Addiction among women and girls is often inextricably linked to experiences of violence and abuse. When appropriate support is not easily available, women living with trauma use drugs and alcohol to cope.
Using data from the Adult Psychiatric Morbidity Survey, Agenda’s Hidden Hurt research shows that the greater the severity and frequency of the abuse, the greater the likelihood of substance misuse. An estimated one in 20 women in England and Wales had experienced extensive abuse both as a child and as an adult, according to the report. Women who had experienced the most extensive abuse were more than twice as likely to have an alcohol problem (31 per cent) than women with little or no experience of abuse. One in five women in the extensive violence group had used drugs in the previous year and eight per cent were dependent on drugs, compared to just one per cent of women who had experienced little or no abuse.
Using drugs and alcohol can make women much more vulnerable to further sexual and physical abuse and exploitation. For example, there are an estimated 80,000 women involved in prostitution in the UK and the vast majority of those women are addicted to either heroin or crack. We also know drugs and alcohol were used by perpetrators of child sexual exploitation rings across the country to help them abuse girls.
The entire introduction to substances and process of addiction among women and girls tends to look different to that of men and boys. Women who face addiction are more likely to be introduced to drugs through partners, whereas for men it is via their peers. Women face greater shame and stigma around drug and alcohol use, they can often be judged much more harshly because their behaviour goes against societal norms of what is expected of women. Women who are mothers are often more afraid of accessing support for fear their children will be taken away. While women of Black, Asian and Minority Ethnic groups can face additional barriers and stigma. But despite women having particular needs and experiences – they are continually overlooked in drugs policy and practice.
A recent report by Pulse showed that 87 per cent of councils had cut funding for general drug and alcohol services. This is particularly alarming because we know that there was so little out there for women in the first place.
Agenda’s recent report with AVA, Mapping the Maze, showed that less than half of local authorities in England and a fifth in Wales have substance misuse support specifically for women. Even then, the most common types of support were weekly women’s groups within a generic service or the availability of a substance misuse midwife, which obviously only supports women who are having a child. That means women often have no option but to access mixed services or nothing at all.
Given women’s likely histories of abuse, generic, mixed services, which are usually dominated by men, may at the very least be intimidating and can even be dangerous. Research suggests that 34 to 68 per cent of men in substance misuse treatment have a history of perpetrating intimate partner violence (IPV). Mixed services also often don’t have the capacity or expertise to deal with women’s experiences of abuse and trauma. This can result in women being misunderstood and even blamed for what has happened to them. This might explain why women who misuse substances often have particularly complex needs by the time they reach treatment, with poorer mental and physical health and worse quality of life than men, at both the start and end of treatment.
So what needs to happen to improve the situation? As part of Mapping the Maze, extensive research was conducted on what constituted a good service for women. It all pointed to specialist women’s services being the best way to meet women’s needs, with a caring culture and flexible support also being important, especially to the women themselves. We need to see more investment in such gender-specific and trauma-informed support that treats women as a whole person, taking into account their histories of violence and abuse, and the complex, overlapping needs they face. Not just responding to their label as ‘addict’ or ‘user’.
Lisa Jones is Communications & Campaigns Manager at Agenda, the alliance for women and girls at risk.