includes 30+ concrete recommendations. You can download the full version below.

 Written by Joël M, AIVL’s Policy & Evaluation Specialist 

Note on the use of Artificial Intelligence: Joël used DeepSeek-V3, a Mixture-of-Experts language model, to suggest summaries based on AIVL’s original submission. They then restructured and edited the summaries. 

Lire la soumission complète

Inquiry into the health impacts of alcohol and other drug use in Australia

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