Sexual Assault: An Even Darker Side of the Opioid Crisis

By Paul Fuhr 09/11/17

“It's an assault active drug users often don't report out of shame, distrust of police or fear they'll be labeled a 'cop caller' and have trouble buying heroin.”

sad woman sitting alone in a empty room

By now, it’s virtually impossible to avoid hearing about the opioid crisis in one way or another. The stories are everywhere in all the same ways opioids are everywhere. According to Boston’s NPR station WBUR, however, there is still one story about the opioid crisis that no one is talking about: sexual assault

Among women with addiction, rape is a major threat that is hugely under-reported. “It's an assault active drug users often don't report out of shame, distrust of police or fear they'll be labeled a 'cop caller' and have trouble buying heroin,” the WBUR story said. “It's an injury women say they can't figure out how to prevent. And it's one few doctors think to ask about, and thus do not treat.”

It’s a harrowing reminder of what really happens to people who live off the grid—especially since rape is also a threat to people who aren’t living in the shadows of society. Non-medical use of prescription medication markedly ratchets up the risk of sexual assault, one researcher observed, as impaired decision-making and motor skills “decrease the ability to recognize danger or fend off a potential perpetrator.”

The WBUR story focuses on homeless women with addiction on the streets of Cambridge, Massachusetts—all of whom shared at least one encounter of being sexually assaulted on the streets. And since medical professionals are rarely involved, everything from unwanted pregnancies to STDs to injuries are just a few of the reasons for concern.

“Sometimes women are alert and recognize or can recall their assailant. Other times they only realize they’ve been raped because their clothes are torn, they have cuts or bruises and a sore vagina,” the story continued.

The article is heart-wrenching, if not depressingly straightforward about how commonplace rape is among women with addiction living on the streets. 

Perhaps more startling is that experts aren’t surprised—even when there’s little evidence or data to support the claims. (A 2015 NYU study did, however, find that 41% of female subjects with opioid addiction reported they’d been forced to have sex while on drugs.)

The director of the Boston Area Rape Crisis Center remained unfazed by the women’s accounts: “Like a job, stable housing, people that know where they are and care where they are," she said, noting that many assailants thrive on chaos and instability. "The isolation piece is a huge vulnerability for sexual violence because the offender will see that as an opportunity."

In other words, attackers know they won’t be found—even on the off-chance that a rape victim actually reports the incident. 

Some experts argue that emergency room doctors should do a better job of screening overdose patients for rape, while others point toward creating clinics where people with addiction can get high under the watchful eye of medical staff. Still, the fact remains that there are scant solutions available.

“I have these moments of clarity ... like, this has got to stop,” one of the story’s rape victims said. “I know better, I’m smarter than this, I’m going to die. But then there's this very apathetic, I don't care attitude to what happens to me.”

And while she says she won’t let her sexual assaults define her (“It’s easier to completely detach myself from it, put it in a box, throw it away, don’t think about it”), she—and all the others around her—remain haunted by their experiences.

Out in the fringes, it’s clear that women with addiction live at the mercy of chance. As the story reveals, they constantly find themselves caught in the terrible catch-22 of using drugs to blot out the reality of rape which, sadly, makes them all the more vulnerable to it.  

Please read our comment policy. - The Fix

Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at You can also find Paul on Linkedin and Twitter.