This is a blog post written by Shinasa Shahid, a member of the Addiction Special Interest Group (SIG). For more information about the SIG, including upcoming dates and how to join, please visit this page or click below.
Shinasa’s research on the recovery journeys of ethnic minority women in the UK
When it comes to addiction in the UK, ethnic minority women are largely invisible. As a PhD researcher at the University of Derby, I began asking why. Why do South Asian and African Caribbean women delay seeking recovery support? Why do many hide their drinking or drug use until they reach crisis point? And why do mainstream recovery systems so often fail to recognise them?
Reaching out to over five hundred services and contacts who work in addiction, domestic abuse, faith-based, mental health, peer-based, etc, my research confirmed what many practitioners quietly suspect but rarely name directly: the UK recovery system was not designed with ethnic minority women in mind. Most addiction research has historically focused on White men, and even today, ethnic minority women are often described as “hard to reach” rather than understood as a group facing specific cultural, structural, and racialised barriers. This persistent invisibility led me to centre their voices and ask what recovery looks like from their perspective.
Why ethnic women are hidden in plain sight
Across interviews, one fear came up repeatedly: “What will people say?” Concepts such as izzat (honour), sharam (shame), and protecting family reputation shaped almost every recovery decision. Many women explained that speaking about addiction risked gossip, social exclusion, or being blamed for bringing disgrace to their family, even when their health was deteriorating.
Women also described feeling misunderstood within recovery services. Several said they were perceived as “too strong,” “too loud,” or “intimidating” when they tried to explain their distress. This often led to self-monitoring: lowering their voice, softening their language, or withholding parts of their story to avoid being judged. Over time, this eroded trust and led some women to disengage from services altogether.
When I compared these accounts with those of White women, the contrast was striking. White women also described hardship, but they generally reported greater freedom to attend groups, speak openly without fear of community surveillance, and seek help without anticipating racism.
What the data showed and why it matters
Using a mixed-methods design, I studied sixty-four women and identified clear differences in recovery capital across groups (the available resources in personal life, socially, and in the wider community to help initiate and sustain recovery). South Asian women consistently scored low on social and community recovery capital, meaning limited social support from near and dear ones, almost no participation in recovery groups, and little engagement in community-based activities such as volunteering, peer groups, or structured wellbeing programmes. African Caribbean women reported the highest unmet needs in mental health and primary care. White women showed the highest overall recovery capital scores and the strongest engagement with recovery groups.
The interviews explained why these differences existed. South Asian women avoided groups because they feared being recognised by someone from their community. But some joined more discreet groups because they feared being exposed. African Caribbean women avoided groups because they experienced racism or felt emotionally unsafe with them. White women attended because these spaces felt familiar, culturally comfortable, and non-judgemental.
Crucially, motivation was not the issue. Across all three groups, women showed similar levels of commitment to being sober. The difference lay in what each group had to experience in order to access support. Many ethnic minority women described living under constant observation by family, extended family, and wider community networks. Others spoke about feeling they had to prove they were “deserving” of care, worrying that expressing distress would lead to them being labelled difficult. These are structural barriers because they shape trust, help-seeking, and how suffering is interpreted by professionals. Women’s support network never really supported them. Hence, they experienced recovery in isolation. They were trying to stay sober while also carrying shame, stigma, and lack of trust in the services. This isolation was structural.
And that’s what makes the next part important. After I shared my initial findings with a group of women in a project in the Northeast of England, they used my research as the starting point to do something different. For the first time, services that deal with trauma, addiction, and violence came together. For the first time, white services and black and Asian services came together. They reached out to Nigerian and South Asian women’s groups to build a relationship that didn’t exist before. There was no link between grassroots recovery and these communities, and now there’s a bridge being built. My work also fed into another local project that got funding through the Mayor’s Opportunities Fund. That project responded to the racist attack that happened in Horden last August. We can’t keep leaving Black and Asian women out of the picture and hence, my study helped to highlight that their invisibility is systemic. And it gave people language and evidence to do something about it.
