The research

The study was focused on provision for women using drugs and/or alcohol in the West Midlands and was commissioned by the Police and Crime Commissioner. The research findings are based on interviews conducted at three drug community drug treatment centres and one women’s centre, across three local authorities.

Participants included 28 women currently in treatment, and 20 practitioners. All had experience of both women-only and mixed-sex provision.

Only two of the three centres in the study guaranteed women the choice of a female key worker; one treatment service and the women’s centre were the only providers of women-only spaces, and this was limited to a small number of women with complex needs; one of the three centres offered mixed-sex group sessions only.

In the interests of transparency, I should note that I undertook a rapid literature review for this report in addition to some data analysis.

Conclusions

Women who seek treatment for drugs and alcohol face different needs from their male counterparts, including high incidence of trauma and abusive relationships, a greater burden of stigma around substance use and more common childcare responsibilities. Yet the research found that women’s needs were not being met within the treatment system, where they can struggle to achieve recovery in a system where they are outnumbered two to one by men.

The report (‘Exploring women’s experience of drug and alcohol treatment in the West Midlands’) found that some women were forced to attend mixed-gender treatment groups, which made it difficult for some to talk about traumatic experiences that might be linked to their substance use, such as sexual violence. Mixed gender treatment spaces were also found to be putting the women at risk, with some women describing that they felt vulnerable to ‘predatory males’. One treatment worker likened mixed groups to ‘a hunting ground‘ for men, while others described women being groomed into sex work after being targeted by male service users. 

Women also described how the way that services were set up meant that it was difficult to manage treatment alongside childcare responsibilities.  Barriers to accessing treatment were seen as particularly pronounced for members of some minority communities, including women of South Asian or Eastern European backgrounds.

To enable women to have the best chance of achieving recovery, the report recommends providing access to gender-specific support and treatment in ‘safe, appropriate spaces’, suitable for those with children, and providing gender-specific care which can help safely explore drivers of addiction such as trauma and abuse. 

Given the fact that women who use drugs and/or alcohol may have overlapping needs, the research also recommends a whole systems approach (WSA). A term which refers to a system-level redesign which reorients the work of all the agencies in a system to ensure that women can access gender-responsive support at every point in their journey. In seeking to change practice across a whole system, WSAs go beyond inter-agency partnership models like co-ordination or co-location. WSAs tend to have at their centre an integrated, whole-person support service such as a women’s centre which offers a package of support informed by an understanding of the inter-relationship between the targeted problem and other issues such as domestic abuse, drug and alcohol use, mental health, poverty and trauma.

In the case of women who use substances, a WSA might mean tracking the range of points where women with drug and alcohol issues might come into contact with statutory agencies including children’s services, criminal justice and primary healthcare and exploring how all of these agencies could form part of a network which facilitates access to and contributes to appropriate support.

These findings come at a pivotal time, as the welcome restoration of treatment funding through the Government’s 2021 drugs strategy, From Harm to Hope, offers a vital opportunity to ensure that treatment services can meet women’s needs.