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Substance use: helping women with drug and alcohol problems

Substance use: helping women with drug and alcohol problems. This theme explores issues around women, homelessness and substance use. Our Expert Group member Martin Barnes, Chief Executive of DrugScope, is leading on this theme. Read the theme round-up here.

As Martin writes in his blog:

It is important that women experiencing homelessness and substance use problems  are seen as survivors with an incredible capacity to move forward with their lives against all odds.

“Serious substance use can be an escape from traumatic experiences. Our approach to providing support must recognise the complex histories and circumstances women face…Drug and alcohol use can often exacerbate and compound problems around mental health, domestic and sexual violence, family and children, involvement in prostitution and the criminal justice system.”

DrugScope has also produced an Essential Guide for practitioners on the impact for women who become pregnant while using substances.

Why has Martin joined the campaign and become one of our Expert Group leads? He says: “Well, drug and alcohol services and homelessness agencies have a long history of working closely together. Joint work, however, that specifically focuses on women’s recovery and accommodation needs is rare.

“We are aware there is great practice out there though and, through this theme, we hope to gather this together to influence future policy and service provision.”

How do we make sure women with drug and alcohol issues get the right help, at the right time? We want to hear from practitioners on the ground and from women using services themselves, about what works and what support is missing, in particular:

  • Specialist treatment, detox and rehab providers for women, or those which run women’s groups or services
  • Wet and Dry women’s accommodation
  • Partnerships between the drug and alcohol and homelessness services that are working well for women
  • Move on options and floating support in the community for women with substance use issues.

Please also submit any relevant research so we can gather this together to improve the support out there for women.

If you have already joined the campaign, please log in to submit evidence. If you are not already a member, please click here to register. Send us your contributions on this theme by 28 February 2013.

Theme started on: 07 Jan 2013

24 Submissions

  1. Lorna Haw

    Emmaus is a worldwide charity, with communities where homeless people can live and work to rebuild their lives. We take both women and men, although the number of women is normally fairly low, corresponding to the ratios of rough sleepers in London, from where our referrals mostly come. We provide a supportive envronment to help our clients (known as Companions) overcome the difficulties that led to their becoming homeless. We have a cohort of 27 in our residence, and in five years have accommodated 120 people, so our stastics are not necessarily relevant to the larger picture of women with drugs and alcohol problems. The most important factor I have found in working with any of our clients, is to get to the bottom of the psychological reasons for their problems (duh, but then not all people “outside” realise that mental health is the biggest factor in homelessness, not the lack of somewhere to live) and getting people into counselling or some form of therapy is the most critical step we can achieve. however this has had to be done through private counsellors for the most part, as the NHS mental health services are hugely overloaded and the provision is not sufficient for someone with complex needs. We don’t treat women differently in our Community, but their presence has a very civilising influence on the male residents. They all support one another, but the men are protective towards the women, and helps both build trust. We take only low support needs, so I don’t normally have anyone who has been through multiple traumas, although we have had a woman fleeing from domestic violence from her mother. I am interested in other people’s experience of working with women, particularly women who drink, as I find that my women clients who drink won’t admit it to themselves, let alone to anyone else.

  2. Sue Kenten

    The Drug and Alcohol Service for London (DASL) run a range of services in Newham including detox, day programmes and aftercare. This includes a Women only service on Tuesday’s between 10.30am – 1.30pm and a Late Night drop-in service for women sex workers – Monday 9.00pm – 11.00pm. These service are accessed by some women who are experiencing homelessness, and we work in partnership with homelessness services to ensure their need are met. For more information see:

    http://www.dasl.org.uk/newham-services.html

  3. Laura Smith

    St Mungo’s recently conducted an internal literature review on this subject. Some of the key sector research is briefly summarised below:

    • Crisis (2011) Homelessness: A Silent Killer. A research briefing on mortality amongst homeless people. London, 2011 http://www.crisis.org.uk/data/files/publications/Homelessness%20-%20a%20silent%20killer.pdf
    Key findings
    o The average age of death of homeless women is 43, five years lower than for homeless men, despite women in the general population having a higher life expectancy than men.
    o Drug and alcohol use account for a third of all deaths amongst the homeless population.
    o Four out of five people start using at least one new drug after becoming homeless.
    o It is more difficult to address a drug or alcohol problem when also experiencing homelessness. 40 per cent of homeless alcohol users site a lack of stable housing as the primary barrier to their recovery.

