Ms Paula Kearney:

I work at the SAOL Project in the north-east inner city in Dublin. SAOL is a project that works with women who use substances and are working towards positive change in their lives. We support women in that journey through change. We are a women’s rehabilitation project, and all of our programmes are designed with a gender lens on addiction. I am the team leader for the BRIO programme within SAOL. BRIO works with women who have the co-occurrence of substance use and criminality in their stories.

I want to tell the committee a story about one woman to give members a clear understanding of what life is like for women who use substances. I hope that through this story, we will have a shared understanding of what is needed to support women. I wish to introduce the committee to Davina, which is not her real name. Davina is a 35-year-old woman who is also a loving mother to her beautiful son and daughter. Davina grew up in a home where she experienced multiple forms of violence and abuse. Her father was an alcoholic who would regularly beat her mother while Davina watched in terror. He had also abused her from a very early age.

As Davina grew up, she began hanging with friends and like many people she experimented with substances which then led on to cocaine and heroin. She never thought she could become dependent because many of her friends did not. Maybe her friends had not experienced the same traumatic experiences that she did, and Davina soon found herself using more because it helped her suppress the pain she was feeling from her childhood.

Davina met her partner Dave, who is the father of her first child. Dave was confident and strong, and she thought she had finally found somebody that could take care of her and protect her. Within two months of meeting Dave, she found out she was pregnant and Dave began treating her differently. He would beat her and isolate her from her friends. He also began injecting heroin and soon introduced Davina to the needle too. She was scared at first but her addiction to heroin was severe and it was much cheaper to inject because she would need less. She then began committing petty crimes - Davina, not Dave. He had her committing petty crimes such as shoplifting to feed both their habits, and even though she was the one paying for it she then still had to wait for Dave to get himself together to have the first hit and all that, before she would actually get a turn. That put her at further risk because a lot of the time they had to share a syringe. It was getting later in her pregnancy, and she started to worry about her unborn baby, so she started a methadone programme and was doing fairly okay.

Let me tell the committee about how well she gets on when she tries different treatment and rehabilitation agencies. Davina was attending the DOVE clinic in the Rotunda Hospital and instead of being yet another mother who was waiting to welcome her baby into the world, she experienced stigma and discrimination at the hands of the people who were supposed to be there to support her. Every urine test she provided was tested for drugs and she felt scrutinised if she happened to have a sleepless night, which many women do. Many pregnant women find it difficult to sleep. If she looked in any way tired, she was asked what she was taking, and she experienced all the other pieces that come along with that, which other women generally do not experience through their pregnancy.

Davina would be tired and have to face a barrage of questions. She was always honest but always felt doubted. She had her son and faced the dreaded monitoring of her baby which all women on methadone or using substances do, where every sneeze, cough and tremor their babies have - like any other baby - is charted and scored as if they are competing for the Eurovision. The nurses are not specifically trained in addiction either, so many would give her dirty looks when they were filling in the scoresheet, making the already worried mother feel like a failure.

Davina was not allowed to leave the hospital with her baby as the baby was showing signs of withdrawal. Davina wanted that child home so badly that she decided to try to get more help for her addiction. She put a care plan in place which consisted of some support services and Tusla. After her son got well, she was delighted to take him home.

Davina tried the drop-in service for a short time and Davina was happy because it was the only place available to her with her son, but she felt many of the staff were constantly asking questions about the baby and her relationship with Dave, and never focused on Davina's needs. They also offered her unwanted advice about parenting as if she was incapable, they were pulling her up about every little thing and making her feel like she was doing things wrong. She wanted support for herself but felt that it was about everything else but her and she also felt that if she talked about or disclosed what was really going on, she would be judged as a mother, so again, she felt stigmatised.

Davina tried a CE scheme. The CE scheme that Davina started was like many other addiction-specific schemes in Ireland. It was predominantly male and Davina found it difficult to open up or be honest about everything in her life. Many of the issues she was experiencing were things it would be easier to talk to women about because she felt that men could not relate to her. Some of the men also displayed traits of toxic masculinity and constantly flirted with her, which made her feel even more unsafe. There were also no childcare facilities, so she could not fully commit to the service. She decided to drop out.

She and Dave had got a flat together, but they slipped back into addiction. This was around the time of Covid and she could not earn money from shoplifting because many of the shops were closed due to lockdown. Dave encouraged her to turn to sex work. She was terrified. This brought all the trauma she had buried to the surface. She would be out until late at night and then go get their heroin. They were also using crack cocaine by then. They used it together and, as usual, Dave would go first, but when the drugs were gone, Dave's jealousy about her sleeping with other men would come out even though he had forced her into it. One night, he left her so battered that a neighbour called the police. When they came, instead of being treated as another woman would be in that situation, she was made to feel like a complicit victim and as if, somehow, his rage was partly her fault. Tusla was called and her son was taken into care.

She left Dave and tried to get into a women’s shelter but, because she was a woman who had used substances and was on methadone, she could not get a shelter and ended up sleeping in a friend's home. She was there without her son. At the time, she was extremely vulnerable and this friend, who was a male, took advantage of that. They began a relationship that was also toxic. She also found herself pregnant again. This time, Davina got the strength to leave him. She did not stay with him and went through her pregnancy alone. She tried residential detox. She could not concentrate because she was worrying about her son. All she wanted was for her child to be with her, but she felt that she was being punished for all the trauma she had experienced in life.

She blamed herself for ending up in yet another situation like that. She did not know that victims of such abuse are vulnerable to it happening many times in their lives. This is why she really needed a female-specific service where she could finally begin to heal. She finally began a female-only service where she began to build an analysis of what her life had been and what were the contributing factors. She also had her baby girl. She was just on methadone at the time and her baby was born healthy and happy. With the right supports, there was finally a trajectory plan put in place, and Davina got her son back home with her. Now, she wants to come off methadone in a residential centre that caters for children, but she can only take one with her, and only the youngest. The thought of leaving her son again is too hard for her to bear, so she is waiting until she is in a place where he feels secure and her children are old enough to understand her making those decisions.

Society treats women who use substances as less than, and this feeds into how they feel themselves. Women are under-represented within treatment services and policymakers can sometimes miss the clues and not ask the right questions. There needs to be gender-specific services that are trauma-responsive. They need to be not just trauma-informed but to actually respond to the trauma that women experience. We need to create supports that are tailored to the complex intersectional needs of women, instead of them being an add-on to services that are made for and predominantly used by men. Women's health and societal needs are different from men's, so they require a gendered lens and more funding for services that also provide childcare.

I will also highlight that I read something the other day about 1,100 new prison places. There need to be alternatives to prison, specifically when we talk about women. The issues women have do not get fixed in prison. I firmly agree that nobody should be in prison for petty crimes anyway, but when it comes to women, we have to look at the damage that does to a family as a whole rather than just putting women in prison. That should always be a final alternative, with every other avenue having been explored first. I thank the committee.