Extensive data link women’s use of drugs and their subsequent involvement in illegal activity to their growing involvement with the criminal justice system. Although research has established causal factors and consequences for drug use among women, these factors do not take into account the fundamental social injustices that also contribute to drug use among women, including interactions with social institutions, social sigma, and punitive public policy. In this paper, the term justice signifies the range of conditions that would expand opportunity for those who have been constrained by their social position or lack of access to institutional privileges. Justice works to both validate the sense that macro variables play a role in the creation of individual pathology and treatment of injustice is corrective at the level of broader social forces. An analysis that points to the need for advancing justice as part of the solution to a social problem like drug abuse by women focuses attention on the role that the state and its institutions play in the creation of conditions that lead to individual dysfunction. Intervention is aimed at restoring rights, creating opportunity and strengthening the social position of those who suffer the most in contemporary society; as in the case of women who use drugs.