What helps women recover and how services can respond in practice
My research shows that recovery for ethnic minority women is strengthened by specific conditions. Importantly, each condition has clear implications for how services are designed and delivered.
- Culturally safe, women-only spaces
Women described staying engaged in recovery spaces where they did not have to explain, justify, or dilute their cultural identity. These were often women-only, peer-led groups where cultural norms around family honour, faith, gender roles, and shame were recognised rather than minimised. This was about their safety. Many women said they avoided mainstream groups because they feared being recognised by someone from their community or being misunderstood by staff and peers.
How this can be done in practice: Services can commission women-only, culturally specific groups facilitated by women from similar backgrounds. Existing models such as BAC-IN, KIKIT, etc., show how this works in practice by embedding recovery support within trusted community settings rather than expecting women to enter unfamiliar mainstream spaces.
Action: Fund and protect women-only, peer-led recovery spaces as core provision, not short-term pilots.
- Faith and spirituality as part of recovery.
For many South Asian and African Caribbean women, faith provided meaning, structure, and a way to reduce shame. Recovery felt more acceptable when it could sit alongside spiritual beliefs rather than being framed as something that conflicted with them. A common assumption in services is that faith should be kept separate from recovery work. My findings challenge this. For these women, ignoring faith often meant ignoring a central source of resilience.
How this can be done in practice: Practitioners can invite, rather than avoid, conversations about faith, allowing women to decide whether and how spirituality is included in their recovery. This might involve acknowledging prayer, faith leaders, or spiritual coping strategies as part of the recovery narrative, without imposing them.
Action: Create space for faith-informed conversations in assessment and ongoing support, led by women’s own choices.
- Emotional safety in relationships with practitioners
Women opened up when practitioners were careful with language, curious rather than dismissive, and aware of how culture and racism shape disclosure. Silence, guardedness, or emotional restraint were often protective strategies. Several women described withdrawing from services after being labelled “intimidating” or “difficult” when they were, in fact, trying to initiate recovery.
How this can be done in practice: Practitioner training needs to focus on recognising how trauma, racism, and cultural expectations influence communication styles. Supervision should support staff to reflect on how their own assumptions shape assessments and responses.
Action: Practice cultural humility, train practitioners to interpret guardedness and silence as potential indicators of risk and mistrust and not non-compliance. Embed anti-racist reflection into supervision.
- Lived-experience leadership and giving back
Volunteering, mentoring, and peer roles helped many women rebuild identity after years of secrecy and stigma. These roles allowed women to move from being seen as “service users” to being recognised as knowledgeable and valuable. However, many women described being asked to support others informally, without recognition or pay.
How this can be done in practice: Services can develop paid peer roles with clear boundaries, training, and support, ensuring women with lived experience are not relied upon as unpaid emotional labour.
Action: Create paid, supported peer and mentoring roles for women with lived experience of recovery.
- Family involvement, handled carefully
Family relationships were often a source of pressure, but they were not always barriers. When involvement was handled with consent and clear boundaries, families could become sources of support rather than surveillance. The risk lies in assuming family involvement is always helpful or always harmful.
How this can be done in practice: Offer optional, women-led family conversations or education sessions that prioritise safety, confidentiality, and autonomy.
Action: Develop family-inclusive options that women can opt into, rather than making family involvement an expectation.
Conclusion
My work makes it clear: if the system stays the same, it will keep failing the same people. My research shines a light on women who have been overlooked for decades. They carry their pain in silence because speaking out is too risky. The women in my study showed extraordinary strength, but they also showed us where the system falls short. Their narratives are a reminder that recovery cannot be separated from culture, identity, gender, or racism. And if services want to reach these women, they need to adapt and this should not be other way around. To conclude, “The ethnic women were never difficult to reach. Services just never learned how to meet them. For them, services are difficult to reach.”