    • Joseph Rowntree Foundation (2011) Tackling homelessness and exclusion: Understanding complex lives. McDonagh, T. JRF: York, 2011 http://www.jrf.org.uk/sites/files/jrf/homelessness-exclusion-services-summary.pdf
    A summary of findings from four projects considering the interaction between homelessness and other support needs. The research outlines how services for people with complex needs could be improved to better address homelessness.
    o A disproportionately high number of the homeless people surveyed who experienced mental health problems including anxiety and depression were women.
    o The data analysis found the impact of gender to be less significant than expected.

    • Shelter (2006), Safe as Houses, An inclusive approach for housing drug users http://england.shelter.org.uk/professional_resources/policy_library/policy_library_folder/?a=48062
    o A report about issues relating to the needs of homeless drug users, emphasising that improvements in safety are achieved by actively acknowledging drug use.

    • The Griffin Society (2011), Louise Sandwith ‘Score, smoke, back on the beat’ An exploration of the impact of homelessness on exiting street sex working in Manchester, http://www.thegriffinssociety.org/Research_Paper_2011_01.pdf ;
    o A qualitative research paper examining women’s experiences of homelessness and sex working.
    o Finds drug use to be an common aspect of women’s experiences of homelessness and a significant pathway into both sex work and homelessness.

  4. Laura Smith

    In April 2011 Alcohol Concern and St Mungo’s produced the report White cider and street drinkers, recommendations to reduce harm following a study which explored the impact of white cider consumption on the health of homeless people.
    Findings included:
    • 100% of the professionals who work with dependent drinkers questioned and 50% of the drinkers themselves believe that white cider should either be banned or that it should be priced out of their reach.
    • For the majority of dependent street drinkers all links with family have been broken
    • Women who develop jaundice through liver disease tend to die during their first hospital admission whereas men in the same situation more frequently survive the first few instances.

    Recommendations made by the report included the introduction of a minimum price per unit of alcohol and a ban on strong cider being sold in any container larger than one litre.

  5. Laura Smith

    In 2011 St Mungo’s undertook some research in partnership with Marie Curie and produced a report last year on how best to support homeless people who are dying from liver disease.
    Key findings:
    • Over half of the deaths of people receiving care from St Mungo’s each year are associated with liver failure (31 out of 56 deaths in 2009/10).
    • In this group there is a high rate of hospital admissions, as well as significant distress in the last six months of life.
    • UCL academics studied the cases of 27 St Mungo’s residents who died between January 2009 and April 2010. Of these, 26 were men, one a woman, aged between 32 and 84 years with an average age of 55.

    The report, ‘Supporting homeless people with advanced liver disease approaching the end of life’ is available to view on the Marie Curie Cancer Care website: http://www.mariecurie.org.uk/en-gb/healthcare-professionals/innovation/st-mungos/

  6. Helen Deeson

    Blenheim CDP has been providing services to people with drug problems in London since the early 60’s. We have been and remain a pioneer in developing services to address the wide range of issues facing communities from problematic drug and alcohol use. An accessible, non-judgemental, client-focused and proactive approach is central to our philosophy alongside our passionate belief in people’s capacity to change.

    We provide a range of evidence based initiatives that reflect the multicultural and diverse needs of the communities we work in. This includes providing ‘women only space’ in a number of services we provide, including Eban, an adult drug treatment service in the Borough of Haringey specialising in crack and powder cocaine interventions for stimulant and poly-drug users, and Evolve, a service for stimulant and cannabis users, and their families living in Southwark. Both these services see women who are experiencing homelessness.

    In Islington we run the Islington Community Alcohol Service which provides information, advice, immediate support, or ongoing treatment to any Islington resident who is concerned about their own or someone else’s drinking. As part of this service we have ‘The Reaching Out Project’ which supports groups of people who are often under-represented at alcohol services. This includes parents of dependent children and vulnerable women including pregnant women, people in the criminal justice system, people with mental health needs and the street population. We shall reach out with regular weekly satellites, visits to other organisations, street outreach, and the use of the phone and email.

