The critical problem in providing treatment for women drug abusers is that existing treatment dollars go almost exclusively to treat the male heroin addict. Although our evidence shows that women are the major consumers and abusers of drugs, that fact goes unrecognized by the drug treatment industry. However, rhetoric alone has proved unsuccessful in revising this trend. This article, which was prepared under contract for the City and County of San Francisco, formed the basis for a proposal to the state for the first Comprehensive Treatment Program for Women Drug Abusers in the country. We see this document as a model for the women in the country to use as their basis for reversing funding patterns. We found that without this kind of hard documentation, no amount of political lobbying was effective in combatting the sexism that is such a part of the allocation of treatment dollars. drug use studies indicate that women are the primary users and abusers of psychotherapeutic drugs. An analysis of San Francisco drug and mental health programs reveals few women request treatment for this problem except in emergency rooms during drug crises. The experience of the San Francisco Polydrug Project suggests that: (1) women will request treatment for psychoactive drug abuse only when such treatment is explicitly offered; and (2) that the population requesting treatment will be heterogeneous as to age, race, class, and ethnicity.[1] In order to determine the scope of the problem among women in San Francisco, we investigated four major sources of information: * Incidence and prevalence studies indicating the extent of abuse nationwide. * Data from national reporting systems monitoring for nonopiate drug abuse problems. * Data from reporting systems monitoring entry rates and diagnoses for opiate and nonopiate drug abuse problems in San Francisco. * Data from individual drug, community mental health, and women's programs. While the term polydrug has been used to define drug abuse problems involving either the multiple use of drugs and heroin, or the single use of a drug other than heroin, we are confining this needs assessment to an investigation of what is called prescription drug use and abuse. Prescription refers to drugs that can be obtained by legal prescription-barbiturates, sedative hypnotics, minor tranquilizers, and amphetamines-however, the method by which these drugs are obtained may, of course, be illegal. The emphasis is on a pattern of drug abuse because, among women, this is thought to be a major problem which is not currently seen in existing treatment systems. We are not including women whose primary drug of abuse is heroin or alcohol because they currently surface in existing drug treatment prog-