This is the third in a series of posts linked to the materials published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) alongside its recent (24 October 2017) 188-page report: Health and social responses to drug problems: a European guide. This post is based on the EMCDDA’s policy and practice briefing on: Women with drug problems.

Women and drug treatment

Women make up approximately a quarter of all people with serious drug problems and around one-fifth of all entrants to drug treatment in Europe. They are particularly likely to:

• experience stigma and economic disadvantage, and to have less social support;
• come from families with substance use problems and have a substance-using partner;
• have children who may play a central role in their drug use and recovery; and
• have experienced sexual and physical assault and abuse and have co-occurring mental disorders.

A number of sub-groups of women with drug problems have special needs. These sub- groups, which often overlap, include pregnant and parenting women; women involved in sex work, who may often experience violence and stigma; women from ethnic minorities, who may have been trafficked; and women in prison.

Knowledge gaps

Worryingly, there has been very little women-specific research on drug issues and treatment in Europe and the EMCDDA briefing highlights:

• The need for and the benefit of specific interventions for women who have problems with different drugs, including prescription drugs and polydrug use, should be investigated.
• Evaluations, including cost-effectiveness studies, of interventions for women in diverse settings across Europe are needed.
• Large knowledge gaps about women’s drug use exist for a number of reasons: studies do not always include women; those that do may not disaggregate by gender, or address gender issues; most research on drug-using women of child-bearing age only deals with opioid users; research on cannabis, new psychoactive substances, misuse of medicines and polydrug use among women is limited.

Responses

The EMCDDA identifies five types of responses for women drug users seeking treatment:

1. Specific services for women. These services may be offered in female-only or mixed-gender programmes. They need to be welcoming, non-judgmental, supportive and physically and emotionally safe, in order to address stigma and trauma. They should promote healthy connections to children, family members and significant others.
2. Collaboration between drug treatment and mental health services in order to address co-occurring substance use and mental health needs.
3. Services for pregnant and parenting women, which need to deal with drug use, obstetric and gynaecological care, infectious diseases, mental health, and personal welfare, as well as providing childcare and family support.
4. Measures to overcome the barriers to care for women involved in the sex trade, such as evening opening, mobile outreach services and open access support.
5. Sensitivity towards ethnic and cultural aspects and the possibility of interpreter services when working with women from ethnic minorities.

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