Written by: Patrick Fox, CTRS
One’s struggles with addiction has an effect on everyone in their family, including, but not limited to, parents, grandparents, sisters, brothers, children, cousins, nieces, nephews, aunts, uncles, friends and co-workers. Sadly, quite often these “loved ones” are the guiltiest enablers to the addict. Having worked in hospitals since 1978 (nine years at a teaching hospital for children in Valhalla, N.Y. and 25 years in Psychiatry and substance abuse in South Florida), I have a “feel” for just how severe the drug problem truly is here in the United States. During the past 13 years I have worked in the very specialized field of Maternal Addiction. The stigma that goes along with working with this population is tough to move away from.
“Maternal Addiction? What exactly is that?” I am often asked. Misinterpreted as being an addiction to being pregnant, it is otherwise the addiction to a drug or drugs, including alcohol, while pregnant. In many cases the woman is already a mother of one or more child, and often without custody of the law. These mothers’ drug of choice varies. They can range from marijuana, crack cocaine, cocaine, heroin, oxycontin and other illicit and/or legal drugs. The objective of treatment is to provide a safe environment for the mother and to protect the unborn fetus from further harm.
The demographics of the Maternal Addiction population cross all socio-economic and cultural backgrounds. No one culture is totally immune from this disease and mainstream society still has not come to openly accept the reality that it exists. In recent years, the epidemic of over-prescribed pain killers by unregulated “Pain Clinics” has contributed to the problem. More the 60% of admissions of clients are addicted to one or more pain killer. But treating the patient is challenging to say the least. The majority of those being treated for their addiction have been through it before. They relapse either during a previous, or the same, pregnancy.
Court ordered, some come directly from jail as an alternative to sitting in a cell. There is often a resistive attitude because previous attempts have failed or possibly due to being “forced” into treatment by family members or friends. In order for recovery to be successful, the addicted mother to be must have the desire and willingness to “get” and stay clean. YES, it does take a lot of humility and — for one to come to the realization that they want to make a serious change in their lives “for the better.” This is done, not only for themselves, but for their unborn children — family and friends.
Sometimes, the recovery process takes longer than one would hope which stems from various causes. Codependence often plays a role in determining where the mother-to-be’s mind frame will be. But quite frequently the “significant other” ends up being a detriment to the process of recovery. All too often, the partner and/or family members are enablers and abusers themselves. Also, sometimes the partners are themselves incarcerated — though many of them do tend to be hard working and caring. But most alarmingly, there is also a percentage of the client population that is unsure of whom the father of the unborn child may be.
In treating Maternal Addiction, the initial attitude plays an important role as to whether or not the woman progresses or digresses in treatment. The break-through only occurs when the client accepts that they are “Powerless over their addiction” and have come to the reality that they need help from a “Higher Power” greater than themselves. Unfortunately, the behaviors observed in many of the pregnant addicts are manipulative, impulsive and dishonest.
In my experiences being a therapist, as much as I’d want each client to stay “clean,” all the preaching in world won’t cure the problem. The woman needs to accept the fact that recovery is an ongoing lifelong process and that a three week stay in an inpatient setting is not a cure-all. It is indeed an important first step, but follow-up aftercare, whether it is further inpatient, or done on an outpatient basis, is another step on the road to “True Recovery.” They must remember that it is very important to attend AA, NA, GA and other support groups. Family members need to also seek other support services remembering the addiction affects everyone in the pregnant addict’s life.
The numbers of success stories are but a small fraction of the population served. Although, occasionally, we therapists see “clean” mothers revisiting to “show off” their beautiful child and it truly makes it all worthwhile. It does tend to give one who is a professional in a highly specialized field a sense of purpose and provides the drive to continue to serve this rather challenging population. Those who make the best of their time in treatment and endure the trials of “detox” and therapies have gone to complete schooling and/or training to become EMTs, business owners, case managers, dental hygienists, hair stylists and other professions. But, most importantly, they “grow” to become productive members of society.
Working with the pregnant addict, because of the stigma it carries, is a challenge that most people in healthcare shun within the field. But consistency and continuity of care among staff, helps the client to learn structure and begin to take responsibility for their actions. If you are a pregnant addict (or know one) there is help but most importantly, the mother-to-be must have the willingness and the desire to be helped. Just as there is no “magic pill” in life, there is no “Instant Recovery Treatment.” It is an ongoing Process.