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This case study examines unique overdose risks and prevention strategies for women who have used heroin during pregnancy in New York City. The overdose crisis has resulted in increased efforts to implement drug user health services; yet, pregnant and parenting women who use drugs continue to be left behind. Three women who currently use heroin and had experienced at least one pregnancy during their heroin use history were interviewed using semi-structured qualitative interviews. Their experiences documented in this case study illustrate several gender-specific considerations when responding to the overdose crisis in New York City. Overwhelmingly, barriers to healthcare and overdose prevention were correlated with perceived stigma and the fear of or actual loss of child custody. Compassionate, gender-responsive interventions remain largely absent in policy and practice, especially for pregnant women. The shared experiences highlighted in this case study should be used to develop improved drug user health policies and practices as well as increase overall advocacy efforts for women of reproductive age who use drugs.

Over the past decade, an increase in the numbers of women prosecuted, sentenced and imprisoned for drug-related offences has prompted concern and debate amongst criminal justice practitioners and policymakers. The female prison population in Southeast Asian countries is high compared to other regions. The direction of national drug policies and law enforcement are critical determinants of this situation. This chapter discusses the trends in the illicit drug market, the different types of policy responses, and the impacts on correctional services in the region. It provides an overview of women prisoners’ profiles, their backgrounds and their involvement in drug-related crimes. Key issues relating to the treatment of women in Southeast Asian prisons are analysed and addressed through the lens of the relevant provisions of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders.