• David Otiashvili, Irma Kirtadze, Kevin E O'Grady, William Zule, Evgeny Krupitsky, Wendee M Wechsberg, and Hendrée E Jones.
• Addiction Research Center, Alternative Georgia, Tbilisi 0177, Georgia. Electronic address: dato@altgeorgia.ge.
• Int. J. Drug Policy. 2013 Nov 1; 24 (6): 566-72.

BackgroundIn the Republic of Georgia, women comprise under 2% of patients in substance use treatment and to date there has been no empirical research to investigate what factors may facilitate or hinder their help-seeking behaviour or access to treatment services.MethodsThis study included secondary analysis of in-depth interviews with 55 substance-using women and 34 providers of health-related services.ResultsThe roles and norms of women in Georgian society were identified as major factors influencing their help-seeking behaviour. Factors that had a negative impact on use of drug treatment services included an absence of gender-specific services, judgmental attitudes of service providers, the cost of treatment and a punitive legal position in regard to substance use. Having a substance-using partner served as an additional factor inhibiting a woman's willingness to seek assistance.ConclusionWithin the context of orthodox Georgian society, low self-esteem, combined with severe family and social stigma play a critical role in creating barriers to the use of both general health and substance-use-treatment services for women. Education of the public, including policy makers and health care providers is urgently needed to focus on addiction as a treatable medical illness. The need for more women centred services is also critical to the provision of effective treatment for substance-using women.Copyright © 2013 Elsevier B.V. All rights reserved.

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