We investigate the relationships between violence, drug use and methadone maintenance treatment (MMT) for women injection drug users (IDUs). The data presented here come from a longitudinal study of 233 IDUs both in and out of MMT in the San Francisco Bay Area. Each was interviewed five times over a period of three years, both qualitatively and quantitatively. Using grounded theory principals, we analyze 55 women's accounts of violence. We find that violence acts both as a barrier to entry to treatment and to successful treatment outcomes. Violence is related to drug use and treatment in several ways, primarily in that violence is a traumatic experience to which some women respond by using drugs. Violence may include forced drug use or methadone diversion. Violence may cause women to interrupt or postpone treatment. Finally, two women experienced violence from their treatment providers, which forced them to leave their programs. We suggest that in order to maximize successful treatment outcomes and reduce drug‐related harm for women, violence must be addressed in the treatment process.
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