Dr. Teresa Orengo. UCA (Addictive Behaviour Unit) Grao Coordinator. Malvarrosa Clinical Department Valencian Ministry for Health Valencia.

Dr Teresa Orengo using the concept of stigma, raised in the 2nd Edition of the Days on Women and Addiction the problems that she faces every day in the treatment of women with substance use disorder. She noted that the woman who uses drugs faces a double stigma: being a drug addict and being a woman. In the units of attention and treatment of addictive behaviors, the need to implement specific treatments for women has been seen as their problem is different from that of men; the damage they present is greater, their recovery requires totally different keys. They have developed groups only for women, after observing that in mixed groups their presence was diluted, they became invisible.

The stigma depersonalizes the individual, it is an expectation of discredit to include the subject in silos and thus separate and shelve it. The woman stops being a person, mother or daughter to become a "drunk" "whore"...When she comes to request treatment, she carries all this baggage, arrives with the pejorative definition that defines her diagnosis and defines her as a person. The substance, the drug objectifies; in women it has the conditions of shame, loneliness, concealment: "she does not want to be seen" she hides herself and her problem, which affects her health behavior. Addiction in women creates invisibility.

She also indicated that this stigma affects the treatment. The effectiveness of the interventions is uncertain. The differential efficacy of gender-based treatment is not contemplated because there are no studies that consider the different aspects of addiction in women. In harm reduction it is necessary to have different interventions with women, that should be characterized by being closer, more affective and by avoiding the stereotype.

It should be noted that from her experience she has observed that it is not true that a woman who uses drugs has a worse prognosis than a man. The prognosis is good when considering women on equal social conditions and not only considering their biology. Therefore, in the treatment it is necessary to consider the social mandate: childcare; the gender role that penalizes women more, the access to resources: barriers to access to treatments. Using the gender perspective in the treatment of women implies considering social conditions, such as the underestimate of symptoms, diagnostic errors, stereotypes and cultural and cross-cultural conditions.