Complex social and health care needs of women who seek addiction treatment: listening to their voices to guide long-term integrated services that take into account gender

Influence of gender on psychoactive substances (PS) use is still poorly documented, programs and services in this field that are implemented and evaluated being largely unsuited to gender issues, contributing to or even accentuating certain iniquities. The PS-use and services trajectories require more study to improve interventions that address the complex social and health care needs of women who use PS.

The general aim of this study is to better understand how gender influence addiction, health risks, and recovery trajectories in order to guide the development of integrated services that address complex social and health care needs. The two specific objectives are to 1) identify specific vulnerabilities and capacities of women in addiction treatment; 2) understand long-term service and recovery trajectories.

Semi-structured interviews on PS use and recovery trajectories were conducted in Quebec (Canada) with 68 participants, including 26 women. In the year preceding their participation, participants had to present problematic PS use and a combination of two or more associated problems (e.g. socio-judicial, housing, mental health difficulties). Thematic analysis of interviews transcriptions were performed, guided by the intersectional approach and Pederson’s gender-based services analysis framework.

Women underline their difficulties in accessing services that are specifically suited for their needs, emphasizing the importance of feeling safe in order to reveal certain sensitive experiences, such as trauma history. They also denounce the obstacles experienced with regard to the involvement of their family, particularly in the context of residential treatment. Several women point out that services centered on mutual help between women and that emphasize their strengths are necessary.

This study put in light the importance to develop and evaluate gender-specific addiction services in both mixed-care setting and women-only environment that facilitate children and family implication and that take into account complex needs such as those related to trauma and violence.