Addiction treatment for women and girls: stigma, privacy and a safe path

Is there confidential addiction treatment for women and girls?

Yes. Addiction treatment for women and girls is available, and it can begin in confidence: with an appointment with a psychiatrist, outpatient therapy sessions, or a call to a confidential government hotline. The International Standards for the Treatment of Drug Use Disorders describe drug dependence as a health disorder with biological, psychological and social causes that can be treated, in women as in men, and note that early intervention can prevent complications and stop the problem progressing to advanced stages.

The obstacle is usually not a lack of treatment but fear: a girl's fear of her family, the family's fear of what people will say, a wife's fear of divorce or of losing her children. This article is for you if you are a worried mother, sister or friend, or if you are the one struggling and looking for a safe way in.

Why do so few women reach addiction treatment?

Official figures in Egypt show the gap. According to the Fund for Drug Control and Treatment of Addiction, in its statement on the first quarter of 2026 published by the State Information Service, more than 40,000 new and follow-up patients used its hotline services, and only 3% of them were women, against 97% men.

A rapid situation assessment of women who use drugs in Egypt, published by the United Nations Office on Drugs and Crime (UNODC) in 2023 with the participation of the General Secretariat of Mental Health and Addiction Treatment, found that women made up only about 1.3% of people seeking treatment in 2019, and about 2% in the first half of 2022. This does not mean addiction is rare among women; it means many of them never reach treatment at all.

The gap is global too: according to the UNODC World Drug Report 2024, only one in 18 women with a drug use disorder receives treatment, compared with one in seven men.

These reports point to the same reasons again and again:

• Double stigma: society judges a woman who uses drugs more harshly, so she feels ashamed, blames herself and hides what is happening.
• Families who don't recognize the problem: some families don't notice the signs, or notice them and deny them to protect the family's reputation.
• Home and childcare duties: looking after children and everyday responsibilities make it hard to keep treatment appointments.
• Few services built for women: most services are mixed or designed mainly around men.

How does addiction often start in women?

A woman's path into addiction often looks different from a man's. The US National Institute on Drug Abuse (NIDA) explains that women are more likely to have chronic pain and may take opioid painkillers without a prescription to cope with pain, or with anxiety and tension, and that they are more likely to seek treatment for misuse of sedatives and sleeping pills, medicines that may be prescribed for anxiety and sleep problems.

In Egypt, the 2023 UN report found that tramadol was the most common substance among women in treatment in 2019, and that pregabalin (Lyrica) was more common among women than among men that year. Some women in the report said they started in order to ease physical pain from work or period pain, or to calm psychological stress from marriage problems or bereavement, and sometimes a husband or relative introduced them to drugs.

• A medicine prescribed for pain or insomnia, taken at higher doses or for longer without follow-up.
• Trying to escape grief, anxiety or violence at home.
• A husband or partner who uses drugs and encourages her to join in.
• An untreated mental health condition such as depression or anxiety.

The UN report on Egypt also notes that women tend to develop a substance use disorder in a shorter time than men, and NIDA says the same about cannabis, for example, so don't wait for the problem to become "big" before you act. To learn more about specific medicines, read about sedative and sleeping pill addiction.

Stigma, family honor and the fear of divorce

Professionals interviewed for the 2023 UN report on Egypt described how conservative social norms deepen the stigma of drug use by women, and how shame and self-blame stop women from asking for help. The report concluded that marital conflict and the fear of divorce and of losing custody of their children cause women considerable stress and isolation.

If you are family, remember that hiding the problem does not protect the family's reputation; it lets the illness grow in the dark. Your daughter or sister needs someone to stand beside her, not someone to put her on trial. Harsh words like "You've disgraced us" push her to hide even more, while a sentence like "I'm worried about you and I'm with you" opens the door.

Drug use during pregnancy: why not stop suddenly on your own?

Fear for the baby can push a woman to stop suddenly without telling anyone. But NIDA warns that suddenly stopping some prescribed medicines, including medicines used to treat substance use disorders, may be more risky for both mother and baby than continuing them under a doctor's care. The UK's National Health Service (NHS) advises pregnant women who regularly use heroin or other opioids, or cocaine, not to stop or cut down before speaking to a doctor, because withdrawal needs to be done the right way to reduce the risks to them and their baby.