    For more information on all of our services see: http://www.blenheimcdp.org.uk/

  7. OIWG

    The Outside In Women’s Client involvement Group meet every month in different St Mungo’s hostels. At the January meeting women discussed their experiences of drug or alcohol treatment:

    ‘Women have always had a bad deal economically. This is the biggest issue in recovery from drug or alcohol problems and homelessness, access to employment and being able to move on and support yourself independently, I think there are a lot more options for men.’

    ‘I access an alcohol service and have half an hour to talk about a ‘drinks diary’. I don’t find it very helpful as it is not enough support. For women who have been through so many hardships, it is no wonder they turn to drink. It is really hard to come off drink or drugs when you are in a hostel. It sounds silly but the worst thing is not having enough, so you end up going out to look for money and spiralling into debt. I would like to have an allocated amount of alcohol in stock each week and then try to reduce, rather than have to go out and look for money to buy more.’

    ‘For me I don’t mind being in mixed treatment services, the biggest issue is that there are not enough choice in types of treatment is available, if I had lots of money then there would be other options, but because I don’t the only offer is methadone. The treatment service workers and my GP don’t listen to me in terms of what I want. I have explained that I can get by on a lower dose of methadone and only pick it up once a week but they haven’t listened. Instead I am on a programme to pick it up three times a week and purposely miss one of the appointments and get buy on two. It feels like a problem with the power balance.’

    ‘There is a lack of long term support when you have moved on from a hostel and on methadone. The only option if you don’t have money is NA and I don’t agree with their philosophy.’

    ‘The one problem being a woman in treatment is men latch on to you. Sometimes women can be exploited when men put them to work begging or selling sex to fund their habit.’

  8. Kate Moss

    Women Rough Sleepers is an EU DAPHNE-funded project which aims to increase the knowledge base related to domestic abuse suffered by Women Rough Sleepers. As part of the research, in the UK, we found that drug and alcohol use for female rough sleepers was significant, and an issue for 50% and 55% respectively. This was a higher percent than the women we interviewed in both Spain and Hungary.

    To find out more about this project see: http://www.womenroughsleepers.eu/

  9. Kelly Pain

    WDP is an organisation providing drug and alcohol services in London and the South East. This includes services for women and street based sex workers. For example, our Croydon outreach service focuses on various substance misusing street populations including: street based sex workers, chaotic drug users, poly drug users, dual diagnosis clients, service users from black, minority and other ethnic groups, homeless people, and street drinkers. As well as engaging with substance users, the team makes contact with local businesses and members of the public to ensure that they are aware of the services that are available. This also provides further insight into the local community, helps to identify any problem hotspots and new clients in need of substance misuse support.

    For more information on all our services see: http://www.wdp-drugs.org.uk/index.php

