Women make up approximately a quarter of all people with serious drug problems in Europe and around one-fifth of all entrants to drug treatment. Yet much still needs to be done to provide interventions tailored to their needs, with many drug services remaining male-oriented.

These issues are explored by the EU drugs agency (EMCDDA), on International Women’s Day  (8 March), in a new miniguide Women and drugs: health and social responses. The guide outlines key considerations for planning and delivering health and social responses for this group, reviews the availability and effectiveness of existing services and explores implications for policy and practice.

In the EU, it is estimated that over 30 million women (and 50 million men) (15-64 years) have tried an illicit drug at some point in their life. Women and men with drug problems differ in their social characteristics, living conditions and drug use patterns, in the consequences of their substance use and in the progression to dependence.

Women who use drugs, for example, are particularly likely to experience stigma and economic disadvantage, come from families with substance use problems, have childcare responsibilities, be the victims of childhood abuse or suffer from co-occurring mental disorders. Although women present unique concerns that are sex- and gender-related, there is a risk that programmes for women may be deprioritised when limited funds are available.

‘The complex, overlapping issues faced by many women who use drugs require coordinated and integrated services. Across Europe, drug use, mental health networks and social services are often separated’, states the guide. It adds: ‘Adopting a gender-responsive approach to drug problems benefits gender-diverse people including women, men, and transgender and non-binary people’.

According to the guide, women’s needs should be considered and incorporated into all aspects of service design and delivery. Involving women in planning and developing relevant policies and programmes may also improve services and increase their reach. The guide calls for: training for staff in health and social services to provide appropriate assistance (non-judgmental, empathetic), the creation of safe environments to facilitate women’s access to care, and gender-responsive and trauma-informed services.

There is a pressing need for research that addresses gender issues and considers gender in all aspects of service design. More research into the effective evaluation of approaches that respond to the needs of women who use drugs is also of key importance. Including breakdowns by sex in routine statistical data collection may enhance understanding of drug use trends, sociodemographic factors and the issues faced by women within a given region. This is a crucial step in developing appropriate responses.

In summary, the only adequate way to meet the diverse and complex needs of women who use drugs is through a gender-responsive approach based on integrated services.