In Cambridge, a woman named Kristin sits down on a stone bench to talk about a common, but rarely discussed injury during the opioid epidemic: rape.

We’ve agreed to use just Kristin’s first name because she’s a victim of this crime. Kristin says she, like many women who live on the streets, cope with the daily fear of an attack that they are too sedated to fend off — or of waking up to find their pants pulled down, bruises and other signs of an assault.

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. 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.

The road to trouble starts many mornings, says Kristin, when she wakes up, sick and desperate for heroin but afraid to shoplift, sell the goods, and seek a dealer on her own. So she finds a male buddy, someone she calls a running partner.

“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,” says Kristin, 32, who still has the lanky body of a high school backstroke champion. She’s been addicted to opioids since she was 13 and prescribed them to relieve pain after shoulder surgery.

Sometimes that strong man with a good reputation turns out to be another danger. Kristin cringes at the memory of falling into a drug-induced sleep near a running partner she’d come to trust.

“I woke up to him on top of me, with my pants off, pretty much demanding that we have sex,” Kristin says, the emotion draining from her voice. “I’m weak because of the drugs I’ve taken, so I’m trying to push him off. I can’t do it. I grab my phone and just kind of barrel roll off the bed, pull my pants up, and run outside.”

This time Kristin got away. In two other attacks she did not. She has story after story of unwanted kissing and groping. She says that for many women there is steady pressure from those they partner with to perform sexual favors. After the attempted rape, Kristin pressed charges. Shortly before trial, the man died of a drug-related heart infection.

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