Stigma a barrier to women accessing drug and alcohol treatment, says study

Women using drugs and alcohol can feel stigmatized and shamed when seeking support from professional services, a new study has found.

The research, published in the International Journal of Environmental Research and Public Health, is based on the experiences of women using community drug and alcohol treatment services across the West Midlands, as well as professionals in the field.

Sarah Page, Associate Professor in Social Justice and Social Learning at Staffordshire University, said that "while there are pockets of great practice, there are also times when the words and actions of professionals across drug and alcohol services, health and mental health, social work, and the criminal justice sector can leave women feeling failed.

"We found that women very much experience the stigma of the 'lying drug addict,' and as a result, they constantly have to prove themselves. This can create significant social and emotional harm to the individual."

Interviews and focus groups with women using services were conducted by Staffordshire University in partnership with Expert Citizens CIC, and a world café event was undertaken with professionals. The research collaboration included the Center for Justice Innovation, which led data collection via interviews with professionals.

An important feature of the research is that women with lived experience of using drug and alcohol services also helped to design the study, helping to conduct the interviews and to reflect upon the data.

One woman in the study spoke about not being believed after reporting that a police GP had sexually assaulted her. Another was accused of taking drugs after providing a urine sample, which turned out to be a mistake made by a professional and could have resulted in the woman losing her child when the inaccurate findings were shared with social services.

Evidence was also found that some professionals misrepresent events in case notes, including legal documents for court hearings, which adds to the emotional trauma experienced by women.

The research was conducted in response to the government's 'From Harm to Hope' drugs strategy, which promises funding for 54,500 new drug treatment places by 2025, and findings raise concern that the strategy somewhat overlooks the treatment needs of women.

Findings from the wider study reported on by the authors also revealed that women are at risk of being targeted by abusers in "chaotic, intimidating or unsafe" mixed-gender drug and alcohol treatment services.

"We, and others in the field, were concerned that the 'From Harm to Hope' strategy doesn't fully acknowledge women's specific treatment needs and doesn't offer nuanced guidance on how to work with women," commented Fiona McCormack, from Staffordshire University's Center for Health and Development.

"Our findings establish that stigma negatively impacts the identification of treatment needs and access to appropriate support. Social harms to women with addictions could be significantly reduced with timely, authentic, honest, gender-informed and trauma-informed practices."

The authors are now calling for women's only services to ensure that women addicts feel safe and believed. Based on the views of women in this study, a further recommendation is for lived experience experts to work in recovery support worker roles to provide enhanced empathy and act as role models, as well as provide input into service design.

Other recommendations include mandatory training with regular updates for professionals in all related services pertaining to trauma, gender discrimination, and harassment, ethical professional practice, being non-judgmental, and responding to service user complaints.

Associate Professor Sarah Page added, "It is important to recognize that women in recovery are working really hard to prove themselves."

"Several public health areas have already signed up to provide a women's only service, which is a great achievement, and we hope that more across the UK will do the same. Staffordshire Police also invited us to deliver training to ensure that the custody suites in Staffordshire are more trauma-informed in the approach of working with women and drug users more broadly. So that's a great outcome, which we're hoping to build on and roll out nationally."