Like many of you, I read Maud Clarke’s harrowing interview (‘Breaking the Silence’) in The Impartial Reporter on May 9.

As she detailed the consequences of one man’s actions for her and her family, I thought of the many women who exist in the aftermath of trauma.

This week, I want to talk about women and why we drink.

Far beyond the specific incidents of abuse, women face a lifelong legacy of harm. Harm which, as Maud is testament to, can be overcome with the right supports, by being believed and heard and through seeing Justice served.

In general, women drink less than men, both in frequency and volume. The ‘Extent of substance misuse in NI update’, October, 2020, reports just 2 per cent of women drinking heavily, compared with 9 per cent of men.

There are specific cultural factors at play for us in Northern Ireland which go some way to explaining why we drink so much, our attitudes to alcohol consumption and the social pressures at play, particularly for our young men.

For the purposes of this column, I want to talk specifically about women’s experiences of addiction and the gendered underlying causes.

The correlation between combined adversity; violence, abuse, poverty and multiple disadvantages, are well documented and are critical in providing effective multi-disciplinary approaches to addiction services in.

Put very simply, the more adversity we face, the more maladaptive coping mechanisms we employ.

Given the disproportionate traumas women face across their life course, women are more likely to suffer from significant addictions as a result of the combination of violence, poverty and sexual abuse.

We can all relate to this to some extent. How many of us have heard an exhausted work colleague ask: “Is it wine o’clock yet?”

I am reminded of WC Fields’ quote: "Set up another case bartender! The best thing for a case of nerves is a case of Scotch.”

Among those with alcohol problems, for women, depression and anxiety are more likely to be experienced before the problem drinking.

In men however, alcohol tends to be the underlying cause of their depression.

These nuances have implications for mental health services in teasing out the underlying cause needing attention.

This is what we need to get to grips with. As far back as 2016, the Joseph Rowntree Foundation published ‘Joining the dots’, laying bare the scale of the hurt behind addiction in women.

“Half of women in combined adversity are smokers, a quarter had a problematic pattern of alcohol consumption”.

Statistics from the Northern Ireland Substance Misuse Database 2022/23 confirm that women (93.4 per cent) are more likely than men (85.1 per cent) to report alcohol as their primary problem substance.

This goes beyond those classified as ‘heavy drinkers’.

The consequences of addiction can compound the trauma which triggered it initially.

Children may be removed as a consequence of drinking in order to mitigate the recognised adverse childhood experience of living with a parent in addiction.

Some will find themselves estranged from adult children, or homeless as a result of being unable to maintain a steady income.

Each of these experiences emanating from the addiction serve to deepen the trauma which triggered the problem behaviour in the first place.

Close to 60 per cent of women seeking treatment for substance misuse report being a parent and/or living with their child.

There are implications here for services including providing access to treatment facilities which facilitate recovery for women while keeping families together and keeping children safe.

There are examples of good practise we can learn from, including Jasmine Mother’s Recovery programme in Devon.

Formerly known as ‘Trevi’, it is a residential rehabilitation centre for mothers and their children.

Some 84 per cent of women who access this service successfully detox, and almost 8 out of 10 children get to stay with their mother.

The reason for the existence of women-only refuges or women-only Domestic and Sexual Violence Services is based on the fact that the women who access those services have been subjected to violence at the hands of men.

In Fermanagh, in 2023/24, 96 per cent of women who needed our services were abused by men – the majority being male current or former intimate partners. 

We need to acknowledge this context within addiction services. Many women battling addiction initially began drinking either to numb themselves in preparation for a violent assault, to block the memory of them, to dim their fear, or lower their inhibitions so they could fight back.

For others, it was a solemn resignation to hopelessness. By an overwhelming majority, these abuses were perpetrated by men, making recovery difficult in integrated services which were designed for men.

There is learning here also for women’s Domestic Violence Services and an ongoing need to ensure that our services can adequately support those with comorbidities, or facing additional risks resulting from trauma, including addiction and mental health issues.

Further specialism in safely housing those with addictions, mental health issues, victims of sexual exploitation, women with no recourse to public funds, or previous criminal behaviours, all warrant further investment in order to interrupt the cycle of trauma and reduce the lifelong health consequences and costs of the same.

Peeling back the onion of the behaviour – or ‘lifestyle choice’, as I have sometimes heard it called – is important.

Approaching addiction from a place of compassion and empathy with professional curiosity around which events set the addiction in motion is important.

We cannot expect women to ‘just get off the drink’ without providing the specialist wraparound supports and pathways to set them up for success.

How many of us read Maud’s interview, and thought we would have had a drink too? I know I did.

I know I was in awe of her ability to rebuild her life, and I know how many women fall through the cracks.

Addiction is a predictable consequence of significant trauma. We know that women experience telescoping, meaning that there is a quicker timeline from the initiation of substance use, to dependence on that substance, so the clock is ticking for all of us.

Kerrie Flood is Development Manager at Fermanagh Women’s Aid.