Side event: Barriers in access to treatment and recovery – Issues faced by women living with substance use disorders

Organized by Europe Against Drugs (ERAD), Proslavi Oporavak/Celebrate Recovery, Stand & Western Cape Substance Abuse Forum, Women’s Organizations Committee on Alcohol and Drug Issues, World Federation Against Drugs

Moderator: Regina Matterson, UN Women Sweden:

Welcome. This side event today is part of Women’s Organizations Committee on Alcohol and Drug Issues (WOCAD) 10 year strategy that focuses on women and children. [Introduces all speakers].

Janina Emgstrom, Women’s Organizations Committee on Alcohol and Drug Issues (WOCAD). Welcoming remarks.

I represent the oldest Swedish organization working with women. Today, I speak on behalf of 300,000 women which we represent. I wanted to start with a song, James Brown ‘It’s a man’s world’. It is important to note that risk for abuse is gendered and there is large body of research supporting this. There is only one international treaty, the Convention on the Elimination of All Forms of Discrimination against Women that
was ratified by 187 countries in 1979.

Women are being slaughtered in Sweden and the authorities are not doing anything. When we look at the research we find the vast majority of women with substance use disorders have experienced violence.

WOCAD promotes access to trauma-informed treatment, important to note this is different to trauma-specific interventions. We focus on the need to address competence and understand the survivor and their environment. It’s crucial to empower women, and make sure women are safe. Stigma should end with me. This is an issue of life insurance and human right to life.

Lucia Gobena, Dianova International:

Dianova International is an international network of 24 NGOs. We focus on treatment and recovery. [Plays video]

Gender-specific programs help empower women and the wider society. Yesterday UNODC’s Executive Director, Ms. Ghada Fathi Waly, noted gender disparities in her opening remarks in the plenary, and we know from the most recent World Drug Report that only 1 in 7 people with substance use disorders are getting treatment. The figures are much worse for women. Stigma is one of the biggest gender barriers to accessing treatment and women who use drugs experience double stigma: substance use and gender stigma. Other barriers to accessing treatment include the ‘caregiver role’ – that women traditionally put others first and fear of loosing children. Many treatment options have no childcare service. Furthermore, many programs are not gender-specific, and exist in masculinized spaces. We need to infrastructure to ensure women’s security and tackle underrepresentation in treatment. There should be the same number of places for both men and women. Also important to note that gender-specific should not forget about gender non-binary people and people from the LGBTQ community.

Chantelle Pepper, Dept Social Development, South Africa:

Today I’m going to examine barriers to treatment for women in recovery. In South Africa we have legislative policy framework with a 3 tier national drug master plan: supply reduction, demand reduction, and harm reduction. While it looks like a top down approach from the national level, at the local level, we work to understand the issues from the bottom-up. Each region in South Africa is very different. Our region is rural and have long history of alcohol being used as form as payment to farm workers.

We cover a large region of the West Cape in South Africa. Annual research from SA Medical Research Council found that across 35 specialist treatment centers, for a 6 month period, 2719 patients were treated, with 73% male and 27% women. The majority (79%) of patients were treated in outpatient settings and males continue to dominate patient intake. A greater percentage of patients were people of color (66%) and black Africans (20%).

Femicide is a reality on the ground in SA. Something needs to be done urgently.

Women who live below the poverty line cannot afford treatment and the other major issue is funding and spaces. We need to understand our community and focus on local prevention. Without structural changes women come out of treatment and are at high-risk of relapse.

Barriers include long waiting lists, transport issues, gender-based violence, lack of childcare and child friendly treatment centers. Finally, there are unlicensed treatment centers in SA and serious human rights violations occur in these centers, they are mostly for-profit and don’t meet minimum standards. Violence is a very major issue.

Children: where do women leave their children during the treatment? Often it is not safe to leave them with a family member. We teach women parenting skills. Stigma is a major issue for women, even from law enforcement and medical professionals.

Dual diagnosis and lack synergy between health and mental health. Referrals can be tricky, and women get bounced around between health and mental health services. Issues with women with SUD and living with HIV.

Stacy Doorly-Jones STAND, South Africa:

Good morning. We honored to put our voice on the global map today at the UN. We are facing the same issues that others have already discussed today.
STAND provides Recovery programs, Mindfulness, Arts and Crafts, Animal Assisted therapy and more.

Stigma is a major issue and results in a lack of specialist care and interventions. Women with SUD turning up at hospitals, particularly in rural areas are often face major stigma and are often turned away. Barriers include intergenerational trauma. It will take years to heal from the harms that apartheid caused. Lack of funding is also major issue. Need to get creative with lack of funds. Created MOU with health care providers and diverse community programs, from NGOs to faith-based groups. Today we seek global support and collaboration for women with SUD.

Wouter Vanderplasschen, Ghent University, Belgium:

Today I’m going to be discussing moving towards gender-based recovery. What do we know about gender-sensitive treatment? Women tend to start drug use later, but they tend to become addicted more quickly than men. There is a major gender gap and women are underrepresented in alcohol and drug treatment. We need a gender-sensitive approach as most services are developed through the lens of managing men, not women. Gender-sensitive approaches are ‘a set of comprehensive, family-focused interventions which are provided in a strengths-based, relational, and trauma-informed fashion’ (Grella 2008, Tang 2012).

The definition of recovery was initially defined by the Betty Ford clinic. Recovery looks different for different people.

In Belgium we did a study of 60 women in treatment. Outcomes: there was a desire to feel safe, for an holistic approach, and experts with lived experience/peers. We also found that some women prefer mixed gender programs – but not all. There was a need to feel safe: not only from gender-based violence but also from the temptation of drugs. We also need to meet women where they’re at.

Pathways to recovery: US research states that an estimated 9% of US population is some form of recovery. This includes ‘unassisted or natural recovery’. This is particularly important for women, especially as they don’t access treatment at the same rates as men. Other research found that less women in residential treatment. Women in recovery are less likely to have  housing issues.

Male bias in recovery literature is also an issue.

Need a wide range of services that are not just focused on white, middle-class men. Need to take into account gender-sensitive principals. Online treatment and recovery alternatives need to be explored as a way of supporting women.

Leave a Reply

Your email address will not be published.