Women make up approximately a quarter of all people with serious drug problems and around one-fifth of all entrants to drug treatment in Europe. They are particularly likely to:
A number of sub-groups of women with drug problems have special needs. These sub- groups, which often overlap, include pregnant and parenting women; women involved in sex work, who may often experience violence and stigma; women from ethnic minorities, who may have been trafficked; and women in prison.
Screening and brief interventions
Health care providers should:
Health care providers managing pregnant or postpartum women with alcohol or other substance use disorders should offer comprehensive assessment, and individualised care.
Detoxification or quitting programmes
Health care providers should, at the earliest opportunity, advise pregnant women dependent on alcohol or drugs to cease their alcohol or drug use and offer, or refer to, detoxification services under medical supervision where necessary and applicable.
Pregnant women dependent on opioids should be encouraged to use opioid maintenance treatment rather than to attempt opioid detoxification.
Pregnant women with benzodiazepine dependence should undergo a gradual dose reduction, using long-acting benzodiazepines.
In withdrawal management for pregnant women with stimulant dependence, psychopharmacological medications may be useful to assist with symptoms of psychiatric disorders but are not routinely required.
Pharmacological treatment (maintenance and relapse prevention)
Pharmacotherapy is not recommended for routine treatment of dependence on amphetamine-type stimulants, cannabis, cocaine, or volatile agents in pregnant patients.
Pregnant patients with opioid dependence should be advised to continue or commence opioid maintenance therapy with either methadone or buprenorphine.
Adapted from WHO Guidelines for the identification and management of substance use and substance use disorders in pregnancy.
The implications for future development of responses for this group include: