(see Poster Gallery) Herstory: Women and Drugs Women in the Environment Perspective Using Meta-Ethnography

Background and Purpose: Women are underrepresented in drug and alcohol treatment programs globally. Socio-economic inequities and stigma continue to plague women seeking treatment. The macro and mezzo environments are often ignored, with more of a focus on women "choosing" drugs over traditional feminine roles. Social consequences and punishment are used to deter rather than to treat.

Method: Meta-ethnography is a seven-phase qualitative evidence synthesis valuable method for social research. Meta-ethnography was used to explore the treatment barriers involved with women seeking drug treatment. Qualitative studies were examined from EBSCO, PubMed, ProQuest, JSTOR, PubPsych, ResearchGate, ScienceDirect, Google Scholar, and Sage, yielding 422 peer-reviewed records. Inclusion and exclusion criteria were applied, and 26 studies from 2005 to 2021 were reviewed using the critical appraisal skills program qualitative checklist prior to the final sample's inclusion.

Results: Seventeen countries, nine from Global South and eight from Global North, were represented in the final sample. First-order and second-order constructs identified 85 codes between two coders. Using MAXQDA, the auto-coding analysis yielded 54% of Global North hits, while Global South received 46%. The total number of women participants was n=592. Drug of choice was reported as follows: opioids 41%, crack/cocaine 24%, methamphetamines 20%, cannabis 11%, benzodiazepines 2%, tramadol 1%, and LSD 1%. Global North and Global South were compared using the four social-ecological levels: individual, relationships, community, and societal. Reciprocal analysis indicated 65% similarities compared to 35% of refutational themes. Reciprocal themes included the following: shame/guilt, trust, abandonment, physical/sexual abuse, violence, power/control, stigma, and labeling. Refutational themes included: initiation, rejection, registered drug user, and punishment. The line of argument synthesis concluded that macro gender disparities create obstacles for women seeking drug treatment.

Conclusion and Implications: Social workers have an opportunity to mediate and address gender inequities through leadership and education. Social workers can intervene in all systems and collaborate with women to gain access to treatment and improve environmental conditions that can help promote recovery successes. Future research areas should include a mixed-method approach in examining women's relapse rates per illicit drug while focusing on the environmental contexts.