Women and substance use

If drinking or using a substance has become a way of coping, you are not alone, and there is a path back to feeling more like yourself.

What it is

Substance use in women often develops differently than it does in men. It may be more closely tied to coping with stress, trauma, anxiety or depression, and it can progress more quickly to dependence. Social stigma also tends to hit women harder, which can make it more difficult to ask for help or admit there is a problem at all.

Substance use is not a moral failing. It is often a way the mind and body try to manage pain, stress or difficult emotions, even when it ultimately makes things harder.

Signs to notice

• Using alcohol or other substances to cope with stress, sadness or anxiety
• Needing more of a substance over time to get the same effect
• Hiding or minimising how much you're using, even to yourself
• Feeling guilt or shame around use, but struggling to cut back
• Substance use interfering with work, parenting or relationships
• Withdrawal symptoms, like shakiness or irritability, when you try to stop

What helps

• Be honest with yourself about the role substances are playing, without harsh self-judgement.
• Identify the underlying stress, trauma or emotional pain that use may be masking, ideally with professional support.
• Build alternative coping tools - movement, connection, rest, and structured routines - that can gradually reduce reliance on substances.
• Reduce access where possible, and avoid situations that strongly trigger use, especially early on.
• Involve someone you trust. Recovery is far more sustainable with support than in isolation.
• Be patient with setbacks. Change in this area is rarely a straight line, and that doesn't mean it isn't working.
• Consider how shame may be keeping you stuck. Guilt about use often fuels more use - self-compassion tends to support change more effectively than harsh self-criticism.
• Look after basics like sleep, food and routine, which can make cravings and low moods easier to manage.

When to reach out for help

Reach out if substance use is affecting your health, relationships, parenting or work, if you've tried to cut back without success, or if you experience withdrawal symptoms. A professional can assess your situation and guide you towards the right level of support, whether that's counselling, a support group or medical treatment.

Getting help in South Africa

Cleared Mind's EAP counsellors offer confidential support around substance use, including referrals for further treatment where needed. SADAG's Mental Health Line (011 234 4837) can help connect you with appropriate resources. If gambling is part of what you're navigating, the National Responsible Gambling Programme is available on 0800 006 008.