Why rehab is especially difficult for women

From logistical hurdles to financial barriers, societal judgment, and pregnancy-related concerns, learn about the challenges women face with substance use treatment.

Ophelia team
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Fact checked by
Erica Lyons, DNP, MS, APRN, FNP-BC

Women with opioid use disorder (OUD) face unique challenges when pursuing treatment options. Unfortunately, these challenges can become insurmountable hurdles, deterring some women from getting the help they need.

We think it's time to highlight the unique circumstances surrounding women and addiction. We can find ways to overcome these challenges only by shining a light on them.

5 challenges of substance use treatment for women

1. Lacking childcare and/or elder care

One common concern women have when they're considering seeking treatment is, "Who will take care of my kids?" Mothers who lack a reliable partner or support network may be afraid to move ahead with treatment. In-patient treatment facilities, in particular, seem out of the question in these cases.

On top of that, some women also provide care for aging parents or other elderly family members. In fact, one in four women report providing care for a relative or friend, and it’s common for family caregivers to be helping out for more than 20 hours a week. Again, if there is no backup system to step into this caregiving role, women may hesitate to seek treatment that takes them away from home. Worries about leaving their loved ones in the lurch may outweigh concerns for their own well-being.

2. Logistical hurdles

Treatment for OUD is a big undertaking that requires time, effort, and dedication—and if it involves travel, women often worry about who will drive them to and from treatment. Even driving to and from sessions at local outpatient rehab for women becomes complicated for a single-car household or those living in a rural community or other areas with limited public transportation.

How bad is the transportation problem? Research shows that during a 12-month period, 21.6 million people in the U.S. needed drug or alcohol treatment, but only 2.3 million actually received care. While there can be many barriers to care, the lack of reliable, affordable transportation plays a significant role because it leads to people missing appointments and being unable to develop a consistent, effective treatment regimen.

The logistics become incredibly complex in cases involving an unsupportive partner or even an abusive partner. In severe cases, abusive partners may restrict their victims' movement, preventing them from leaving the house and their sphere of influence, making substance use treatment for women seem impossible.

3. Financial barriers

OUD treatment can be expensive, especially if a patient needs ongoing support or undergoes multiple rounds of treatment. While subsidized and cost-efficient programs exist, there aren't always sufficient resources to help everyone in need. But it's not just a question of paying for the treatment itself. Women who are the sole breadwinners in their families may also wonder who will support their loved ones if they need to take time out of work.

Caring for children or elderly family members can include everything from paying for routine expenses, like groceries and utilities, to periodic fees for activities and appointments. Trying to balance a loss of income with ongoing expenses and the new cost of pursuing rehab can get in the way of successful treatment.

Drug treatment can even lead to lost job opportunities in the future. The Americans With Disabilities Act (ADA) includes provisions that are supposed to prevent employers from discriminating against people with a history of addiction and undergoing treatment. However, people still experience hurdles in the job market for a variety of reasons, including:

  • The need for additional education and skills training
  • Accommodating childcare and other family responsibilities
  • Low pay that would prevent them from taking care of the essentials

Despite the ADA’s requirements, personal bias can also affect the hiring process. Drug-free workplace policies account for almost half of all alleged ADA violations—and those are just the cases involving lawsuits. 

4. Pregnancy-related concerns

Pregnancy introduces a whole new set of questions about OUD treatment. First, some women may wonder whether seeking certain kinds of treatment, notably medication-assisted treatment (MAT), could affect their unborn child. And these questions could prompt them to avoid seeking treatment as a result. Women may also worry that child protective services (CPS) will intervene to take their child.

Additionally, research suggests that the healthcare system makes it difficult for pregnant women to get treatment. In a "blind shopper" style experiment, pregnancy was shown to negatively impact a woman's ability to even get an appointment for a medication-based OUD treatment program. Even if a woman is prepared to seek care for OUD, the clinicians aren’t necessarily willing to meet her halfway.

5. Societal judgment

What’s at the root of so many of these barriers to treatment? Society’s assumptions about women’s experiences and the very real pressure they might feel can lead to misunderstandings about their treatment needs.

Women with children and pregnant women, in particular, often face criticism when they would be better served by compassion. Drug overdose deaths more than doubled among pregnant and postpartum women from 2017 to 2020. Sadly, 80% of these deaths were preventable.

Greater sensitivity is needed regarding women and addiction. The path toward compassion starts with education. A good starting point? Busting common myths around opioid use and raising awareness regarding women and substance abuse.

How online treatment for substance use disorder can help women 

Online treatment programs can help address many of the challenges women face when seeking treatment for substance use disorders. With online treatment for OUD, concerns around childcare and elder care are no longer barriers.

Online treatment also addresses logistical hurdles since women don't need to leave home to get care. Such programs are significantly cheaper than in-patient options and reduce the need for time off work or lost income, which addresses financial barriers to care.

Ophelia connects women with MAT securely, discreetly, and simply. We connect patients with a care team who will be available to help seven days a week. Eligible patients are given a prescription for Suboxone® or another buprenorphine-naloxone medication to fill at their local pharmacy. This medication helps to manage cravings and make withdrawal more manageable.

It’s simple: Ophelia helps women get the treatment they need on the terms that work for them.


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