It is the way you treat yourself, but also the way you allow other people to start treating you as well: perceptions of overdose risk among women who inject drug

Purpose Women who inject drugs face risks of blood-borne virus transmission and violence in heterosexual partnerships. While recognising these harms is vital, focusing solely on victimhood reinforces stereotypes. Building on sociological work that aims to understand relational power not only in harm but also in care, this study aims to examine women’s perceptions of overdose, with attention to how social dynamics such as care and stigma shape perceptions of safety. Design/methodology/approach The authors drew on interview data from 19 women who inject drugs and have lived-living experience of overdose in Queensland, Australia. Using semi-structured interviews, the authors explored women’s experiences with drug use, overdose, stigma and interpersonal relationships. Data were analysed through an iterative categorisation approach, involving collaboration between the research team, partly comprised of peer-researchers. Findings While harmful, overdose prompts acts of care and solidarity as women navigate avoidance and response. Interpersonal relationships, including intimate partners and the community of women who inject drugs feature as carers and the cared-for, are crucial for safety from overdose. The primary disruptor of safety for women was stigma. Women reported internalising stigma about injecting drugs, leading to secrecy around their drug use and overdose, in turn compromising safety and help-seeking. Originality/value Beyond conventional understandings of intimate partners as a source of risk for women who inject drugs, this case study in overdose offers a broader re-conceptualisation of relations among people who inject drugs. While care is not always foregrounded, women’s navigation of safety through social networks underscores the relational enactment of protection and possibilities for harm reduction.