Treatment FAQ

barriers and strengths to treatment for pregnant women who are substance abusers

by Prof. Adolphus Fritsch Published 2 years ago Updated 2 years ago

For many pregnant women, substance use treatment is difficult to obtain due to lack of programs willing to treat pregnant women, cost, lack of medical coverage, fear of legal consequences, and threat of child protection involvement for women who have children [16,17].

Full Answer

What are the barriers to addiction treatment for pregnant women?

A significant barrier to treatment for pregnant women is caregiver attitudes. Pregnant women who abuse substances are the mostly likely group to be stigmatized and Ideas and Research You Can Use: VISTAS 2015 4 treated punitively for their addiction-related behavior. Often, pregnant women will not

What are the barriers to substance abuse treatment?

Another often overlooked barrier is that women who are addicted to alcohol or other drugs may have partners who are also addicted (Ashley et al., 2003). If one’s partner is unwilling to seek treatment, he or she may not support the pregnant partner’s choice to seek treatment.

Is childcare a barrier to care for substance-using mothers?

Childcare during treatment has previously been identified as a barrier to care for substance-using mothers (Blume, 1990; Center for Substance Abuse Treatment, 1994; Finklestein, 1994; Marsh et al. 2000), but women in this study reflected that having their children there was not necessarily helpful:

Is there a substance abuse treatment facility in Florida that accepts pregnancy?

It became obvious that women were talking about this single treatment facility because, to their knowledge, it is the onlyresidential substance abuse treatment program in the state that will accept pregnant women.

What are the unique needs of pregnant women with substance use disorders?

What are the unique needs of pregnant women with substance use disorders? Using drugs, alcohol, or tobacco during pregnancy exposes not just the woman but also her developing fetus to the substance and can have potentially deleterious and even long-term effects on exposed children.

How do you think we can best provide treatment to chemically dependent pregnant women?

This includes:Daily walks.Education on addiction and recovery.Education on smoking cessation, blood borne pathogens, birth control and sexually transmitted diseases.Intensive case management and aftercare planning.Family involvement.Education on parenting, childbirth and breastfeeding.

What are some barriers to avoiding drugs?

These barriers may include:A complicated system of care to treat SUDs. ... Lack of interagency coordination and communication. ... Limited resources and personnel. ... Lack of mental health services. ... Insufficient capacity in hospitals to treat SUDs. ... Transportation barriers. ... Homelessness and substandard housing.More items...

What are the negative influences of drugs during pregnancy?

Illicit Drugs Illicit drug use during pregnancy may cause miscarriage, preterm labor, birth defects, stillbirth, withdrawal symptoms in the baby after birth, a higher risk of sudden infant death syndrome (SIDS), poor fetal growth rate, and cognitive and behavioral problems.

What is the most effective intervention for substance abuse?

CBT is often rated as the most effective approach to treatment with a drug and alcohol population.

Which of these treatments has been found to be most effective in treating addiction?

According to American Addiction Centers, Cognitive Behavioral Therapy (CBT) is a valuable treatment tool because it can be used for many different types of addiction including, but not limited to, food addiction, alcohol addiction, and prescription drug addiction.

What are the barriers for a person seeking treatment?

Prominent barrier themesPublic, perceived and self-stigmatising attitudes to mental illness. ... Confidentiality and trust. ... Difficulty identifying the symptoms of mental illness. ... Lack of accessibility. ... Self-reliance. ... Concern about characteristics of provider. ... Knowledge about mental health services.More items...•

What are barriers to intervention?

The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived 'sick role' (patient), and lack of proper equipment and human resources (unit level).

What are the five major barriers to the scaling up of mental health services?

Barriers to Mental Health Services Scale-Revised (BMHSS-R) Five intrinsic barriers include: help-seeking attitudes; stigma; knowledge and fear of psychotherapy; belief about inability to find a psychotherapist; and belief that depressive symptoms are normal.

Which factors increase risk during pregnancy?

High blood pressure, obesity, diabetes, epilepsy, thyroid disease, heart or blood disorders, poorly controlled asthma, and infections can increase pregnancy risks. Pregnancy complications.

What are the effects of drugs during pregnancy and lactation?

The most common teratogenic effects are neural tube defects, congenital heart abnormalities, cleft lip or palate, and fetal stillbirth. Conversely, adverse fetal effects result in dysfunction of an organ or tissue after that organ or tissue has been formed.

What are the effects of drug abuse?

Seizures, stroke, mental confusion and brain damage. Lung disease. Problems with memory, attention and decision-making, which make daily living more difficult. Global effects of drugs on the body, such as breast development in men and increases in body temperature, which can lead to other health problems.

How does OUD affect women?