  10. Maxine Brown

    I think women in recovery need someone they can identify with that has been through addiction, abuse, and exploitation as well – somebody who can have empathy and compassion, gentleness, patience and tolerance.
    Women experience pain then they get trapped in a cycle of hurting themselves, wanting a drug to numb their feelings. You become trapped in a spiral of obsession and compulsion. And negative patterns of behaviours
    Women can get involved in street sex work and that can reinforces the feeling of being not good enough (I am such a failure, I have lost the power of choice drugs are dictating my life).
    The grip of addiction is overpowering. Nothing works until you are honest with yourself. I had the best therapist and key worker but it wasn’t sufficient enough, I was using drugs for 20 years. It wasn’t until I was honest and saw all the different parts of myself- including the dysfunctional, the hurt and the confused areas. All these parts lead to isolation because of the shame and stigma associated with drug use.
    Narcotic anonymous (NA) has helped me as I started to talk about what I was facing, and by talking, took the power out of it. I learnt to look at recovery one day at a time, as a lifelong journey, and made new associations with those who had been through it. Knowing people 10 years clean had a big impact, or even better six months I saw hope for me.
    I think talking through it all is what women find the hardest. We don’t want to go back over the abuse, in what should have been a safe home. But you have to; go there to come out the other side. We trust someone even though we have trust issues’, we learn to take positive risk with the chosen person for the first time in a long time and we let someone into the painful empty dark place within us that is so tired and used up. We seek towards a power greater than ourselves to restore us back to sanity.
    Sometimes in NA, women can be called up by men in the group, saying it is about recovery when really they want to get close and have a relationship or just sex. You have to keep up some barriers in this way to make sure you are not being exploited.
    In mixed treatment services both men and women can cling to each other in relationships. If a woman thinks a man likes her she can mistake that feeling for self worth. We need to challenge our core beliefs developed in childhood about being not loved or not safe.
    Women who work as prostitutes have a barrier up to shield out feelings of sadness and shame. They develop a pattern of behaviour to numb their feelings with drugs and start to believe ‘this is who I am’. A punter can rape her and not pay, her boyfriend could be pimping her out, and the drugs are both killing and comforting her. You are left in a lonely space, with emotions creeping out as you sit on your own waiting for a dealer.
    The message I want to share with other women is ‘we recover’. Be honest and take it one day at a time. It takes courage, support and time. I have done it, and everyone deserves a second chance. I have built my self esteem up though things like volunteering at St Mungo’s. I am happy to say that from feeling dead and blank, today I feel alive.

  11. Esther Sample

    Feedback received from a London Complex Needs Worker:

    ‘In London as far as I’m aware there are two Housing Benefit funded male only treatment centres (ODAAT and Acorn House). There is currently nothing like that for women. This means that women have to go through the funding panel for mixed/ female only treatment, which is more of a rigorous process and more lengthy. If our clients are able to sustain abstinence within the community via attending pre treatment groups and access our support having housing benefit funded treatment centres would really reduce the length of waiting time and stress on the client.
    The referral to the Substance Misuse Team is out of our hands as treatment providers have to make this referral. The number of hoops our clients have to jump through in my opinion is excessive for referral. The Treatment model for residential is pretty generic as it is anyway, and is difficult for our more entrenched clients to fit in, more complex needs residential settings are expensive and not on the contracts list in most areas. Making the pathway a little easier and accessible for treatment in general would make a massive difference.’

  12. Glyn Davies

    Breaking Free Online is an online treatment and recovery programme that allows people to resolve the psychological and lifestyle issues that drive their use of alcohol, and so conquer their dependence once and for all

    It employs a wide range of innovative multimedia formats, making it powerful, engaging and very easy to use

    It contains 20 evidence-based intervention strategies, giving it the depth and flexibility to help anyone who is struggling to control their drinking or use of drugs

    It offers people a toolkit of 46 downloadable resources that will continue to support their recovery far beyond the 3-month treatment period, safeguarding all the positive changes they make

    It includes comprehensive guidance for supporters and practitioners, allowing them to enhance the treatment process by participating actively in it

    You can find out more about how Breaking Free Online can help you by visiting: http://www.BreakingFreeOnline.com

    Or by contacting the Breaking Free Online support team:

    Email: info@breakingfreeonline.com

    Tel: 0161 834 4647

  13. Eleanor Levy

    The main challenges that women face in receiving the right support, at the right time include that there is too little integration of services that address mental health and wellbeing, alcohol with other drugs, housing and social needs, physical health and criminal justice and legal needs. For women in our client cohort, there is a high prevalence of a particular group of problems. However, mainstream services tend to address these needs individually rather than together (if at all) and a single approach is often being pursued, rather than multiple approaches which are harmonised by multi-agency coordination which is often lacking.

    Women may find themselves in a service where they are in a minority and it is not unusual for women putting themselves forward for support in a particular niche to be advised that they may be the only woman in the service, though some good practice has emerged where services have set a policy to maintain an appropriate gender balance, which is often all that is needed for the issue to be addressed. There is a strategic need to recognise and support this sort of good practice but commissioning nationally, regionally and locally is rarely integrated to a level where services that introduce this policy are given the necessary strategic support.

