Women with drug problems have special needs that require specialized interventions, but there are few treatment services catering exclusively for women or even taking their particular needs into account. Most services, as noted above, were originally designed primarily for white male injecting opiate users and many have failed to adapt. Women going into residential rehabilitation frequently have to go into mixed-sex facilities and significant numbers drop out of treatment to break away from relationships they have formed with male residents.

Female drug users need help when they are pregnant. In general, where mothers are taking drugs there is a greater risk of miscarriage, premature delivery and slower growth for the babies (plus a greatly increased chance of HIV or hepatitis for the babies of injecting users). Stimulants may promote anorexia in the mother and thus malnutrition in the baby; the mother’s heroin use can produce a withdrawal syndrome in the baby that may last for several weeks and can include fever and fits. Cocaine can lead to a far higher risk of Sudden Infant Death syndrome.

Many female users are young single mothers, isolated in the community and lacking family support. Unable to afford childcare or to travel far, they need services that both provide childcare facilities and offer reassurance that presenting themselves for treatment will not lead to their children being taken away. Many other women are locked into violent and abusive relationships. A proportion of injecting women users are involved in sex work. Besides being more isolated and more exposed to dangers, both from their clients and from the criminals who groom and control them, they are also more vulnerable to blood-borne viruses. One European authority comments, ‘Although, overall, more men inject drugs and die from using them, one cannot ignore the fact that female injectors may be at greater risk and harder to reach.’