A qualitative study of barriers, facilitators and experiences in treating substance (ab)use among female alcohol and drug users in Belgium

Background: Significant gender differences have been reported worldwide regarding substance (ab)use. Despite the benefits and availability of drug treatment in Western countries, low utilization rates among women and a gender gap is observed, especially among women in the childbearing age.
Objective: The purpose of this study was to obtain a better understanding of the barriers and facilitators for treatment among substance (ab)using women. Women’s personal accounts of critical life events were explored, as well as experiences with services along the continuum of care, leading to practical implications for treatment services.
Method: In-depth interviews were conducted with 60 Belgian female substance (ab)users known to outpatient and residential treatment services. A critical feminist theoretical perspective was adopted to examine the barriers to and facilitators of their enrolment in drug treatment, as well as their experience with services.
Results: Thematic analysis on the heterogeneous sample resembling diversity regarding age, socio-economic background, primary substance of abuse and previous treatment experiences, revealed several themes in meeting treatment needs and treatment utilization. First, the threat of losing custody is an essential barrier for treatment. Second, women report social stigma in private as well as professional contexts as a barrier to treatment. Last, the participants suggest changes that would encourage treatment utilization.
Conclusions: The findings indicate various barriers and facilitators to treatment as well as suggestions for good practices. Focusing on inequalities and gender in policies and research on women’s drug treatment, the findings may inform the development of strategies to overcome those treatment barriers.