Background: Opioid use disorder (OUD) is associated with substantial morbidity and mortality for women, especially during the perinatal period. Opioid overdose has become a significant cause of maternal death in the United States, with rates highest in the immediate postpartum year. While pregnancy is a time of high motivation for healthcare engagement, unique challenges exist for pregnant women with OUD seeking both substance use treatment and maternity care, including managing change after birth. How women successfully navigate these barriers, engage in treatment, and abstain from substance use during pregnancy and postpartum is poorly understood. The aim of this study is to explore the experiences of postpartum women with OUD who successfully engaged in both substance use treatment and maternity care during pregnancy, to understand factors contributing to their ability to access care and social support. Methods: We conducted semi-structured, in-depth interviews with postpartum women in sustained recovery (n = 10) engaged in a substance use treatment program in northern New England. Interviews were analyzed using grounded theory methodology. Results: Despite multiple barriers, women identified pregnancy as a change point from which they were able to develop self-efficacy and exercise agency in seeking care. A shift in internal motivation enabled women to disclose need for OUD treatment to maternity care providers, a profoundly significant moment. Concurrently, women developed a new capacity for self-care, demonstrated through managing relationships with providers and family members, and overcoming logistical challenges which had previously seemed overwhelming. This transformation was also expressed in making decisions based on pregnancy risk, engaging with and caring for others, and providing peer support. Women developed resilience through the interaction of inner motivation and their ability to positively utilize or transform external factors. Conclusions: Complex interactions occurred between individual-level changes in treatment motivation due to pregnancy, emerging self-efficacy in accessing resources, and engagement with clinicians and peers. This transformative process was identified by women as a key factor in entering recovery during pregnancy and sustaining it postpartum. Clinicians and policymakers should target the provision of services which promote resilience in pregnant women with OUD.

How are digital resources used in women's health?

Background Digital health resources are being increasingly used to support women with substance use concerns. Although empirical research has demonstrated that these resources have promise, the available evidence for their benefit in women requires further investigation. Evidence supports the capacity of interventions that are sex-, gender-, and trauma-informed to improve treatment access and outcomes and to reduce health system challenges and disparities. Indeed, both sex- and gender-specific approaches are critical to improve health and gender equity. Violence and trauma are frequent among those with substance use concerns, but they disproportionately affect those who identify as female or women, further underscoring the need for trauma-informed care as well. Objective The objective of this investigation was to evaluate the evidence supporting the efficacy or effectiveness of online or mobile interventions for risky or harmful substance use in adults who identify as female or women, or who report a history of trauma. Methods This scoping review is based on an academic search in MEDLINE, APA PsycINFO, Embase, Cochrane Central, and CINAHL, as well as a grey literature search in US and Canadian government and funding agency websites. Of the 7807 records identified, 465 remained following title and abstract screening. Of these, 159 met all eligibility criteria and were reviewed and synthesized. ResultsThe 159 records reflected 141 distinct studies and 125 distinct interventions. Investigations and the interventions evaluated predominantly focused on alcohol use or general substance use. Evaluated digital health resources included multisession and brief-session interventions, with a wide range of therapeutic elements. Multisession online and mobile interventions exhibited beneficial effects in 86.1% (105/122) of studies. Single-session interventions similarly demonstrated beneficial effects in 64.2% (43/67) of study conditions. Most investigations did not assess gender identity or conduct sex- or gender-based analyses. Only 13 investigations that included trauma were identified. Conclusions Despite the overall promise of digital health interventions for substance use concerns, direct or quantitative evidence on the efficacy or effectiveness of interventions in females or women specifically is weak.

What are the barriers to substance abuse?

Perhaps the Most Significant Barrier: Interpersonal Violence. Most women entering substance use treatment are victims of child sexual abuse, or other forms of interpersonal violence , such as spousal assault (often also referred to as ‘domestic violence’), sexual harassment or rape.

What is the role of women in substance use?

Many researchers examining women’s use have acknowledged the significant role women’s relationships play in the initial substance use, as well as its maintenance, escalation, or renewed use following treatment completion. For example, unlike men, women’s problematic use often starts at the encouragement of male friends or a boyfriend.

Why is waiting for things to improve so you can quit an addiction dangerous?

Waiting for things to improve so you can quit an addiction is like waiting to get fit before taking up exercise.Waiting for the right time to quit is dangerous because the mind will always be able to come up with another reason to delay.

Why are women more prone to harsh judgment and stark disapproval?

While men’s open confession to having a problem with addiction may be met with support and encouragement to seek treatment, women are more prone to receive harsh judgment and stark disapproval, especially by those closest to them. This is a significant barrier to treatment, as women tend to define their lives and personal worth by the quality of their relationships. The support and continued love by those they are close to are therefore crucial for success in treatment, and in continued recovery.

Why is it important to have a relationship with a woman?

