As momentum grows around women’s health, the Women’s Treatment Working Group calls for drug and alcohol treatment services to confront gendered inequalities and centre women’s voices in the design of care. Nic Adamson, Deputy Chief Executive of Change Grow Live, outlines three priorities for building services that break down barriers to access, address stigma and safeguarding, and ensure women receive holistic, compassionate support.

In 2022, a group of female leaders from across the drug and alcohol and women’s sectors came together to establish the Women’s Treatment Working Group. Drawing on years of professional expertise, lived experience, and a deep understanding of the challenges women face, the group united around a shared purpose: to transform women’s experiences within the drug and alcohol treatment system.

Recognising that services need to change – and that, as leaders, we have both the responsibility and the capacity to drive that change – we recently published the Womanifesto, calling for a change in how women are treated.

Addressing women’s health in drug and alcohol treatment services

Women have distinct biological, psychological, and social experiences that shape their health needs. These differences are often ignored, misunderstood, or unmet within mainstream health and social care systems.

The launch of the first Women’s Health Strategy for England in 2022 outlined a 10-year plan to improve health outcomes for all women and girls, marking a vital step forward. We welcome this commitment. However, we believe we must go further. For women affected by drugs and alcohol, the risks and barriers are amplified, and their needs are too often overlooked.

Substance use is not just a health issue. It intersects with trauma, poverty, parenting, and gender inequality. Women experiencing issues with drugs or alcohol are more likely to:

  • live in areas of high deprivation where health inequalities are stark (e.g. smoking in pregnancy affects just 2% of mothers in Kensington, compared to 21% in Blackpool)
  • experience gender-based violence, which is both a cause and consequence of substance use
  • face intense stigma rooted in societal expectations around femininity and motherhood
  • fear child removal or have already experienced it, which can deter them from seeking help

As a result, women are less likely to engage with health services. When they do, many find that their experiences are misunderstood or dismissed.

The Womanifesto is our collective commitment to change this. It sets out the actions we will take to ensure that women’s voices, contexts, and aspirations are at the heart of the services we provide. As individual organisations and as a collective, we commit to the following:

1. Listen to what women want and need

Women’s treatment needs are different from men’s, yet women often tell us they do not feel heard. We must listen more to better understand the barriers women face when accessing services. Support must be shaped within the context of women’s changing health and life stages.

We need to work more closely with women to design and develop support that reflects their unique clinical needs, harm reduction priorities, recovery aspirations, and relapse prevention requirements.

The Essex Liaison and Diversion service has developed a resource for women who have been arrested and find themselves in custody. Co-produced with women who have previously experienced custody, the workbook draws on their insights to provide the information they say they wished they’d had at the time. It includes guidance on women’s rights, answers to frequently asked questions, information on accessing drug, alcohol and mental health support, a real-life case study, grounding techniques, and space for women to journal their own thoughts and questions.

2. Offer women-only spaces and services

Women need spaces where they feel safe, seen, and supported. Many of the women we work with have experienced trauma, often at the hands of men. A women-only space can be the difference between showing up and staying away.

These spaces do not need to be costly or complex. A dedicated women-only session, a partnership with a local women’s centre, or simply offering a female key worker can help create the safety and trust women need to engage.

Women Only Wednesday (WOW) in Peterborough is a weekly, women-only, pamper and support initiative facilitated by Change Grow Live at an external venue, designed for women experiencing homelessness, poor mental and physical health, domestic abuse, or involvement with the criminal justice system. The sessions provide a space where women can access coffee and cake alongside holistic wellbeing activities such as yoga, dance, exercise, bingo, health support, hairdressing, hair braiding, beauty makeovers, and general pampering. The programme is strengthened through close partnership working and co-location with specialist agencies including Women’s Aid, Outside Links, social care, GP surgeries, probation, sexual health services, dual diagnosis and mental health services, and The Garden House (rough sleepers project).

3. Honour motherhood

The stigma surrounding drugs and alcohol and motherhood is powerful and deeply rooted. Too many mothers delay seeking help because they fear judgement – or worse, losing their children. As a result, many women and mothers arrive at services as a last resort: when mandated by the courts or social care, or when their situation has become so desperate they feel they have no other option.

We must change this. We must create a new narrative that does not shame or question a mother’s love. While we have a responsibility to ensure that children are safe, conversations about parenting must focus on practical support, not moral judgement. By reaching more mothers earlier, we can give the support needed to help families stay together.

Harper House in Saltcoats supports mums to be admitted with their children, to address their drug and/or alcohol use, and improve their mental health and quality of life. There is a nursery on-site, and local school and health visitor pathways ensure children’s education and developmental outcomes can be prioritised while mums engage in the recovery program. Harper House further benefits from a local midwifery team pathway to allow pregnant women from all local authorities to access the service.

Our call to action

The Womanifesto is our call to action. We invite organisations, practitioners, and policymakers to join us in signing up to our three commitments: listening to women’s voices, creating women only spaces, and honouring motherhood.

We invite you to:

by Nic Adamson

Nic Adamson is the Deputy Chief Executive at Change grow live and Chair of the Women’s Treatment Working Group. She has spent her career working across complex public and charitable services, focused on making systems work better for the people who rely on them. Driven by a belief that real change comes from listening to people’s experiences, doing what we say we’ll do, and leaving things better than we found them.

In chairing the Women’s Treatment Working Group, Nic works alongside leaders, practitioners and women with lived experience to push for a more responsive, compassionate, and effective treatment system for women.

To mark International Women’s Day 2026, the Women’s Treatment Working Group is hosting a webinar on 11 March exploring how women are shaping residential detox and rehabilitation services, and what this means for the future. Find out more and register to attend.

The opinions expressed in this post reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the SSA.

The SSA does not endorse or guarantee the accuracy of the information in external sources or links and accepts no responsibility.

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