    For example, a residential treatment facility that would hold places open specifically for women so as to maintain a balance, and not fill them with men, will naturally have a slightly lower level of occupancy at some times, which has economic consequences. Overall, their results might be more effective in terms of completion of treatment and sustaining gains afterwards, yet usually commissioning criteria are not adjusted to recognise and reward this.

    Some of the key themes in relation to women and substance use include that there is still an imbalance in sentencing for women who are seen as drug users, whereby harsher sentences than might be expected are still resulting in too many women going to prison rather than receiving interventions in the community that would support them better.

    There is a high propensity towards cocaine dependence for women who have suffered trauma, such as childhood sexual abuse. This trauma tends also to pre-dispose them towards abusive relationships. There is recognised research to substantiate this, yet services such as residential rehab which integrate approaches for both drug dependence and trauma are extremely rare.

    The elevated adrenalin levels produced by cocaine dependency mirror and entrench the effects of trauma, and the side effects are uncomfortable. It is therefore very common for women who have suffered trauma and become dependent on cocaine to mitigate the effects with alcohol, heroin or other central nervous system depressants. The combined use of alcohol and cocaine is particularly problematic, because when these are metabolised in the liver, cocaethylene is produced, which is itself more addictive than either taken separately. Use of one often produces strong cravings for the other, reinforcing the cycle of dependence, which is underpinned by trauma. The neuroscience of these mechanisms is now much better understood, but this improved scientific understanding is not yet reflected in treatment developments.

    One should also mention “shame” as a component of drug and alcohol problems. For women, cultural factors make the experience of shame related to use and dependency different. While there are recognised treatment methods to address this for both men and women, they are rarely available to either in substance use treatment services.

  14. Simon Jenkins

    Narcotics Anonymous (NA) is a nonprofit fellowship or society of men and women for whom drugs had become a major problem. We are recovering addicts who meet regularly to help each other to stay clean. There are no dues or fees. The only requirement for membership is the desire to stop using.
    You don’t have to be clean when you get here, but after your first meeting we suggest that you keep coming back and come clean. You don’t have to wait for an overdose or jail sentence to get help from NA, nor is addiction a hopeless condition from which there is no recovery. It is possible to overcome the desire to use drugs with the help of the Twelve Step program of Narcotics Anonymous and the fellowship of recovering addicts.
    Addiction is a disease that can happen to anyone. Some of us used drugs because we enjoyed them, while others used to suppress the feelings we already had. Still others suffered from physical or mental ailments and became addicted to the medication prescribed during our illnesses. Some of us joined the crowd using drugs a few times just to be cool and later found that we could not stop. Many of us tried to overcome addiction, and sometimes temporary relief was possible, but it was usually followed by an even deeper involvement than before. Whatever the circumstances, it really doesn’t matter. Addiction is a progressive disease such as diabetes. We are allergic to drugs. Our ends are always the same: jails, institutions, or death. If life has become unmanageable and you want to live without it being necessary to use drugs, we have found a way. Here are the Twelve Steps of Narcotics Anonymous that we use on a daily basis to help us overcome our disease.
    1. We admitted that we were powerless over our addiction, that our lives had become unmanageable.
    2. We came to believe that a Power greater than ourselves could restore us to sanity.
    3. We made a decision to turn our will and our lives over to the care of God as we understood Him.
    4. We made a searching and fearless moral inventory of ourselves.
    5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
    6. We were entirely ready to have God remove all these defects of character.
    7. We humbly asked Him to remove our shortcomings.
    8. We made a list of all persons we had harmed, and became willing to make amends to them all.
    9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
    10. We continued to take personal inventory and when we were wrong promptly admitted it.
    11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
    12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.
    Recovery doesn’t stop with just being clean. As we abstain from all drugs (and, yes this means alcohol and marijuana, too) we come face-to-face with feelings that we have never coped with successfully. We even experience feelings we were not capable of having in the past. We must become willing to meet old and new feelings as they come.
    We learn to experience feelings and realize they can do us no harm unless we act on them. Rather than acting on them, we call an NA member if we have feelings we cannot handle. By sharing, we learn to work through it. Chances are they’ve had a similar experience and can relate what worked for them. Remember, an addict alone is in bad company.
    The Twelve Steps, new friends, and sponsors all help us deal with these feelings. In NA, our joys are multiplied by sharing good days; our sorrows are lessened by sharing the bad. For the first time in our lives, we don’t have to experience anything alone. Now that we have a group, we are able to develop a relationship with a Higher Power that can always be with us. We suggest that you look for a sponsor as soon as you become acquainted with the members in your area. Being asked to sponsor a new member is a privilege so don’t hesitate to ask someone. Sponsorship is a rewarding experience for both; we are all here to help and be helped. We who are recovering must share with you what we have learned in order to maintain our growth in the NA program and our ability to function without drugs.
    This program offers hope. All you have to bring with you is the desire to stop using and the willingness to try this new way of life. Come to meetings, listen with an open mind, ask questions, get phone numbers and use them. Stay clean just for today. May we also remind you that this is an anonymous program and your anonymity will be held in the strictest of confidence. “We are not interested in what or how much you used or who your connections were, what you have done in the past, how much or how little you have, but only in what you want to do about your problem and how we can help.”

