Breaking the generational cycle of addiction

The “cocaine crisis” of the 1980s sparked an increase in treatment programs for addicted pregnant women. Since then, of course, the number of babies born addicted to drugs remains a major issue. Many of you may recall the study last year in The Journal of the American Medical Association that estimated that in the U.S., each hour a baby is born who displays opiate withdrawal symptoms—about 13,500 babies each year.  Known as neonatal abstinence syndrome, some of its symptoms include seizures, heightened irritability, and breathing problems. Infants born with this condition are often treated with methadone, buprenorphine, or morphine until they can be very carefully weaned off the substance used by their mothers.

Unfortunately, despite our growing understanding of addiction among pregnant women, there remain many serious barriers to treatment. As I stated in my first post, women who are the sole family caretakers may forgo seeking treatment because few centers accommodate for housing children on campus. Many women fear losing custody of older children, as well as their future newborn, if they admit to substance use.  There also remains the fact that many recovery programs simply will not accept pregnant women because of the specialized care they require. 

Those that do accept pregnant women often still rely on male-based recovery models that fail to address the intrinsically important relationship between mother and child. Fear of facing negative attitudes from treatment staff also plays a role in keeping pregnant women, many of them underserved, away from the care many of them desperately need.

How do we as treatment providers set out to diminish this problem?

Ensure a safe space. An unfortunate number of stigmas still exist about women addicts, and an even greater number exists about those who are pregnant. Fear of being judged an unfit mother, combined with the emotional highs and lows that result from hormonal fluctuations during pregnancy, makes it more difficult to engage pregnant women in treatment, or to convince some women of their need for it. Staff members are not rescuers here to “fix” her, and should clearly acknowledge the woman’s autonomy over her own body. Now this advice may seem like common sense for most in the field of addiction treatment, but too often it’s overlooked in practice. From the minute a woman calls or sets foot within a treatment center, she should feel welcomed, not judged, by any staff member she comes into contact with, from receptionists to counselors.

Provide as comprehensive a program as possible.  A review of more than two dozen studies showed that offering a gender-specific treatment program along with prenatal care leads to more favorable recovery outcomes. Bear in mind that length of treatment has also served in many cases as a strong indicator of future abstinence and success, particularly among pregnant women. 

The benefits of providing childcare on campus are multifold, as they encourage more women to undergo treatment, but also allow providers the chance to help children begin to work through the emotional and perhaps physical issues they will inevitably carry with them as a result of their parents’ drug use. 

Address the mother-child relationship. Attending classes, workshops, or groups about child development and healthy parent-child relationships can be an invaluable and empowering experience for a woman dealing with the combined physical and mental stress of pregnancy and addiction. By exploring the importance of healthy relationships in the context of more favorable treatment outcomes overall, and by increasing her confidence in her own ability to parent, she may be more motivated to see treatment through to its end.

If as a treatment provider you do not have access to best practices, refer the patient to a facility that has the ability to provide effective individualized care.