Zoe M Adams1, Callie M Ginapp1, Carolina R Price2, Yilu Qin3, Lynn M Madden4, Kimberly Yonkers5, Jaimie P Meyer6. 1. Yale School of Medicine, New Haven, CT, United States of America. 2. Yale School of Medicine AIDS Program, New Haven, CT, United States of America. 3. Yale New Haven Hospital, HIV Training Track, New Haven, CT, United States of America. 4. Yale School of Medicine AIDS Program, New Haven, CT, United States of America; APT Foundation, Inc., New Haven, CT, United States of America. 5. Yale School of Medicine, Department of Psychiatry, New Haven, CT, United States of America; University of Massachusetts Medical School/U Mass Memorial Medical Center, Worcester, MA, United States of America. 6. Yale School of Medicine AIDS Program, New Haven, CT, United States of America; Yale School of Public Health, Chronic Disease Epidemiology, New Haven, CT, United States of America. Electronic address: jaimie.meyer@yale.edu.
Abstract
BACKGROUND: Women are underrepresented in substance use disorder (SUD) treatment. Interpersonal and structural factors affect women's access to SUD treatment, but limited research evaluates how motherhood is a potential barrier and facilitator to engagement in SUD treatment. We focus on women from young to middle adulthood, and capture women's identities as mothers, caretakers, and grandmothers, outside of pregnancy and the postpartum period. METHODS: Study staff conducted twenty qualitative interviews with women in SUD treatment to assess experiences with SUD treatment, in which motherhood emerged as a key theme. Twelve women then participated in four focus groups centered on motherhood. The study audio-recorded and transcribed interviews, and two independent authors analyzed interviews, followed by group consensus. RESULTS: Most women identified their children and responsibilities as mothers and caretakers as important motivators to accessing SUD treatment. Motherhood was also a barrier to treatment, in that women feared losing child custody by disclosing substance use and few residential programs accommodate women with children. Multiple women expressed guilt about their substance use, sensing that it contributed to perceived abandonment or separation from their children. Reunification was important to SUD recovery. CONCLUSION: Women with SUD who are mothers experience specific barriers to treatment engagement and recovery. Women need SUD treatment programs that address these interpersonal and structural factors across the lifespan.
BACKGROUND: Women are underrepresented in substance use disorder (SUD) treatment. Interpersonal and structural factors affect women's access to SUD treatment, but limited research evaluates how motherhood is a potential barrier and facilitator to engagement in SUD treatment. We focus on women from young to middle adulthood, and capture women's identities as mothers, caretakers, and grandmothers, outside of pregnancy and the postpartum period. METHODS: Study staff conducted twenty qualitative interviews with women in SUD treatment to assess experiences with SUD treatment, in which motherhood emerged as a key theme. Twelve women then participated in four focus groups centered on motherhood. The study audio-recorded and transcribed interviews, and two independent authors analyzed interviews, followed by group consensus. RESULTS: Most women identified their children and responsibilities as mothers and caretakers as important motivators to accessing SUD treatment. Motherhood was also a barrier to treatment, in that women feared losing child custody by disclosing substance use and few residential programs accommodate women with children. Multiple women expressed guilt about their substance use, sensing that it contributed to perceived abandonment or separation from their children. Reunification was important to SUD recovery. CONCLUSION: Women with SUD who are mothers experience specific barriers to treatment engagement and recovery. Women need SUD treatment programs that address these interpersonal and structural factors across the lifespan.
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