Harmful drug use by women is a growing problem. The objective of this study was to identify and discuss the relationship between gender inequality and the factors that lead women to abuse psychoactive substances, as well as the difficulties encountered in the performing treatment. This is a qualitative study, in which a semi-structured interview was conducted with seven women undergoing treatment at the Psychosocial Care Center for Alcohol and Drugs -CAPS ad in Manaus, Brazil. The results indicated some issues related to gender inequality as influencing the maintenance of drug abuse by women, discussed in five categories: 1st Notions about gender inequality; 2nd use of drug abuse; 3rd lived social vulnerabilities, 4th Difficulties in treatment; 5th Perception of public policy for women with drug problems. Thus, it is concluded the importance of discussions and new research with a feminist context to address this problem, in order to think about better forms of prevention and treatment aimed at women and their particularities.