Treatment Access Barriers Among Women Who Use Drugs: A Systematic Review

Abstract

Introduction. Substance-related disorders have profound effects on individuals, families, workplaces, and communities, impacting health, well-being, and quality of life. Despite advances in cognitive, behavioral, and pharmacological interventions for substance abuse, women who use drugs often face social, economic, and gender-specific barriers to accessing adequate care. Objective. This systematic review examines the perceived barriers adult women encounter when seeking outpatient or residential treatment for drug-related mental health challenges. Method. A comprehensive literature search was conducted across PubMed, Scopus, and Redalyc for English and Spanish articles published between 2015 and 2025. Of 428 identified publications, 19 met the inclusion criteria. Each study was analyzed for population characteristics, methodology, and findings to identify barriers specific to adult women who use drugs. Results. Across diverse global contexts, stigma consistently emerged as the most significant barrier to treatment. Fear of losing child custody, often linked to anticipated stigma and legal repercussions, further discouraged treatment-seeking. Structural barriers such as limited treatment availability, financial hardship, transportation difficulties, long waiting times, and poor information access were also prevalent. Psychosocial obstacles, including exposure to violence, trauma, and lack of family or community support, further affected engagement. Discussion and conclusion. The findings underscore an urgent need for gender-responsive, trauma-informed, and personalized treatment models that address women’s distinct experiences, including caregiving responsibilities and co-occurring mental health conditions. Expanding childcare services, reducing stigma through nonjudgmental care, and enhancing family support can improve access and retention in treatment, ultimately fostering recovery and well-being among women affected by substance-related disorders.