ROBERT SIEGEL, HOST:
Now a warning about our next story - many listeners may find it disturbing. It is about rape. WBUR's Martha Bebinger has been talking with people in Massachusetts who are addicted to heroin. Those who live on the streets are beginning to speak openly about their fear of being assaulted and of being too high to stop it.
KRISTIN: There are times you go with someone you don't trust, and that's a very vulnerable situation you put yourself in. You don't know if they have...
MARTHA BEBINGER, BYLINE: A woman named Kristin sits down on a stone bench in Cambridge, Mass., to explain how the problem starts. We're only using Kristin's first name because she claims to be a victim of sexual assault. Most mornings, says Kristin, she wakes up sick and desperate for heroin but afraid to seek a dealer on her own. So she finds a male buddy, someone she calls a running partner.
KRISTIN: It's just safer. People are less likely to beat you, rob you, sell you fake drugs if you've got a strong, well-known man with a reputation - a good reputation, you know?
BEBINGER: But sometimes that strong man turns out to be another danger. Kristin, who's 32 and still has the lanky body of a high school backstroke champion, cringes at the memory of falling into a drug-induced sleep near a running partner she'd come to trust.
KRISTIN: I woke up to him with my pants off and him on top of me pretty much, like, demanding that we have sex. And I'm weak because of the drugs that I had taken, so I'm, like, trying to push him off. I can't do it.
BEBINGER: Finally she does. In two other attacks, Kristin says she did not get away. After each assault, Kristin tried going solo on the streets, but then she'd get robbed or sold fake drugs and find a new running partner. The addiction, she says, overpowers fear and common sense warnings.
KRISTIN: In hindsight, it's crazy. You look back, and you're like, red flag, red flag, red flag and pushing it aside because there's a high waiting for me at the end.
BEBINGER: She glances at friends standing nearby when I ask if her experience is unusual.
KRISTIN: Between the other two women that were sitting here with me and the few that are across the street combined, we probably have about 20, 25 assaults or rapes. It's almost become normalized. And that's messed up.
BEBINGER: There's little data on sexual assault among people addicted to opioids. A survey of 164 young adults in New York found 41 percent of women and 11 percent of men said they had been forced to have sex while using drugs. Boston Area Rape Crisis Center Director Gina Scaramella says many drug users would be afraid to report sexual assaults to law enforcement and have lost other protections.
GINA SCARAMELLA: A job, you know, stable housing, people that know where they are and care where they are. The isolation piece is a huge vulnerability for sexual violence because the offender will see that as an opportunity.
BEBINGER: One Boston physician says virtually all of her patients, mostly homeless women, have stories about often violent sexual assaults.
JESSIE GAETA: I wasn't as aware of this until more recently, but I'm just struck by how common it is. In fact it seems really ubiquitous.
BEBINGER: Dr. Jessie Gaeta is medical director at the Boston Health Care for the Homeless Program where she oversees an unusual clinic that monitors patients while they're high on drugs. Gaeta says women often pull her aside as they come out of a high to ask if she'll look at infections, cuts or swelling around their genitals.
GAETA: The stories are just so heart-wrenching.
BEBINGER: Few emergency room doctors ask overdose patients if they've been raped. Gaeta says this is understandable in the chaos of trying to save a life. But she says screening must become routine so doctors don't miss related traumas.
GAETA: Like unintended pregnancy, sexually transmitted illness. Even physical injuries, lacerations we've seen.
BEBINGER: And the mental injuries, which Kristin tries to ignore.
KRISTIN: I think the reason I'm able to, like, get up and go on, like, and - I didn't let the assault and the rape, like, define me. For me, it's easier to completely detach myself from it. Put it in a box. Throw it away. Don't think about it.
BEBINGER: Except, Kristin admits, the sexual assaults become one more pain she numbs with heroin, one more reason she clings to the drug for escape. For NPR News, I'm Martha Bebinger in Boston.
(SOUNDBITE OF RYAN HELSING AND MATTHEW SALTZ'S "LAYERS")
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