The International Standards for the Treatment of Drug Use Disorders, published by the World Health Organization (WHO) and UNODC in 2020, stress that a pregnant woman has the same right to treatment and must not be excluded from it because she is pregnant, and that her treatment plan should be individual and reviewed regularly during pregnancy and after the birth. With opioids, the Standards add, citing WHO recommendations, that a pregnant woman should be encouraged to have ongoing treatment with a medicine such as methadone or buprenorphine where it is available, rather than attempting withdrawal, because withdrawal during pregnancy is linked to high rates of dropping out of treatment and relapse, and opioid withdrawal raises the risk of miscarriage. The doctor decides what suits her, and the options available differ from one country to another. For details on psychiatric medicines, see our article on psychiatric medicines in pregnancy.

How does confidentiality in addiction treatment work in practice?

Confidentiality is not a vague promise but a set of everyday working rules. The Fund for Drug Control and Treatment of Addiction says its services through the 16023 hotline are provided at no cost and in complete confidentiality as long as the person comes forward for treatment voluntarily, and that its network had reached 35 centers in 20 governorates, according to its statement on the first quarter of 2026. The State Information Service also says that beds have been set aside for women in a number of the Fund's centers.

• Egyptian law: the narcotics control law, as amended in 1989, treats all data and information known to people working in addiction treatment as confidential, and punishes disclosure.
• Keeping the file safe: the 2020 International Standards recommend keeping patient records in a secure place that only the staff directly involved in treatment can access.
• Confidentiality has limits: there can be exceptions in some cases, and laws differ from one Arab country to another, so ask clearly in the first call: who will know, and where is my information kept?
• One-to-one sessions: if group sessions don't feel comfortable, ask about individual sessions; the UN report on Egypt recommended individual counseling for women, with their confidentiality protected.

Read more in our article on confidentiality in addiction treatment.

What does treatment that suits women look like?

The 2020 International Standards recommend adapting treatment services to women's needs in every detail: location, staffing, program content and attention to children. The 2023 UN report on Egypt recommended individual counseling, couples and family therapy, attention to mental and reproductive health, and training staff to treat women with respect and without judgment.

• A full assessment that includes mental health, since depression, anxiety and trauma are common alongside addiction.
• Medically supervised detox when needed, especially with sedatives, pregabalin, alcohol and opioids (including tramadol).
• Individual psychotherapy, and the doctor may decide on medicines that suit her situation.
• Involving the family with her consent, and practical help with childcare and follow-up appointments.

At Oxygen Center in Damanhour, we see people aged 15 and over (under 18 with a guardian's consent). Outpatient appointments with a psychiatrist, psychotherapy sessions, behavior-modification sessions and drug tests are open to women and men, while inpatient stays are for males only. If her situation needs an inpatient stay, the doctor will help you think through the right option, including the centers that the 16023 line refers people to. Families can also come alone first to understand the options.

When should you seek help, and how can a mother or sister help with the first step?

Seek help if you notice that the use of a medicine or substance is out of control, that attempts to stop have failed, that sleep, mood, study or work have changed, that packets or money are being hidden, or that use continues during a pregnancy.

1. Choose a calm time and a private place, away from the rest of the family, and talk when she is sober.
2. Start with love, not accusation: "I've noticed you've been struggling lately, and I'm here for you."
3. Reassure her about confidentiality, and explain that people working in treatment are bound to keep her secrets, and that she has the right to ask about the limits of that confidentiality.
4. Offer a small step: a call together, an outpatient appointment, or a drug test to start with.
5. Don't threaten her with scandal or divorce, but don't stay silent about the danger either.
6. Don't lock her in at home to make her stop suddenly: stopping tramadol, pregabalin or sedatives suddenly can cause severe and dangerous withdrawal symptoms, and the safe route is medical supervision.
7. Get support for yourself too, because families need guidance to help without burning out; read about supporting a loved one without enabling.

You can contact Oxygen Center on mobile and WhatsApp at +20 101 687 0711 or the landline +20 45 320 0011, or Egypt's government addiction treatment line 16023.