Background: Women compose a sizable percentage of individuals who consume alcohol and drugs problematically in the Republic of Ireland, and much research supports the need for gender sensitive drug policies and services. This paper reviews three decades of alcohol and drug policy in the Republic of Ireland to see how strategies have framed women.

Method; We initially conducted a content analysis and then a critical policy analysis of the four national alcohol and drug strategies, and other key documents, published between 1996 and 2025. Carol Bacchi's 'What's the problem represented to be?' approach guided the analysis.

Results: The historical analysis shows Irish alcohol and drug policy moving through a number of non-linear stages, with a consistent theme of concern for women who consume alcohol or drugs during pregnancy. Women-specific recommendations were only included in the most recent strategy (2017–2025). The analysis shows a development from initial denial around women's drug use to an almost exclusive focus on pregnancy and parenting, to an acknowledgement of the need for 'gender informed approaches'.

Conclusion: The paper concludes by discussing how these problematisations, and silences, can be viewed within the context of wider women's health inequality.