    Contact details:
    UK Helpline (24/7): 0300 999 1212
    Website: http://www.ukna.org

  15. OIWG

    Feedback from a focus group at a St Mungo’s women’s semi-independent accommodation project, Chepstow Villas:

    ‘I think it is important to have a balance of women only and mixed environments, I live in a women only accommodation project so I am happy with the fact that the treatment service I go to is mixed. There are certain issues that it is better to talk to other women about such as pregnancy and women’s health issues.’
    ‘People use drugs to cover up what’s wrong. Sometimes they need counselling, sometimes medical intervention too. I was with a guy who was using heroin and he could be really horrible, only focussed on getting money for drugs. He once beat me so that I had to have 4 stitches under my eye. He said things like ‘I would like to go to prison- at least they would look after me properly there’. Men should have access to counselling and support too. I think also if both partners in the couple have some kind of meaningful occupation to take their mind off the nihilistic frustration, this can really help and take the focus off fighting all the time.’
    ‘I won’t stand for any male bullies now and neither does my project worker. Women feel powerless to stop it but just need to speak out and communicate to officials. In the past I have accessed refuges very quickly. It is a shame that the police need to see bruises before they believe it is going on – there needs to me more early intervention. I know of a woman who was sexually abused as a child and then was in a relationship and was murdered. These things make me very sad.’
    ‘Sometimes when a woman is in a relationship with another person who is using drugs, their partner prevents them from going in to detox. I knew one case where the woman’s partner was arrested for something and then while he was in prison she decided she did want to go into detox and really got her life together. She also met someone else so by the time he was released she had moved on. Treatment services don’t usually work with couples together, however I knew one couple where this was done successfully, this was because there was no abuse or violence involved and they had been together for many years.’

  16. Stephen Gaetz

    The Canadian Homelessness Research Network is dedicated to ending homelessness by improving the impact homelessness research has on policy and practice. It aims to bring together top researchers and work in collaboration with a range of different stakeholders and institutions. There is a cluster network of researchers focusing upon Women and Homelessness.

    The below link shows various research papers on the topic of substance use and addiction in the context of homelessness:

    http://www.homelesshub.ca/Topics/Substance-Use-and-Addiction-182.aspx

  17. Sandra Machado

    EACH provides inclusive services that empower and meet the needs of individuals and families from diverse communities affected by drugs and alcohol, mental health and domestic violence.
    We have developed culturally sensitive and gender specific services to meet the needs of Black, Asian, Minority Ethnic and Refugee (BAMER) communities.
    EACH recognises that certain communities experience additional difficulties and barriers to access appropriate services due to cultural and religious practices where alcohol and drug use is forbidden. Thus, people from BAMER communities often find it hard to disclose, which can lead to the problem escalating and remaining hidden, particularly where they also experience mental health issues, like depression and anxiety.
    For women from these communities it is more difficult to access services as disclosure of alcohol or drug problems can damage their honour, bring shame, and further isolate them from their families and communities. This can result in women unwilling to disclose and seek help, particularly where children are involved. Sometimes, she may also be experiencing mental health and violence and abuse issues alongside her drinking and drug use and therefore require support on all of these issues.
    EACH’s services respond to BAMER groups and women to address their inter-related issues of alcohol and drug use, mental health and domestic violence. Staff are competent to work with people from different cultural and ethnic backgrounds and speak the relevant community languages.
    Advice, information, counselling and support groups are provided in the key community languages. We undertake outreach and satellite work to raise awareness, provide health education and engage with the community.
    Gender specific groups on alcohol and drugs and domestic violence are provided to Asian women, Somali women and Tamil women as well as on alcohol and drugs to Asian men and as part of our day care programmes.
    Services for BAMER families and carers in community languages are available across our centres as they are often isolated, feel anxious and unaware of how to cope with the impact of alcohol and drug use by a relative on them.
    For more information see: http://www.eachcounselling.org.uk/

