Skoun and UN Women join forces to address the intersection of GBV and substance use

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Out of respect for the privacy and safety of the individuals Skoun supports, photography is limited and often intentionally blurred. Photo credit: Skoun

Out of respect for the privacy and safety of the individuals Skoun supports, photography is limited and often intentionally blurred. Photo credit: Skoun

In Lebanon, where overlapping crises have strained the country’s protection systems, a growing but often ignored intersection is deepening the marginalization of vulnerable women and girls: substance use and gender-based violence (GBV). 

According to global studies cited in a recent assessment by Skoun – a Lebanese Harm reduction and outpatient treatment center for substance use disorders – women who use drugs are 5 to 24 times more likely to experience GBV, while many survivors of GBV turn to substance use as a coping mechanism. Yet, as Skoun’s findings also highlight, mainstream GBV response systems rarely account for this dual vulnerability, leaving critical gaps in support for women facing compounded risks. 

But a pioneering project by Skoun, supported by UN Women, is working to change that by shifting societal norms. By integrating substance use into GBV response mechanisms, this project is not only offering essential services but also reshaping attitudes, training frontline actors and influencing systems to recognize and respond to the realities of marginalized communities.

This intersection is not a side note, it is central. Women experiencing GBV are often driven to substance use for survival, while women who use substances face heightened risks of violence and systemic exclusion. Recognizing this, Skoun places the overlap at the heart of its strategy, ensuring that every component, from mental health support to frontline training, confronts the institutional blind spots that perpetuate harm.

A holistic vision rooted in community needs

“At the end of the day, we all have different ways of coping; be it social media, nicotine, or even food. Some of these coping mechanisms may lead to addiction or disorders. Understanding that substance use disorders may affect any of us is a gateway to understanding vulnerability itself.,” says Michelle Wazan, Drug Policy Programme Manager at Skoun. This perspective sits at the heart of Skoun’s mission, to provide accessible treatment, education and protection for all people who use drugs in Lebanon. 

Through this WPHF-funded project, Skoun conducted an in-depth baseline study, held focus groups and validated findings in participatory workshops with civil society organizations and community leaders. 

“This helped us zoom in on how drug use, violence and marginalization intersect,” Wazan explains. “It showed us what to build on, whether it’s services, advocacy or partnerships.”

The project’s focus on women who use drugs – particularly those who are refugees, sex workers, formerly incarcerated, or migrant workers – was both deliberate and urgent. “These women are criminalized, stigmatized and pushed out of protection systems,” Wazan says. “Our work is about shifting the lens, from criminal justice to public health; from judgment to care,”.

Healing begins at the front line

For Dala Fakhreddine, Skoun’s Senior Clinical Psychologist and Clinical Coordinator, the project is deeply personal. “My role combines therapy and coordination. I work with individuals who carry immense trauma, from substance use, from violence, from systemic neglect,” she shares.

Operating in a country reeling from economic collapse, medication shortages and war, Fakhreddine describes the compounded challenges faced by patients and providers alike. “When the war escalated, we had to close our physical space and shift to online services. It was destabilizing for everyone, especially those already in pain.”

Despite these challenges, Skoun has integrated mental health and substance use services into primary healthcare centres in Bekaa and Tripoli, an achievement made possible through close collaboration with local leaders.  “Their feedback and trust made our work possible,” Fakhreddine emphasizes. “Decentralizing services is key. Most services are Beirut-based, which creates huge access barriers.”

What keeps her going? “Transformation,” she says. “When a survivor finds their voice, when trust replaces fear, that’s the true impact. We’re not just offering treatment, we’re shifting mindsets.”

Training to transform systems

A training session for frontline staff

Nada Kaii leads a training session for frontline staff from local civil society organizations, equipping them to better integrate substance use into GBV response systems. Photo: UN Women

Nada Kaii, a senior therapist and addiction treatment specialist, has led Skoun’s training component under the project. Her goal: to change how Lebanon’s front-line responders, caseworkers, social workers and healthcare staff, understand and engage with substance use in GBV cases.

“At the start of each session, when I ask who uses addictive substances, people are shocked. They don’t see themselves in that category,” Kaii explains. “But by the end, there’s a real shift. They start to see addiction as part of the human condition, not a moral failure.”

The need for these trainings is stark. “Substance use is not included in most curricula for protection workers,” she says. “These professionals often come from backgrounds where drug use is stigmatized or criminalized. That stigma filters into their work, consciously or not.”

While the long-term impact is still being assessed, Kaii sees the ripple effects already. “Front-liners are starting to question their assumptions. They’re listening differently. They’re asking better questions. That’s where change begins.”

She’s clear about the road ahead. “Lebanon needs systematic training across all sectors. We’re far behind [meeting] the need, but this project is laying the foundation.”

Beyond a project: A paradigm shift

The WPHF-supported project has done more than fill a gap; it exposes the very structure of the gap itself. By connecting taboo topics, substance use, gender-based violence and social marginalization, Skoun is helping reframe what protection means, and who it includes.

From clinical care to community engagement, from training sessions to national advocacy, the project’s legacy is already visible. It has strengthened local organizations, informed national dialogue and, most importantly, brought women who use drugs out of the shadows and into systems of care and dignity.

As Michelle puts it: “This project is only the beginning. We’ve made the connections visible. Now we need to keep building on them, so that healing, safety and dignity are possible for all.”