Women are much more likely to identify relationships as source of identity, support and strengths. As such, it is important that loved ones are involved in a woman’s treatment, to the extent it is deemed safe and practical. Additionally, as many women with traumatic backgrounds typically lack healthy relationships, an exploration as to interpersonal violence, healthy versus unhealthy relationships, personal boundaries and co-dependency may prove helpful in paving the way to building a healthy and lasting support network.

Why is recovery community important?

As free of costs, recovery communities may play a very important role in the treatment and long-term support of marginalized women, given their economic limitations of accessing paid community resources. Those fulfilling women’s need in addressing and connecting with others facing multiple barriers may be of particular value.

Why do women downplay their use?

In order to avoid harsh judgment by loved ones and society at large, women may be very much inclined to downplay their use. In fact, an expectation to receive negative judgment may also be the culprit in regards to denial, the soil in which any and all addictive behavior flourishes so well.

What are the reasons for avoiding treatment?

Decades of research supports common themes for avoiding treatment: cost, denial, stigma, work and lack of awareness or knowledge. Psychological characteristics, lifestyles and environmental factors all contribute to the excuses.

Why are people reluctant to seek treatment for substance abuse?

People may be reluctant to seek addiction treatment because of high treatment costs and low accessibility, denial of their substance use disorder, societal stigma and time constraints. The vast majority of people who need treatment for substance use disorders do not seek it.

Why do people with substance use disorders fear judgement?

People with substance use disorders fear the judgment of society, friends and loved ones because addiction has become stigmatized. A 2014 Johns Hopkins study found Americans are more likely to have negative opinions of people with substance use disorders than other mental illnesses.

What is the most common response to substance use disorder?

“I don’t have a problem” might be the most common response people with substance use disorders give for not attending rehab. The other might be “I can quit on my own.”

How do rehab facilities determine their cost?

Many rehab centers also determine cost based on a sliding scale determined by the patient’s income. Other centers receive funding from the government to lower the cost of rehab.

Does insurance cover substance use disorders?

In the past, insurance plans didn’t have to cover treatment for substance use disorders. However, the Affordable Care Act now requires insurance plans to cover mental health disorders, including substance use disorders. The system isn’t perfect, though.

Is it easy to get help for addiction?

Getting help for addiction isn’t easy, though. Withdrawal symptoms and cravings can discourage people from trying to quit. Many parts of society condemn trying drugs, leading many people to hide their addiction. There are countless reasons why people who need addiction treatment avoid it.

Strengths

  • Is important to note that pregnant women who use drugs or alcohol are often highly motivated to access services and that they do so despite many barriers and complicating factors. Motivation often comes from concern for the health of their baby. Like most parents-to-be, they desperately want their baby to be healthy and well. For some, becoming pre...
See more on addiction-ssa.org

Fears Around Custody of The Baby

  • Running through all the literature, and throughout the One-Stop team’s work, is the fear that social services or a partner or parent will take custody of the baby. Whilst this can motivate some women to access services, it can also have the opposite effect. Whether it is pregnancy services that know you use drugs, or addiction treatment services that know you are pregnant, or an A&E …
See more on addiction-ssa.org

Stigma

  • There is, Anna says, “a toxic mixture of guilt and shame, which can be exacerbated by a local authority emphasis on the baby”.Whilst this is understandable, as safeguarding is the local authority’s key focus, the woman at the centre of it all can end up feeling dehumanised and undeserving. The focus of specialist treatment centres – such as the one-stop-clinic – is on the …
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Opioid Substitution Therapy

  • Most stigma is based on a lack of knowledge and understanding: “Issues can arise when working in a multi-disciplinary team. For example, a social worker may suggest – with the best intention – that a woman reduces her prescribed methadone too quickly in the postnatal period, as they see it as the woman is still ‘on drugs’. Our role is to educate, inform and share the evidence that reduci…
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Community Services

  • Outside of NHS services, Anna is full of praise for the outreach services that work without stigma to get the best outcomes for women: “Community services do an absolutely brilliant job… because they already are non-judgemental and help women to engage. They are often instrumental in getting pregnant women and people in to see us as soon as possible. I would say to get them in …
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Guidelines

  • There are NICE guidelinesfor pregnant women with complex social factors; this includes women who use drugs, who are young, who experience domestic abuse and who are migrants or asylum seekers. Many women will experience several of these issues and will therefore need more intensive, personalised and specialist support. At the centre of the guidelines is the importance …
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Commissioning

  • When it comes to providing the best services, this often comes back to commissioning. Local authorities need to provide, pay for and commission specialist services to help pregnant women who use drugs. And this is not always a priority: by Rob Calder The opinions expressed in this post reflect the views of the author(s) and do not necessarily represent the opinions or official positio…
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