  18. Laura Smith

    Associate Parliamentary Group for Parents and Families – Tues 5 March 2013 focused on parental substance use: ‘Hidden Harm 10 years on – where now for parental substance use?’

    Joanna Manning from the Children’s Society spoke about development of policy and practice around parental substance use. Key points included:
    •The importance of Children’s Services working closely with the Community and Voluntary Sector
    •Parental alcohol use should not be sidelined. It was not addressed in the Government’s recent alcohol strategy as it was in the drugs strategy.
    •The ‘voice of the child’ is central to effective policy and practice

    Oliver French from Adfam presented their research report ‘Parental substance use: through the eyes of the worker’, available here: http://www.adfam.org.uk/cms/docs/adfam_parentalsubstanceuse_2013.pdf
    Key points included
    •The role of leadership in ensuring workers have confidence to tackle the issues
    •A review of the Guidance on parental substance use was created in 2009 by the Department of Children, Families and Education (DCSF) – which no longer exists, and the National Treatment Agency (NTA) – which will be subsumed by Public Health England from April 2013, is being undertaken; it is not clear who will have responsibility for monitoring.
    •Localism and funding cuts could have a negative impact on effective practice due to loss of services, experience, cross-agency relationships.
    •Organisations’ shared responsibility and need to have knowledge about, signpost and present other services positively to effectively ‘sell’ them to service users.
    •Tackling parental substance use as a “slient partner” in other agendas, including Troubled Families

    Vicky Stewart from Early Break in Lancashire spoke on their Holding Families, a programme of whole family intervention to address parental substance use.
    Key points included
    •The need for non-specialists to be upskilled in this area for effective early intervention, including training for social workers.
    •Focusing on the needs and ‘voice’ of the child.
    More information about the programme is available on their website: http://www.earlybreak.co.uk/

  19. Elliot Elam

    Addaction is one of the UK’s largest specialist drug and alcohol treatment charities. We believe that effective treatment needs to be tailored to the individual. We manage more than 120 services in 80 locations in England and Scotland, including some services specifically for women.

    This includes a city-wide service for pregnant women and those with very young children in Glasgow. The service includes outreach, one-to-one keywork, and intensive support, to help reduce harms to both mother and child.

    For more information on this or other Addaction services see: http://www.addaction.org.uk/

  20. Jane Martens

    RAPt delivers drug and alcohol rehabilitation programmes, both in prisons and in the community, to help people overcome the grip of addiction. In 1992 RAPt established the very first treatment programme in a UK prison and is now the leading provider of intensive, abstinence-based treatment for men and women in custody. In addition to effective treatment, RAPt works to tackle some of the root causes of addiction – poverty, unemployment, homelessness – that keep people locked in a cycle of re-offending.

    At HMP Send in Surrey, the RAPt Women’s Substance Dependency Treatment Programme (WSDTP) has been developed to address the specific challenges faced by women in prison. Female prisoners are 35 times more likely than the general population to be suffering from mental health disorders (male prisoners 14 times) and seven times more likely to be addicted to drugs (men five times). Over half of the female prison population has a history of domestic violence and one in three have experienced sexual abuse. Women are also far more likely to be solely responsible for the care of children than male prisoners when they are taken into custody. Imprisoning women will therefore cause greater disruption to the lives of their children, including placing them at greater risk of imprisonment in later life.

