This article was written by Kendra Gray, BAC O’Connor Centre and Viv Evans, Adfam, members of the Collective Voice Women’s Treatment Working Group
The Women’s Health Strategy Must Not Leave Behind Women with Drug and Alcohol Problems
The publication of the Women’s Health Strategy for England in April 2026 marked a significant step forward in recognising the longstanding inequalities women face in accessing healthcare. The strategy acknowledges that women have often felt unheard, dismissed, and underserved by health services. However, one group of women remains at particular risk of being overlooked: women experiencing drug and alcohol problems. The strategy fails to address the needs of women who are affected by drugs and alcohol which is a missed opportunity.
Women who use substances are among the most marginalised members of society. They often experience a combination of challenges including trauma, domestic abuse, mental ill-health, poverty, homelessness, and involvement with child protection services. These factors do not exist in isolation; they interact to create profound health inequalities that can persist throughout a woman’s life.
Furthermore, the impact of substance use on women’s health extends far beyond those who are using drugs or alcohol themselves. Women also carry the overwhelming burden of caring for family members affected by addiction. Adfam is the leading charity in England for all the millions of people affected by someone else’s drinking, drug use or gambling. Adfam estimates that 97% of those who seek support from their service are women. These mothers, partners, daughters, sisters and grandmothers often experience significant emotional distress, financial hardship, anxiety and social isolation, yet their own health and wellbeing frequently goes unrecognised. They are supporting others whilst receiving little or no support themselves.
Among the most overlooked are kinship carers, many of them grandmothers who step in to care for children when parental substance use makes it unsafe for them to remain at home. These women are navigating one of the most painful dilemmas imaginable: being asked to protect and parent their grandchildren whilst coping with the grief, guilt and loss associated with their own son or daughter experiencing addiction. They are often expected to manage complex family relationships, facilitate contact between parents and children, and absorb the financial, practical and emotional consequences of addiction with little specialist support. Their experiences demonstrate that substance use is not only a treatment issue but a women’s health issue, affecting the physical, emotional and psychological wellbeing of women across generations.
Women in recovery consistently describe the vital role female family members play in sustaining recovery:
“Not giving up faith in me was the most powerful thing and supporting me now through the transition to ‘normal life’.”
Many women still find services inaccessible or unsuitable. Fear of stigma, concerns about losing custody of children, experiences of violence and domestic abuse, and caring responsibilities can all act as barriers to seeking support. Many women report feeling judged rather than understood when accessing healthcare and treatment services:
“It’s across the board, isn’t it? In hospitals as well, so I’ve been in hospitals before, and the hospital staff have just been not very nice. You’re a heroin addict, then they kinda like, when they are doing the medication, they’ll leave you til last… you’re nearly ready to walk out the door to go and score …” (quote from Centre for Justice Innovation report: Exploring women’s experience of drug and alcohol treatment in the West Midlands)
The Women’s Health Strategy rightly highlights the importance of listening to women’s voices and designing services around women’s experiences. Yet women affected by drugs and alcohol have often been absent from national conversations about women’s health. Their needs extend far beyond substance use treatment alone. They are more likely to experience reproductive health problems, poor mental health, chronic physical health conditions, and the long-term impacts of trauma. Many also face significant barriers to accessing routine healthcare, screening programmes, maternity services, and mental health support and deaths for women who use substances continues to rise.
The evidence is clear that gender-responsive approaches work. Women-only spaces, trauma-informed care, integrated support for domestic abuse and mental health, and services that recognise women’s roles as mothers, carers and family members can improve engagement and outcomes. However, access to these services remains inconsistent across the country. This support should extend not only to women in treatment but also to the mothers, grandmothers and kinship carers whose health and wellbeing are profoundly affected by the addiction of someone they love. Despite the critical role these women play in sustaining recovery and protecting children, access to specialist support remains inconsistent across the country.
If the Women’s Health Strategy is to fulfil its ambition of reducing inequalities and improving outcomes for all women, it must explicitly recognise women affected by substance use, those affected by trauma and women who have experienced adverse childhood experiences as a priority population. This means ensuring that women’s health policies, funding decisions, and service design reflect the realities of women’s lives, including the experiences of those who are often the least visible.
Improving women’s health cannot be limited to those who already find it easy to access services. True equity requires us to focus on those who face the greatest barriers. The Women’s Health Strategy highlights the need to improve care across the life course. However, there remains limited recognition of how substance use intersects with key women’s health issues. For example, the relationship between menopause and substance use is an emerging area of concern. Many women report using alcohol or drugs to manage menopausal symptoms such as anxiety, insomnia, low mood, and stress, yet there remains little research, limited clinical guidance, and few services equipped to address these overlapping needs. Women with drug and alcohol problems have been underrepresented, underserved, and too often unheard. The Women’s Health Strategy presents an opportunity to change that—but only if these women are included in the conversation and at the centre of the solutions.
A genuinely inclusive women’s health agenda must recognise that the women with the most complex needs are often those with the most to gain from compassionate, coordinated, and gender-responsive healthcare.
Ultimately, the measure of success for any strategy aimed at reducing inequalities should not be how well it serves those who already have access to support, but how effectively it reaches those facing the greatest barriers. Women affected by drugs and alcohol should not remain a blind spot within women’s health policy. They should be recognised as a priority population whose experiences can no longer be ignored.
The Women’s Treatment Working Group is calling on the Government to engage directly with us to address this significant gap in the strategy. Future policy must recognise not only women experiencing substance use but also the women whose health is affected by supporting loved ones through addiction, including kinship carers and other family members. By working collaboratively with women, families, service providers and experts in the field, we can ensure that future policy better reflects the realities of women’s lives and delivers more equitable health outcomes.