Addiction treatment in Ireland has evolved significantly over recent decades, moving from predominantly medical abstinence based approaches towards community based and harm reduction models (Butler, 2002; Butler, 2007; Morton & O’Reilly, 2019). While these developments have improved access to treatment, and while there has been much research of late into responding to women specific needs in services (Ivers et al, 2021; Morton et al, 2020; Morton et al, 2023) gaps remain in how addiction services implement and respond to the specific need for women to feel safe. 

Women continue to engage with addiction treatment services at lower rates than men (Lynch et al., 2023). Women account for only three in ten treatment cases (Tierney et al, 2025) and face multiple intersecting barriers to accessing support, including trauma, adverse childhood experiences, gendered stigma, childcare responsibilities, fear of Tusla involvement, poverty, homelessness and experiences of violence (Covington, 2008; Ivers et al., 2021; Morton et al., 2020; Lynch et al., 2023). Women with complex needs often encounter fragmented systems of care that fail to adequately address the interconnected nature of their needs. Substance use is frequently understood as a coping response to trauma, while withdrawal and abstinence can intensify trauma related symptoms (Hien et al., 2021). 

Despite evidence and recent research supporting integrated, trauma informed interventions for women with co-occurring trauma and substance use difficulties (Najavits, 2007; SAMHSA, 2021; Morton et al, 2020; Ivers et al, 2021), such approaches remain inconsistently implemented across community addiction services in Ireland. This research summary explores how policy, practice, and organisational supports focused on psychological safety can enhance women’s engagement in treatment and recovery, while outlining the key factors that enable practitioners to create safe, trusting, and supportive environments in Irish community drug services. The summary is based on a research project that combined a scoping literature review and semi-structured interviews conducted with six female addiction practitioners working in community addiction services in Dublin.

Thematic analysis identified several key issues, including the importance of relational trust, trauma informed and gender responsive practice, the impact of stigma surrounding addiction and motherhood, organisational barriers, and the emotional practice involved in supporting women safely and compassionately.