    The RAPt programme at HMP Send is an intensive, rigorous process which seeks to fundamentally change the perceptions women have about themselves and their ability to make changes in their lives. As well as learning strategies to overcome drug and alcohol abuse, women are encouraged to explore the underlying causes of their addiction, to consider education and training opportunities and to build a sustainable plan of recovery.

    After completing the programme, aftercare and resettlement support from the RAPt team is available for as long as needed. Family services are a core part of the programme and helping women re-engage with their children and other family members can continue into the aftercare phase. This aspect of the work is tailored to meet the individual needs of each of the women and will generally include one or more Family Conferences to give every family member a chance to voice their experiences and find a way to move forward together.

    Once a release date is known, the RAPt team liaise with probation and community agencies to ensure no-one is homeless when they leave prison, has somewhere safe to go and someone to meet them at the gate.
    For more information on all of our services see: http://www.rapt.org.uk

  21. Laura Smith

    In 2009 The European Monitoring Centre for Drugs and Addiction produced the paper ‘Women’s voices — experiences and perceptions of women facing drug problems’, a review of qualitative data about women’s experiences and perceptions of women who have had drug problem.

    Some key findings and points:

    • ‘It is widely accepted that drug policy and programme effectiveness is enhanced when sex differences are acknowledged and the different needs of women and men are addressed’ however most drug services are designed for male drug users.
    • Neglect in childhood can be a factor leading to adult drug use for both males and females, but girls are under more pressure to take on domestic responsibilities.
    • Women with substance use problems are more likely than men to have experienced abuse.
    • Women who are subject to social and psychological deprivations are vulnerable to exploitation from men, and substance use can lead women into sex work.
    • Many women who use drugs and are mothers are reluctant to seek treatment as they fear they will be judged negatively.
    • Some Mothers who use drugs would value residential care or home visits that enabled them to stay with their children during detox or rehab.
    • “Stigma permeates the lives of women with drug problems”: ‘Simply I am trying to settle my exterior and interior in the way to give impression of a person, who has never been taking any drugs. I have to confirm and prove myself doubly to be recognised as good, fine young lady’ Drug-using mother, Slovenia.
    • Stigma is a particular issue for mothers and pregnant women. The interests of women can be disregarded as the interests of the child, or foetus, are foregrounded. The report cites an article by E. Ettore in the International Journal of Drug Policy which describes the prevailing view of drug using pregnant women’s bodies as ‘lethal foetal containers’. “Sisters and doctors treated me like a worthless junkie. They gave me the feeling that I did not deserve to have a child…’ Drug-using mother, Slovenia
    • The quotations in the report “do not claim to represent the situation of all drug-using women in Europoe but the overarching theme illustrated…. is about the struggle that female drug users face in fulfilling their social roles.”

  22. Joanne Neale

    Attached are the slides on ‘Some everyday challenges for women in recovery from addiction’ that I gavve at Oxford Brookes University at an event organised by Action on Addiction.

  23. OIWG

    Quotes from St Mungo’s Women’s Peer Research 2013:

    ‘Yeah, I have been supported around that. [It’s difficult when you’re in a using hostel]. I’m actually in a day programme so I go, they do every day an abstinence programme then I come back here every evening and the weekend so it is very hard but my thought I had is I’d rather do that than be taken away somewhere and then be thrown back into this environment – I’m just testing it and seeing how it works. If it doesn’t work, I’ll have to think of another option.’

    ‘It’s difficult because I’m faced with people who try to offer me drugs on a daily basis, and people who know my past – I’ll be walking down the road and I’ve had men who know me from the past and they’ve tried to stop me in the street, begged me to take a lift from them, asked me for my number and tried to lure me back into that way of life. [Must be quite difficult?] Yeah, it is.’

    ‘I don’t feel like my drug project interact with the house where I live. Like, if I’ve got a keyworker at my drug project and a support worker at the house then I feel like they should be engaging because one is supporting me in terms of my accommodation and the other’s monitoring my drug use and supporting me around it, so I do feel they need to be engaging.’

    ‘I need to be out of the hostel environment to maintain control of drugs and alcohol.’

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