The history of gender theory provides a useful framework for examining some key features of the literature on women and drugs as well as a lens for exploring gender sameness and difference in recovery from heroin dependence. For example, the earliest addiction literature generally ignored women or portrayed them as victims or as weak, self-destructive and insecure individuals who were sicker, more deviant, and more psychologically disturbed than their male peers (Broom, 1995, Ettorre, 1989, Ettorre, 1992, Henderson, 1999, Pettiway, 1997, Thom, 2010). A key objective of the first feminist addiction scholars was therefore to give women drug users and the issues that concerned them greater prominence. As Ettorre argued, this required a women-orientated perspective on, and response to, substance abuse that was empowering and rooted in the identity and consciousness of females who actually used drugs (Ettorre, 1989, Ettorre, 1992, Ettorre, 1994).
Much of the gendered drugs literature that subsequently emerged focused only on women, highlighted female drug users’ shared experiences of addiction, and portrayed drug-users who were female in a less stigmatising, more empowering light than had previously been the case. Indeed, a number of very influential studies showed how women drug users were autonomous and assertive social actors who made conscious choices to use substances, could be good and loving mothers, and did not inevitably support their drug use through prostitution (e.g. Ettorre, 1989, Ettorre, 1992, Kearney et al., 1994, Rosenbaum, 1981, Taylor, 1993).
For many years, the literature on women and drugs tended to focus on a relatively narrow number of issues: especially female drug users’ involvement in sex work, their sexual relationships, pregnancy/mothering, and experiences of physical and sexual abuse (e.g. Boyd, 1999, Freund et al., 1989, Glynn et al., 1983, Murphy and Rosenbaum, 1995, Perkins and Bennett, 1985). Additionally, studies started to show that women encountered particular barriers in accessing support for their drug problems, such as negative stereotyping, social stigma, lack of childcare, transportation problems, and services that did not meet women's needs (e.g. Abbott, 1994, Copeland, 1997, Fraser, 1997, Marsh et al., 2000, Nelsonzlupko et al., 1996, Weissman et al., 1995). This, in turn, elicited demands for treatment based on a feminist perspective (Abbott, 1994) and for specialised women's services, such as women-only groups, child care provision, and support in addressing abuse issues (Becker and Duffy, 2002, Grella et al., 2000, Nelsonzlupko et al., 1996, Oppenheimer, 1991, Swift et al., 1996).
Studies comparing the needs and characteristics of drug-using women and men, meanwhile, indicated that rates of substance use were lower for women, but women were more likely to share needles, receive previously used injecting equipment, and have a sexual partner who was also a drug user (Barnard, 1993, Becker and Duffy, 2002, Gossop et al., 1994, Powis et al., 1996). In addition, females were disproportionately likely to have experienced physical and mental health problems, sexual abuse, or domestic violence (Becker and Duffy, 2002, Gilbert et al., 2001, McKeganey et al., 2005). Women in treatment were also more likely than their male peers to be responsible for childcare (Grella and Joshi, 1999, Rowan-Szal et al., 2000) and unemployed (Richardson et al., 2010, Rowan-Szal et al., 2000).
