Women in addiction: ‘He got me in on the coke and the MDMA. ... I ended up in the heights of prostitution’

Domestic violence, coercive control and being “groomed” into drug use by older men, are almost universal experiences of women experiencing drug addiction, a landmark study published on Thursday finds.

A number had engaged in sex-work and transactional sex and said this needed to be “normalised” within services “so that women could talk more openly” about its impact and the risks they faced.

The study, commissioned by Merchants Quay Ireland (MQI) and led by Dr Sarah Morton who is director of the community partnership drugs programme at UCD, examines the unique issues and needs of women drug users.

Drawing on in-depth interviews with 14 women, aged between 25 and 60, it identifies an urgent “need for woman only services, for treatment options that supported motherhood and interventions that recognised the wide range of women’s experiences of exploitation, trauma and abuse”.

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Most of the women were aged between 30 and 40 years, 11 were mothers and four were engaged with the criminal justice system. All were white Irish.

“The majority reported growing up in households where there was parental substance misuse, in most cases alcohol.” They identified “particular vulnerabilities they ... were left with from their childhood experiences, which then potentially left them open to grooming” – into drug use and sexual exploitation.

[ Methadone should be prescribed by nurses to cut long wait times, says addiction expert ]

One woman said: “I would have fallen in love with a teaspoon” after experiencing “a lack of love and attachment” in childhood. Another described how, from age 16, a man started bringing her back to his home and showing her how to use drugs. “He got me in on the coke and the MDMA. And slowly his friends ... I ended up in the heights of prostitution, sniffing, Es, weed, all of that.”

Another was with a man four years her senior, from aged 14. “He actually beat me so bad that I was in hospital and I still went back to him. He broke stuff off me, snooker cues, and I loved him ... And I used to think that was okay, that’s normal because he loved me.” Researchers found: “Domestic violence was a feature of every woman’s experience.”

Women described shame and stigma accessing services. “Society tells you shouldn’t be using drugs. Then as a woman who’s homeless ... A woman who’s engaging in sex work to feed her habit, a woman who’s injecting, all of the other stuff.” She appealed for services to “meet people where they’re at”.

Others found the “derogatory” way sex-workers were spoken about in a mixed-gender service upsetting. “This resulted in further stigma, shame, and a need to hide their own experiences of prostitution or sexual exploitation.”

Key moments precipitating change were when women became mothers, engaged with the criminal justice system or had other health issues. “I was glad it happened because I was tired of going around, I was skin and bone and I was just drained,” said a woman on being arrested, and who then engaged with drugs counselling.

[ Addiction charity reports 52% increase in demand for services ]

Among barriers to getting help were the lack of childcare, geographical location and mixed-gendered services.

Women identified the siloed nature of services failing to address complex issues they struggled to overcome. One said: “Recovering from substance misuse, addiction, whatever you want to call it ... domestic violence, sexual abuse, rape, prostitution. You can’t fix that in six months ... If there’s anything that I could say to critique the systems that are put into support women, I’d say it’s not enough. It’s not long enough”.

The report says women’s drug use must be understood as rooted in “potentially multiple experiences of abuse, trauma and exploitation” rather than as solely problematic use; exploitation and abuse must be recognised as a key issues and women’s safety should be prioritised, and, particular attention should be given to the prescribing and availability of medication, particularly benzodiazepines and pregabalin.